As countries across the world anticipate a pandemic, many in events are deferring to global health organizations to determine their fates. ITB Berlin, the latest casualty, held out long after an outbreak in neighboring Italy caused the closure of all events in affected areas across the north. What can be learned from ITB Berlin in deciding the fate of your own events?
As coronavirus outbreaks continue to pop up across the world, government authorities have taken different approaches to containment.
In Italy, a total quarantine of the country’s impacted northern region is underway, set to last at least two weeks. Major public events have been cancelled in an attempt to contain the outbreak, and people are encouraged to avoid crowds.
Meanwhile, as Italy proved the European risk with infections surpassing 1,700 in a matter of days, Germany’s ITB Berlin event organizers held steadfast in keeping the global travel trade show scheduled under the logic that the local situation at the time didn’t constitute a significant risk of coronavirus at the exhibition. As the coronavirus outbreak in Germany and the rest of Europe intensified, however, ITB Berlin was forced to cancel the event.
In this post, we’ll be taking a moment to pause mid-crisis and take a deep, critical look at the evolution of the decision to cancel ITB Berlin in order to analyze the underlying logic and better understand the factors that will determine the future of our own events.
Contrasting Approaches to Coronavirus Management
There is a clear distinction between each approach and the considerations at play. Italy undertook a methodical process designed to unveil and contain a threat of unknown origin and scale. ITB Berlin, like many events and event planning associations, deferred to the recommendations of international health authorities who, among other responsibilities, have to mitigate panic.
We contacted Messe Berlin, ITB Berlin’s organizers, and corresponded with Julia Sonnemann, their PR manager.
Julia explained that Messe Berlin had met all the requirements set out by the public health authority of Charlottenburg-Wilmersdorf of Berlin, and accordingly, ITB Berlin was on track. Then, the authority greatly increased the requirements for holding the event to include proof that participants were not coming from “defined risk areas” and had not had contact with anyone from those areas, and Messe Berlin was forced to cancel the event as they were unable to comply.
Messe Berlin closely followed their protocol and, as many of us do when it comes to matters of health, deferred to the expertise of others to make the important decisions that decide their fate.
Nevertheless, ITB Berlin’s cancellation has made one thing clear: It is becoming increasingly important that event professionals understand the issues, factors, and consequences associated with these decisions. Doing so will allow us to better predict the real risk of hosting our own events and the likelihood of their eventual cancellation — or worse, their contribution to a super-spreading event.
International health organizations should be consulted, but not uncritically. Even now, the WHO is trying to lower the number of Italy’s reported cases by hinging the term ‘confirmed cases’ on a technicality.
Northern Italy Goes Into Lockdown, Cancelling All Public Events
With over 1,000 confirmed coronavirus cases (including 29 deaths), Italy currently has the highest number of confirmed cases outside of Asia. The vast majority are in the Lombardy region in the northern portion of the country. Cities and towns throughout the region have been placed on government lockdown, effectively quarantining 100,000 people for a period of at least two weeks.
Restrictions in northern Italy include a ban on entering or exiting these areas and the suspension of public events and attractions — including Milan Fashion Week, Venice’s Carnival celebration, and sporting events like Series A soccer matches. Everyday places like offices, bars, and churches are also closed.
These precautionary measures to bottleneck the outbreak have to be both thorough and systematic as the virus is difficult to diagnose in the young and otherwise healthy. In fact, part of the reason Italy is reporting such high numbers is because local authorities are systematically testing everyone in affected zones and identifying cases that would likely go under the radar in a less methodical approach.
Speaking to the Guardian, former president of Italy’s higher health council Roberta Siliquini said that “we have found positive cases in people who probably had few or no symptoms and who may have overcome the virus without even knowing it.”
While some have argued that these measures are draconian compared to those of other countries like Germany, who are only now initiating quarantines (though not nearly to the same degree), the results are telling. The outbreak in Italy confirmed that the coronavirus is much more pervasive than is implied by relatively modest confirmed cases counts.
The Perception of Risk Was Fundamentally Flawed
Rather than following the leads of Italy and Spain in cancelling public events, ITB Berlin organizers were cautiously optimistic about keeping the trade show on track for March 4 through 8.
