Michelle Murti, Toronto’s Medical Officer of Health, says that during the World Cup, the city will expand the viruses it tracks to include mpox, norovirus and measles.Fred Lum/The Globe and Mail
The full-scale exercise mirrored the real-world nightmare still fresh in the minds of first responders: a vehicle plowing into a crowd at a busy festival.
Only this time, the victims were trained role players and the festival was the future site of Vancouver’s World Cup fan zone. A multi-agency team of health, safety and emergency management officials orchestrated the simulated mass-casualty event to evaluate the city’s response to a worst-case scenario.
Police cordoned off the area as paramedics and firefighters rushed in to triage patients and assess injury severity. BC Emergency Health Services notified local health authorities which in turn activated a co-ordination centre to determine which hospitals had capacity. Ambulances transported the injured.
Hours later, a simulated heat alert was issued for the Vancouver region, prompting public-health officials to advise municipalities to activate their heat plans. The local health authority issued a mock information bulletin to the media.
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The full-day exercise, which took place in mid-April, offers a window into how host cities are preparing for the health risks posed by the mass gatherings the World Cup will bring. With Vancouver and Toronto each expecting more than 300,000 visitors and hosting a combined 13 matches, health and emergency officials have spent years working in close co-ordination to plan for a range of scenarios, from infectious disease outbreaks and heat waves to mass-casualty events and other complex emergencies.
Preparation began soon after Vancouver and Toronto were named as host cities in 2022. Both of them established tournament-specific integrated safety and security units consisting of representatives from health agencies, emergency response, law enforcement, government and World Cup-related venues.
Vancouver Police Deputy Chief Don Chapman, co-chair of the city’s integrated safety and security unit, said the group’s years of planning began with regular meetings and tabletop exercises and culminated in April’s simulation, which involved more than 200 police officers alone.
They drew lessons from real events, bolstering vehicle mitigation strategies after the Lapu-Lapu Day vehicle-ramming attack in Vancouver in April, 2025.
“I think you’ve seen, probably, around the city, at all our different events unrelated to FIFA, mitigation measures taking place,” Deputy Chief Chapman said. “It’s something we’ve been very cognizant of, obviously in and around the stadium, definitely in and around the fan fest, and we’re looking at it for secondary sites as well.”
Mark Lysyshyn, public health planning lead for the FIFA World Cup in Vancouver, said risk assessments identified potential health hazards such as a heat event, food-borne illness and substance-use-related issues. Such scenarios are neither new nor specific to the tournament, but will require co-ordinated planning to ensure World Cup activity doesn’t impede established protocols, he said.
Mark Lysyshyn, who leads public health planning for the FIFA World Cup in Vancouver, says his group has clarified lines of responsibility for potential health emergencies after reviewing plans developed for the 2010 Winter Olympics.ETHAN CAIRNS/The Globe and Mail
Dr. Lysyshyn said the region doesn’t typically see increases in health care utilization during large mass-gathering events unless a complex emergency occurs.
“Really, the only major example we’ve had of that is the Stanley Cup riots, where things were fine until they’re not fine – and then when they’re not fine, it’s complex and it requires co-ordination,” he said.
The group dusted off worst-case scenario plans developed for the 2010 Winter Olympics and clarified lines of responsibility. In a chemical event, the fire department would lead; in a biological one, public health; and in a radiological or nuclear incident, provincial and federal authorities.
Sub-working groups focused on specific topics, such as family reunification after an emergency – a task the health care system doesn’t typically handle, Dr. Lysyshyn said.
The World Cup is expected to increase infectious disease risks, with international visitors, large crowds and close proximity facilitating spread. In a risk assessment completed May 1, the Public Health Agency of Canada warned of a high risk of measles transmission during the tournament, and a moderate risk for mpox.
In Toronto, which routinely tests waste water for COVID-19, influenza and respiratory syncytial virus (RSV), the city’s public-health unit has partnered with the University of Toronto and Toronto Metropolitan University to expand surveillance.
Michelle Murti, Toronto’s Medical Officer of Health, said the city will conduct targeted waste-water monitoring around BMO Field, the fan festival and athlete training sites three to five days a week. It is also expanding the viruses it tracks to include mpox, norovirus and measles.
“We chose things that we could action right away, so if we detected it, there’s going to be very specific public-health action during that time period,” Dr. Murti said.
An uptick in mpox signals would trigger public messaging campaigns about risks and vaccine availability, she cited as an example.
The BC Centre for Disease Control, which runs a waste-water surveillance program, will similarly increase sampling to three times a week, from once a week, at treatment plants for Vancouver, Richmond and Surrey during the World Cup, Dr. Lysyshyn said. Samples will be tested for COVID-19, influenza A/B, RSV, norovirus, measles and mpox.
Waste-water testing can be a valuable tool in flagging the presence of a virus before people develop or recognize symptoms of an infection. At Vancouver’s 2010 Winter Olympics, two visitors brought two different strains of the measles virus, resulting in an outbreak of more than 80 cases that was not detected until the weeks after the closing ceremony.
Related: Vancouver outlines police deployment, road closures as it gets set for FIFA World Cup
To combat food-borne illness, Toronto has also launched a new food vendor portal to streamline how vendors register, share food safety plans and communicate with public-health officials during major events, Dr. Murti said. The system, designed as a legacy tool, will also help track vendors and respond more quickly to food-borne illness outbreaks.
All food vendors authorized to operate at Toronto’s World Cup fan sites are required to register for the food safety portal; Toronto Public Health is considering expanding the requirement to other events in the future.
In 2013, more than 200 people fell ill after eating a “cronut” burger – a cheeseburger with a hybrid croissant-doughnut bun – at the Canadian National Exhibition. A Toronto Public Health investigation determined that a maple-bacon jam atop the sandwich had been contaminated with Staphylococcus aureus.
To promote sexual health, Toronto Public Health will also be distributing 250,000 “soccer-inspired” condoms, along with other safer sex supplies.