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The day has finally arrived for excited Swifties in Canada, as Taylor Swift kicks off her highly-anticipated Toronto concert Thursday evening for her Eras Tour at the Rogers Centre.

While the city’s downtown and public transit are set to be flooded with fans eager to catch the superstar, health experts are urging concertgoers to stay vigilant.

With cold and flu season in full swing, along with recent increases in RSV, COVID-19 and walking pneumonia, they warn that packed venues and crowded trains could turn into hot spots for spreading germs.

“There aren’t many things in Toronto that the Taylor Swift concert is not affecting, and transmission of disease is no exception,” explained Dr. Barry Pakes, a public health physician and associate professor at the University of Toronto’s Department of Family and Community Medicine.

“As we saw during COVID, the first thing to go was mass gatherings and the last thing to come back were massive gatherings. And this Taylor Swift concert is as massive of a gathering as we can get.”

Toronto is preparing for an influx of hundreds of thousands of Taylor Swift fans as the pop superstar kicks off her six sold-out concerts. Each show is expected to draw a crowd of 50,000 to 60,000 fans.

3:26 How officials are keeping Swifties safe and sound during Toronto Era’s shows

Respiratory illnesses like the common cold, influenza, respiratory syncytial virus (RSV), COVID-19 and walking pneumonia are just some of the viruses circulating that can spread easily in crowded or indoor settings, he warned.

He noted that there have been significant surges in COVID-19 cases in hospitals over the past few weeks, which may not yet be reflected in federal or provincial data, especially since the virus is no longer monitored through wastewater systems in most jurisdictions.

Toronto Public Health also reminded that having vaccinations against the flu and COVID-19 can help reduce any risks, asking their followers: “Are you ready for it?”

The City of Toronto posted a similar note from Toronto Public Health several days ago to followers.

“If you’re feeling sick and you can’t ‘shake it off’, please think about your fellow fans. Don’t get ‘haunted’ by a cough. Consider wearing a mask, covering your cough or sneezes & getting vaccinated days in advance of the concert,” health officials wrote.

The latest respiratory virus data from Health Canada, as of Nov. 2, shows that enterovirus, rhinovirus (the common cold) and COVID-19 are currently the most prevalent viruses circulating across the country. However, Health Canada also reports that COVID-19 cases are decreasing.

Walking pneumonia has also seen a rise in parts of Canada, especially among children. It spreads easily through the air when an infected person breathes, talks, coughs, or sneezes nearby.

Influenza, RSV, pneumonia and COVID-19 are primarily spread through respiratory droplets and can also be transmitted by contact with infected surfaces. When people gather indoors, especially in close quarters and during colder months, the risk of these viruses spreading increases, Health Canada says.

An infected person releases respiratory particles of various sizes into the air, which can spread up to one metre.

And it can spread even further if a person is singing, Pakes warned.

“You’re travelling, number one. Number two, you’re in a massive, massive gathering. And number three, people are going to be singing and shouting along…. and by doing so they are distributing those particles much further” he said.

3:23 Health Matters: Singing a high-risk activity for COVID-19 transmission

You can become infected with a respiratory illness if you inhale infectious particles, or they come into direct contact with your eyes, nose, or mouth, according to Health Canada.

Another way these viruses spread is through touching someone who has infectious particles on their hands or clothing, then touching your own face before washing your hands. For example, shaking someone’s hand could transfer the virus if they’ve come into contact with infectious secretions.

Infectious particles can linger on surfaces after being touched or sneezed on by an infected person.

High-touch areas like phones, door handles and elevator buttons are particularly vulnerable. You can get infected if you touch these surfaces and then touch your face without washing your hands, Health Canada warns.

The influenza virus, RSV and rhinovirus can survive on surfaces for several hours, while COVID-19 can remain active for up to several days.

Since respiratory illnesses mainly spread through inhalation, the best way to stay safe is by wearing a well-fitting respirator to prevent inhaling infectious aerosols, said David Fisman, a Toronto-based physician epidemiologist.

“I get that people may not be feeling it with respect to masking up, but if you actually want to avoid infection that’s the way to go,” he said.

Pakes echoed this sentiment.

Those who need to be most cautious are individuals who are immunocompromised or older adults, though these groups likely won’t make up the majority of Taylor Swift concertgoers, Pakes said.

If you’re immunocompromised and heading to see Taylor Swift, Parkes said it’s important to wear a well-fitted mask.

2:23 Taylor Swift ‘Eras Tour’ arrives in Canada

Pakes expressed concern that while younger people are attending Taylor Swift’s concert, the real risk lies in who they interact with afterward. Even if they feel fine, they could still be contagious for days, potentially spreading any illness they pick up to more vulnerable individuals.

“The general advice for this gathering, is you come home and sanitize and wash your hands. And if you are going to be interacting with others, make sure you are aware of any symptoms,” he said.

If you’re travelling via public transportation, stay vigilant. Respiratory illnesses are primarily spread through droplets, but it’s still important to wash your hands regularly to reduce the risk of transmission, Pakes said.