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Large sporting events potentially increase the transmission of SARS-CoV-2 and other communicable diseases due to prolonged close contact and socializing with non–household members.1 Although rigorous evidence is lacking, requiring face masks, restricting eating/drinking, reducing spectator capacity, encouraging physical distancing, and reserving space between groups of ticketed seats are strategies that attempt to reduce transmission risk. However, even when face masks are required, spectators’ mask-wearing behavior may be inconsistent. To support public health efforts in reducing disease spread and venues’ preparations for future events during COVID-19 or other epidemics, this study quantified spectators’ mask wearing during a high-profile national sporting event.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Joshua R. Vest, PhD, MPH, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, RG 6155, Indianapolis, IN 46202 (firstname.lastname@example.org).
Accepted for Publication: August 4, 2021.
Published Online: August 16, 2021. doi:10.1001/jama.2021.14057
Author Contributions: Dr Vest had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: All authors.
Acquisition, analysis, or interpretation of data: Vest, Blackburn, Embi.
Drafting of the manuscript: Vest, Blackburn, Peters Bergquist, Embi.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Vest.
Obtained funding: Cash-Goldwasser, Embi.
Administrative, technical, or material support: Vest, Blackburn, Cash-Goldwasser, Peters Bergquist.
Supervision: Vest, Blackburn.
Conflict of Interest Disclosures: Dr Vest reported receiving grants from Resolve to Save Lives to the Indiana University Richard M. Fairbanks School of Public Health during the conduct of the study; receiving personal fees from New York eHealth Collaborative and Pima County for consulting services outside the submitted work; and being a founder and equity stakeholder in Uppstroms, a technology company. Dr Embi reported he is the inventor of the MaskCount web-based app used in this study, developed with support from the Regenstrief Institute, but has no personal financial interests in the product. No other disclosures were reported.
Funding/Support: This work was made possible through funding from Resolve to Save Lives, an initiative of Vital Strategies. Resolve to Save Lives is funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Initiative. Resolve to Save Lives received additional funding for the COVID-19 response from the Stavros Niarchos Foundation and the Start Small Foundation.
Role of the Funder/Sponsor: Resolve to Save Lives had no role in the design and conduct of the study, or in collection, management, analysis, or interpretation of the data. Drs Cash-Goldwasser and Peters Bergquist from Resolve to Save Lives were involved in the preparation, review, and approval of the manuscript and decision to submit the manuscript for publication.
Additional Contributions: We thank Virginia Caine, MD, and Karen Holly, MBA, of the Marion County Public Health Department for logistical support; Katie Allen, BS, Amber Blackmon, MPH, Jyotsna Gutta, MPH, Richard Jones, BS, Nicholas Kiehl, Whitney Seeley, Yvette Tran, MS, Erin Vest, Valerie Yeager, DrPH, MPhil, and Lauren Yoder from Indiana University for data collection support; and Kate Elliott, MPH, MHSMA, and Sasha Litvinov, BA, from Resolve to Save Lives for editorial assistance. Ms Elliott and Ms Litvinov received financial compensation for their contributions.
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