Hsu, Chen YangChen YangHsuYA-MEI CHENSu, Chiu WenChiu WenSuKu, Mei ShengMei ShengKuKim, YeolYeolKimJensen, TimTimJensenLuh, Dih LingDih LingLuh2022-03-212022-03-212021-06-0109296646https://scholars.lib.ntu.edu.tw/handle/123456789/597786Background: The COVID-19 outbreaks associated with mass religious gatherings which have the potential of invoking epidemics at large scale have been a great concern. This study aimed to evaluate the risk of outbreak in mass religious gathering and further to assess the preparedness of non-pharmaceutical interventions (NPIs) for preventing COVID-19 outbreak in this context. Methods: The risk of COVID-19 outbreak in mass religious gathering was evaluated by using secondary COVID-19 cases and reproductive numbers. The preparedness of a series of NPIs for preventing COVID-19 outbreak in mass religious gathering was then assessed by using a density-dependent model. This approach was first illustrated by the Mazu Pilgrimage in Taiwan and validated by using the COVID-19 outbreak in the Shincheonji Church of Jesus (SCJ) religious gathering in South Korea. Results: Through the strict implementation of 80% NPIs in the Mazu Pilgrimage, the number of secondary cases can be substantially reduced from 1508 (95% CI: 900–2176) to 294 (95% CI: 169–420) with the reproductive number (R) significantly below one (0.54, 95% CI: 0.31–0.78), indicating an effective containment of outbreak. The expected number of secondary COVID-19 cases in the SCJ gathering was estimated as 232 (basic reproductive number (R0) = 6.02) and 579 (R0 = 2.50) for the first and second outbreak, respectively, with a total expected cases (833) close to the observed data on high infection of COVID-19 cases (887, R0 = 3.00). Conclusion: We provided the evidence on the preparedness of NPIs for preventing COVID-19 outbreak in the context of mass religious gathering by using a density-dependent model.enCOVID-19 | Mass gathering | Non-pharmaceutical intervention | Religious activityCOVID-19; Mass gathering; Non-pharmaceutical intervention; Religious activity[SDGs]SDG3Article; controlled study; coronavirus disease 2019; disaster preparedness; epidemic; human; major clinical study; religious group; risk assessment; social distancing; South Korea; Taiwan; virus transmission; epidemic; epidemiology; COVID-19; Disease Outbreaks; Humans; Republic of Korea; SARS-CoV-2; Taiwanjournal article10.1016/j.jfma.2021.04.017341193932-s2.0-85107690330WOS:000667684200007https://api.elsevier.com/content/abstract/scopus_id/85107690330https://www.scopus.com/inward/record.uri?eid=2-s2.0-85107690330&doi=10.1016%2fj.jfma.2021.04.017&partnerID=40&md5=cf6285bc1ace2331084b829e8d40f8f1