Tiago Villanueva: Mass gathering medicine

Tiago_VillanuevaI won’t have the privilege of attending the Olympic and Paralympic Games, but I recently had the opportunity to attend a meeting with mass gathering medicine experts chaired by David Heymann at the London School of Hygiene and Tropical Medicine.

Around 8 million spectators, 300 000 accredited professionals, and 10 500 professional athletes will be coming to London for the Olympic and Paralympic Games. With six international airports, London is the most connected global city in the world, even surpassing New York City, and making the British capital a potential global hub of communicable diseases this summer.

Of all the panel members, I enjoyed listening the most to Brian McCloskey, London regional director and head of the WHO collaborating centre on mass gatherings, Health Protection Agency. He explained that UK disease surveillance systems, including laboratory and clinical case reporting, will be enhanced during the games. This will include the use of syndromic surveillance, which tracks changes to patterns of complaints mentioned to doctors by analysing data in primary care, out-of-hours, and emergency services. He was confident that London’s health system will be better off after the games because of scientific and technological communities working more closely together, enhanced  diagnostic capacity, increased partnership working, and the development of new technologies and methods.

Richard Budgett, chief medical officer for the Olympics and Paralympics, stressed that one of the reasons London won the bid, despite initially being considered an underdog, was the reassurances given in terms of medical facilities. The “jewel in the crown” of the Olympics’ health facilities will be a polyclinic, which will be located in the Olympic village, and will be a sort of a mini-hospital, with two MRI machines, CT scanner, sports medicine facilities, and all other health services including general practice, physiotherapy, dental medicine, optometry, pharmacy, and hydrotherapy provided by around 4000 medical volunteers. Someone from the audience asked whether this would cause strain to the NHS as so many professionals will be absent from their jobs to work at the games. Panel members replied that not only will the existence of the polyclinic decrease the burden on the NHS, but only about 1000 healthcare professionals from the NHS will be involved, thus causing minimal disruption to the NHS.

Ziad Memish, deputy minister for public health in Saudi Arabia, who is also a doctor and researcher, shared his experience of overseeing health services in Saudi Arabia during the annual pilgrimage to Mecca—the Hajj. He explained how the Hajj is a very different event to the Olympics, with 50% of the attending population over 50 years old and 25% over 60. Jeddah airport, the main gateway to Mecca, even has a special “Hajj terminal” to process passengers coming from all over the world just to attend the event. Passengers coming from areas within the African Meningitis belt will be vaccinated upon arrival, and the same goes for passengers coming from the few countries where poliomielitis still exists.

Everyone seemed to agree that mass gathering medicine is an emerging field, and David Heymann even called for a textbook to be written as soon as possible.

The event was wrapped up by Valerie Curtis, director of the Hygiene Research Centre at the London School of Hygiene and Tropical Medicine.

She pointed out that for those who are really eager to learn more about this topic, The Lancet has a series of articles on mass gathering medicine. Finally, she said that it is mass gathering events such as the Olympic and Paralympic Games that generate a change capable of pushing the global science of public health forward. Let the Games begin!

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Tiago Villanueva is a locum GP in Portugal and a former BMJ Clegg Scholar and editor, Student BMJ. He is studying for a postgraduate diploma in epidemiology at the London School of Hygiene and Tropical Medicine.