Interim Guidance for Coronavirus Disease 2019 (COVID-19)
Guidance as of 3/15/2020
Large events and mass gatherings can contribute to the spread of COVID-19 in the United States via travelers who attend these events and introduce the virus to new communities. Examples of large events and mass gatherings include conferences, festivals, parades, concerts, sporting events, weddings, and other types of assemblies. These events can be planned not only by organizations and communities but also by individuals.
Recommendations for schools, institutes of higher learning, or businesses are available.
Summary of Recent Changes
Revisions were made on 3/12/2020 to reflect the following:
- Highlights vulnerable populations
- Adds a section on “Considerations for Postponing or Cancelling a Mass Gathering”
- Adds a section on discouraging handshakes and high fives (for sporting events)
- Adds standard language regarding disinfection procedures
This interim guidance is intended for organizers and staff responsible for planning mass gatherings or large community events in the United States. A mass gathering is a planned or spontaneous event with a large number of people in attendance that could strain the planning and response resources of the community hosting the event, such as a concert, festival, conference, or sporting event. Guidance specific to schools and childcare settings, institutions of higher education, and community- and faith-based organizations can be found on CDC’s website focused on prevention COVID-19 spread in communities.
COVID-19 is an emerging respiratory disease and there is more to learn about its transmission, clinical course, and populations at increased risk of disease and complications (see How COVID-19 Spreads). Everyone can do their part to help plan, prepare, and respond to this emerging public health threat.
Older adults and persons with severe underlying health conditions are considered to be at increased risk of more serious illness after contracting COVID-19. Priority should be given to ensuring the safety of these groups of people, particularly for any mass gatherings that are expected to have a large number of older adults or persons with underlying conditions.
As the COVID-19 outbreak evolves, CDC strongly encourages event organizers and staff to prepare for the possibility of outbreaks in their communities. Creating an emergency plan for mass gatherings and large community events can help protect you and the health of your event participants and the local community.
CDC has developed recommended actions for preventing the spread of COVID-19 at mass gatherings and large community events. This guidance suggests strategies to help you plan for and implement ways in which to better protect all involved in a mass gathering.
Organizers should continually assess, based on current conditions, whether to postpone, cancel, or significantly reduce the number of attendees (if possible) for mass gatherings. Listed below are some considerations organizers should keep in mind as they make decisions about whether to postpone or cancel an event. If organizers decide to proceed with an event they should consult the “Steps to Plan, Prepare, and Proceed with a Mass Gathering” section of this document.
There are a number of factors to consider when determining the need to postpone or cancel a large gathering. These include:
The overall number of attendees. Larger gatherings (for example, more than 250 people) offer more opportunities for person-to-person contact and therefore pose greater risk of COVID-19 transmission.
The number of people attending who are at greater risk of more serious illness after contracting COVID-19. Older adults and persons with severe pre-existing health conditions are thought to be at increased risk.
The density of attendees within a confined area. Based on what is currently known about the virus, spread from person-to-person happens most frequently among close contacts (within 6 feet).
The potential economic impact to participants, attendees, staff, and the larger community.
The level of transmission in your local community and the level of transmission in the areas from which your attendees will travel. To better understand the level of community transmission in your community (and in the communities from which your attendees will be traveling), consult with your local and/or state public health department.
If there are ways in which to significantly reduce the number of attendees. For example, for sporting events or school concerts, organizers could consider holding the event but significantly reduce the number of audience members.
At a minimal-to-moderate level of community transmission, it is recommended to:
Cancel community-wide mass gatherings (for example, >250 people; the cutoff threshold is at the discretion of community leadership based on the current circumstances the community is facing and the nature of the event) or move to smaller groupings.
At a substantial level of community transmission, it is recommended to cancel mass gatherings of any size.
The details of your emergency operations plan should be based on the size and duration of your events, demographics of the participants, complexity of your event operations, and type of on-site services and activities your event may offer.
Review the existing emergency operations plans for your venues
Meet with the emergency operations coordinator or planning team at your venues. Discuss the emergency operations plans and determine how they may impact aspects of your events, such as personnel, security, services and activities, functions, and resources. Work with the emergency operations coordinator or planning team to prepare for the key prevention strategies outlined in this guidance. Develop a contingency plan that addresses various scenarios described below which you may encounter during a COVID-19 outbreak.
