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Lollapalooza

Lollapalooza a 'recipe for disaster,' experts warn. Should more music festivals be canceled amid COVID-19?

CHICAGO – The sight was striking. As COVID-19 cases surged in the U.S. last weekend, the city's downtown was a sea of mostly unmasked humanity as hundreds of thousands crowded together for the outdoor music festival Lollapalooza.

A chorus of public health experts sounded the alarm about the fast spread of the contagious coronavirus delta variant – even by the fully vaccinated – and the city called for masking indoors, yet more than 385,000 people packed the four-day event. 

Chicago Mayor Lori Lightfoot defended the decision to hold the festival, citing strict pandemic precautions that required concertgoers show proof of vaccination or a negative coronavirus test and to wear a mask.

Lollapalooza said 90% of attendees on the first day of the event proved they were vaccinated. Lightfoot said hundreds were turned away.

“I feel very good about what we’ve done," she said Sunday, adding that the event delivered shots in arms. "Thousands of young people have been vaccinated because of Lolla."

But others fear the fallout of the mass gathering, which attracted people from across the nation. 

Tina Tan, a Northwestern University Feinberg School of Medicine professor, called the festival “a recipe for disaster.” She raised concerns over how well organizers enforced masks and social distancing, and she criticized Lightfoot for suggesting the event would be safe because it was largely outdoors.

"Yeah it was an outdoor event, but it was an outdoor event with over 100,000 people (a day) in a small space," Tan said. "You're less able to transmit COVID in an outdoor space, but that doesn't mean that you can pack 100,000 people into a small, enclosed space where they're on top of each other and expect nobody's going to transmit. That's not how it works."

People attend the second day of the Lollapalooza Music Festival, Friday, July 30, 2021, at Grant Park in Chicago.

It's too soon to say whether the music festival – which Lightfoot touted as the biggest the world will see this year – will go down as a superspreader event, but health experts warn such large-scale gatherings add fuel to the outbreak.

Emily Landon is executive medical director for infection prevention and control at the University of Chicago Medical Center. She said that when Lollapalooza was first announced, "things were looking really good."

"Americans were still running to get vaccinated, cases were going down, and we didn't see a lot of delta cases on the horizon," Landon said.

Circumstances have changed. Vaccination rates nationwide slowed just as spread of the delta variant skyrocketed. The U.S. reported more than 634,000 coronavirus cases in the week ending Wednesday, according to a USA TODAY analysis of Johns Hopkins University data – a case every 1.05 seconds. 

At the height of the pandemic in mid-January, the country was reporting on average nearly three cases every second. 

And while Chicago's new case rate isn't as high as that of some places, transmission is still considered "substantial" by the Centers for Disease Control and Prevention. The city is reporting an average of 252 cases a day, a 42% increase from the previous week. About 52% of Chicago's residents are vaccinated, which health experts say is less than ideal. Other parts of the country, such as the Seattle area, boast a 70% vaccination rate. 

Hoping for Lollapalooza to be an "economic pick-me-up," Landon said, Chicago officials likely were loathe to pull the plug when the pandemic took a turn for the worse.

"As you get closer and closer to these kinds of events, you're less likely to want to cancel that because the ball's already rolling and things have been paid for," she said.

"What's done is done. Hopefully now we'll escape the worst of it. Time will tell whether or not this should be a cautionary tale."

Guests are asked to show proof of having been vaccinated against the COVID-19 virus as they arrive for the first day of the Lollapalooza music festival July 29 in Chicago. The four-day music festival in the city's downtown was expected to draw 110,000 fans a day.

Will Lollapalooza be a 'superspreader' event? 

Local and national infectious disease experts say it’s likely Lollapalooza will lead to a rise in coronavirus infections, but it may be difficult to track amid the surge in cases and decrease in testing.

“It’s going to be hard to tease out whether or not it did spur a rise in cases because they’re already starting to rise,” said Dr. Mercedes Carnethon, vice chair of preventive medicine at Northwestern University Feinberg School of Medicine. “I do expect to see a rise that’s probably fueled by this large event.”

Cases typically begin to emerge 10 to 14 days after a big event, she said, but health officials may have trouble linking them to the festival because many infections could occur outside the immediate area in nearby restaurants, bars, public transportation and hotel lobbies.

It's also difficult to track down out-of-town attendees, who may have brought the virus home.

“You’re bringing people together from many areas,” said Dr. Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania's Perelman School of Medicine. “People are traveling, and then they’re going to go back to their community, potentially seeding lots of other communities.”

People watch a concert at the Full Throttle Saloon during the 80th Annual Sturgis Motorcycle Rally in Sturgis, S.D., on Aug. 9.

