‘COVID positive from Vegas.’ Phish concerts leave a long trail of infections, fans say

The reports are sparking fresh concerns about the potential for large indoor venues to trigger mass-spreading events just as COVID infections and hospitalizations climb in many areas of the country.

The Vermont health department said it recorded “at least” nine cases potentially linked to the concerts in Las Vegas. Rhode Island is reporting at least five. A Massachusetts health department spokeswoman said the agency had “no knowledge” of confirmed cases linked to the Phish events. But three of five Massachusetts residents interviewed by the Globe said they tested positive days after returning home from the shows. They reported having relatively minor symptoms, though two said they still hadn’t recovered their sense of smell or taste. All five from Massachusetts said they were vaccinated.

MGM said Phish fans at its Las Vegas venue were required to show proof of vaccination or a negative COVID test not more than 72 hours before the event. But that allowed a significant gap: fans who tested negative before the first show were not required to retest if they attended the later concerts.

“We’ve permanently embedded protocols and lessons learned since the start of the pandemic into our operations and have safely hosted thousands of concerts, conventions and other events at our properties since reopening last year,” MGM Resorts International said in a statement. “We remain vigilant in keeping guests and employees safe.”

Widespread fan reports of COVID infections following other recent indoor concerts at MGM have not surfaced on social or mainstream media.

In interviews, Phish fans described a crowded venue with poor ventilation and few people wearing masks, despite a Nevada law requiring their use in indoor public settings. MGM said it requires masks indoors, except when eating or drinking.

Fans reported long, packed lines to get into the shows, especially the first night when those who were vaccinated picked up wrist bands that allowed entry for the remaining nights.

”It was pretty chaotic and I could tell the staff were overwhelmed,” said Sean Hathaway, a 31-year-old Somerville fan who attended the shows with his fiancée. He said both were vaccinated, wore their masks the entire time, and did not get sick afterward.

Dr. Philip Chan, a physician in the Infectious Diseases and Immunology Center at The Miriam Hospital in Rhode Island, said the poor ventilation and crowd size at the Las Vegas event as described by fans are worrisome. He said large indoor events can be held safely at this point in the pandemic but only with sufficient precautions such as good ventilation, reduced crowd size, and universal mask use in areas, such as Las Vegas, where transmission of the virus is high.

“Why are we finding out about these cases on social media?” he said. “We need to understand how people are being infected.”

Because contact tracing is performed by local health departments, one community may not realize a case is linked to many others several states away.

Jill Sinkoff, a Phish fan from the North Shore who tested positive after returning from the shows, said she received a call from her local health department following up on her positive test. But she said the woman only asked questions about other people Sinkoff may have been in contact with in Massachusetts — even though Sinkoff said she told her she had just returned from a trip to Las Vegas. A state health department spokeswoman said it is recommended but not required that health departments ask about out-of-state travel during such calls.

Exactly how many Las Vegas-related cases there may be across the country is difficult to know, in part because some Phish fans posting on social media said they felt ill afterward but did not get tested. Others said they had taken rapid tests, which are often bought over the counter and whose positive results are typically not reported to local or state health departments.

Fans also say they visited restaurants, casinos, and other attractions while in Las Vegas, complicating efforts to pinpoint where they might have been infected.

The Southern Nevada Health District, which includes the Las Vegas area, said it has not identified any cases among its local residents with a “confirmed exposure " linked to the concerts. “It is difficult to identify specific locations where an exposure occurs due to the long incubation period of COVID-19,” said Stephanie Bethel, a district spokeswoman.

The positive test results dampened the aftermath of an otherwise celebratory weekend.

“The feel was, let’s not worry about COVID and have a good time,” said Andrew, a 56-year-old Phish fan from Middlesex County who tested positive Nov. 3. He asked that his last name not be used to protect his family’s privacy.

“It’s easy to do the right thing when everyone else is,” he said. “But then you get into the venue and you see only 1 percent or 2 percent of the people wearing masks and it’s easy to get exuberant.”

As the outbreak of COVID cases last July in Provincetown showed, even fully vaccinated individuals can contract and spread COVID-19, though they are far less likely than unvaccinated individuals to fall seriously ill.

Large indoor shows, shut down during the first year of the pandemic, have been making a comeback, with Lady Gaga playing in Las Vegas in late October and a Billy Joel show recently packing New York’s Madison Square Garden. Vaccination and masking requirements vary greatly from one venue to the next but Madison Square Garden, for instance, does not require masks for people who are fully vaccinated.

Yet the CDC recommends mask-wearing in areas where community transmission of the virus is high, even for people who are fully vaccinated. CDC data show transmission is considered high in both New York City and Las Vegas.

In late July, when Phish kicked off its tour, it urged fans to get vaccinated and also suggested they wear masks at shows where social distancing was not possible.

Red Light Management, which manages Phish, did not respond to requests for comment.

But Red Light did respond to an irate fan from Hampshire County in Western Massachusetts who detailed his concerns in an e-mail last week to the company and MGM. Kevin, a 51-year-old Phish fan who also tested positive after the show and infected his partner, shared the e-mails with the Globe, but asked to remain anonymous because he feared professional repercussions.

He described stagnant air and just one way into and out of the general admission floor area, where fans were packed tightly, standing room only.

Jason Colton of Red Light Management replied to Kevin that the company was “aware of the various issues that arose during this recent MGM run.”

“Fan safety is of paramount importance to all of us (including the band), and we absolutely intend to address these challenges if and when we return to that venue in the future.” Colton wrote.

At the time Kevin wrote his letter, Phish fans who were exposed to the virus but still asymptomatic could have unwittingly infected others. So, Kevin asked Colton if there were plans to inform ticket-holders about their potential COVID exposure and suggest they get tested.

“I am not aware of any plans to do so,” Colton replied.

Dr. Chan, the Rhode Island infectious disease physician, said society is still trying to find the COVID “sweet spot” that will avoid transmission but allow social interactions.

“We need more data-driven, scientific approaches to help guide these mitigation efforts, and I haven’t seen as much of that as we should,” Chan said.

Kevin echoed that sentiment, saying his e-mails to MGM and Phish’s management were intended to spur safety improvements and keep live music afloat, “but to do it in a way that is responsible.”

Kay Lazar can be reached at kay.lazar@globe.com Follow her @GlobeKayLazar.