COVID-19 and the scaled-down 2020 Hajj Pilgrimage - Decisive, logical and prudent decision making by Saudi authorities overcomes pre-Hajj public health concerns

Zumla, Alimuddin; Azhar, Esam I.; Alqahtani, Saleh; Shafi, Shuja; Memish, Ziad A.

On Monday 3(rd) August, 2020, the 2020 Hajj pilgrimage, held during the COVID-19 pandemic, ended successfully with no major public health incident. Compared to 2.4 million pilgrims from 182 countries who attended the 2019 Hajj, this year’s Hajj was a significantly scaled-down event, limited to 1,000 local pilgrims only, due to the growing global COVID-19 pandemic. Against a backdrop of the rapid spread of global COVID-19 pandemic and increasing numbers of COVID-19 cases in the Middle East, several public health concerns dominated the planning of the 2020 Hajj. We discuss the pre-2020 Hajj controversies, dilemmas, debates and dialogue leading to the decisive, logical and prudent decision making and innovative leadership by Saudi authorities. The public health preparedness prior to, and during, the 2020 Hajj, including lessons learnt and opportunities arising for other countries who plan to host mass gathering religious and sporting events are also discussed.