“We have always been taking the situation very seriously, since the safety of our visitors and exhibitors have the utmost priority,” said Sonnemann. “Until the beginning of last week, there had been no recommendation or instruction from the relevant health authorities. So, ITB Berlin was going to take place as planned.”
The show included 10,000 exhibitors this year, and last year, attendees totaled 160,000 — an expected attendance comparable to that of Barcelona’s Mobile World Congress (MWC), which had been cancelled only a few weeks earlier after a number of key exhibitors pulled out over concerns about the level of risk (despite a relatively low local incidence of the virus).
ITB Berlin was explicit about their reliance on the recommendations of the Robert Koch Institute and other global health institutions. The logic behind their recommendation was that, at the time, there had not been any “evidence of sustained viral circulation.” In other words, there were only 21 confirmed cases of coronavirus in the country and nobody had found it spreading beyond that.
— ITB Berlin (@ITB_Berlin) February 24, 2020
But as several countries saw outbreaks that surged their infection rates into the 100s overnight, this rationale didn’t hold up. Any justifying rationale that starts and stops at the local incidence of infection doesn't actually speak to the real event risk factors for two reasons:
They presume that we can know what the local infection rate actually is in real time.
They say nothing of the risk multiplier of having people from all over the world congregate in one place and then go back home again.
The reality is that it had already become virtually impossible to predict where the next outbreaks would be, and without thorough preemptive testing, the virus’ incubation period meant that any outbreak would only be discovered two weeks or more after it happened.
As concerns of community spread and predictions of a pandemic mount, it’s clear that a country’s reported confirmed cases is very unlikely to accurately represent a location's actual risk.
Looking Beyond the Local Risk
As the situation continued to unfold, ITB Berlin organizers went on to announce restrictions requiring exhibitors to fill out a declaration form in order to gain entry to the exhibit hall. Travelers were prohibited from attending if any of following risk factors applied to them:
- Had a recent stay in an identified risk area (identified as specific regions within China, Iran, Italy, and South Korea)
- Been in contact with anyone who has tested positive for coronavirus in the last 14 days
- Displayed typical symptoms such as fever, coughing, or breathing issues
Leaving aside the inherent issues with asking people to self-regulate on an honor-based system where economic pressure and opportunity cost are contravening factors, these measures at least demonstrated that ITB organizers understood the potential for attendees to bring the virus to the event, rather than to come and find it within the local population.
But what of infection rates elsewhere?
Germany’s health minister, Jens Span, warned about the inability to forecast the path of coronavirus.
From a global perspective, cases of coronavirus have reached more than 80,000 and infection rates have been seen to drastically multiply overnight, as in Italy, South Korea, and Iran. The reality is that the same uncertainty that applies to Germany’s infection rate applies elsewhere as well. What’s good for the goose…
Even with a relatively low reported local infection rate, the global risk made it premature to assume that cases would remain low in any industrial country delegates might be coming from.
Faulty But Pervasive Logic
A common rhetorical tactic emerged to minimize the perception of risk around coronavirus by comparing its statistics to those of the more common influenza virus (the flu).
You need to put this in context. More people have died in the US this year so far from the flu than people have world wide from coronavirus.
Do you have a shit-stirring agenda against ITB?
— Press Red Rentals: AV, Sound, Lighting, Video Hire (@pressredrentals) February 25, 2020
There’s some truth to these claims, at least at face value, but they don’t make the point people think they’re making.
According to the CDC, in the U.S. alone, the seasonal flu has produced 280,000 hospitalizations and 16,000 associated deaths this season — clearly exceeding the number caused so far by the coronavirus. But that’s out of 29 million confirmed flu infections.
The number of cases of COVID-19 is a tiny fraction of that (for now), so people shouldn't expect it to have had the same statistical impact. But if 82,000 people get a virus that kills 2,800 of them, the global fatality rate for that virus is nearly 1 in 30, which makes the disease far more serious than one that kills 1 in 1,800 — especially if the disease has the potential to reach a comparable scale.
The True Risk of Coronavirus at Events
Another major distinguishing factor of the coronavirus is the speed at which the illness is transmitted. The average rate of transmission for COVID-19 is between 2.0 and 3.0 compared to influenza’s rate of 1.3. This should raise a major red flag to event planners, since a common thread among many of these infection spikes is large gatherings of people.
