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Habibisaravi R, Khankeh H, Hosseini S H, Aghaei N, Hadinejad Z, Ghasemihamedani F et al . Risk Assessment of COVID-19 Transmission During the Arbaeen Mass Gathering in 2025. Health in Emergencies and Disasters Quarterly 2026; 11 (4) :303-310
URL: http://hdq.uswr.ac.ir/article-1-749-fa.html

Background: Mass gatherings pose significant public health challenges due to the potential for infectious disease (ID) transmission. The Arbaeen religious event is among the largest annual gatherings worldwide. Although COVID-19 is less of a global concern, the emergence of new variants and regression in preventive behavior necessitate a risk reassessment particularly for high-density events like the Arbaeen ceremony.
Materials and Methods: A cross-sectional, expert-based study was conducted in 2025 using the latest version of the WHO COVID-19 mass-gathering risk assessment tool (2022). The participants included 98 experts in epidemiology (EPI), IDs, and disaster and emergency health from Iranian medical universities. The final risk score was derived through consensus and scoring matrices.
Results: Out of 98 respondents, the mean age was 49 years; average work experience was 19 years. The overall risk level for Arbaeen 2025 was categorized as “very high” in EPI and health in disaster and emergency (HDE) and “medium” in IDs. The mean risk evaluation scores were 5.48±0.38, 5.73±0.22, and 6.37±0.36, respectively. Risk mitigation indices showed inadequate preparedness in EPI (22.1±3.6) compared with IDs (55.3±12.3). The overall risk level across all specialties was estimated as “high”. 
Conclusion: Arbaeen 2025 poses a substantial risk of COVID-19 resurgence. Despite increased societal tolerance, proactive risk communication, cross-border coordination, and targeted control strategies are urgently needed.