Risk assessments of venues and events should include variables ranging from the capacity and resources of the local health-care system to potential show floor density, the number of high-touch surfaces, the location of the event, and from where attendees and exhibitors are traveling. Events in states with unchecked community spread such as California, Texas, and Georgia, with 25 or more new daily cases per 100,000 people, pose a greater peril than ones held in Hawaii and North Dakota, which currently average 10 and 22 daily new cases per 100,000 people, respectively, according to risk levels developed by the Harvard Global Health Institute.

In the same way, if many attendees are coming to an event from North Carolina, which as of this writing averages 72 new cases of COVID-19 per day per 100,000 population, that would be objectively considered a higher danger than if a preponderance of guests were originating from Washington. The northwestern state currently is generating about 28 new cases of COVID-19 per day per 100,000 people over the previous week (ranking it 42nd in the nation), which means the threat would be relatively less than that presented by guests from the Tarheel State.

Another risk factor to consider is expected show floor density, which reflects the anticipated crowding of the event space, a key safety consideration now that much of COVID-19 transmission is directly tied to mass gatherings where a few may infect many. Although there are several ad hoc methods for maintaining an acceptable density, the IAEE is recommending the recent Crowd Density Standard (CDS) developed by the International Association of Venue Managers (IAVM). (For more on the CDS, see question five.)

The physical venue itself should also be scrutinized for any accreditations or certifications that would directly reflect its readiness to prevent COVID-19 as part of the risk-assessment formula. Most recently, GBAC has been offering convention centers, hotels, and restaurant its GBAC STAR Facility Accreditation that requires institutions to address a detailed 20-point program ranging from audits and inspections to management and personnel training. If a facility doesn't have GBAC STAR accreditation, it should have a comparable assessment or policy that is transparent and open to inspection. For instance, ASM Global, the venue management and services company, has begun deploying VenueShield, its comprehensive reopening program for its nearly 325 facilities, which, similar to GBAC, addressed components of COVID-19 prevention from personal protective equipment (PPE) to food and beverage.

Show and event organizers will have to approach on-site testing on a case-by-case basis, evaluating the above mercurial factors, as well as the size of the audience, whether guests are traveling from states with high case counts or elevated test-positivity rates, and the relative vulnerability of attendees, e.g., if they tend to be older.

Even if there were an ample supply of test kits to go around, the lag time in receiving testing results would make their use at time-sensitive face-to-face events impractical. The solution to the delay would be diagnostic tests with rapid turnaround times. However, promising candidates are still far away from entering the mainstream. The electronic "nose" from the Dutch company Breathomix BV can read a breath for a COVID-19 infection in 45 seconds, but it's still in the experimental phase. A similar test from the University of Nevada-Reno's College of Chemical and Materials Engineering can analyze a nasal swab or exhalation in about 30 seconds but isn't close to being produced on an industrial level. Currently the best candidate may be a nose-swab test from Lucira Health Inc. that delivers results in 30 minutes. Just recently approved by the Food and Drug Administration (FDA) for limited use in northern California and Miami, it will likely be available to individuals on a nationwide basis in spring of 2021, but it would require a doctor's prescription, though that particular restriction could be eased.

Testing on site may turn out to be something of a moot point if airlines start requiring a negative test result or proof of vaccination. A recent United Airlines Inc. flight from Newark to London was that carrier's first requiring all travelers to submit to rapid testing for the coronavirus before boarding. Qantas Airways Ltd. has stated that once COVID-19 immunizations roll out, passengers will need to show they have been vaccinated in order to fly on international routes.

A new rule, just instituted in January by the CDC, requires all airline passengers coming into the United States to have tested negative for COVID-19 within three days before their flight departs, and to provide written verification of their test results. Alternatively, if they have already had COVID-19, a test would not be required, but medical documents certifying they have recovered from the virus would be. As a whole, the airline industry itself may adopt a similar stance, with the International Air Transport Association's (IATA) Travel Pass, which is now in development. This "health passport" app would display the record of an individual's test results or proof of inoculation and link to an electronic copy of the user's passport to verify his or her identity.

