Adding a psychological dimension to mass gatherings medicine

Shared social identity and social norms shape risk-taking at mass gatherings

Shared social identity and social norms are often un(der)recognized within mass gatherings health literature, yet they can increase infectious disease transmission by motivating people to engage in risk-taking behaviours. Across three experiments (Ntotal = 1551), we investigated how shared social identities, perceived norms of resource-sharing, and perceived riskiness of sharing interact to shape decisions that can lead to disease transmission. In Experiment 1 (N = 528), we examined how shared social identity and perceived descriptive norms affect the likelihood of crowd members sharing resources that may contribute to disease spread. We then replicated this in Experiment 2 (N = 511) using perceived injunctive norms. In Experiment 3 (N = 512), we explored how high shared social identity, perceived norms, and perceived health risks of resource-sharing impact the likelihood of sharing that may, in turn, increase infectious disease transmission at mass gatherings. We found that high shared social identity interacts with perceived descriptive and injunctive norms, and low health risk perceptions, to increase the likelihood of accepting resources and giving resources at mass gatherings. We discuss the theoretical and practical implications for researchers, practitioners, and policymakers to build effective strategies to mitigate infectious disease transmission at mass gatherings.

Public health preparedness, syndromic surveillance, and response during the largest religious gathering at the Catholic pilgrimage center of Velankanni in South India: 2016

Background

The dynamicity and mobility of the population in a mass gathering setting pose a challenge to traditional disease surveillance methods and strain the local health services. Velankanni is one of the most sacred Christian pilgrimage places located in Nagapattinam, Tamil Nadu, India. We participated in the Velankanni festival to describe the public health preparedness, surveillance, and response activities carried out during the festival.

Methods

This was a cross-sectional study. We reviewed the national and international guidelines and published literature and discussed with the key stakeholders. We developed a checklist to observe public health preparedness activities. We facilitated the staff and monitored the activities by the implementers. We established the syndromic surveillance in the designated locations of the event and used tracker software to capture the data. Emergency medical teams were formed with trained health personnel to respond to medical emergencies.

Results

The team monitored all the public health activities. There are 59 primary care public health facilities and nine ambulatory Mobile Medical Units, with 160 medical officers available at the site. Of the 16,169 persons who attended the medical camps, 9863 (61%) were males and 8408 (52%) were aged 15-44. Acute diarrheal disease was the most frequent of the reported syndromes, followed by injuries, acute febrile illness, and animal bites.

Conclusions

There was no outbreak of any disease either identified or reported. Our findings suggest that risk assessments should be used, and establishing an Incident Command Center is vital for executing command and control mechanisms during mass gatherings.

Beyond borders: Exploring the mental, emotional, and spiritual significance of Hajj

For Muslims all across the world, the desire to participate in the religious rites of the Hajj (pilgrimage to Mecca) which stands as one of the five pillars of Islam is a heartfelt longing. It stands for the pinnacle of devotion and spiritual gratification, luring followers to the most sacred city in Islam for a life-changing journey of faith, comradery, and submission to Allah. Muslims hold Mecca in the highest regard; it is a source of endless inspiration and devotion throughout their lives, as seen by their desire to undertake the Hajj and Umrah. The pilgrimage encompasses a series of synchronized rituals and acts of worship, each holding its unique spiritual meaning, and serve as a powerful testament to the universal nature of Islamic teachings. These rituals have a significant impact on Muslims' mental and spiritual well-being. Hajj elicits a spectrum of feelings; creates unity, humility, and thankfulness; and encourages self-reflection as well as personal development. It also instills a sense of spiritual fulfillment. Hajj transcends personal boundaries, strengthening a pilgrim's sense of connection to the larger Muslim community that rejuvenates their hearts and souls toward the teaching of Islam. Hence, it is imperative to explore in depth this transformative journey, illuminating the mental, emotional, and spiritual dimensions that bind Muslims across the globe.

Leadership, mobilization of risky behaviours and accountability: The Church of Greece leaders' public talk during the COVID-19 pandemic

Social psychologists have typically examined leadership and risk-taking behaviours through a social identity lens. However, the rhetorical/ideological aspects of such processes as well as leaders' accountability management practices have not been adequately studied. We address this gap by focusing on leaders of the Church of Greece (CoG), who, at the onset of the COVID-19 pandemic, insisted that their congregation should keep receiving the Holy Communion, which typically involves the practice of spoon-sharing. We present a discursive analysis of 17 interviews with leaders of the CoG given in Greek media channels, exploring how they construct participation in the ritual. When Church leaders urged their audiences to engage in risky practices, they assumed various social identity positions (e.g. scientifically informed; civic minded), implicating competing ideological frameworks. They also managed their personal and institutional accountability for potential viral transmissions by placing responsibility for adverse effects on their followers. Implications for social psychological theory are discussed.

Re-opening live events and large venues after Covid-19 'lockdown': Behavioural risks and their mitigations

This article reviews the behavioural risks and possible mitigations for re-opening large venues for sports and music events when Covid-19 infection rates and hospitalizations begin to decline. We describe the key variables that we suggest will affect public behaviour relevant to the spread of the virus, drawing upon four sources: (1) relevant evidence and recommendations from the Scientific Pandemic Influenza Group on Behaviours produced for the Scientific Advisory Group for Emergencies (SAGE); (2) research evidence from non-pandemic conditions; (3) research on behaviour during the pandemic; and (4) relevant theory. We first outline some basic risks and a framework for understanding collective behaviour at live events. We then survey some trends in UK public behaviour observed over 2020 and how these might interact with the opening of live events and venues. We present a range of mitigation strategies, based on the framework for collective behaviour and on what is known about non-pharmaceutical (i.e. behavioural) interventions in relation to Covid-19.

