The sight was striking. As COVID-19 cases surged in the U.S. last weekend, Chicago’s downtown was a sea of mostly unmasked humanity, with hundreds of thousands crowding together for the outdoor music festival Lollapalooza. A chorus of public health experts sounded the alarm about the fast spread of the contagious delta variant – even by the fully vaccinated – and the city called for masking indoors, yet more than 385,000 people packed the four-day event. Chicago Mayor Lori Lightfoot defended the decision to hold the festival, citing strict pandemic precautions that required concertgoers show proof of vaccination or a negative COVID-19 test and to wear a mask. Lollapalooza said 90% of attendees on the first day of the event proved they were vaccinated. Lightfoot said hundreds were turned away. “I feel very good about what we’ve done,” she said Sunday, adding the event delivered shots in arms. “Thousands of young people have been vaccinated because of Lolla.” But others fear the fallout of the mass gathering, which attracted people from across the nation. Tina Tan, a Northwestern University Feinberg School of Medicine professor, called the festival “a recipe for disaster.” She raised concerns over how well organizers enforced masks and social distancing, and criticized Lightfoot for suggesting the event would be safe because it was largely outdoors. “Yeah it was an outdoor event, but it was an outdoor event with over 100,000 people (a day) in a small space,” Tan said. “You’re less able to transmit COVID in an outdoor space, but that doesn’t mean that you can pack 100,000 people into a small, enclosed space where they’re on top of each other and expect nobody’s going to transmit. That’s not how it works.”
Hoping for Lollapalooza to be an “economic pick-me-up,” Landon said Chicago officials likely were loathe to pull the plug when the pandemic took a turn for the worse.
“As you get closer and closer to these kinds of events, you’re less likely to want to cancel that because the ball’s already rolling and things have been paid for,” she said.
“What’s done is done. Hopefully now we’ll escape the worst of it. Time will tell whether or not this should be a cautionary tale.”
Will Lollapalooza be a ‘super spreader’ event?
Local and national infectious disease experts say it’s likely Lollapalooza will lead to a rise in coronavirus infections, but it may be difficult to track amid the current surge in cases and decrease in testing.
“It’s going to be hard to tease out whether or not it did spur a rise in cases because they’re already starting to rise,” said Dr. Mercedes Carnethon, vice chair of preventive medicine at Northwestern University Feinberg School of Medicine. “I do expect to see a rise that’s probably fueled by this large event.”
Cases typically begin to emerge 10 to 14 days after a big event, she said, but health officials may have trouble linking them to the festival as many infections could occur outside the immediate area in nearby restaurants, bars, public transportation and hotel lobbies.
It’s also difficult to track down out-of-town attendees, who may have brought the virus home.
“You’re bringing people together from many areas,” said Dr. Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania’s Perelman School of Medicine. “People are traveling and then they’re going to go back to their community, potentially seeding lots of other communities.”
A giant festival like Lollapalooza has the potential to do as much harm as the Sturgis motorcycle rally in South Dakota Aug. 2020, health experts said. About 460,000 people attended the rally, which was linked to hundreds of cases reported across the nation.
As of Sept. 8, 2020, South Dakota confirmed 124 COVID-19 cases linked to the event, and at least 12 states reported at least 290 people testing positive after attending the rally. A study found the rally could have resulted in 260,000 cases, but it faced criticisms about its conclusions and methodology.
Unlike the rally, some COVID-19 safeguards were in place during Lollapalooza. But the sheer size of the event makes it nearly impossible for precautions to be enforced, Carnethon said, and only serve as “a little bit of false reassurance.”
Photographs taken throughout the Thursday to Sunday event show almost no concertgoers wearing masks.
“It’s a good start, but especially in a crowd like that, it’s going to be almost impossible to enforce good and consistent mask-wearing,” said Robert Bednarczyk, associate professor of global health and epidemiology at Rollins School of Public Health at Emory University. “Looking at how contagious the delta variant is, my concern right now is that you may get a lot of people who end up with a mild infection.”
Should we be putting a pause on large gatherings?
After the Coachella Valley Music and Arts Festival in Indio, California, was postponed until next year, Lollapalooza took over as the first major multi-genre music festival of 2021. Among the major music festivals still to come are Bonnaroo in Manchester, Tennessee; Summerfest in Milwaukee; Life Is Beautiful in Las Vegas and Governors Ball in New York City, all of which are slated for September.
While some health experts say city officials should be avoiding large gatherings, others acknowledge the decision to postpone may be more complex.
“We need to pause on having large gatherings such as this, even if they are outdoors, and that’s because the landscape has changed,” Carnethon said.
A recent report by the CDC shows how even fully vaccinated can have so-called breakthrough infections and spread COVID-19.
The study, published Friday, found fully vaccinated people made up nearly three-quarters of COVID-19 infections that occurred in a Massachusetts town during and after Fourth of July festivities.
Out of 469 cases identified in Barnstable County, Massachusetts, from July 3 to 17, the agency found 74% occurred in fully vaccinated people. The CDC sequenced samples taken from 133 patients and discovered 90% were caused by the delta variant.
After a year of social isolation postponing a large festival may have economic and psychological impacts, but if it leads to a COVID-19 outbreak hospitals may be overwhelmed, especially in pockets of rural areas where populations are largely unvaccinated, said Dr. Ricardo Franco, assistant professor of medicine at the University of Alabama in Birmingham.
“We’re dealing with an outbreak, and in an outbreak situation, deliberations about large gatherings should be very careful. One size doesn’t fit all,” he said. “That doesn’t mean they shouldn’t happen, but we should be very careful about them until further information emerges.”
If the epidemiological data from Lollapalooza shows numerous outbreaks stemming from festival, he said, canceling future events could be justified.
Health experts also worry large gatherings could threaten students’ return to in-person learning in the fall. With the start of the school merely weeks away – and already underway in some parts of the country – experts say hospitals are already seeing more children with more severe symptoms.
According to the American Academy of Pediatrics, more than 70,000 child COVID-19 cases were reported from July 22 to July 29, representing 19% of the weekly reported cases.
“I want (kids) back in school, and now with unchecked spread, the virus is going to find those unvaccinated individuals,” Carnethon said. “That’s going to be children and we’re going to have to hope that the young children make it out of this.”
What should I do if I went to Lollapalooza?
Landon said Lollapalooza attendees have the responsibility “to take action to protect people around them.” She said many interact with others who are high risk or unvaccinated, not by choice, but because of factors like age. Vaccines aren’t yet approved for kids 12 and under, and those with weakened immune systems might not be as protected even if they’ve been fully vaccinated.
She suggested unvaccinated attendees proceed under the assumption that they’re exposed by quarantining and getting tested. For vaccinated attendees, she suggested wearing a mask and getting tested.
“They made the decision to go to this event and now they need to consider that when they’re interacting with others afterward,” she said.
Contributing: Jennifer McClellan
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