Doctors in FIFA World Cup cities worry about ER capacity, strain on health system

TORONTO — Doctors in Canada’s FIFA World Cup host cities say they’re concerned the already strained health-care system will buckle if a sudden, unexpected surge slams emergency departments during the games.

Dr. Catherine Varner, an emergency medicine physician in Toronto, wrote an editorial in the Canadian Medical Association Journal Monday raising concerns about vulnerabilities in the health-care system that she says need to be addressed before more than 300,000 soccer fans set foot in Toronto and Vancouver in June.

Both cities have hosted mass gatherings in the past. Local and provincial public health officials are actively anticipating health risks, with Public Health Ontario flagging measles, food-borne illnesses and COVID-19 as potential concerns. Toronto and Vancouver also have wastewater surveillance systems set up to detect infectious disease outbreaks during and after the World Cup.

But Varner said it’s the anticipation of unexpected events that gives her chills when she walks into a night shift while the city is rowdy, and the hospital is running at 100 per cent capacity, or above.

During Games 1 and 7 of the MLB World Series, Varner said she saw a surge in trauma, alcohol and substance-use-related visits in the emergency department. But stitching a person’s head from a bar brawl is not what stuck with her.

“That’s expected and it’s well documented. The challenge was thinking about an urgent need for a lot of hospital beds. In my hospital that night, there was only one ICU bed available,” she said.

She contemplated what might have happened if there had been a crisis at that moment. “I don’t know where we would have decanted our emergency department patients,” she said.

Varner referenced the fire on New Year’s Eve at a bar in Switzerland as an unexpected event that overwhelmed the closest hospital, as several dozen badly burned patients required emergent care.

“I can’t think of a hospital right now in downtown Toronto that could take on 80 patients all of a sudden,” she said.

Toronto emergency physician Dr. Raghu Venugopal said it doesn’t take much to imagine the cascade effect that a tragic, hypothetical event such as a stadium bleacher collapse would have on local hospitals.

“Multiple broken bones. Internal organ injuries. Hospitals overwhelmed. ORs need to be activated and you need beds. We don’t have beds,” he said.

Even on a “boring” Friday afternoon, he said they don’t have enough beds for an 84-year-old patient with RSV who is left on a hospital gurney in the hallway.

“So, why would we have the capacity at a global event?”

As medical director of the Vancouver Infectious Diseases Centre, Dr. Brian Conway said measles is his main concern. A measles outbreak infected more than 80 people after the Vancouver Olympics in 2010.

Since then, measles vaccination rates have declined in Canada, and the contagious illness has resurfaced, with ongoing outbreaks, he said.

“My concern might be that someone has paid thousands of dollars for tickets, for a hotel room and so on, and gets told by a public health official here in British Columbia, that they need to isolate in their hotel room for a week or 10 days, and they would … potentially look for a reason not to do that,” Conway said, referencing the challenge of asking an international fan to isolate if they are exposed to measles.

Public Health Ontario published a risk assessment document last week to advise Ontario’s government, public health organizations and health providers, who are responsible for high-quality health care during the games.

Measles, food-borne illnesses and COVID-19 were ranked as moderate health risks for the games.

They recommend monitoring epidemiological trends before FIFA, planning for potential surge capacity for outbreak activities and public health investigations, and considering the feasibility of enhanced surveillance during the tournament.

The report also acknowledges there is always general uncertainty of what the global and local epidemiological trends will look like months from now and recommends health officials re-evaluate risks closer to June.

During the pandemic, hospital staff and administrators communicated with one another to maximize critical care resources at a time when every intensive care bed was needed.

Many of those protocols have continued, and Varner said hospitals should band together in advance of anticipated surges.

“Let’s plan early so that we’re not doing it on the fly in the middle of the night trying to figure out how best to provide care for a patient when we don’t have the resources available.”

This report by The Canadian Press was first published Jan. 19, 2026.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Hannah Alberga, The Canadian Press