The annual Sturgis motorcycle rally in South Dakota is America's largest bike rally, a 10-day blowout, with attendance this year exceeding 250,000. It was also a serious pandemic stress test. By bringing together hundreds of thousands of people, Sturgis helps answer a simple yet critically important question: Are we at a point in the pandemic where we can safely stage big-crowd events?
If there were a place where this could have happened, it should have been Sturgis. The best data suggests that at least 75% of the entire South Dakota population has some degree of immunity against the virus: About half of South Dakotans have immunity because they've been infected by COVID-19, and about half of the population has been vaccinated — some of whom have already had COVID-19 when they got their shot, so there is some overlap between these two groups. South Dakota, despite its middling vaccination rates, probably has among the highest levels of population immunity in the nation, driven largely by horrifying winter outbreaks.
That's what makes Sturgis an important test. If it had gone off without big spikes in COVID cases, it would have provided strong evidence that this level of population immunity — around 75% — would allow us to get back to the way we did things in 2019. But unfortunately, that's not what happened. In the weeks since the rally began in early August, infection numbers have shot up more than 600% in South Dakota. We can expect to see big increases in other states, too, since bikers returned home from the event. Last year, after Sturgis, we saw massive outbreaks across the Dakotas, Wyoming, Indiana, even Nevada. Much of the region was aflame because of Sturgis, probably causing thousands of deaths.
Does the large Sturgis outbreak this year mean we can't stage large gatherings? The answer affects things far beyond bike rallies: music festivals, state fairs, large concerts and so much more. The good news is that the outbreak doesn't have to mean we rule all of that out. We can begin to get things back to a new normal. And here we can look to other examples where high levels of vaccinations or other tools helped prevent a lot of illness and death.
The first example is what happened in Provincetown, Mass., over the July 4 weekend. Provincetown unfortunately also led to a spike in cases — but the infection numbers peaked quickly, dwindled and were gone three weeks later. There were very few hospitalizations and no deaths. Why? Because most of the people in Provincetown were vaccinated. That may be an indicator that population immunity from vaccinations is better and more protective than immunity from infections.
Consider also this summer's Lollapalooza music festival in Chicago. All those attending were required to provide proof of vaccination or a negative coronavirus test. Anyone unvaccinated was required to wear masks throughout, even though the festival was outdoors. And those attending were asked to accept a "Lollapalooza Fan Health Pledge" promising they had not tested positive or been exposed to COVID within two weeks or experienced any COVID symptoms within 48 hours. The result? Of the hundreds of thousands of fans who attended the festival, only a few hundred have subsequently tested positive — and it is unclear whether any of them were infected at Lollapalooza.
Eighteen months into the pandemic, we've learned that outdoor gatherings are reasonably safe — it's the indoor activities that invariably follow that are deadly. At Sturgis, it is unlikely that the outdoor bike rallies were a problem. Most of the spread likely happened in the evenings, when people crowded into bars and restaurants, most unvaccinated, all unmasked. Large gatherings that work on keeping indoor spaces safe through vaccinations, masking, ventilation and other techniques can keep the entire gathering safer.
Over the past year, every time we have tried to defy the virus by scorning precautions, the virus has won, and people have suffered and died: significant outbreaks, a lot of hospitalizations, too many deaths. Large gatherings like rallies, festivals and fairs are the biggest test of what our society can do in a pandemic.
The simple interpretation of the large outbreak after Sturgis is that big gatherings are just not possible during a pandemic. But that is the wrong lesson. It's important for Americans to find ways to come together. So we should ask how we can make gatherings safer.
Here, the pandemic playbook is straightforward: Ensure you have a highly vaccinated population. Verify people's vaccination status. Require rapid and frequent testing, especially for the unvaccinated. Improve indoor air quality, and use masking intermittently when needed.
None of these are difficult to achieve. And none of them should be particularly inconvenient. If we do all that, we can safely get back to the things we love and the events that bring us together, like music festivals, concerts and motorcycle rallies.
Ashish K. Jha is a physician, health policy researcher and the dean of the Brown University School of Public Health.