Evaluating the impact of a mass gathering (2018 Commonwealth Games) on emergency department presentations with communicable diseases: A retrospective cohort study

Abstract

To identify the impact of a mass gathering event (MGE) on emergency department (ED) patient presentations with communicable diseases and underpinning syndromic indicators (SIs). Methods: This retrospective observational cohort study was undertaken in one large public teaching hospital ED in Queensland, Australia. Routinely collected ED data for patient presentations with an ICD-10 diagnosis corresponding to a communicable disease were used to compare demographic characteristics, clinical characteristics, and outcomes before (March 23 to April 3), during (April 4 to April 15), and after (April 16 to April 27) the 2018 Commonwealth Games. Results: Over the study period, there were 10 595 patient presentations to the ED; 14.2% (n = 1503) were diagnosed with a communicable disease. The median age of those with a communicable disease was 8 years, 50.5% (n = 759) were female, and 24.8% (n = 373) arrived by ambulance. The most common communicable disease profile was respiratory in nature (51.4%, n = 772). The most common SI was altered breathing (24.0%, n = 185). ED length of stay (LOS) increased over the study period (pre: 160 min; during: 163 min; post: 180 min, p < 0.001). Conclusions: The 2018 Commonwealth Games had an impact on ED presentations with communicable diseases, in terms of LOS. A longer LOS and higher percentage of patients with a LOS of more than 4 hrs in the ED were noted following the MGE period. This outcome indicates a potential need to continue with up-scaled services. Future research is required to understand the broader impact on other EDs in the area, and longitudinal patient follow-up is needed to determine the potential spread of communicable diseases.

Rethinking Mass-Gathering Domains for Understanding Patient Presentations: A Discussion Paper

“…18 This is of new importance in the context of COVID-19. Public health research and evaluation of MGEs are often reported related to specific events, such as the Commonwealth Games or Olympics, 19,20 or related to specific communicable diseases such as Dengue. 21,22 However, the integration of public health principles for research and evaluation are seldom reported in the literature alongside the biomedical, environmental, and psychosocial domains.…”