India has the third-highest COVID-19 burden. Hosting the Sabarimala pilgrimage of an estimated 25 million can compromise the near-mitigated but fragile COVID-19 status of the host State of Kerala, accelerate the ongoing outbreaks in other states of India, and potentially in multiple countries with emigrants from Kerala.
Keywords: SARS-CoV-2; mass gathering; pandemic; religious pilgrimage; transmission.