Local preparedness for Mass Gatherings in Northern Portugal

Issue Lack of preparedness for mass gatherings and their possible impact on public health at the local and national level Description of the Problem Due to an outbreak in a Mass Gathering (MG), that took place in the northern region in 2018, the Public Health Unit (PHU) of Alto Tâmega and Barroso's, in collaboration with the Northern Region Public Health Department and the local government of Montalegre, implemented a risk assessment tool to new MGs, to mitigate the identified risks. Although Montalegre's MGs have considerable importance to the region's local economy, they are also high-risk events, to local and international health, due to the high number of foreigners on those events and the proximity to the Spanish border. Results The first in the field collaboration was the Forest Soul Gathering, a biennial transformational festival, held from 17th-21st of July 2019, with more than 1000 participants, from more than 20 countries. The collaboration with the local government continued throughout the year with several work meetings on Mass Gatherings and risk management. On Friday 6th, 2020, the PHU provided a risk assessment to the local government on the event Friday 13th (40.000 participants) and classified that risk as major due to the COVID-19 epidemic. In the local civil defense meeting, it was decided unanimously to cancel the event, taking into account the risk assessment of the PHU. Lessons There has been an increase in MG's in Portugal. This requires straight collaboration with the organization, health sector, and local authorities, to mitigate the risks of each event. This can be an example of how to go from theory to practice, in public health risk prevention, and institutional cooperation, being one of the first of its kind in Portugal. In the end, it allowed a fast response to the threat of COVID-19 and public health protection of the community of Montalegre. Key messages Proper preparation with partners to a public health emergency is vital to contain an outbreak. Local public health departments need to implement their emergency protocols and risk assessment procedures before a public health emergency.