Temperature-scanning devices measure heat radiating from a surface, which in the context of live events would mean attendees' forehead skin or inner eye. Any individuals displaying a high temperature – a threshold generally set at 100.4 degrees Fahrenheit/38 degrees Celsius or more – should be removed and taken to a private area for a secondary temperature screening to verify that the earlier reading was indeed accurate. Though the initial testing would be accomplished using so-called contactless devices, the ancillary screening would likely rely on more traditional oral or tympanic thermometers, the latter of which uses an infrared ray to measure the temperature inside the ear canal.

Some health agencies, including the WHO, have maintained that such screenings are ineffectual for impeding the spread of COVID-19 at live events. First, individuals infected with COVID-19 may be asymptomatic. The number of those infected who are asymptomatic runs anywhere from 17.9 percent to 50 percent, based on studies published in medical journals and tests conducted by Decode Genetic Inc. Second, others afflicted with the virus may incubate for several days before displaying any discernible symptoms, such as a fever. Third, individuals running a fever might evade detection by consuming antipyretics such as acetaminophen (e.g., Tylenol) and ibuprofen (e.g., Advil) that would mask it. Given these factors, the WHO warns filtering measures such as temperature screening can necessitate significant expenditures of time and staff for what may be insignificant benefits.

The FDA states, too, that contactless temperature scanners might be fooled into showing an elevated temperature for a variety of reasons: other infections or conditions, high ambient temperatures, guests' physical exertion, visitors' hats or scarves, and inadequate training of persons handling the devices. Nonetheless, 2014 research published by the Canadian Agency for Drugs and Technologies in Health established that contactless temperature scanners are just as accurate as oral or rectal thermometers. Still, detecting too-high temperatures should not be viewed as a stand-alone defense but as one of several measures forming a kind of multilayered shield that live events might use to minimize the number of potential infections.

Weighing the pros and cons, exhibitions have opted for thermal testing as a single, but not sole, element of their safety protocols. In its report, "Events in the New Normal," Reed Exhibitions, the event organizer with a portfolio of around 500 events in 40 countries, has formally backed the use of temperature screening. The Messe München GmbH, which operates three venues in Munich, is also applying this filtering practice.

The GBAC, which is now accrediting facilities for their adherence to its COVID-19 safety precautions, supports temperature screening along with a secondary screening to confirm the initial finding of a high temperature in an attendee. The UFI backs this type of screening effort as well. As a consequence, shows such as the MBC Architecture Expo in Seoul, South Korea, and the Together Again Expo in Orlando, FL, employed temperature screening.

For example, shows and events could supply Quick Response (QR) codes to attendees beforehand via online registration. Once they arrive at a show, guests could hold up their phones with the QR code displayed, which could subsequently be read by an automated kiosk or by a staffer wearing personal protective equipment (PPE). Such digital credentials can reduce or eliminate the need for physical badges and lanyards, objects that could carry the virus and are often touched by their wearers. A secondary advantage of QR codes is that the more information that is recorded digitally, the easier any form of contact tracing would be should infections occur.

In this enhanced scenario for safer registration, attendees would likely see dispersed, self-serve check-in counters and discrete mobile badge printing at venues (if electronic badges are unavailable). Additionally, Plexiglas separators placed between any mask-wearing registration staff and registrants would become the norm. Registrants would be encouraged to maintain the 6 feet of social distancing by show personnel as well as by signage and markings on the floor during the registration process. These efforts, combined with the likely reduction of queues, would allow guests to enjoy a safer registration experience.

Pursuant to the IAVM, the optimum floor density is based on the above-mentioned 6-foot radius of space that individuals should use to keep others at a safe distance. That imaginary circle – again, extending 6 feet on all sides – surrounding everyone works out to approximately 28 square feet of space per person, which is then used to calculate the CDS for a given environment.

To calculate a CDS for a venue measuring 100,000 square feet, divide 100,000 by 28, and the optimum safe capacity would therefore be 3,571 people. To take a real-life example, Hall F2 at McCormick Place West in Chicago is listed at 222,535 square feet. Applying the CDS square footage/social distancing formula (222,535 divided by 28), 7,947 people could be allowed into Hall F while maintaining current social-distancing standards.

