Preparedness and Response at World Youth Day 2023 in Portugal - Challenges and Lessons Learned

Summary: World Youth Day 2023, hosted in Lisbon, Portugal, likely represented one of the largest mass gatherings in the country’s history, with an estimated 1.5 million attendees. The Ministry of Health established a comprehensive task force involving 17 institutions to coordinate public health preparedness and response efforts. Key initiatives included capacity building and scaling up essential services, such as food and water safety measures, legionella and vector surveillance, the issuance of temporary National Health Service (NHS) numbers to facilitate health care access, and the enhancement of IT systems for interoperability. Primary, pre-hospital, and hospital care services were expanded, with resources pre-deployed, including WHO-certified Emergency Medical Teams (EMT) and Primary Medical Aid (PMA) units. The preparedness phase also faced challenges, including a lack of historical data from previous editions, unpredictable participant numbers, logistical complexities across multiple venues, and environmental concerns such as a potential heatwave. Surveillance was conducted using both indicator-based systems (SINAVE, eVM, SICO-VDM, INEM) and event-based tools (RONDA Bulletin, MediSys, mobile and meteorological data) for real-time situational awareness. Communication strategies included the use of the SNS24 Helpline, a mobile app with health recommendations, and regular situation room briefings featuring real-time data dashboards. International cooperation with organizations like the ECDC and WHO bolstered these efforts. Key takeaways from the event emphasized the importance of data integration for evidence-based decision-making, a clearly defined organizational structure, thorough training programs, and a solid legal framework to support response activities. The conference underscored the legacy potential of these initiatives, aiming to improve public health emergency responses for future events of similar magnitude.