Development of an Enhanced Surveillance and Epidemiology Program to Support the Birmingham 2022 Commonwealth Games in England: Outcomes and Lessons Learned

Introduction: The 2022 Commonwealth Games (B2022) was hosted by Birmingham, United Kingdom (UK) from July, 28 2022 to August 8, 2022. As a major global sporting event and mass gathering, B2022 included over 4,500 athletes (from 72 countries and territories) and attracted 1.5 million spectators. Robust public health surveillance and support for health protection incidents was required from the UK Health Security Agency (UKHSA) to protect the health of both those directly involved in B2022, and the local population. Method: UKHSA surveillance activities in the UK West Midlands region were enhanced, utilizing lessons learned from the response to the London 2012 Olympic and Paralympic Games and the 2021 G7 Summit (hosted in England). Enhancements included: adaptation of existing and development of new methods for the identification of increased activity of a range of pathogens/diseases/conditions of particular concern to a mass gathering; standardized daily situation reporting to inform both public health action and the B2022 organizing committee. Three streams of routine UKHSA surveillance data were assessed each day: a UKHSA health protection/clinical management system, statutory laboratory reports of infection, and syndromic surveillance. Bespoke surveillance was also implemented using B2022 health data sources. Results: Enhanced daily surveillance activities successfully met the need for next-day public health surveillance and reporting during B2022. No outbreaks or incidents of public health significance to the Games were identified. Syndromic surveillance reported an increased impact on local health services due to periods of extremely hot weather before and following the competition period, although these impacts were not unique to the Birmingham area. Conclusion: Surveillance and epidemiology reporting for B2022 provided reassurance there were no incidents/outbreaks of public health significance to the Games. The enhancements made will inform future routine surveillance and reporting activities and will be employed for similar activities during future mass gathering events.