Even if an organizer's ability to institute the CDS at an event prioritizes safe interactions among guests, it does not automatically confer a benign environment should attendees decide to clump together and ignore the 6-foot standard, abjure face masks, and insist on shaking hands. In order to increase the chances that the CDS would be a successful step, the IAEE suggests organizers further reduce the number allowed into a space below that offered by the formula and/or expand event or exhibition hours, which would allow for staggering the attendance by permitting designated numbers of attendees in at selected times. Further, organizers could create single-direction aisles as well as expand aisle widths (the standard is either 8 or 10 feet), both of which can reduce massing together. Additionally, show staff could be employed to maintain traffic flow and break up crowding when it arises.

The IAEE also proposes applying technology to detect crowd density such as beacons and Radio Frequency Identification (RFID). Density Inc., for one, offers single sensors that each covers 1,325 square feet and alerts users in real time when attendees linger too long or mass together. Offering more sophisticated analysis, NEC Corp.'s Crowd Behavior Analysis Technology analyzes security camera footage for crowd behavior and can predict when and where clumping might occur up to 10 minutes ahead of time, allowing event personnel to intervene.

While efforts to avoid crowding and maintain social distancing would help combat the pandemic at live events, face masks remain the only way to literally block exhalations of viral particles. Exhalations – breaths, coughs, sneezes – can project as many as 30,000 particles that, according to the study "Turbulent Gas Clouds and Respiratory Pathogen Emissions" published in the Journal of the American Medical Association, can soar more than 26 feet through the air, or more than four times the social distancing standard of 6 feet.

Researchers also have discovered that the cough cloud emanating from a person without a mask is about 23 times larger than the cough cloud of someone wearing a nonsurgical mask (that is, the kind that might be purchased on Etsy or Amazon). This finding is especially relevant now that the notion of COVID-19 being an aerosol – meaning smaller, lighter particles of it can float further or remain in the air longer than previously assumed – has been generally adopted by health authorities.

Even with the rollout of apparently highly effective vaccines, inoculation against COVID-19 likely won't be available on a widespread basis until late March or April at the earliest. No matter how speedy the immunizing process goes, however, a significant portion of people may spurn viral protection, since the Pew Research Center confirmed that 27 percent of all adults state they would "definitely" or "probably" not be vaccinated. Worse, a Gallup Inc. poll suggests that number could be as high as 42 percent. This so-called "vaccine hesitancy" means that any sizable gathering (e.g., a trade show) would likely contain unvaccinated and infected persons. Such a scenario would form a double-edge sword: Not only would the unvaccinated pose an impending threat to each other if any among them were infected, but they in turn might be vulnerable to those who were vaccinated but are carrying viral particles. Despite the fact the vaccinated would be immune themselves, medical experts are still unsure if they could still unknowingly spread the coronavirus to others who have not received an inoculation against COVID-19.

Lastly, the most powerful of vaccines are 95 percent effective, but that leaves 5 percent of people unprotected. Consequently, at a trade expo such as the Specialty Equipment Market Association Show (SEMA) with pre-pandemic attendance hitting 160,000, 8,000 people would still be left vulnerable to the virus even if every single guest had been immunized. Furthermore, those who receive vaccinations aren't immediately shielded from the virus. Given the time that the immune system needs to generate the antibodies that block viral infections, and given that some vaccines (such as Pfizer's and Moderna's) will require two doses around three and four weeks apart, correspondingly, this means complete protection won't be attained until five or six weeks after the first shot. With their science-backed seal of approval, widespread availability, and general affordability, face masks will likely remain as part on the ongoing mitigation strategy against the coronavirus at live events for the near future.

First among these would be the calculation of booth density numbers, which would encompass staff and visitors allowed in at any one time based on total square footage. Using the CDS, exhibitors would divide their stands' square footage by 28 feet. For a 20-by-20-foot booth (400 square feet), an exhibitor would divide 400 by 28, with the result – 14.3 – meaning the stand could safely hold no more than 14 people at once, while a 20-by-40-foot stand (800 square feet) would securely accommodate a maximum of 28 attendees at a time. Keep in mind that this refers to the gross square footage of a booth, with a varying percentage of its total footprint taken up by items such as tables, kiosks, furniture, monitors, display cases, or other elements, thus possibly reducing the amount of space staff and guests can safely move around in. Subsequently, exhibitors may wish to base their CDS calculation on the amount of net space available after accounting for those items instead. However, they should also keep in mind that many of the objects taking up the area – again, tables, kiosks, and so forth – may actually keep people apart physically and therefore help them stay within norms for social distancing, and therefore factor that into their estimations.

