Hajj is one of the largest mass gatherings (MGs) of Muslims hosted by the Kingdom of Saudi Arabia. Muslim pilgrims perform Hajj from the 8th to the 12th of Dhul-Hijja annually in the city of Mecca and visit the city of Medina. Over 2 million Muslims perform Hajj every year. Though pilgrims stay together to perform rituals for a period of five days, most of them spend three to six weeks in Mecca and Medina before and/or after the Hajj. During and after the Hajj rituals pilgrims come in close proximity to each other.
Pilgrims from various nationalities, their close proximity, and intense congestion during the Hajj period may have several threats to pilgrims including crowd crush, sunstroke, skin infections, recurrence of medical issues, and contagious transmissible diseases. During the 2000 and 2001 Hajj pilgrimages, outbreaks of invasive meningococcal disease (IMD) occurred and led to the global spread of the responsible strain.
Respiratory tract infections may frequently occur and spread due to crowds, close proximity during rituals and shared accommodation in tents in Mina. The emergence of the severe acute respiratory syndrome coronavirus-1 (SARS-CoV-1) in 2002 and of the Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 raised concerns about public health, and fortunately, these two viruses did not cause outbreaks during the Hajj.
The emergence of SARS-CoV-2 (COVID-19) led to the disruption of international travel and cancellations of various MGs including Hajj 2020. The 2020 Hajj was extraordinary with no international pilgrims and very few selected individuals with extreme levels of monitoring before and during Hajj. In 2021 a limited number of pilgrims performed Hajj with SOPs and complete monitoring. However, in 2022 KSA has lifted restrictions on Umrah and 1 million pilgrims will perform Hajj.
The risk of a resurgence of the COVID-19 outbreak with the currently spreading variants of concerns (VOC) strains or new emergent variants and respiratory tract infections during the 2023 Hajj is a possibility. After experiencing the pandemic Covid-19, reducing the chances of infection spread is the top priority of every person. People look for a permanent and effective solution.
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