Risk mitigation tool for gatherings and events operating during the COVID-19 pandemic

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• What are the COVID-19 risks at your gathering/event?
• How can event planners, organizers and operators of gathering/events mitigate COVID-19 risks?

For Canadians seeking public health advice on small gatherings/events of family and friends, please refer to the Public Health Agency of Canada’s awareness resources to find information on personal preventive practices such as physical distancing, hand hygiene, environmental cleaning, as these practices will be essential in preventing and reducing COVID-19 spread.

In response to the COVID-19 pandemic, many provinces and territories established public health orders restricting gatherings/events of different purposes and sizes in order to contain COVID-19 spread. Refer to your provincial or territorial website for details on current restrictions related to gatherings/events as well as relevant tools and guidelines pertinent to your jurisdiction. As provinces and territories progressively lift or adjust restrictive public health measures, considerations will be given to gradually ease restrictions on gatherings/events of different purposes and sizes, as recommended in the Guidance for a strategic approach to lifting restrictive public health measures. Provinces and territories' decisions on resuming these gatherings/events will vary across jurisdictions over the course of the pandemic based on local epidemiology, and public health and health care capacity.

For the purposes of this tool, gatherings/events include a range of interpersonal gatherings/events of varying purposes and sizes, from gatherings/events of family and friends (e.g., weddings, funerals, baptisms, birthday parties and cultural ceremonies) to community gathering spaces (e.g., places of worship, places of traditional gatherings,  libraries, community and recreation centres, drop-in centres, women's centres, food banks and communal kitchens, museums, theatres, cinemas, and tourist attractions) to larger planned or structured gatherings/events, including mass gatherings^{Footnote 1} (e.g., large meetings or conferences, national sporting events, large cultural/religious events, festivals). 

Public health measures taken by planners, organizers and operators of gatherings/events are part of Canada's collective approach to mitigate the transmission of COVID-19. This tool is based on concepts outlined in the guidance developed for community-based measures titled: Community-Based Measures to Mitigate the Spread of Coronavirus Disease (COVID-19) in Canada. It reflects the currently available scientific evidence and expert opinion, and is subject to change as new information on COVID-19 transmissibility and epidemiology emerges, and the effectiveness of public health and risk mitigation measures becomes available.

All planners, organizers and operators of gatherings/events, regardless of their purposes and sizes, have an inherent responsibility to assess the risks associated with their gatherings/events and their ability to mitigate these risks. Planners and organizers of larger gatherings/events, as well as those lasting several days, should collaborate with public health authorities, relevant ministries, and Indigenous community governance structures to consider the potential impact of their gatherings/events on the community's healthcare and public health systems. In doing so, they should consider the ability of those systems to manage additional potential COVID-19 cases that may emerge as a result of the gatherings/events. Larger gatherings/events may pose a greater risk of COVID-19 spread if there is a large number of attendees over an extended period of time, and gatherings/events that last longer may present more opportunities for transmission due to increase duration, frequency and intensity of interactions between attendees. These partners and stakeholders can also provide additional direction and guidance to planners and organizers on key mitigation strategies that may need to be prioritized such as the need for an emergency preparedness and response plan or outbreak management protocols.

Planners, organizers and operators of indoor public community gathering spaces that operate continuously (e.g., recreation facilities such as gyms, libraries, museums, theatres, cinemas) can also refer to the Risk mitigation tool for workplaces/businesses operating during the COVID-19 pandemic for guidance on risk factors and risk mitigation measures specific to employers, employees and clients, such as the use of personal protective equipment and non-medical masks (NMM). Planners and organizers of gatherings and events catering primarily to children and youth, or gatherings/events offering childcare on site to facilitate participation of certain attendees, can refer to the Risk mitigation tool for child and youth settings operating during the COVID-19 pandemic for guidance tailored to that population. Planners and organizers of gatherings and events being held outdoors, can also refer to Risk mitigation tool for outdoor recreation spaces and activities operating during the COVID-19 pandemic, for additional examples of mitigation strategies.

What are the COVID-19 risks at your gathering/event?

The following facts about COVID-19 and associated questions can help you consider the risks of COVID-19 at your gathering/event.

The risk level is affected by whether there is COVID-19 transmission in the local community where the gathering/event is occurring. If there is known COVID-19 activity in the community, the likelihood that it could be introduced at the gathering/event is higher. The risk of COVID-19 introduction and spread at the gathering/event is also presumed to be greater if a higher proportion of attendees come from outside of the community, where active local transmission is occurring. In general, measures put in place to mitigate risks should be proportionate with the risk in the host community or with the risk in the surrounding communities where attendees are coming from, which is informed by local epidemiology including social, economic and demographic factors. Public health authorities can be consulted for information about local COVID-19 transmission.

