Summary: Rock in Rio Lisboa, a prominent four-day music festival in Portugal, attracts over 160,000 attendees each weekend across two weekends. To safeguard public health and ensure medical readiness for such a large-scale event, comprehensive strategies were developed. These strategies required close coordination among emergency services, festival organizers, healthcare providers, and public health authorities to address challenges stemming from high-density crowds, extended event hours, fluctuating weather conditions, and the potential for public health hazards. A multi-tiered healthcare infrastructure was established on-site, which included a fully equipped medical center, advanced life support modules, and strategically positioned mobile response teams to provide immediate care. A strong focus was also placed on mental health support, with professionals trained in psychological first aid available to manage anxiety, stress, and other crowd-induced psychological concerns. Additionally, preventive measures such as hydration stations and effective crowd management were implemented to reduce the risk of serious health incidents. Public health teams, consisting of public health physicians, regulatory authorities, and environmental health officers, enforced stringent food and water safety measures. Daily water quality assessments were conducted, and strict audits were performed on the 79 food and beverage vendors to ensure compliance with safety regulations, thereby preventing outbreaks of foodborne and waterborne illnesses. Medical teams provided care to 1,644 individuals during the event, addressing issues such as dehydration, minor injuries, and heat-related illnesses, with fewer than 1% of cases requiring transportation to external healthcare facilities. This report illustrates the efficacy of proactive, multidisciplinary planning in managing health risks at large gatherings. The strategies employed at Rock in Rio demonstrate a scalable model for future events that prioritizes attendee well-being and resilience, showcasing how well-coordinated public health and medical interventions can minimize the impact of health crises in mass gatherings.
Mexia et al. (Sun,) studied this question.