Ad hoc organization relies on creativity, ‘scrappy’ funding to monitor public health during World Cup

Soccer footwork

Bernie Zimmermann / Flickr cc

While scanning social media, Katelyn Jetelina, PhD, MPH, noticed a lot of people talking about gastrointestinal symptoms in the Seattle area, one of the North America host cities during the 2026 FIFA World Cup. 

“We’re like, ‘Oh that’s weird. There’s an uptick of people chattering about this,’” Jetelina, the CEO of Your Local Epidemiologist (YLE), told CIDRAP News. “We gave that to the wastewater people at HSCO [Health Security Operations Center], and lo and behold, there was a very big spike of adenovirus around the Seattle area. Then we handed that over to the local and the state public health departments.” 

Jetelina—who is harnessing social media to spot infectious disease signals through YLE’s Project Stethoscope—is one of the almost two dozen experts working with HSOC to bolster public health efforts during the World Cup. It’s the largest soccer tournament in FIFA’s history, with more than 100 matches in 16 cities across the United States, Canada, and Mexico. 

Rebecca Katz, PhD, MPH, director of the Center for Global Health Science and Security at Georgetown University, came up with the idea for HSOC, a partnership between Georgetown and MedStar Health, while observing public health planning leading up to the World Cup, which started June 12 and lasts until July 19.

“I was very carefully watching where the preparedness efforts were and realizing… that this was going to be complicated. Fairness wasn’t quite what we thought it would be,” she said. “That was the origin of the idea.” 

Every day, HSOC releases a situation report and hosts stand-up calls that address public health risks near host cities and base camps for competing teams. Along the way, staff have added new data, such as those from a tracker for airport exposures, to the reports. 

When HSOC finds public health signals such as increased talk of stomach troubles on social media and adenovirus in wastewater in Seattle, the team alerts local public health officials. “They were very responsive and looked into it,” Jetelina said. “That’s the reality of public health. It’s a team sport, and that’s why HSOC is here to help—to help make others’ lives easier.” 

New approaches to detect public health flares

HSOC is using monitoring tools, such as wastewater surveillance and Project Stethoscope, to look for potential public health flares across North America during the World Cup. 

“We really bring in what we learned during COVID,” Jetelina said. “You have an academic institution like Rebecca’s, a private company like mine. You have us helping coordinate and working with public health departments—really all of us at the table for one goal.” 

HSOC analyst looking at data
Georgetown University

Jetelina credits Katz with encouraging creative approaches to public health, such as social listening, which includes “community insights data… concerns and confusion [that] we’re hearing from the ground.” 

Then Jetelina shares that data with HSOC and local public health officials. “That’s been really, really fun and innovative to integrate with traditional sources,” she said. 

Employing newer technologies during the World Cup allows Katz and her colleagues to learn more about these tools and share how they can benefit public health in the future. “Because it hasn’t been used at scale, there’s no great playbooks on what to do with wastewater signals,” Katz explained. “We are building a library of case studies in real time.” 

Patching together research funds, donations

To support HSOC, Katz had to be resourceful with the budget. She is not receiving any federal funding for the group’s work. “The finances behind this—we’re just going to call them scrappy,” she said. “This is being creative and figuring out how to make things work.” 

She’s patched together a budget from her research funds, money from foundations such as Pax sapiens, the partnership with MedStar, and in-kind data donations from private-sector organizations such as Verily, Biobot, SecureBio, YLE, and Wastewater Scan. 

“Because they believe in what we’re doing, they’re providing us direct access to their data,” Katz explained. 

Currently, 22 people work in the HSOC. “It’s fair to say that everybody working at HSOC is being compensated, although probably undercompensated,” Katz said. “There’s a bit of commitment to the effort and willingness to do the work, even for the amount of funds we were able to pull together.” 

Federal organizations are also observing public health signals during the World Cup, including tasks forces at the Centers for Disease Control and Prevention (CDC), the Department of Homeland Security, and the Department of State, Katz said. 

That’s the reality of public health. It’s a team sport, and that’s why HSOC is here to help—to help make others’ lives easier.

Katelyn Jetelina, PhD, MPH

But recent budget cuts and staff reductions could mean less robust efforts. “I was at the CDC,” Jetelina said. “I was very looped in the reality that resources and workforce and money and coordination and collaboration have all been hit in the past 18 months.” 

For those working with HSOC, “it is a moment to think through: How can we help fill gaps? How can we help… complement, and support local, state, and federal health?” she added. 

Much of host cities’ funding went to public safety

Host cities received money to manage the mass gathering at the games, yet much of it has been dedicated to public safety. Through the FIFA World Cup Grant Program, the Federal Emergency Management Agency (FEMA) awarded $625 million to the 11 host cities to bolster their security capabilities. FEMA provided an additional $221 million for cities to protect against “drone threats,” according to the FEMA website.  

Public health departments in host cities could apply for funding from the grants. Seattle and King County’s World Cup organizing committee dedicated $725,000 to public health, according to Kate Cole, communications specialist at Public Health-Seattle and King County. 

The money pays for overtime and temporary staff salaries to manage extra visitors and any disease outbreaks. Massachusetts allocated $310,800 to public health, according to a press release from Gov. Maura Healey. Los Angeles received $961,424 for its public health efforts during the World Cup, Politico noted. 

The money went only to host cities, but other locales are home to base camps and tourist sites that fans visit. Those cities are without extra support to boost their public-health capabilities. 

Take Providence, Rhode Island. The Ghanese soccer team settled there as a base camp, but many Scottish fans stayed in the city because they could find cheaper accommodations than in Boston. This is exactly where HSOC fills in the gaps. 

“You have situations like that where you have huge influxes of people but maybe not in official locations,” Katz said. “We have feeds coming in from all over the country. Actually all over the continent, really.” 

Sustaining HSOC’s efforts

Monitoring so many locations allows HSOC to alert base camps or tourist sites if they spot a potential public health risk. “Our entire approach has been more of a population health approach with a focus on where you’re seeing the largest gatherings but also acknowledging that there’s more than just the official sites,” Katz said.

Rebecca Katz looking at public health data
Rebecca Katz
Photo: Georgetown University

Katz hopes that HSOC can use what it has learned from the World Cup to continue monitoring public health signals in the future. She expects that she would need 10 to 12 people to staff HSOC during times with no mass gatherings or disease outbreaks and 20 to 25 for “full activation.”

Katz continues brainstorming ways to fund HSOC for ongoing surveillance and special-event monitoring, such as for the 2028 Los Angeles Summer Olympics and Paralympics. “My background stress is trying to figure out what’s the best way that we sustain the effort,” she said. “I want to be able to keep it going. I have to figure out what that looks like.” 

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