COVID-19 spreads from person to person, most commonly through respiratory droplets (e.g., generated by coughing, sneezing, laughing, singing, shouting or talking) during close interactions (i.e., within 2 metres). People who have COVID-19 may have few to no symptoms, or symptoms may be mild. COVID-19 can be spread by infected individuals who have mild symptoms, or who have not yet or who may never develop symptoms.

• Will attendees interact (i.e. within 2 metres) with one another? Gatherings/events with a higher number of contacts are presumed to have greater risk.
• Will attendees have close interactions with one another? Close interactions are defined as those within 2 metres of others. Close interactions are presumed to have greater risk of transmission than interactions at a distance.
• Will attendees have prolonged close interactions with one another? Prolonged exposure is defined as lasting for more than 15 minutes^{Footnote 2} of time being less than 2 metres away, and may be cumulative (i.e., over multiple interactions). Person-to-person spread is more likely with prolonged close contact.
• Will the gathering/event involve activities that may increase the potential of droplet spread, such as singing, cheering, playing wind instruments, or sharing food or drinks? Gatherings/events with activities likely to generate droplets are presumed to have greater risk.

COVID-19 can also be spread through touching something with the virus on it, then touching your mouth, nose or eyes before washing your hands.

• Will attendees frequently have contact with high-touch surfaces (i.e. frequently touched by others)? A higher frequency of contact with high-touch surfaces (e.g., washrooms, door handles, service counters, electronic equipment, communal items such as religious artifacts, card payment machines) is presumed to have greater risk.

The risk of COVID-19 spread can vary based on the characteristics of the gathering/event and the location/venue.

• Will the gathering/event be indoors or outdoors? If indoors, can windows be opened? A confined indoor space (e.g., gym, place of worship, sweat lodge) is presumed to have greater risk.
• Will the gathering/event be crowded (i.e. high density of people in close proximity)? A crowded setting is presumed to have greater risk.
• Will the gathering/event last a few hours (e.g., party, wedding, concert) or several days (e.g., conference, tournament, pow wow)? Gatherings/events that last longer and/or require overnight accommodation (either at the setting or in close proximity) present more opportunities for transmission due to increase duration, frequency and intensity of interactions between attendees and are presumed to have a greater risk.
• Will the gathering/event be offered to multiple groups of attendees in a limited period (e.g., overlapping of groups, back-to-back groups)? Repeated gatherings/events (e.g. multiple faith services) in a limited timeframe present more opportunities for exposure, either from others or from contaminated surfaces/objects if proper mitigation strategies are not implemented, and are presumed to have a greater risk.
• Will the gathering/event be held at one single location/venue or multiple locations/venues? Gatherings/events that are spread out over multiple locations/venues, where attendees travel between sites, provide more opportunities for the introduction of the virus and are presumed to have a greater risk.

COVID-19 can cause more severe illness among people who are 65 and over, and those who have compromised immune systems or other underlying medical conditions.

• Will the gathering/event include attendees who are at high risk for severe illness from COVID-19?

COVID-19 can be spread when personal preventive practices are not consistently followed.

• Will the attendees be able/likely to follow hygiene practices such as frequent hand washing or sanitizing, respiratory etiquette, physical distancing, and isolating themselves if they feel ill? The ability of attendees to comply with these practices routinely and at the gathering/event will depend on a number of factors including age, maturity, physical or cognitive ability, and an environment that enables and supports these practices. For example, if attendees consume substances that could impair their judgment before or during the gathering/event, these attendees may be less able/likely to comply with personal preventive practices.
• Will the set-up at the gathering/event enable accessibility for attendees when following personal protective practices (e.g., access to hand hygiene stations/supplies at varying heights, NMMs or cloth face coverings, high-contrast and/or Braille signage regarding public health hygiene instructions) and a culturally safe space to isolate if an attendee becomes ill?

How can event planners, organizers and operators of gathering/events mitigate COVID-19 risks?