Further safety measures would include establishing one-way traffic flow into a stand with clearly marked entrances and exits. Dividers could be erected in any areas where visitors would likely find themselves close to each other or staff. PPE (e.g., face masks, shields, gloves, etc.) would be distributed to and worn by all staffers. Exhibitors should also consider touchless alternatives to physical engagement.

Organizers in turn should provide assistance, such as simple peel-and-stick floor decals for exhibitors to apply in their booth spaces in front of counters or other appropriate locations to communicate the proper distance for attendees to stand apart from each other. Show producers might also ration the lengths of time meetings between visitors and staff in booths could run. Last, organizers should schedule a mid-day break for booth and hall sanitization in order to visibly demonstrate their commitment to enhanced safety.

While state, county, or municipal health departments would be steering many of the parameters, of course, the IAEE's white paper set forth several suggestions that would affect everything from the ordering to the serving process. Specifically, its recommendations include posting menus electronically on a tablet or printing them out on single-use paper to minimize transmitting the virus (or other germs, for that matter) via the usual but riskier reusable plastic menus. The IAEE also encourages ordering by text message when available, which could allow customers to be notified electronically when their order is ready at a designated pick-up location, fashioning a contactless experience and cutting out wait staff who could be a vector for both receiving or transmitting the virus.

On top of those endeavors, masks should be worn by all employees who are involved with food service, including food preparers, servers, and cashiers. Abundant hand sanitizer stations must be available at all food areas entrances. Additionally, all food should be served individually wrapped, and items such as straws, condiments, and prewrapped cutlery must be single-use only to ensure maximum safety. Finally, seating should be arranged to reflect physical distancing standards.

Even though the CDC, WHO, and Mayo Clinic all state that there's no hard evidence people have contracted coronavirus from handling food, including fresh fruits and vegetables as well as food containers or food packaging, recent findings suggest it would be prudent to take proactive steps to prevent the chances of it anyway. Precautions outlined by the IAEE are informed by the experience of Chinese health authorities, who reportedly found genetic traces of the virus on refrigerated and frozen foods. The particular danger posed by these chilled exteriors is that the COVID-19 virus can last longer on cold surfaces. Findings from the Commonwealth Scientific and Industrial Research Organisation (CSIRO), Australia's national science agency, compared the virus's ability to survive different temps and substantiated that COVID-19 stopped being infectious within 24 hours on some surfaces at roughly 104 Fahrenheit/40 degrees Celsius, but lasted 28 times as long when kept at 68 degrees Fahrenheit/20 degrees Celsius, which is almost room temperature.

Admittedly, acquiring COVID-19 from food packaging is much less likely than obtaining it by receiving viral respiratory particles from someone who is currently infected. (First, an infected person would have to cough or sneeze on packaging, then someone else would need to touch that packaging while the virus was still active and then touch his or her own eyes, nose, or mouth.) However, given that the Bureau of Labor Statistics estimates there are 11.9 million people involved in the restaurant and food-service industry, the sheer number of individuals handling food warrants precautionary measures.

After notifying medical personnel, the ill individual should then be quarantined in a local medical facility or removed to a quarantine room located within the venue for further examination. At that point, the relevant medical authorities would decide on the amount of medical care needed, as well as when the guest in question should be sent home.

Despite the IAEE mentioning only "symptoms of acute respiratory illness," it does not necessarily exclude any of the other well-known signs of COVID-19 infection. These indications would include a combination of congestion, nausea, vomiting, diarrhea, sore throat, runny nose, and sudden loss of the ability to taste or smell. Should attendees with these symptoms report themselves to show organizers, it would possibly warrant a response similar to that of reporting severe respiratory complaints – that is, contacting the relevant medical and health authorities to further investigate.

Even though the white paper does not explicitly reference contact tracing in this context, it is likely that some form of the procedure would occur. Trained health-care personnel would methodically debrief infected persons on the physical locations they recently visited and the people they lately encountered to get a detailed sense of who else should be notified of potential exposure.

