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

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.