To prevent or limit the spread of COVID-19 at gatherings/events, consider the risk mitigation principles and measures outlined in this section. Risk mitigation measures that are more protective involve separating people from each other and limiting access to shared surfaces through physical distancing and physical barriers. However, these protective measures are not always possible at larger gatherings/events. Measures that are less protective rely on individuals to consistently and properly follow personal protective practices (e.g., hand hygiene, wearing of NMM or cloth face coverings). To maximize safety, use a “layered” approach with multiple measures to reduce the risk of COVID-19 spread, including decreasing the number of interactions with others and increasing the safety of interactions. Layering multiple mitigation measures strengthens the overall potential to mitigate COVID-19 risks. If planners and organizers have concerns regarding their ability to mitigate risks appropriately, either by implementing more protective measures or layering multiple measures, they can consult with public health authorities for additional advice on whether or not the gatherings/events should occur.

The following examples of risk mitigation measures are provided for your consideration, as per the risk factors associated with your gathering/event, and are not meant to be used as a checklist. Planners, organizers, and operators of gatherings/events are encouraged to find creative and adaptive ways to mitigate risks for their gathering/event that align with public health advice and are respectful of attendees, staff and the communities in which they occur. 

Discourage people who are ill from accessing/attending the gathering/event.

• Consider pre-gathering/event communications (e.g., phone, text, email or web-based notices) to attendees to share information on the expected behaviours (e.g., screening for symptoms and staying home if ill, physical distancing, hand hygiene, whether the use of NMM or cloth face coverings is recommended, self-monitoring for symptoms of COVID-19 post-attendance and isolating if appropriate). The communications should be accessible and appropriate for the attendees' age, reading level, comprehension abilities and language and cultural preferences.
• Ensure that strict exclusion policies are in place for attendees who are symptomatic, even if symptoms are mild, or have been advised by the public health authority to quarantine (self-isolate) due to exposure.
• Ask attendees if they are ill or have symptoms of COVID-19 before attending or ask attendees to take a self-assessment tool to determine if they have symptoms consistent with COVID-19.
• Adjust cancellation and reimbursement policies to encourage and enable attendees to stay home when ill, undergoing COVID-19 testing, in quarantine (self-isolation), or if they are taking care of someone who is ill (e.g., child).
• Post non-stigmatizing, culturally appropriate, and accessible signage that is suitable for the attendees' age, ability, literacy level and language preferences to identify symptoms of COVID-19 with clear instructions for what to do if prospective attendees are experiencing symptoms.
• For larger gatherings/events in a structured environment, follow directions from the local public health authority of the host community about policies for screening attendees, staff and volunteers for symptoms of or recent exposure (14 days prior) to COVID-19 before allowing them to enter the venue or attend the gathering/event.

Develop plans for dealing with attendees who become ill and/or are suspected of having COVID-19 while at the gathering/event.

• Develop plans/procedures/protocols in advance that specifically address how to safely care for attendees who develop COVID-19 related symptoms or who need care (e.g., injury, illness, emotional upset) while at the gathering/event.
• Populate and keep detailed lists of attendees and their contact information^{Footnote 3} (e.g., sign in sheet, /log book maintained by one operator to prevent sharing of communal pens/papers) in a safe and secure manner to facilitate public health investigation of cases and contacts in the event of an exposure at the gathering/event. Identify a space where attendees can be isolated from others if they develop symptoms or have been exposed to COVID-19 until they can go home safely in a private vehicle and/or undergo medical assessment.
  • If the attendees are from outside the community where the gathering/event is occurring, and public transportation was used, public health authority can provide advice on a safer return home.
• Establish workplace procedures and protocols if physical distancing cannot be maintained with the ill attendees (i.e., direct care is unavoidable). The Risk mitigation tool for workplaces/businesses operating during COVID-19 pandemic provides advice on personal protective equipment. 
• Notify the local public health authority promptly when illness compatible with COVID-19 is observed in or reported by/for a gathering/event attendee for advice on way forward. 

Promote and facilitate personal preventive practices. Everyone plays a part in making gatherings/events safer including attendees, planners, organizers, operators, contractors, and all others who interact with the setting before, during or after the gathering/event.

