Spontaneous and Unplanned Mass Gathering Events: A Scoping Review of Health Considerations for Riots, Civil Unrest, and Protest
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Gray, Lesley
Mortelmans, Luc
Sultana, Nazneen
Achour, Nebil
Barten, Dennis G
Carlström, Eric
Ciottone, Gregory
De Cauwer, Harald
Goniewicz, Krzysztof
Granholm, Fredrik
Hertelendy, Attila J
Kupietz, Kevin
Ratnayake, Amila
Robinson, Yohan
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Abstract
Objective To identify the health planning, health provision, and health lessons learned from unplanned or spontaneous mass gathering events.
Methods This research used a scoping review design. Data was collected from 4 databases, using search terms relating to “mass gathering events,” “spontaneous events,” and “health services.” Data was extracted relating to the event characteristics, health usage, and patient outcomes. Extracted data were deductively coded against the surge capacity domains of staff, stuff/supplies, space, and systems.
Results Ten papers were included in this review. Most spontaneous mass gathering events were related to riots, civil unrest, or unplanned large parties, which required a response from the health care system. Health staff were predominantly from an ambulance, pre-\hospital, or emergency medical services. Additional personal protective equipment, such as ballistic equipment and respiratory protection, was required.
Conclusions The planning for a health care response to a spontaneous mass gathering event requires a risk-based approach. Such an approach should be applied in local disaster and mass casualty plans as a hazard-specific response. Preparation and response should include interagency collaboration. Enhancing the reporting of spontaneous mass gathering events will provide insights for future planning and response.
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Disaster Medicine and Public Health Preparedness
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19
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© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
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Epidemiology
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Ranse, J; Gray, L; Mortelmans, L; Sultana, N; Achour, N; Barten, DG; Carlström, E; Ciottone, G; De Cauwer, H; Goniewicz, K; Granholm, F; Hertelendy, AJ; Kupietz, K; Ratnayake, A; Robinson, Y; Somville, F; Tin, D; Khorram-Manesh, A, Spontaneous and Unplanned Mass Gathering Events: A Scoping Review of Health Considerations for Riots, Civil Unrest, and Protest, Disaster Medicine and Public Health Preparedness, 2025, 19, pp. e269