CASE STUDY REPORT: Targeted Hygiene: a risk-based approach to applying policies and hygiene interventions in public settings and large events: a case study of hygiene interventions at COP26 2021

Lisa M. Ackerley, Adrian C. Paskey, Carolyn Buckley, Stephanie M. Cooper, Katy Slater, James Logan, Stuart Bainbridge

The United Nations Climate Change Conference (COP26) occurred at the height of the COVID-19 pandemic; this international event brought together over 38,000 delegates over 13 days and posed a significant risk for transmission of the SARS-CoV-2 virus.  To mitigate risk of spread of infection, a hygiene intervention based on risk assessment/risk management was developed.

This involved developing protocols for disinfection of contact surfaces throughout the venue during the sessions by cleaning operatives, combined with measures to facilitate and motivate delegates to practice effective hand and surface hygiene whilst attending sessions. A detailed risk-assessment was carried out to identify key moments for surface hygiene interventions to be performed by cleaning operatives within COP26 venues. This was used to develop training modules and protocols for cleaning operatives. Behavioural science principles were used to motivate delegates to use the hand and surface hygiene products provided to them.

The number of individuals affiliated with COP26 that tested positive for SARS-CoV-2 during the conference was 2 in 1,000, compared with 11-12 in 1,000 individuals in Scotland during the same period. Despite high levels of COVID-19 infection in the surrounding community and identified cases amongst conference delegates, the conference was completed successfully without the disruption of a COVID-19 outbreak. Hand and surface hygiene interventions were considered to have contributed to the reduced incidence of COVID-19 infection in those visiting COP26 by breaking the chain of infection via hands and contact surfaces.

Based on the findings of this study we propose that, in future, a risk assessment/risk management approach should be adopted and developed as the blueprint for effective and sustainable nonpharmaceutical interventions for preventing transmission of respiratory and other infections at large scale events.

 Importance of this study – and future considerations

The observations and outcomes set out in this report support the growing body of opinion that protocols based on well-accepted, evidence-based risk management approaches (as opposed to protocols based on clinical evidence for individual interventions and/or the use of “deep cleaning”) provide a more reliable and effective means to mitigate spread of infections in large populations and should be adopted as an effective and sustainable blueprint for hygiene interventions at large-scale events.