A giant festival like Lollapalooza has the potential to do as much harm as the Sturgis motorcycle rally in South Dakota in August 2020, health experts said. About 460,000 people attended the rally, which was linked to hundreds of cases reported across the nation.

As of Sept. 8, 2020, South Dakota confirmed 124 COVID-19 cases linked to the event, and at least 12 states reported at least 290 people testing positive for the virus after attending the rally. A study found the rally could have resulted in 260,000 cases, but it faced criticisms about its conclusions and methodology.

Unlike at the Sturgis rally, some COVID-19 safeguards were in place during Lollapalooza. But the sheer size of the event makes it nearly impossible for precautions to be enforced, Carnethon said, and serve only as "a little bit of false reassurance." 

Photographs taken throughout the Thursday-to-Sunday event show almost no concertgoers wearing masks.

“It’s a good start, but especially in a crowd like that, it’s going to be almost impossible to enforce good and consistent mask-wearing,” said Robert Bednarczyk, associate professor of global health and epidemiology at Rollins School of Public Health at Emory University. “Looking at how contagious the delta variant is, my concern right now is that you may get a lot of people who end up with a mild infection.”

Festivalgoers enjoy Day 1 of the Lollapalooza Music Festival on Thursday, July 29, 2021, at Grant Park in Chicago.

Should we be putting a pause on large gatherings? 

After the Coachella Valley Music and Arts Festival in Indio, California, was postponed until next year, Lollapalooza took over as the first major multi-genre music festival of 2021. Among the major music festivals still to come are Bonnaroo in Manchester, Tennessee; Summerfest in Milwaukee; Life Is Beautiful in Las Vegas; and Governors Ball in New York City, all of which are set for September.

While some health experts say city officials should avoid hosting large gatherings, others acknowledge the decision to postpone may be more complex.

“We need to pause on having large gatherings such as this, even if they are outdoors, and that’s because the landscape has changed,” Carnethon said.

A recent report by the CDC shows that even fully vaccinated people can have so-called breakthrough infections and spread COVID-19. 

Machine Gun Kelly performs a surprise set on the Bud Light Seltzer Sessions stage on Day 3 of the Lollapalooza Music Festival on Saturday, July 31, 2021, at Grant Park in Chicago.

The study, published Friday, found fully vaccinated people made up nearly three-quarters of coronavirus infections that occurred in a Massachusetts town during and after Fourth of July festivities.

Out of 469 cases identified in Barnstable County, Massachusetts, from July 3 to 17, the agency found 74% occurred in fully vaccinated people. The CDC sequenced samples taken from 133 patients and discovered 90% were caused by the delta variant.

After a year of social isolation, postponing a large festival may have economic and psychological consequences. But if it leads to a COVID-19 outbreak, then hospitals may be overwhelmed, especially in pockets of rural areas where populations are largely unvaccinated, said Dr. Ricardo Franco, assistant professor of medicine at the University of Alabama in Birmingham.

“We’re dealing with an outbreak, and in an outbreak situation, deliberations about large gatherings should be very careful. One size doesn’t fit all,” he said. “That doesn’t mean they shouldn’t happen, but we should be very careful about them until further information emerges.”  

If the epidemiological data from Lollapalooza shows numerous outbreaks stemming from the festival, he said, canceling future events could be justified.

Festivalgoers enjoy Day 1 of the Lollapalooza Music Festival on Thursday, July 29, 2021, at Grant Park in Chicago.

Health experts also worry large gatherings could threaten students’ return to in-person learning in the fall. With the start of the school weeks away – and already here in some parts of the country – experts say hospitals already are seeing more children with more severe symptoms. 

According to the American Academy of Pediatrics, more than 70,000 child coronavirus  cases were reported from July 22 to July 29, representing 19% of the weekly reported cases.

“I want (kids) back in school, and now with unchecked spread, the virus is going to find those unvaccinated individuals,” Carnethon said. “That’s going to be children, and we’re going to have to hope that the young children make it out of this."

What should I do if I went to Lollapalooza?

Landon said Lollapalooza attendees have the responsibility "to take action to protect people around them." She said many interact with others who are high risk or unvaccinated, not by choice but because of factors like age. Vaccines aren't yet approved for children 12 and under, and those with weakened immune systems might not be as protected even if they've been fully vaccinated.

She suggested unvaccinated attendees proceed under the assumption that they're exposed by quarantining and getting tested. For vaccinated attendees, she suggested wearing a mask and getting tested.

"They made the decision to go to this event," she said, "and now they need to consider that when they're interacting with others afterward."

Contributing: Jennifer McClellan

Follow Adrianna Rodriguez and Christine Fernando on Twitter: @AdriannaUSAT @christinetfern

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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