Mass meets mosh: Exploring healthcare professionals' perspectives on social identity processes and health risks at a religious pilgrimage and music festivals

RATIONALE

The field of mass gathering medicine has tended to focus on physical factors in the aggravation and mitigation of health risks in mass gatherings to the neglect of psychosocial factors.

OBJECTIVES

This study sought to explore perspectives of healthcare professionals (HCPs) on (1) implications of social identity processes for mass gathering-associated health risks; and (2) how social identity processes can be drawn on to inform and improve healthcare practices and interventions targeted at mitigating health risks in mass gatherings.

METHODS

Semi-structured interviews, complemented by a brief survey, were conducted with 17 HCPs in the United Kingdom operating at a religious pilgrimage and music festivals.

RESULTS

The findings from a thematic analysis suggest that HCPs recognise that social identity processes involved in identity enactment in mass gatherings are implicated in health risks. HCPs also perceive value in drawing on social identity processes to inform and improve healthcare practices and interventions in mass gatherings. The findings from the survey corroborate the findings from the interviews.

CONCLUSION

Taken together, the research highlights avenues for future research and collaboration aimed at developing healthcare practices and interventions informed by the social identity approach for the management of health risks in mass gatherings.

Welcome to Wonderland? A Population Study of Intimate Experiences and Safe Sex at a Transformational Mass Gathering (Burning Man)

Transformational festivals are socially immersive artistic mass gatherings that are said to promote a strong feeling of belonging and experiences of personal transformation. The purposes of the present study were (1) to investigate the social and intimate experiences of Burning Man participants and (2) to study the factors predicting safe sex practices in the context of that transformational festival. The study was based on data from two consecutive cycles (2013 and 2014) of the yearly post-event online survey done in collaboration with the Burning Man Project. Participants consisted of people who attended the event (N = 19,512). The results were weighted based on the sociodemographic characteristics of the population. A typology of social and intimate experiences was created using a k-means cluster analysis. Predictors of having had unprotected sex with someone met during the event were identified using a nested logistic regression. Five profiles of social and intimate experiences were identified. Profiles with high levels of emotionally and physically intimate experiences were associated with a strong feeling of belonging and a high proportion of personal transformation. Predictive analyses showed that unprotected sex was mainly predicted by variables associated with one of three factors: (1) a lower lever of preparation and practice in using protection, (2) sex education and/or subcultures, and (3) the perceived costs and benefits associated with protection. The results also indirectly suggest a positive effect of the event on safe sex. Implications in terms of public health intervention are discussed.

Predicting collective behaviour at the Hajj: place, space and the process of cooperation

Around 2 million pilgrims attend the annual Hajj to Mecca and the holy places, which are subject to dense crowding. Both architecture and psychology can be part of disaster risk reduction in relation to crowding, since both can affect the nature of collective behaviour-particularly cooperation-among pilgrims. To date, collective behaviour at the Hajj has not been systematically investigated from a psychological perspective. We examined determinants of cooperation in the Grand Mosque and plaza during the pilgrimage. A questionnaire survey of 1194 pilgrims found that the Mosque was perceived by pilgrims as one of the most crowded ritual locations. Being in the plaza (compared with the Mosque) predicted the extent of cooperation, though crowd density did not. Shared social identity with the crowd explained more of the variance than both location and density. We examined some of the process underlying cooperation. The link between shared social identity and giving support to others was stronger in the plaza than in the Mosque, and suggests the role of place and space in modulating processes of cooperation in crowds. These findings have implications for disaster risk reduction and for applications such as computer simulations of crowds in pilgrimage locations.This article is part of the theme issue 'Interdisciplinary approaches for uncovering the impacts of architecture on collective behaviour'.

What is the experience from previous mass gathering events? Lessons for Zika virus and the Olympics 2016

All previous experiences from different mass gathering show that vaccine preventable diseases is the most important infections like influemza, hepatitis A, polio and meningitis. Three mass gathering held in Africa during the Ebola outbreak accepted participants from West Africa and was able to handle the theoretical risk without any incident. Therefore we believe that the Olympc games in Rio de Janeiro should not be canceled. The number of visitors to the games is a tine fraction (1%) of other visitors to Zika endemic con tries and it will have no measurable effect on the risk of spreading Zika virus, if the games was cancelled.

Travelers to the FIFA world cup 2014 in Brazil: Health risks related to mass gatherings/sports events and implications for the Summer Olympic Games in Rio de Janeiro in 2016

BACKGROUND

Health threats during mass gatherings, such as the FIFA world cup 2014 differ from traditional health risks. The influence of event type, demographics of attendees and environmental conditions are still not fully understood.

METHODS

An observational, prospective case-control survey conducted at the Frankfurt international airport in Germany on 544 travelers to the FIFA world cup 2014 and 432 regular travelers to Brazil departing after the end of the world cup.

RESULTS

Travelers to the FIFA world cup 2014 were predominantly male whereas the gender distribution in the control group was more balanced. The majority in both groups obtained insect bites and sunburns as environmental risk factors. Every third traveler suffered from diarrheal complaints in both groups, whereas the proportion of travelers with flu-like symptoms was higher in the case group. Travelers to the FIFA world cup 2014 indicated alcohol intake and sexual contacts outside of a relationship more frequently than travelers in the control group.

CONCLUSIONS

The additional health risks of travelers to sporting events as the FIFA world cup 2014 should be addressed in addition to traditional health threats in pre-travel counseling for the Summer Olympic Games 2016 in Brazil.