This decidedly visible cleaning during an event – a reversal of the customary cleaning after hours – is considered an essential part of building confidence among attendees that an organizer and a facility are enacting preventive measures. Once identified by a show producer, say, or a convention center, the objects and locations in question would then be evaluated for how often they need to be cleaned and with what appropriately effective materials. To this end, look for a venue's adherence to the recommendations set forth in the Environmental Protection Agency's (EPA) Emerging Pathogen Policy regarding disinfectants effective against COVID-19.

The greatest areas of concern for cleaning are the high-risk, aka high-touch, surfaces – e.g., handrails, door handles, and touchscreen monitors – and heavily trafficked areas such as registration and meeting rooms. Based on the latest research, these may pose a slightly greater health concern than previously thought. Researchers from CSIRO, the Australian national science agency, concluded that under optimum conditions COVID-19 can remain infectious on surfaces such as phone screens and stainless steel for as long as 28 days. (By comparison, the same test verified the influenza virus could survive for just 17 days.)

Beyond the above items, check for the use of electrostatic sprayers. First developed in the 1930s, these devices are useful in disinfecting large areas in far less time than would be possible using manual spraying and wiping methods. By electrically charging liquids (e.g., sanitizers and disinfectants) as they pass through a nozzle, the sprayers issue charged droplets that repel one another – that is, they don't clump together, thereby amplifying their overall efficiency in covering surfaces. Per the EPA, electrostatic sprayers should be paired with EPA-registered disinfectants and sanitizers. (For use against COVID-19, disinfectants on the EPA's List N should be chosen.) Currently, convention centers such as the Von Braun Center in Huntsville, AL, and the Greater Tacoma Convention Center are using the sprayers. What's more, major hospitality brands have embraced electrostatic sprayers for their properties, as evidenced though their official response to the pandemic, such as Hyatt Hotels Corp.'s Global Care and Marriott International Inc.'s Commitment to Clean programs.

The pandemic is likely to usher in a new era of what's being referred to as "clean tech," especially after a slew of such devices debuted at the 2021 International Consumer Electronics Show (CES). The coming year could witness everyone from live-event producers to individual exhibitors employing health-monitoring tech like BioIntelliSense Inc.'s BioButton, which measures users' heart rate, respiratory rate, and temperature to instantly alert them if they begin developing symptoms of COVID-19. The Wave Plus for Business Virus Risk Indicator from Airthings ASA could continuously monitor an entire event space by letting organizers know when variables such as room occupancy, ventilation rate, and the typical virus survival rate in the air raise the risk of virus transmission indoors to critical levels.

Each stall door, door handle, stool, and urinal must be spray disinfected. Hand-sanitizer stations should be placed at a restroom's entrance and prescriptive signage (e.g., "Remember to wash your hands for 20 seconds") prominently displayed. Show and venue management should also consider limiting the number of individuals who can use bathrooms at the same time, supplying plenty of paper towels and encouraging their use as air dryers can spread airborne particles.

Often ignored in the early research on ways COVID-19 is transmitted, restrooms have come to be seen as a crucial element in flattening the upward curve of the coronavirus. Part of the reason for this was that until recently, COVID-19 was not officially considered to be an aerosol. Earlier, the virus was known to spread through respiratory particles expelled by talking, coughing, sneezing, etc., with those bits traveling like missiles to another person, where they might propel into their eyes, lungs, or nose, possibly igniting an infection. Generally, however, many of the infected globules were thought to quickly fall to the ground after being expelled simply because of their relatively large size and heavy weight.

Newer research now indicates otherwise. Last July, 239 scientists published a commentary in the journal Clinical Infectious Diseases encouraging medical authorities to accept that the COVID-19 virus was an aerosol. Deeming the virus an aerosol meant the particles that can carry a COVID-19 infection could be smaller and lighter than usual and, as a result, be able to move farther or linger in the air for longer than assumed. A research team at the University of Florida succeeded in isolating live virus samples from aerosols collected at a distance of 7 to 16 feet from patients hospitalized with COVID-19 – much farther than the 6 feet recommended in social-distancing guidelines.

