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Evidence for transmission of SARS-CoV-2 at religious mass gatherings: A systematic review[1]
Summary
A PRISMA systematic review of evidence for SARS-CoV-2 transmission at major religious mass gatherings during the COVID-19 pandemic, searching PubMed and Scopus. Ten articles covering events including the Grand Magal of Touba, Hajj, Umrah, Kumbh Mela, Arbaeen and Lourdes met inclusion criteria. No cases were detected at the 2020/2021 Grand Magal of Touba or the 2020 Hajj; 7% of tested individuals were positive after the 2022 Grand Magal; prevalence during the 2021–2022 Hajj and Umrah seasons ranged 0–15% across studies; roughly 0.4 million COVID-19 cases were diagnosed among returning Kumbh Mela pilgrims across India (1% positive in a one-day survey); and 3% of 2021 Arbaeen pilgrims tested positive.
Key findings
- Ten studies across six major religious mass gatherings met inclusion.
- Detected transmission ranged from none (2020 Hajj; 2020/21 Touba) to 0–15% (2021–22 Hajj/Umrah).
- ~0.4 million COVID-19 cases diagnosed among returning 2021 Kumbh Mela pilgrims across India.
- Outcomes were highly dependent on mitigation, density, and background prevalence.
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