Big Events theory and measures may help explain emerging long-term effects of current crises

Abstract

Big Events are periods during which abnormal large-scale events like war, economic collapse, revolts, or pandemics disrupt daily life and expectations about the future. They can lead to rapid change in healthrelated norms, beliefs, social networks and behavioural practices. The world is undergoing such Big Events through the interaction of COVID-19, a large economic downturn, massive social unrest in many countries, and ever-worsening effects of global climate change. Previous research, mainly on HIV/AIDS, suggests that the health effects of Big Events can be profound, but are contingent: Sometimes Big Events led to enormous outbreaks of HIV and associated diseases and conditions such as injection drug use, sex trading, and tuberculosis, but in other circumstances, Big Events did not do so. This paper discusses and presents hypotheses about pathways through which the current Big Events might lead to better or worse short and long term outcomes for various health conditions and diseases; considers how pre-existing societal conditions and changing 'pathway' variables can influence the impact of Big Events; discusses how to measure these pathways; and suggests ways in which research and surveillance might be conducted to improve human capacity to prevent or mitigate the effects of Big Events on human health.

Could the 2010 HIV outbreak in Athens, Greece have been prevented? A mathematical modeling study

“…This theory was confirmed in Athens, Greece: at the initiation of the severe economic recession in Greece, which was the most recent Big event in the country, an HCV outbreak emerged, which was the root of the HIV outbreak [ 5 , 35 , 36 ]. Nowadays, the COVID-19 pandemic, i.e., the current Big Event, has switched health care priorities and monopolizes the attention of politicians and policymakers [ 37 , 38 ]. After a Big event, HIV testing and harm reduction interventions should be more intense to prevent new outbreaks among PWID, since it is quite common that surges of HIV or HCV infections in hidden and marginalized populations are detected years after their onset.…”

Emerging Zoonotic Infections, Social Processes and Their Measurement and Enhanced Surveillance to Improve Zoonotic Epidemic Responses: A “Big Events” Perspective

“…(See Figure 1 ) Importantly, all of these considerations can precipitate mass political and social movements, shaped to varying degrees by pre-existing patterns of political conflict, stigmatization, household organization, economic inequality and exploitation, and institutionalized oppression or subordination [ 27 , 55 , 56 ]. In the case of COVID-19 in the United States (US), for example, the pandemic has caused far greater mortality for Native American, Latinx, and Black people than for white people; these disparities were also reflected both in politics (where the great majority of anti-vaccination and anti-masking activists have been white people, many of them overt racists) and perhaps in the huge antiracist demonstrations across the US in the summer of 2020 [ 14 , 57 , 58 ].…”

“…We have previously developed a “Big Events” framework for research and interventions on pandemics, including zoonotic pandemics, that create, or occur under, situations of social emergency and interact with pre-existing social structures and processes [ 14 , 15 ]. We developed this perspective out of analysis of HIV/AIDS outbreaks that took place in the countries of the former Soviet Union after the dissolution of the USSR; in South Africa after the end of apartheid; and in Indonesia after the economic crisis and overthrow of the dictatorship in the late 1990s [ 7 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”

“…We refined this framework based on what we learned by applying it to an HIV upsurge which occurred in Athens, Greece, amidst financial and economic crisis [ 15 , 23 ]. Importantly, such HIV outbreaks appear to be historically and contextually contingent –similar events in Argentina early this century did not lead to an HIV outbreak despite there being a sizable number of infected people who could have served as seeds for a wide epidemic [ 14 , 15 ].…”

Politics and pandemics

“…Fofana analyses the ways in which two controversies related to COVID-19 are linked to processes of exploitation, marginalisation, pathologisation and saviourism rooted in coloniality and focuses on the need for equity as a guiding principle to dismantle global health colonialism. This article is then followed by an analysis by Friedman et al that looks at the way in which 'Big Events theory and measures may help explain emerging long-term effects of current crises' (Friedman et al, 2021). They define Big Events as periods during which abnormal large-scale events like war, economic collapse, revolts, or pandemics disrupt daily life and expectations about the future in ways that lead to rapid change in health-related norms, beliefs, social networks and behavioural practices.…”