One societal aspect affected immensely by the pandemic has been sporting and live music events. The social impact is important, but the economic impact of large outdoor events being banned has been substantial. 

In hopes of safely returning to some normalcy, German researchers sought to address the infectious risk of restarting some of these events by setting up an experimental indoor mass gathering event, described in a new study published on the preprint server medrxiv. A simulated pop concert for 1,400 participants was set up on August 22 in the Leipzig Arena. The exercise was so realistic that the organizers engaged German pop performer Tim Bendzko to perform for the audience. Each participant and staff member provided a negative SARS-CoV-2 test completed within 48 hours of the event and all concert goers were required to wear a N-95 during the event. 

Three different seating scenarios were researched: (1) no restrictions; (2) checkerboard seating pattern with twice as many entrances/exits; (3) paired seating with 5 feet between groups, 4 times more entrances/exits. Each participant was monitored during the event with contact tracing devices. The event consisted of a 60-minute entry period followed by a 45-minute first half. A 20-minute intermission then occurred with simulated catering, followed by another 45-minute set. At the conclusion of the event, a 15-minute exit period occurred. The number and time of contacts within five feet were recorded.  Contact numbers were high but when reduced to a 15-minute exposure threshold, the numbers decreased to below ten. The largest contact time was during entrance and exit. Not surprisingly, scenario 2 (checkerboard seating) and scenario 3 (paired seating with space between groups) reduced contact numbers. Aerosol exposure was also simulated during the event with the maximum number of exposed people per simulated infectious person estimated at ten. 

The researchers explore what the implications of such "mass gathering events" in a community with relatively low case counts might be. Based on relatively low local incidence, if 100,000-200,000 people per month participated in such events, 0.4%, 1.1%, and 2.3% of all of a community's cases would be predicted to be attributable to the events (these estimates correspond to the three scenarios listed above). But if ventilation in the building was poor, the incidence would increase dramatically—up to 23%.  

Among the surveyed participants, 89% felt wearing a N-95 was restrictive but acceptable if it meant attending a concert safely. How these findings apply to real-world settings is hard to extrapolate. At many sporting events and concerts people are often very close together and standing, unlike this carefully simulated seated concert. In addition, compliance with N-95 mask wearing could be difficult. Nevertheless, this study was still a bold attempt to try and explore what bringing some "normalcy" back to people's lives might entail, and what the costs might be.

A new preprint slated to be published in the  Journal of General Internal Medicine assess trends in physician voting over time. This topic is particularly timely for a few reasons, including the current presidential election and health care providers who are currently overworked during the covid-19 pandemic, which may limit the time they have to vote. 

Researchers from University of Michigan looked at data from the Current Population Survey (CPS) November Voter Supplement from 2004 through 2018. The CPS is household survey data from the U.S. Census Bureau. Voting rates and behaviors of healthcare providers (physicians, dentists, pharmacists, registered nurses, physician assistants) were compared to five other professions (postsecondary teachers, chief executives, civil engineers, social workers, lawyers). 

The average age of physicians in the study sample was 47.6 years of age, with 33.5 percent identified as women. Sadly, healthcare providers were much less likely to vote compared to both the general public and the other aforementioned professions. Voting rates were 12 percent lower than expected when compared to the general public. Interestingly, physicians were 30 percent more likely to vote by mail and 15 percent more likely to vote before election day when compared to the general public. When compared to the general public, healthcare providers were 70 percent more likely to report the main barrier for not voting or not registering to vote was "Too busy, conflicting work or school". 

As providers on the frontline of the covid-19 pandemic, time has been quite limited with regards to registering to vote, as well as voting. The one silver-lining of the pandemic was the normalization and nationwide effort to educate on mail-in registration and voting. Hopefully, the authors do a follow-up study in a few years to see if trends in healthcare provider voting changed during the current presidential election.