Establish relationships with key community partners and stakeholders. When forming key relationships for your events, include relevant partners such as the local public health department, community leaders, faith-based organizations, vendors, suppliers, hospitals, hotels, airlines, transportation companies, and law enforcement. Collaborate and coordinate with them on broader planning efforts. Clearly identify each partner’s role, responsibilities, and decision-making authority. Contact your local public health department for a copy of their outbreak response and mitigation plan for your community. Participate in community-wide emergency preparedness activities.
Address key prevention strategies in your emergency operations plan
Promote the daily practice of everyday preventive actions. Use health messages and materials developed by credible public health sources such as CDC or your local public health department to encourage your event staff and participants to practice good personal health habits. Consider displaying signs (physical and/or electronic) throughout the event to provide frequent reminders to participants to engage in everyday preventive actions to help prevent the spread of COVID-19. These include:
- Stay home when you are sick, except to get medical care.
- Cover your coughs and sneezes with a tissue, then throw the tissue in the trash.
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not available, use hand sanitizer that contains at least 60% alcohol.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Clean frequently touched surfaces and objects daily.
Handshakes and “high-fives” are often exchanged at meetings and sporting events, and these can be ways in which COVID-19 can be transmitted from person to person. As a way of decreasing the social pressure to engage in these common behaviors, consider displaying signs (physical and/or electronic) that discourage these actions during the gathering.
Note: Use culturally appropriate messages, materials, and resources.
Provide COVID-19 prevention supplies to event staff and participants. Ensure that your events have supplies for event staff and participants, such as hand sanitizer that contains at least 60% alcohol, tissues, trash baskets, disposable facemasks, and cleaners and disinfectants. Clean frequently touched surfaces and objects with detergent and water prior to disinfection, especially surfaces that are visibly dirty.
- Routinely clean and disinfect surfaces and objects that are frequently touched. Clean with the cleaners typically used. Use all cleaning products according to the directions on the label.
- For disinfection most common EPA-registered household disinfectants should be effective.
- A list of products that are EPA-approved for use against the virus that causes COVID-19 is available here. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
- Additionally, diluted household bleach solutions can be used if appropriate for the surface. Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted. Prepare a bleach solution by mixing:
- 5 tablespoons (1/3rd cup) bleach per gallon of water or
- 4 teaspoons bleach per quart of water
- Additional information on cleaning and disinfection of community facilities can be found on CDC’s website.
Note: Disposable facemasks should be kept on-site and used only if someone (worker or attendee) becomes sick at your event. Those who become sick should be immediately isolated from staff and participants who are not sick and given a clean disposable facemask to wear.
Note: Use culturally appropriate messages, materials, and resources.
Plan for staff absences. Develop and implement flexible attendance and sick-leave policies. Event staff need to stay home when they are sick, or they may need to stay home to care for a sick household member or care for their children in the event of school dismissals. Allow staff to work from home when possible. Identify critical job functions and positions and plan for alternative coverage by cross-training staff (similar to planning for holiday staffing). Provide instructions about how and when to safely return to work.
Implement ﬂexible staff attendance and sick-leave policies (if possible). Require staff to stay home if they are sick or caring for a sick household member. Notify staff when you plan to implement COVID-19 leave policies.
Note: Direct staff who get sick with COVID-19 symptoms to avoid contact with others and to seek medical advice.
Consider alternatives for event staff and participants who are at increased risk for complications from COVID-19. Currently, older adults and persons with severe underlying health conditions are considered to be at increased risk for severe illness and complications from COVID-19. Event organizers can consider reassigning duties for higher-risk staff to have minimal contact with other persons. People in higher-risk groups should consult with their healthcare provider about attending large events. Consider providing refunds to event participants who are unable to attend because they are at high risk and/or provide information on alternative viewing options.
Promote messages that discourage people who are sick from attending events. This could include electronic messages sent to attendees prior to travel to the event as well as messages requesting that people leave events if they begin to have symptoms of COVID-19, which include fever, cough, and shortness of breath. Attendees should be encouraged to seek medical advice promptly by calling ahead to a doctor’s office or emergency room to get guidance. See CDC guidance on what to do when sick with COVID-19.
Note: Use culturally appropriate messages, materials, and resources.
