Only 38 of the 58 SSEs that I recorded were documented in a way that permitted me to determine their date with any specificity. (And even in these cases, I sometimes had to make educated estimates because of the vague nature of the reporting.) In the case of multi-day SSEs, such as religious festivals, I picked a day corresponding to the middle of the event. Unfortunately, some of the largest SSEs, such as those at North American meat processing plants, can’t be usefully pinpointed at all because the infections span multiple weeks (or even months), and the employers haven’t released detailed date-tagged data.
Of the 38 SSEs for which dates could be usefully identified, about 75 percent (29/38) took place in the 26-day span between February 25th and March 21st, roughly corresponding to the period when thousands of infected COVID-19 individuals were already traveling around the world, but before social distancing and event-cancelation policies had been uniformly implemented in many of the affected countries. (A notable early outlier is Steve Walsh, who spread COVID-19 from a Singapore corporate meeting to a French ski resort to his native UK in late January and early February.) No doubt, a vast number of SSEs occurred in January and February without being reported as such, because public-health officials and journalists weren’t alive to the nature or scale of the coming pandemic. But it is reassuring that, so far, April has been almost entirely bereft of publicly reported SSEs.
I was struck by how few of the SSEs originated in conditions stereotypically associated with the underclass (though a March outbreak at a Qatari migrant workers camp in the industrial area north of Doha offers one such example). Many of the early SSEs, in fact, centered on weddings, birthday parties, and other events that were described in local media as glamorous or populated by “socialites.” Examples here include a March 7th engagement party at a Rio de Janeiro “mansion” that attracted “high society” fly-ins from around the world, and a similarly described birthday party in Westport, CT.
It is theoretically possible that socioeconomically privileged individuals really do lack some immune-response mechanism that protects individuals who have been exposed to a wider array of infectious pathogens. (A recent report on COVID-19 surveillance testing at a Boston homeless shelter contained the stunning disclosure that 36 percent of 408 screened individuals tested positive for COVID-19. Yet the vast majority were asymptomatic, and even the few who were symptomatic did not diverge statistically from the 64 percent of tested individuals who were COVID-19-negative.) But absent more data, the more obvious explanation is that these early SSEs are linked to the intercontinental travel practices of the guests. (In the case of the Connecticut event, reports the New York Times, “a visitor from Johannesburg—a 43-year-old businessman—fell ill on his flight home.” And the Rio party was attended by guests who’d traveled recently from, or through New York, Belgium and Italy.) Moreover, COVID-19 outbreaks in poor communities are simply less likely to be reported, because the victims have less access to testing, high-end medical care, or media contacts.
In fact, the truly remarkable trend that jumped off my spreadsheet has nothing to do with the sort of people involved in these SSEs, but rather the extraordinarily narrow range of underlying activities. And I believe it is on this point that a close study of SSEs, even one based on such a biased and incomplete data set as the one I’ve assembled in my lay capacity, can help us:
- Of the 54 SSEs on my list for which the underlying activities were identified, no fewer than nine were linked to religious services or missionary work. This includes massive gatherings such as February’s weeklong Christian Open Door prayer meeting in Mulhouse, France, which has been linked to an astounding 2,500 cases; and a massive Tablighi Jamaat Islamic event in Lahore that attracted a quarter-million people. But it also includes much smaller-scale religious activities, such as proselytizing in rural Punjabi villages and a religious meeting in a Calgary home.
- Nineteen of the SSEs—about one-third—involved parties or liquor-fueled mass attendance festivals of one kind or another, including (as with the examples cited above) celebrations of weddings, engagements and birthdays.
- Five of the SSEs involved funerals.
- Six of the SSEs involved face-to-face business networking. This includes large-scale events such as Biogen’s notorious Boston leadership meeting in February, as well as one-on-one business meetings—from the unidentified “traveling salesperson” who spread COVID-19 in Maine to Hisham Hamdan, a powerful sovereign-wealth fund official who spread the disease in Malaysia.
All told, 38 of the 54 SSEs for which activities were known involved one or more of these four activities—about 70 percent. Indeed, the categories sometimes overlap, as with patient A1.1 in Chicago, who attended both a party and a funeral in the space of a few days; or the New Rochelle, NY man who covered the SSE trifecta of Bar Mitzvah party, synagogue services, and local funeral, all the while going to his day job as a lawyer in New York City.
But even that 70 percent figure underestimates the prevalence of these activities in COVID-19 SSEs, because my database also includes five SSEs involving two warships and three cruise ships—the USS Roosevelt, Charles de Gaulle, Diamond Princess, Grand Princess and Ruby Princess—at least three of which (and probably all five) featured onboard parties.
These parties, funerals, religious meet-ups and business networking sessions all seem to have involved the same type of behaviour: extended, close-range, face-to-face conversation—typically in crowded, socially animated spaces.
So you probably want to avoid such events for the near future. Snip.
In the case of religious SSEs, Sikhs, Christians, Jews and Muslims are all represented in the database. The virus makes no distinction according to creed, but does seem to prey on physically intimate congregations that feature some combination of mass participation, folk proselytizing and spontaneous, emotionally charged expressions of devotion. In the case of Islam, it is notable that the same movement, Tablighi Jamaat, has been responsible for massive outbreaks at completely separate events in Lahore (noted above), Delhi and Kuala Lampur. At Mulhouse, the week’s schedule included Christian “choir performances, collective prayer, singing, sermons from preachers, workshops, and testimony from people who said God had cured their illnesses… Many people came day after day, and spent hours there.” And in Punjab, dozens of Sikhs died thanks to the itinerant rural preaching of a single (now deceased) infamous septuagenarian named Baldev Singh.
Sporting events? Out. Choir performances? Out. Snip.
Again, read the whole thing.