Risk of Infection of SARS-CoV-2 in a Massive Musical Show With Transmission Prevention Measures: Randomized Study

The coronavirus disease 2019 (COVID-19) outbreak, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan in December 2019 and has spread globally, representing a serious threat to public health. While 80% of patients are asymptomatic or have a mild illness, 20% develop a severe illness. The predominant symptoms include fever, cough, and myalgia. Mild disease can resolve without medical attention or it can progress to pneumonia and respiratory failure requiring hospitalization. Patients can rapidly progress to acute respiratory distress syndrome (ARDS) with multiple organ dysfunction and death.

The degree to which the virus is infectious during the incubation period is uncertain, but it has been shown that the pharynx reaches peak viral load before day 5, and this peak viral load is 1,000 times higher than in severe acute respiratory syndrome coronavirus (SARS-CoV). This active and high viral clearance from the pharynx at a time when symptoms are still mild makes the transmission of SARS-CoV-2 more efficient than that of SARS-CoV. Later in the disease, COVID-19 resembles SARS in terms of replication in the lower respiratory tract. The decrease in viral load appears to be slow, and there is no sudden shedding of the virus at the time of seroconversion. Seroconversion, at the beginning of week 2, has been observed to coincide with a slow but steady decrease in sputum viral load. Prolonged viral shedding in sputum is relevant not only for infection control in hospitals and discharge management, but also for asymptomatic people who can transmit the virus for longer periods after infection.

Although it is true that the majority of people infected by SARS-CoV-2 will have a benign course with few symptoms, approximately 20% will require hospitalization and 5% will present serious complications and admission to an intensive care unit, this is it translates into a saturation and collapse of health systems, with a high percentage of mortality in relation to it. Unprecedented confinement measures have been implemented that have been effective in containing the progression of the number of infections, but these have had a great social and economic impact, among others with a paralysis of most of the activities related to leisure (concerts , music festivals, theaters, etc.) that are an important component in the economy of most of the countries of the European community. While waiting for highly effective treatments or the development of an effective vaccine, it is necessary to reactivate key economic activities that are related to leisure and culture in an environment that is safest for the participants.

The use of a rapid screening test for SARS-CoV-2 viral antigens with high sensitivity could be a useful tool to detect asymptomatic SARS-CoV-2 infected people, and thus be able to carry out events related to leisure in a safe environment.

It is necessary to implement versatile circuits in which diagnoses with rapid tests can be carried out in the same place of the events in a massive way and to be able to communicate the results of the tests to the assistants at the same time, in order to do this screening of people that they give negative and carry out activities with them in a safe environment for all participants.