If possible, identify a space that can be used to isolate staff or participants who become ill at the event. Designate a space for staff and participants who may become sick and cannot leave the event immediately. Work with partners, such as local hospitals, to create a plan for treating staff and participants who do not live nearby. Include a plan for separating and caring for vulnerable populations. If any staff member or participant becomes sick at your event, separate them from others as soon as possible. Establish procedures to help sick staff or participants leave the event as soon as possible. Provide them with clean, disposable facemasks to wear, if available. Work with the local public health department and nearby hospitals to care for those who become sick. If needed, contact emergency services for those who need emergency care. Public transportation, shared rides, and taxis should be avoided for sick persons, and disposable facemasks should be worn by persons who are sick at all times when in a vehicle. Read more about preventing the spread of COVID-19 if someone is sick.
Note: Providing a sick staff member or event participant with a disposable facemask to wear does not replace the need for that person to leave as soon as possible, stay home, and seek medical advice. Wearing a disposable facemask in the workplace or while participating in a large event is not a sufficient infection control measure.
Plan ways to limit in-person contact for staff supporting your events. Several ways to do this include offering staff the option to telework if they can perform their job duties off-site, using email, and conducting meetings by phone or video conferencing. Reduce the number of staff needed such as staggering shifts for staff who support essential functions and services during events.
Develop ﬂexible refund policies for participants. Create refund policies that permit participants the flexibility to stay home when they are sick, need to care for sick household members, or are at high risk for complications from COVID-19.
Identify actions to take if you need to postpone or cancel events. Work closely with local public health officials to assess local capacities in the area. During a COVID-19 outbreak, resource limitations among local healthcare systems and/or law enforcement can influence the decision to postpone or cancel your events. If possible, plan alternative ways for participants to enjoy the events by television, radio, or online.
Communicate about COVID-19
Stay informed about the local COVID-19 situation. Get up-to-date information about local COVID-19 activity from public health officials. Be aware of temporary school dismissals in your area because these may affect event staff.
Note: Early in the outbreak, local public health officials may recommend schools dismiss temporarily.
Update and distribute timely and accurate emergency communication information. Identify everyone in your chain of communication (for example, event staff, participants, suppliers, vendors, and key community partners and stakeholders) and establish systems for sharing information with them. Maintain up-to-date contact information for everyone in the chain of communication. Identify platforms, such as a hotline, automated text messaging, and a website to help disseminate information. Update key community partners and stakeholders regularly. Share information about how you and the emergency operations coordinator or planning team for the venues are responding to the outbreak.
Identify and address potential language, cultural, and disability barriers associated with communicating COVID-19 information to event staff and participants. Information you share should be easily understood by everyone attending the events. Learn more about reaching people of diverse languages and cultures by visiting: Know Your Audience. You also can learn more about communicating to staff in a crisis at: Crisis Communications Plan
Remember, a COVID-19 outbreak could last for a long time. When public health officials determine that the outbreak has ended in your local community, work with them to identify criteria for scaling back COVID-19 prevention actions at your events. Base the criteria on slowing of the outbreak in your local area. If your events were cancelled, work with your venues to reschedule your events.
Evaluate the effectiveness of your emergency operations and communication plans
Meet with the emergency operations coordinator or planning team for your venues to discuss and note lessons learned. Gather feedback from event staff, participants (if possible), community partners, and stakeholders to improve plans. Identify any gaps in the plans and any needs you may have for additional resources.
Maintain and expand your planning team. Look for ways to expand community partnerships. Identify agencies or partners needed to help you prepare for infectious disease outbreaks in the future and try to add them to your planning team.
Participate in community-wide emergency preparedness activities.
- Visit cdc.gov/COVID19 for the latest information and resources about COVID-19
- COVID 2019 Situation Summary
- Prevention and Treatment
- What to Do If You Are Sick
- Pregnant Women and COVID-19 FAQs
- FAQs: Coronavirus Disease-2019 (COVID-19) and Children
- Handwashing: A Family Activity
- Handwashing: Clean Hands Save Lives
CDC Interim Guidance for Specific Audiences
- Get Your Household Ready for Coronavirus Disease 2019 (COVID-19)
- Interim Guidance for Administrators of US Childcare Programs and K-12 Schools to Plan, Prepare, and Respond to Coronavirus Disease 2019 (COVID-2019)
- Interim Guidance for Administrators of US Institutions of Higher Education (IHE) to Plan, Prepare, and Respond to Coronavirus Disease 2019 (COVID-19)
- Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)
- Interim Guidance for Travelers
CDC Communication Resources