key: cord-0931659-rckn3pny authors: Mallhi, Tauqeer Hussain; Khan, Yusra Habib; Alotaibi, Nasser Hadal; Alzarea, Abdulaziz Ibrahim; Tanveer, Nida; Khan, Amjad title: Celebrating Eid-ul-Adha in the era of COVID-19 pandemic in Pakistan: potential threats and precautionary measures date: 2020-07-23 journal: Clin Microbiol Infect DOI: 10.1016/j.cmi.2020.07.019 sha: 6c006836df6432eaecbc020ae06df08b285a42a9 doc_id: 931659 cord_uid: rckn3pny nan To the Editor, Eid-ul-Adha is an annual religious festival observed by Muslims, expected to be celebrated in the early August this year, during which nearly 8 million animals are sacrificed in Pakistan [1] . However, celebration of this festival during the COVID-19 pandemic is quite challenging amid alarming resurgence of positive cases nationwide. In most of the Muslim countries, the animals slaughtering during the festive is controlled and confined to the limited places [2] . However, the pattern of animal slaughter changes in accordance to the various cultural and religious beliefs in Pakistan. These changes include factors such as transport of animals for sale from rural to urban areas, little regulation of animal sales, advanced purchase of animals, freelance and non-professional butchers, slaughtering of animals in public areas, gathering of spectators around the butcher to watch the slaughter, and in-house social gatherings [1] [2] [3] . Since celebration of the festive cannot be cancelled amid religious obligations, we felt inclined to share potential threats that could lead to a sharp spike in COVID-19 cases during the preparation of the Eid-ul-Adha. The travelling of cattle farmers from rural to urban areas for selling their animals is a common practice before Eid-Ul-Adha in Pakistan. These farmers sell their animals directly to the purchasers at designated markets. However, many of them move around the city for selling at roadside or in commercial and residential areas. These traders along with leftover animals move back to their hometowns immediately after the festive [4, 5] . Currently, Pakistan is experiencing unprecedented rise in COVID-19 cases which are primarily confined to the urban areas. Since approximately 64% population of Pakistan is rural, such widespread rural-urban-rural migratory activities may further deteriorate the situation in the country by facilitating the disease transmission to COVID-19 free regions. Keeping in view the low literacy rate in rural population, the containment of COVID-19 would be a great challenge for the health authorities and may result in a sharp rise in cases. Another challenge during this festive will be the congested animal selling points which could serve as potential source of disease spread (Figure 1 ). Since government of Pakistan allows limited livestock markets on the outskirts of the cities, thousands of people rush to these places resulting in congestions and crowds. Moreover, these markets lack compliance with the safety and health protocols amid low literacy among the animal handlers. These factors may facilitate the human to human disease transmission and subsequent spillover to the rural areas. Moreover, due to the limited healthcare and administrative facilities in the rural areas, implementation of preventive measures would be difficult or even impossible to persuade. We believe that Eid-ul-Adha poses logistic challenges and requires effective planning to avoid any possible catastrophe. Keeping in view the high risks of disease spread during the festive, we felt inclined to share few suggestions to avoid any possible surge in COVID-19 cases. • The potential risks of COVID-19 spread during the Eid-Ul-Adha must be communicated to the public in timely and effective manners through electronic media in-order to create the sense of responsibility. • Online purchase will be an effective approach during the current health crisis. Various websites in Pakistan provide facilities for online purchase through which people can choose the animals which are delivered at their doorsteps. Alternatively, purchasers can also request to slaughter the selected animals on their behalf and meat will be delivered at their addresses. Encouraging people for this practice will help in reducing the crowds in the cattle markets, thereby facilitating the movement control measures. • Livestock markets should be limited to the designated places. Administrative authorities should monitor illegal cattle markets that spring up inside cities and towns. Moreover, the principles of social distancing must be ensured during the purchase. The provision of sufficient space for animals, availability of face masks, gloves, and hand sanitizers should be mandatory in the markets. • In-house slaughtering of animals by non-professional butchers is a common practice in Pakistan due to convenience. Prohibition of such activities and limiting the sacrifice to the slaughterhouses will control the movement of people and spectators during the festival. Many Muslim countries have confined the slaughtering at designated places in the presence of veterinarians in-order to combat Crimean-Congo hemorrhagic fever [2] . • A systematic educational campaign on precautionary measures such as social distancing and the use of protective equipment should be considered for the staff at abattoirs. • Animal traders should be encouraged to practice self-quarantine for at least fourteen days before going back to their hometowns. Moreover, post-festival surveillance programs needs to be in place for timely identification of variation in pattern of incident cases. As the COVID-19 pandemic is ongoing, health authorities must remain on high alert while special measures should be taken for aggressive surveillance during the festival. The government must refocus their energies and provide sufficient finances in-order to implement the controlling measures during Eid-ul-Adha. Financial Disclosure: None Crimean-Congo haemorrhagic fever virus and Eid-Ul-Adha festival in Pakistan. The Lancet Infectious Diseases Consensus report: preventive measures for Crimean-Congo hemorrhagic fever during Eid-al-Adha festival Surveillance of Crimean-Congo haemorrhagic fever in Pakistan. The Lancet Infectious Diseases The reasons why Pakistan might be at high risk of Crimean Congo haemorrhagic fever epidemic; a scoping review of the literature Commentary: Surveillance of Crimean-Congo Haemorrhagic Fever in Pakistan. Frontiers in public health