Well, the run starts at 8:00 AM, but the rest is true. I would say 80% of the runners have stayed awake the whole night, obviously drinking and partying. Alcohol is not allowed in the course but still, cameras catch some runners sipping wine the moments prior to the unleash
The other 20% are cold-headed people who take it seriously, train, know how to run, not to touch the bulls, not to run in the outside of the curbs -so the slipping bulls doesn't crash into them- and know to lay down if the fall and not stand up until the bulls run over them.
Just last week a 27year-old boy was killed. The horn cut his aortha in half. It died in less than half an hour, despite the paramedics were right there. He was a "professional" -been running the bulls for years- but couldn't do anything with the tourist-runners in front of him who didn't leave him an escape.
According to the news, last man killed in the runs was in 1996, an american. From what the news said, the parents later would buy the head of the bull and took it with them to US -taxidermied -whatever the right word is- bull heads are typical in Spain-

And the video of the death. The paramedics were right with him, but they couldn't save his life