What to know

Catherine Varner, a Toronto Emergency doctor, says the city’s emergency departments are not prepared for a surge in demand that could come with the upcoming FIFA World Cup.

In addition to alcohol- and substance-related injuries, Varner says there are risks of mass casualties, and infectious diseases.

The city is working on developing a FIFA World Cup 2026 Operational Plan.

Toronto is expected to welcome over 300,000 out-of-town visitors for the FIFA World Cup, and an urgent care physician says the city’s emergency departments are not prepared.

“There’s a fairly large body of evidence around what happens to emergency department utilization during mass gathering events,” Dr. Catherine Varner, deputy editor of Canadian Medical Association Journal (CMAJ), tells Now Toronto.

Sporting events, Varner says, are categorized separately from other mass events.

“That’s because there’s an association with increased alcohol- and substance-related visits as well as traumatic injuries,” she explains.

Varner is the author behind an editorial published on CMAJ that highlights the vulnerabilities of emergency departments across Canada against a surge in demand following mass gathering events.

“Canada is increasingly vulnerable to events that may result in a surge in health care utilization, including climate emergencies, mass gathering events, infectious disease outbreaks, and global defence escalation,” she wrote.

With Toronto expected to host six FIFA matches this summer, Varner says its emergency rooms are not immune.

“We’re at 100 per cent capacity,” she says. “If we had an event where we needed a lot of hospital beds quickly … it would be hard for us to surge and continue to provide the high quality of care that patients deserve.”

Additionally, the World Cup differs from other sporting events because it takes place over several weeks.

“Given that there’s game after game, and more and more visitors, you’d anticipate having a surge that lasts throughout that period.”

How are Toronto’s EDs preparing for FIFA?

Emergency departments across Toronto regularly assess their protocols for mass casualties – often referred to as ‘Code Orange’.

In her editorial, Varner points to the tragedy of Lapu-Lapu Day in Vancouver last year, where 11 people were killed and nearly 30 were injured when a vehicle rammed into a crowd.

“We don’t experience those very often in Canada, and we’re very grateful for that,” Vaner says. “But keeping it top of mind is still part of our job.”

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In October 2025, Toronto Public Health released its report outlining the supportive role it’s playing for the city in enhancing its existing emergency preparedness by developing a comprehensive FIFA World Cup 2026 Operational Plan.

Some of the risks outlined in the report include food safety, extreme heat, wildfire smoke, sexually-transmitted diseases, and respiratory infections.

“[An infectious disease outbreak] is one of the major vulnerabilities of mass gathering events like FIFA,” Varner says.

“There was a measles outbreak that occurred after the Vancouver Olympics [in 2010] that was directly related to international visitors, and it affected their health-care system in the area for about three months after.”

In the report, TPH said it will continue to promote awareness and vaccination against the disease through collaboration with health-care providers. It comes as Canada lost its measles-free status last November.

At the time, it also said it would “refine its planning and risk assessments to address health risks specific to incoming fans” once the list of participating nations was announced in December 2025.

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When asked about the status of the Operational Plan today, the city told Now Toronto, there are “no further updates to share at this time.”

TPH had said it was working in partnership with Toronto Emergency Management and the Toronto Police who are “developing comprehensive emergency preparedness and communication strategies.”

There is also expected to be approximately 3,000 volunteers who will assist with fan services, media operations, accessibility and logistics.

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Ontario’s Ministry of Health (OMH) is also playing a role in the city’s planning, most recently releasing its Hazard Identification and Risk Assessment, 

In a statement to Now Toronto, OMH says, “Throughout FIFA, and beyond, our government will work with our healthcare partners to ensure they have the tools they need to deliver high-quality care for all Ontario residents, spectators, and players.”

Planning not enough to address systematic shortfalls: Varner

According to Varner, there are plans to have health-care personnel on-site at FIFA events. But she worries it may not be enough, particularly given that a lot of emergency room visits during mass events are due to incidents that take place outside of the event site.

“It’s not so much what happens in the stadium, but more about what happens in the surrounding area where people are going to bars and clubs or congregating on the streets,” Varner says.

There is expected to be an added pressure from attendees putting off seeking medical care until they have left the venue, especially if they consider their injuries to be minor.

“We’ve seen, attending these events are extremely expensive, which means people don’t want to leave [the venue] when they’ve had a minor injury,” Varner says.

Varner says one of the ways in which the emergency departments can navigate the surges effectively is to increase staffing in anticipation.

“In our health-care system right now, we’re having a very difficult time retaining [health-care providers] because of the difficulties of the environment,” she says.

Adding salt to injury, the Ontario Hospital Association had announced earlier this month that hospitals would have to make tough choices in cost-saving measures amid a “persistent and deepening structural deficit of approximately $1 billion.”

Varner is calling for action from all levels of government with FIFA events around the corner for Toronto.

“A coherent, feasible, actionable, and national plan is urgently needed to increase hospital beds and train the required personnel such that quality of care can be maintained.”