Is Canada’s healthcare system ready for a worst-case scenario disease spread during the World Cup?

As thousands get ready to gather in Toronto and Vancouver for FIFA, public health experts say the events could spread illnesses. Kamil Karamali reports.

While both Toronto and Vancouver brace for roughly 300 thousand visitors to flood into their cities in less than a month for the FIFA World Cup, Canada’s health agency is warning of a “high risk” of measles spread from the domestic and international tourists that will be mingling for the matches in the two cities. Doctors are warning about what that could do to an already overburdened healthcare system, should a worst-case scenario take place.

“I think the challenge as somebody who works in the system now, with the worst-case scenario, is that the system is already operating at a 100 per cent capacity,” Gerald Evans, medical director of infection prevention and control at Kingston Health Sciences Centre told CTV News Saturday. “In the event of a major outbreak… that can really overwhelm the healthcare system hugely because we’re already working at one hundred percent capacity.”

“Even with all the preparations that you’d have at the first responder level, where you’ve got plenty of paramedics – they’re delivering to the hospitals,” Evans said. “(And) the hospitals are overwhelmed and are full of people already. So, emergency departments and other places like that are really going to be completely overwhelmed.”

The Public Health Agency of Canada examined 14 infectious disease pathogens with the potential of spreading during the global event and found that two had a “higher likelihood” of being imported and widely transmitted, with measles deemed as “high risk” and Clade Ib Mpox virus, formerly known as monkeypox listed as a “moderate risk.”

The agency listed all others, like poliovirus and Ebola virus, having a low or negligible risk.

“It’s expected to see that measles is topping that list because of how readily measles communicate,” Dr. Dale Kalina Samji, Chief Medical Information Officer at Brant Community Healthcare System told CTV News Saturday.

“The reality is, in most of the communities, particularly that surround Toronto and also in Alberta, we see lower vaccine rates. As a result, we’ve got a very high risk for diseases like measles to spread like wildfire.”

Canada’s measles vaccination rate has declined in recent years, with public health officials warning that immunization coverage in several provinces has fallen below the roughly 95 per cent threshold needed to prevent outbreaks.

Canada experienced its worst measles resurgence over the past two years when an outbreak began in late 2024 and accelerated sharply through 2025, resulting in more than 5,400 cases nationwide — marking the country’s largest outbreak since the virus was declared as eliminated in 1998.

Since then, the outbreak has significantly slowed across Canada, with national weekly reports showing far fewer new cases and some provinces declaring the end of outbreaks or moving to sporadic imported cases only.

Although the decline in cases continues across the country, it remains elevated globally – particularly in countries such as Mexico, the United States, Bangladesh, Romania and parts of Europe, where significant outbreaks are still ongoing due to declining vaccination coverage and post-pandemic immunity gaps.

“In the case of the FIFA World Cup, there are a lot of people there are going to come from around the world, from a lot of the countries where measles is endemic,” Dr. Zahid Butt, an infectious disease epidemiologist and assistant professor at the University of Waterloo told CTV News Saturday. “Which means that (they) may not have up-to-date vaccinations and that (they) can pose a risk of transmission to other people.”

‘We are already understaffed’

Physicians who spoke to CTV News now question whether Canada’s overburdened health-care system would be able to supply the resources – such as beds and hospital staff – in the event a worst-case scenario of a large outbreak takes place.

“I think we are already understaffed, and this is something we need to seriously think about, particularly ahead of the World Cup,” Butt added.

“How are you going to get additional staff? How are you going to transfer one staff to another place where they’re required?” he said. “That planning has to be there before the World Cup because it’s already understaffed, overburdened.”

While Evans believes that it’s not just measles that is at risk of spreading, but that provincial health agencies must be prepared for even cases of low-risk diseases spiking.

“I think the worst-case scenario would be if we do see a massive spread of contagious illnesses – be it measles or Mpox or the respiratory virus or a gastrointestinal illness – that would then overwhelm our already taxed medical system. I think that’s a particular concern,” Evans said. “It is what has been prepared for, but it would be concerning to see individuals who can prevent illness like this having to come into emergency departments and that sort of thing.”

In a statement to CTV News B.C.’s Ministry of Health said there will be “enhanced public health surveillance activities” during the FIFA World Cup to “detect any importation of communicable diseases.”

“As part of the planning for FIFA World Cup matches and gatherings in Vancouver, BCCDC completed a public health risk assessment in collaboration with regional and provincial public health partners,” the B.C. Ministry of Health said.

“The risk assessment considered increased population density, close contact among people in indoor and outdoor venues, higher demands on food services, summer heat, potential wildfires during this period, and changes in social behaviour and transportation. Most public health risks were categorized as low, with some assessed as moderate.”

While Ontario did not respond for comment, a recent Public Health Ontario infectious diseases risk assessment for the World Cup showed measles, food and waterborne diseases, and COVID-19 had a “moderate risk” of spreading.

The report says that during the event, there will be “robust surveillance,” and that provincial and local authorities should “continue to scan local, national and global public health signals that might warrant action or impact.”

Infectious disease specialist at Toronto General Hospital, Dr. Isaac Bogoch says that the risk of an outbreak is minimal, even with slumping vaccination rates because much of the older population has already had the disease, making them immune for life.

“When we’re talking about measles, let’s remember this: the vast majority of Canadians are okay,” Bogoch told CTV News Saturday. “People born before 1970s are presumed to have been infected, then recovered, and have lifelong immunity. Those born after 1970, the vast majority have had the vaccination and the vaccination provides very significant and durable protection.”

“This would only be concerning for people who are not immune to measles, which would be smaller groups of individuals who have not received the measles vaccine,” he added.