Laboratory studies conducted in idealized conditions by CDC scientists showed that the COVID-19 virus can exist in an aerosolized form for up to 16 hours. This makes bathrooms a greater potential vector of transmission. Even if smaller, enclosed spaces characteristically occupied by several people always posed a danger, such areas with infected aerosols would be even more unsafe. (A recent study of two hospitals in Wuhan, China, concluded that bathrooms contained the highest aerosol concentration of COVID-19.) And a study from City University of Hong Kong found that a single toilet flush can release up to 80,000 polluted droplets that can hang in the air for hours. This phenomenon, known as toilet plume, causes stool or urine particles to escape from the toilet in a kind of invisible cloud, then extend out into the surrounding air and spread disease.

The humidity setting in any indoor environment is often sidestepped, which may reflect its somewhat new and marginalized status at the moment. However, Stephanie Taylor, an infection-control consultant at Harvard Medical School, is advocating that companies that make sensors and humidifiers to improve air quality adopt guidelines around safe humidity levels. Specifically, she recommends that indoor humidity should be maintained somewhere between 40 percent and 60 percent, which is also the current recommendation of the EPA. The reason behind adjusting the humidity levels is twofold. First, the human immune system generally works better with higher humidity. For instance, the cilia that protrude from cells in respiratory system do not function as well in dry conditions, so they cannot repel viral particles as effectively as they otherwise would.

Second, the higher the humidity, the worse the virus itself fares. After evaluating 10 international studies on the subject of humidity and virus transmission, the Leibniz Institute for Tropospheric Research and the National Physical Laboratory in New Delhi concluded aerosol particles infected with coronavirus would have greater difficulty both in traveling far and being absorbed by nasal mucous membranes in settings with higher humidity. Another study, this time by researchers from the University of Sydney and the Fudan University School of Public Health in Shanghai, discovered that for every 1-percent decrease in relative humidity, there was a corresponding 7- to 8-percent increase in COVID-19 cases. As such, event organizers may wish to add another tool to their antiviral arsenal by requesting that meeting spaces of any size be set to a humidity between 40 percent and 60 percent.

In the context of events, this could conceivably include not using the broadly accepted best practices for cleaning, not executing a thorough temperature screening of attendees, or failing to react in a prompt fashion when attendees become ill with the coronavirus. To circumvent that possibility, the IAEE recommends diligently following as many safety protections – like those outlined in its paper – as possible in a transparent and accessible manner. Equally important, organizers should maintain a paper trail of digital and/or physical evidence of their safety measures. (A date-stamped video recording of the event space showing the various virus-mitigating steps is highly recommended.) That proof, once completed, should always be verified by at least one other person to ensure it is complete and accurate.

To date, litigation regarding COVID-19 has generated 1,573 lawsuits (including 137 class actions) filed against various employers due to purported labor and employment violations, according to the COVID-19 Labor and Employment Litigation Tracker. While many of these lawsuits have been lodged against entities such as landlords, nursing homes, and cruise lines, the sphere of defendants will likely expand to other businesses, including those related to the live-events industry.

Presently, approximately a dozen states (e.g., Georgia, Louisiana, and Utah) have passed legislation restraining COVID-19-connected civil liability for a wide array of businesses. On a larger scale, the U.S. Senate's proposed Safe to Work Act would address this current hodgepodge of state civil immunity laws. The bill's current legislative limbo is in part due to what some believe is a too-permissive stance toward defendants, where the existence of a published policy on a company's COVID-19-mitigation efforts might be sufficient to presume it had carried out reasonable efforts to prevent virus-related injuries.

Show organizers may find themselves particularly vulnerable to litigation, given the vast number of people and the enormous spaces necessary for exhibitions such as the International Consumer Electronics Show (CES) and the National Association of Music Merchants (NAMM) Show, which in their pre-COVID-19 iterations reached attendance of 170,000 and 115,000, respectively. Such expos would shoulder a huge logistical burden of multiple protective measures that would have to be carefully and consistently followed to be effective. As a supplement to the above, show organizers might consider waivers for attendees. Such voluntary relinquishment would shield show organizers from claims stemming from the contraction or spread of the disease. Event producers would have to carefully weigh the benefits of such a disclaimer versus the risks of antagonizing their attendees.