When the World Cup Kicked Off, Pediatric Emergency Rooms Quietly Emptied

When Argentina and France walked out onto the pitch in Lusail for the 2022 FIFA World Cup final, emergency physicians in Switzerland were watching a different kind of scoreboard. In the pediatric emergency departments of two of the country’s largest hospitals, the usual winter stream of coughing children and anxious parents had slowed to something noticeably thinner than expected. A new retrospective multicenter study, published in BMC Health Services Research, suggests that the tournament’s live broadcasts were associated with a subtle but measurable reshaping of when and how families sought emergency care for their children during one of the busiest respiratory virus seasons in recent memory.

The research, led by Delphine S. Courvoisier, Denis Mongin and Johan N. Siebert of the University Hospitals of Geneva and the University of Geneva, together with colleagues at Lausanne University Hospitals, set out to answer a question that health services researchers rarely get to test so cleanly: what happens to emergency department attendance when a major sporting event captures the attention of an entire population? The 2022 World Cup, held in Qatar from November 20 to December 18, offered an unusual natural experiment. It coincided precisely with an early and severe surge of respiratory syncytial virus and other winter pathogens that had already pushed pediatric emergency services across Europe toward capacity, making any shift in attendance patterns clinically meaningful rather than merely statistically interesting.

The team analyzed electronic medical records from two tertiary pediatric emergency departments, in Geneva and Lausanne, covering the months of October through December in both 2021 and 2022. The 2021 window served as a control period without a World Cup, allowing the researchers to account for the baseline rhythm of a respiratory virus season. In total, the study captured 16,889 visits in 2021 and 19,566 in 2022, a substantial year-on-year increase in overall attendance that reflected the intensity of the 2022 viral surge. The primary outcome was the visit rate during match windows, while a secondary outcome was the proportion of children who left without being seen, a widely used indicator of emergency department crowding and patient frustration with waiting times.

One of the study’s methodological strengths lies in how it handled the comparison. Rather than simply counting visits on match days, the researchers calculated a standardized visit rate: the share of a given day’s total visits that occurred during the hours when matches were being broadcast. This normalization matters because overall attendance fluctuates with the severity of the viral season, the day of the week and countless other factors. By expressing match-window activity as a proportion of daily activity, the analysis isolated the temporal redistribution of care from the raw seasonal trend. Differences between game and nongame periods in the two years were assessed using permutation tests, a nonparametric approach that makes no assumption about the underlying distribution of the data and is well suited to the irregular, event-driven structure of the comparison. The results were stratified by the Canadian Triage Acuity Scale, the five-level triage system in which CTAS 1 denotes resuscitation and CTAS 5 denotes the least urgent cases.

The findings were consistent in direction across acuity levels: during match windows, the standardized proportion of visits either remained stable or decreased. The effect reached statistical significance for children triaged at CTAS levels 2 and 3, the urgent and emergent categories that include many of the febrile and respiratory presentations dominating the winter surge. In 2021, such patients accounted for 12.5 percent of daily visits occurring in the corresponding time windows; in 2022, during the World Cup, that figure fell to 11.2 percent, a difference the authors report as statistically significant with a p-value of 0.002. In other words, even the families of moderately to severely unwell children appeared slightly less likely to arrive at the emergency department while a match was on screen.

The second key result concerned the children who did come but gave up before being evaluated. Left-without-being-seen rates are a sensitive barometer of emergency department strain, because they rise when waiting rooms overflow and fall when the system has breathing room. Among low-acuity patients triaged at CTAS levels 4 and 5 who presented during match time, the proportion leaving without being seen dropped significantly, from 15.2 percent in the comparison period to 10.1 percent during the tournament, with a p-value of 0.018. The interpretation offered by the researchers is that fewer competing attendances during broadcasts eased pressure on the departments, shortening waits for those families who did seek care and making it more likely that they stayed to be seen.

The dose-response character of the effect strengthens the case that television audiences, rather than some unrelated seasonal quirk, drove the pattern. When the analysis was restricted to matches with at least 300,000 television or online viewers in Switzerland, a threshold that captures the games most likely to command national attention, the observed differences became more pronounced. This gradient, in which bigger audiences corresponded to larger shifts in attendance and lower abandonment rates, is exactly what one would expect if the mechanism were a temporary reallocation of families’ time and attention toward the broadcast. The authors also constructed emulated control windows during the tournament period itself, of the same length as actual matches but outside broadcast hours, and used permutation testing with 1,000 samplings to generate the null distributions against which the observed differences were judged.

The study was retrospectively registered at ClinicalTrials.gov on April 18, 2023, under identifier NCT05818215, and the authors are careful about what their results do and do not show. This was an observational analysis of routinely collected, fully de-identified data, and the Geneva Cantonal Research Ethics Committee determined that it fell outside the scope of the Swiss Human Research Act. Association, not causation, is the appropriate frame: the World Cup did not demonstrably reduce the total burden on pediatric emergency care, and overall attendance in 2022 was in fact higher than in 2021. What changed was the timing and distribution of visits within the day. The authors describe the effect as a temporary change in the pattern of health care seeking rather than a reduction in overall or low-acuity attendance, a distinction that matters for anyone hoping to translate the finding into policy.

Even so, the implications are intriguing for emergency medicine. Pediatric emergency departments in many countries chronically operate at or beyond capacity during winter viral surges, and interventions to smooth demand are scarce. The Swiss results hint that even passive, unplanned events that hold a population’s attention can measurably relieve pressure during specific hours, and they raise the speculative question of whether hospitals could anticipate and plan around the broadcast schedules of major sporting events, adjusting staffing or public communication accordingly. The finding that left-without-being-seen rates fell among low-acuity patients during matches is particularly relevant, since those departures represent both a safety risk and a signal of system stress. A temporary dip in walkaways, even one produced by a football tournament, illustrates how sensitive attendance dynamics are to factors entirely outside the health system.

The research also adds to a small but growing literature on the health services effects of major sporting events, a field in which most attention has traditionally focused on injuries, alcohol-related harm and mass gatherings rather than on the quiet epidemiology of who stays home. By exploiting a well-defined exposure, a precise temporal window and a concurrent viral surge that pushed baseline demand to its limits, the Geneva and Lausanne team has produced one of the cleaner demonstrations that population attention can shift emergency care-seeking in real time. As the authors conclude, the World Cup period was associated with a lower standardized proportion of urgent visits and a reduced rate of departure before evaluation, effects that were strongest for the most widely watched matches. For pediatric emergency physicians bracing for the next winter surge, the message is a curious one: sometimes the most effective crowd management arrives not from the hospital, but from the television schedule.

Subject of Research: The association between 2022 FIFA World Cup broadcasts and pediatric emergency department attendance during a winter respiratory virus surge

Article Title: Association between the 2022 FIFA world cup and pediatric emergency department attendance during a winter respiratory virus surge: a retrospective multicenter study

Article References: Courvoisier, D. S., Mongin, D., Buclin, C. P., Salomon, C., Angoulvant, F., Wagner, N., Sahyoun, C., Gualtieri, R., Lacroix, L., Manzano, S., & Siebert, J. N. (2026). Association between the 2022 FIFA world cup and pediatric emergency department attendance during a winter respiratory virus surge: a retrospective multicenter study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15655-z

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15655-z

Keywords: pediatric emergency medicine, FIFA World Cup 2022, emergency department crowding, left without being seen, respiratory syncytial virus, triage, health services research, sporting events, health care utilization, Switzerland, retrospective study, winter virus surge