To put the real risk of an event like ITB Berlin into perspective, nearly 60% of South Korea’s over 4,212 confirmed cases have been traced to the Shincheonji Church of Jesus in the city of Daegu. There are now more than 9,000 church members in quarantine. This scenario grimly depicts how quickly the coronavirus can spread within crowds much smaller and more homogenous than you would expect at an event like ITB Berlin.
When you combine that with international travel, you get the situation in the Middle East: first cases in Kuwait, Bahrain, Oman and Afghanistan being linked to outbreaks in several religiously significant sites in Iran.
We must remember that the real risk for international events has to factor in an unpredictable local infection rate combined with (and multiplied by) the number of major industrial locations our attendees are coming from.
Any events that go forward in spite of this must do all they can to mitigate that risk. ITB Berlin organizers had been basing their strategy on recommendations from their trusted health authority. “The safety of our visitors and exhibitors has the utmost priority," Sonnemann said. "We have adhered to all the requirements of the responsible health authority of Charlottenburg-Wilmersdorf of Berlin."
The condition that became too unwieldy for the 160,000-person conference? That "Every trade fair participant must prove to Messe Berlin that they do not come from the defined risk areas or have had contact with a person from the risk areas."
So what does this say about the actual risk of the event prior to the decision to cancel?
ITB Berlin's final attempt at protective measures was to ask everyone to self-certify that they did not belong to a high-risk group defined by the criteria listed above, but the step that made the measure impracticable was that they prove it. This begs the question, how effective was the measure ever going to be if nobody was expected to substantiate what they were declaring?
Weighing Health Risks Against Economic Risks
But it's not just an issue of trusting participants to honestly represent their exposure to coronavirus. Considering the recent outbreak in Washington state and the estimated 1,500 unidentified cases, many people simply would have no idea if they were putting others at risk.
Without a sense of control over the spread, there is a temptation to reconcile yourself to the inevitable pandemic: If it’s inevitable, what’s the point in suffering the economic harms of stopping business as usual?
Citing the essential role events play in securing the stability and growth of many industries, global exhibition association UFI cautioned that the economic aftermath of prematurely canceling them “actually damages the path to recovery after this outbreak, and it inflicts additional harm.”
Huge events like ITB Berlin do have a significant economic impact. The cancellation of MWC certainly caused negative repercussions in Barcelona and beyond. Last year, the event’s economic impact was estimated at 473 million Euros (US$516 million). It would be fair to guess a similar estimate for ITB Berlin, which is of comparable size to MWC.
The New York Times reported that Italy is particularly vulnerable as Europe’s slowest-growing economy, with Lombardy and Veneto comprising 30 percent of the country’s economy. It’s not surprising that both the WHO and Italy’s central government are trying to pressure the medical community to report the number of confirmed coronavirus cases more conservatively and shift the methodical testing approach to one that exclusively targets already-symptomatic infections in at-risk patients.
However, despite controversy over the efficacy of regional quarantines in slowing the spread of coronavirus, one thing is certain: the struggle for global healthcare systems is real. The medical infrastructure within both South Korea and China have been tested by the influx of potential coronavirus infections, and medical staff are at risk of contracting the virus themselves.
These systems are designed to cope with diseases we know at a predictable volume, said Dr. Patrick Tang in a recent interview with Al Jazeera, making it important to contain the outbreak as much as possible.
Considering that the total number of confirmed cases globally is approximately half of what ITB Berlin expected in attendance, the worst case scenario of a super-spreading event could be catastrophic for the medical systems saddled with dealing with the aftermath.
The coronavirus situation is rapidly evolving, and the overall rhetoric has clearly begun to shift from one of carrying on as usual to a distinct need for stronger action across the globe.
The decision to cancel ITB Berlin was not a product of a revelation about the level of risk, it was a consequence of not being able to meet a requirement set out by a local health authority, but we have to look at those requirements critically and in a global context, assessing them against other approaches. While the financial aftermath of cancelling major events like ITB Berlin is sure to be felt alongside other economic impacts due to coronavirus, it speaks to the severity of the situation.
Nevertheless, IMEX Frankfurt, set to take place this may, released a statement to let the world know that it is going forward as planned, cautioning prospective registrants to stay calm, be rational, and separate fact from fiction.