• Keep attendees informed about public health advice applicable to the gathering/event.
• Use technology, whenever possible (e.g., display screens, social media reminders), to share appropriate and accessible messaging for attendees (e.g., age, language, ability) on personal preventive practices.
• Model and promote the use of personal protective practices (e.g., frequent hand hygiene, avoid touching the face, respiratory etiquette, and wearing a NMM or cloth face covering if physical distancing is not possible to maintain or is unpredictable, clean and disinfect frequently touched surfaces with approved products).
  • Post signage in multiple locations that reminds attendees to practice these measures, ensuring that the signage is accessible and appropriate for the attendees' age, reading level, comprehension abilities, and language and cultural preferences.
  • Provide convenient and increased access to hand hygiene facilities (e.g. by placing hand sanitizer dispensers or hand wash stations in easy to see locations) and ensure accessibility for attendees with disabilities or other accommodation needs.
  • Ensure adequate supplies are available to reinforce hand hygiene and respiratory etiquette such as liquid soap, alcohol-based hand sanitizer (at least 60% alcohol), paper towels, tissues, and no-touch waste receptacles.
  • Promote increased environmental cleaning of attendees' personal environment if appropriate (e.g. provide sanitizing wipes so attendees can clean their own space/equipment such as the arms of a seat).
• Encourage attendees to self-monitor for symptoms of COVID-19 after attending the gathering/event, and to quickly isolate if symptoms develop.
• Place dedicated staff/volunteers at prominent locations to encourage attendees to follow hand hygiene practices and the use of NMM, if appropriate (e.g., entrances, washrooms, concession areas).
• Consider providing attendees personalized swag encouraging personal preventive practices (e.g., hand sanitizer, liquid hand soap, NMMs).

Promote physical distancing (keeping a distance of 2 metres from others), which is one of the most effective ways to reduce the spread of illness.

• Reinforce general personal practices to maintain physical distancing, such as avoiding greetings like handshakes, high fives, fist bumps, and hugs.
• Determine the maximum of number of attendees (and staff) allowed in the location/venue at any one time to maintain physical distancing. Encourage and facilitate virtual participation for those not attending in person, if feasible. 
• Restrict occupant capacity of indoor/outdoor spaces^{Footnote 4} to avoid crowding.
• Establish 2-metre separation between attendees (e.g., leave empty seats between attendees, leave space between each household grouping or “social circle/bubble”, separate the tables), with exception for support workers accompanying persons with disabilities.
• In areas where attendees would typically congregate, use spacing aids such as visual cues to encourage 2-metre distances (e.g., accessible signage, floor markings in indoor spaces, circles or “bubbles” marked or painted on the ground in outdoor spaces).
• Place dedicated staff/volunteers in potential high traffic areas to direct the movement of attendees and encourage physical distancing.
• Assess whether infrastructure can be enhanced or expanded, even temporarily, to provide more square footage (e.g., multiple locations/venues, common areas, foyers, outdoor tents).

Create physical barriers between attendees and/or staff when physical distancing is not possible.

• Install physical barriers between attendees and staff (e.g. plexiglas window at a booth/kiosk/cubicle higher than head-height), if possible.
• Provide barriers to assist with distancing at entrances and exits, while ensuring appropriate and safe accessibility for those with different mobility needs (e.g., strollers, wheelchairs, scooters).

Increase ventilation.

• Move the gathering/event outside when possible (ensuring physical distancing is maintained) and consider how to accommodate if inclement weather suddenly arises (e.g., plan for an alternative safe indoor space, or cancelling the gathering/event if it cannot be safely moved indoors while ensuring physical distancing).  
• Ensure that indoor ventilation systems operate properly (check in with site operator if needed).
• Increase air exchanges by adjusting HVAC systems (check in with site operator if needed).
• Open windows if possible and, if weather permits.^{Footnote 5}

Mitigate risks from exposure to high-touch surfaces (i.e. frequently touched by others).

• Increase frequency of environmental cleaning, especially washrooms and high touch surfaces or equipment (e.g., door/chair handles, tables, elevator buttons, water fountain spouts or knobs, electronic devices, touch screens, railings, pay stations) before, during and after the gathering/event.
• Reduce the number of common surfaces that need to be touched and eliminate any shared objects that are not essential for safety (e.g., prop doors open, use no-touch plastic-lined waste containers, remove common holy water bowl, talking stick).
• Eliminate or restrict non-essential shared equipment (e.g., hands-on station at museums, condiment stations at concession stands, sporting equipment).
• Encourage attendees to bring own supplies and equipment to the extent possible (e.g., refreshments, lawn chairs, towels, reusable cups, personal prayer rug, head and feet coverings).
• Ensure adequate supplies or alternative options, where possible (e.g., toys, pens, water, resource materials [electronic vs paper-based]).
• Prohibit buffet meals and family-style meals (i.e., where communal cutlery is shared), provide single-serving refreshments only.
• Offer contactless payment methods (i.e. minimize use of cash), if possible.^{Footnote 6}

Mitigate risk for people at higher risk of severe illness due to COVID-19

• Refrain from holding or consider delaying gatherings/events that specifically cater to people at high risk of severe illness due to COVID-19 (e.g., conferences for seniors).
• Actively encourage individuals who are at high risk for disease to stay at home and provide information about alternative programming, if available (e.g. notice on invitation or on event website).^{Footnote 7}
• Post signage that reminds attendees who are at higher risk for disease to avoid the gathering/event, ensuring that the signage is accessible and appropriate for the attendees' age, ability, reading level, and language and cultural preferences.
• Arrange for special provisions to accommodate those who are at high risk for disease (e.g., special visitation hour, virtual programming/access, outreach pastoral options for services).
• Provide alternative ways to provide programming if possible (e.g., by television, radio, online).

