key: cord-0705795-bgn04zh3
authors: Mubarak, Naeem; Zin, Che Suraya
title: Religious tourism and mass religious gatherings — The potential link in the spread of COVID-19. Current perspective and future implications
date: 2020-06-09
journal: Travel Med Infect Dis
DOI: 10.1016/j.tmaid.2020.101786
sha: ee2525d10156dbae3821392e2f5e8bbddf988abf
doc_id: 705795
cord_uid: bgn04zh3

nan

Religious tourism -visit to sacred places in a given country -is a huge market that significantly contributes in the revenue of many countries. Churches, mosques, temples, shrines, synagogues, gurdwaras and other sites of religious significance attract hundreds and thousands of tourists globally. [1] Religious tourism takes full swing in certain months and results in mass religious gatherings (MRGs) which pose a significant public health risk in context of the potential spread of infections across the borders and within the communities. It has always been challenging for the governments to effectively implement preventive measures in MRGs. Table 1 enlists some of the prominent planned MRGs in different parts of the world. In the past, MRGs, for instance Kumb Mela, and Hajj 2013, have been identified as the locus of spread of antibiotic resistant bacteria and respiratory infections. [2] Religious tourism and MRGs have been linked with the explosive spread of COVID-19 across the globe. To begin with, 35% of the new Malaysian COVID-19 cases stemmed from an MRG of 19000 Muslims which include 1500 foreigners from 30 countries. This was organized by Tableeghi Jammat, a Muslim evangelists group involved in proselytization of masses. This transmission has now been termed as the largest known viral vector that spread the virus to other countries. [3] In Iran, religious tourism -a substantial source of revenue - congregations. [4] Hajj -an obligatory pilgrimage for Muslims to the "House of Allah" in Mecca, Saudi Arabia -is the most diverse MRG in the world (2.5 to 3 million pilgrims, from 180 countries in 2019). Respiratory infections were common among the Hajj pilgrims and many studies reported low adherence and implementation of preventive measures during the Hajj in the previous pandemic of H1N1(2009) and MRES outbreak (2013). [5, 6] COVID-19 has prompted Saudi government to consider cancelation of the Hajj this year. However, it would not be an easy decision, and most likely Saudi Kingdom will open its boarder for Hajj-2020 (28 th July-2 nd August) because of the associated religious emotions and potential economic loss of $8.5 billion revenue from the religious tourism pertaining to Hajj. In this case, any country opening its boarder for religious tourism and MRGs must demonstrate capability to implement adequate preventive measures and diagnostic capabilities. Furthermore, to avoid any potential ramifications, authors suggest restrictions on the entry of the Hajj pilgrims who are/from: a. epicentres and hotspots, b. over 50 years old, c. chronic disease patients with diabetes and cardiovascular complications, d. countries with suboptimal diseases surveillance system, and e. countries with inadequate quarantine and diagnostic infrastructure for returning pilgrims Saudi Arabia needs to deploy a pre-emptive approach for all the necessary arrangements. The threat of the virus spread out of Hajj could be a reality, hence, time for action is now or never. Table 1 Prominent mass religious gatherings in the world

Religious tourism -a review of the literature

Hamer DH; GeoSentinel Network.International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

A Single Mass Gathering Resulted in Massive Transmission of COVID-19 Infections in Malaysia with Further International Spread

The missing link for an effective social distancing in Pakistan. Time for some unpopular decisions

Mass gathering-related mask use during 2009 pandemic influenza A (H1N1) and Middle East respiratory syndrome coronavirus

COVID-19: preparing for superspreader potential among Umrah pilgrims to Saudi Arabia