The implications of religious event and holidays on the transmission of SARS-CoV2 : the impact of behavioral changes on transmission

  1. Abdulkarim Abdulrahman
  2. Muath AlMajthoob
  3. Abdulla I AlAwadhi
  4. Manaf M AlQahtani

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Abstract

Introduction

The risk factors for transmission of SARS-CoV2 have been widely studied and it was evident that a population’s behavior has a direct effect on the risk of transmission. Public health measures and regulation are largely kept to control and direct these behaviors. In this study, we describe the change in transmission in SARS-CoV2 in relation to demographics before and after two major religious events: “Eid Alfitr” and “Ashura”

Methods

This is a national observational study conducted in Bahrain in September 2020 to compare the number and demographics of all newly diagnosed cases before and after Eid Alfitr (religious holiday) and Ashura religious event. A 10 day period before the event was compared to a 10 day period after the event by ten days. Data on the number of tests, number of new cases, their demographics (age, gender, nationality) and presence of symptoms were collected and analyzed.

Results

There was significant increase in the number of COVID-19 cases after both Eid Alfitr (1997 more cases, with a 67% increase) and Ashura (4232 more cases with 2.19 times more cases). The majority of new cases after the religious events were found in local Bahrainis, from 472 cases to 2169 cases after Eid, and from 2201 to 6639 cases after Ashura. The rise was most notable in females (increased by 4.89 times after Eid and by 2.69 times after Ashura), children (increased by 4.69 times after Eid and by 5 times after Ashura) and elderly above the age of 60 years (increased by 5.7 times after Eid and by 3.23 times after Ashura).

Conclusion

It is evident that religious events and holidays have important implications on the transmission of SARS-CoV2. This increased in transmission is related mainly to the behavior of the population in those days. Children, female, and elderly were the most affected categories due to these events. A thorough public health plan to limit the spread of the infection at these events should be planned and implemented ahead of time.

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  1. ScreenIT

    SciScore for 10.1101/2020.10.17.20214056: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIACUC: Data handling, statistical analysis and graphs were done on Microsoft excel (Version 16.4) and STATA (Version 15.1) Ethical considerations: Ethical and research approval was obtained from the National COVID19 research and ethics committee (approval code: CRT-COVID2020-081).
    IRB: All methods and analysis of data was approved by the National COVID-19 Research and Ethics Committee and carried out in accordance with the local guideline and ethical guidelines of the Declaration of Helsinki 1975.
    Consent: Informed consent was waived by the Research and Ethical Committee for this study due to the absence of any patient identifying information and the nature of the study design.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data handling, statistical analysis and graphs were done on Microsoft excel (Version 16.4) and STATA (Version 15.1) Ethical considerations: Ethical and research approval was obtained from the National COVID19 research and ethics committee (approval code: CRT-COVID2020-081).
    Microsoft excel
    suggested: (Microsoft Excel, RRID:SCR_016137)
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Personal hygiene, physical distancing, wearing face masks, time limitation and proper ventilation are all measures that can help reduce the risk of transmission in such events and gatherings. (22, 25). This could be a crucial measure to decrease the transmission and help fight the pandemic. Conclusion: It is evident that religious events and holidays have important implications on the transmission of SARS-CoV2. This increased in transmission is related mainly to the behavior of the population in those days. Children, female, and elderly were the most affected categories due to these events. Symptomatic individuals increased after these events. These events are considered high risk for transmission and should be included in models forecasting the number of cases. A thorough public health plan to limit the spread of the infection at these events should be planned and implemented ahead of time. The plan should include raising public awareness prior to the event, limiting the events, proposing a safer substitute, involving religious leaders, and enhancing measures to decrease the risk of transmission within an event.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.10.17.20214056 on medRxiv