Modify practices and programming to reduce how long attendees are in contact with each other and how many attendees come into contact with each other.

• Consider virtual options (e.g., live streaming the gathering/event, recording a podcast or video) to provide programming to limit attendance.
• Offer more gatherings/events at a reduced capacity rather than hosting a single large/gathering event (e.g., offer multiple, staggered services at a place of worship with a limit on the number of attendees), while being careful to allow sufficient time between gatherings/events to implement proper mitigation strategies such as environmental cleaning.
• Keep the duration of the gathering/event to a minimum to limit contact among attendees.
• Consider cohorting attendees in designated social circles/bubbles, if possible, to limit exposure risk (e.g., same attendees partake in same conference sessions).
• Cancel or modify group activities (e.g., individual play stations, story hours).
• Stagger arrivals, departures and breaks, where possible, to reduce congestion at points of entrance and exit and in common areas, while respecting observances.
• Prohibit activities that can contribute to the spread of COVID-19 in confined indoor spaces and encourage alternative practices, where applicable (e.g., group singing, cheering, playing wind instruments, hugging).
• Close or restrict access to non-essential common areas (e.g., photo booth with props, merchandise kiosks, concession stands, communal lounges).
• Prohibit communal food services (e.g., buffets, passing of hors-d'oeuvres) and consider making service accommodations.
• If possible, cancel receptions following the services/ceremonies. If receptions cannot be avoided, personal preventive practices such as physical distancing, hand hygiene, environmental cleaning, and the use of NMMs or cloth face coverings should be implemented. 

Consider whether a policy about attendees wearing masks is required for your gathering/event.

• When the local epidemiology and rate of community transmission warrant it, the wearing of NMMs or cloth face coverings is recommended for periods of time when it is not possible to maintain a 2-metre physical distance from others consistently, particularly in crowded settings.
• To protect others, the wearing of commercially available or homemade NMMs or cloth face coverings is an additional personal practice that may help prevent the infectious respiratory droplets of an unknowingly infected person (the wearer) from coming into contact with other people. NMMs or cloth face coverings play an important role in situations and community settings where physical distancing is not possible or is unpredictable. 
• NMM or cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance. The establishment of policies regarding the use of NMMs or cloth face coverings should be based on the gathering/event-specific risk assessment. The following factors should be considered: the characteristics of the attendees (e.g., age, maturity, physical ability, comprehension), the characteristics of the location/venue, the nature of the activities, the number of people with COVID-19 in the community, and the implementation of other risk mitigation measures (e.g. physical distancing).
• Considerations should be given to NMM becoming an unintended hazard (e.g. physical injury if it caught on equipment, or psychological injury associated with stigmatization or bullying if all attendees are/are not wearing a NMM, particularly those with invisible disabilities or trouble breathing that may prevent them from wearing NMM).
• The wearing of NMM and cloth face coverings is not a replacement for other important public health measures. Those wearing masks should be reminded to comply with essential personal preventive practices such as frequent hand hygiene and physical distancing.

Additional resources

• World Health Organization. Practical considerations and recommendations for religious leaders and faith-based communities in the context of COVID-19. 7 April 2020. Available from: https://www.who.int/publications-detail/practical-considerations-and-recommendations-for-religious-leaders-and-faith-based-communities-in-the-context-of-covid-19
• CDC. Interim Guidance for Administrators and Leaders of Community- and Faith-Based Organizations to Plan, Prepare, and Respond to Coronavirus Disease 2019 (COVID-19). March 21, 2020. Available from; https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/guidance-community-faith-organizations.html
• Key planning recommendations for mass gathering/events in the context of the current COVID-19 outbreak: https://www.who.int/publications/i/item/key-planning-recommendations-for-mass-gatherings-in-the-context-of-the-current-covid-19-outbreak
• Considerations for Events and Gatherings: https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/considerations-for-events-gatherings.html