What unfolded across China in the summer of 2026 was not a string of isolated bad luck. It was, according to the scientists and commentary accompanying the events, a demonstration of a new normal: extreme events once labeled “once-in-a-century” are increasingly compound, concurrent, and geographically dispersed, arriving faster than the institutions and infrastructure built to manage them. A warming trend that outpaces the global average, as officially acknowledged by Chinese meteorological authorities, is raising both the frequency and the intensity of extremes. When a single season delivers typhoon remnants to a northeastern inland province, catastrophic urban flooding to central China, and near-record heat to the northwest simultaneously, the premise that hazards arrive one at a time, separated by decades of recovery and planning, collapses entirely.

The term “once-in-a-century” is shorthand for an event with a 1 percent chance of occurring in any given year, a statistical construct known to hydrologists as the hundred-year return period. Specialists have long recognized that this language is easily misinterpreted: it describes a probability, not a promise that such an event will occur only once every hundred years. In any given century, a 1-percent-annual-chance flood may strike twice, three times, or not at all, and independent river basins can each experience their own hundred-year event in the same year. Yet the intuitive public reading — that a community has earned a century of safety after surviving one such flood — persists, and it shapes how residents, officials, and even engineers respond when the waters return far sooner than the label implies.

Climate change has rendered the historical baseline on which those return periods rest effectively obsolete. The statistics embedded in flood maps and design standards assume stationarity, the idea that the range of natural variability observed in the past will continue into the future. That assumption no longer holds. On 20 July 2021, Zhengzhou recorded 201.9 millimeters of rainfall in a single hour, a new national record, with three-day cumulative rainfall of 617.1 millimeters, approaching the city’s entire annual mean. The deluge overwhelmed a city that had, in part, been built under China’s “sponge city” programme, an ambitious urban design initiative intended to absorb and reuse stormwater rather than shunt it into overburdened drainage networks. Four years later, in August 2025, Zhengzhou’s flood-control emergency response was again raised to Level III, with work, business, classes, and public transport suspended citywide. The hundred-year flood had taken four years to make its second appearance.

These events carry direct and severe health consequences, from drowning and traumatic injury to the disruption of routine and emergency medical care. Globally, public health systems have developed genuine capacity to respond to the acute aftermath of a single flood. China’s Centers for Disease Control and Prevention, for example, issues detailed post-flood guidance on indoor mold identification and remediation, with explicit precautions for vulnerable groups including pregnant women, children under 12, adults over 65, and people with asthma. This is well-designed, evidence-based guidance. But it is guidance calibrated to a single, bounded event: dry the building, remove saturated porous materials within 48 hours, ventilate, and protect vulnerable residents during cleanup. It says nothing about a household, or a health system, absorbing a second or third such event within years rather than decades, nor about heat and flood advisories issued in the same week to the same population. Adaptation guidance built for isolated disasters, however rigorous, is necessary but insufficient for compound, recurring ones.

The problem is not merely communicative but structural. Reservoirs, drainage systems, evacuation routes, and emergency stockpiles are sized against historical exceedance probabilities, and insurance and recovery budgets are paced to the expectation of long intervals between catastrophic losses. When extremes cluster, recovery is truncated. Communities still repairing one flood face the next before foundations have dried, and the cumulative physical and psychological burden of repeated displacement and rebuilding accumulates in ways that single-event frameworks never anticipated. Meanwhile, simultaneous hazards compete for the same response capacity: the personnel, shelters, and supply chains needed for flood evacuation in one province are the same resources a heat emergency in another might demand, and heat itself compounds flood risk by pre-conditioning drought, hardening soils, and altering atmospheric moisture available for subsequent downpours.

Three shifts follow from this pattern, argued in commentary published in The Lancet Regional Health – Western Pacific by John S. Ji and Qihong Deng. First, risk communication should retire probabilistic century-scale language in public-facing materials in favor of terms that convey trend and recurrence, such as “increasingly frequent severe rainfall” rather than “once-in-a-century flood,” so that recurrence within a decade is not received as a statistical anomaly requiring no institutional response. The words officials choose shape whether a second hundred-year flood in four years is read as a freak coincidence or as evidence of a trend demanding action. Second, infrastructure and early-warning design standards, including within the sponge city and reservoir safety programmes, should incorporate non-stationary risk models that use recent-period distributions rather than full-record historical baselines, which mathematically dilute the recent shift toward higher-intensity rainfall. A century of rain-gauge data in which the wettest years cluster in the last decade tells a very different story than the same record averaged across its full length.

Third, public health guidance should evolve from single-event response protocols toward compound-event and cumulative-exposure frameworks, addressing populations facing sequential or simultaneous heat and flood risks within the same season, as well as the mental and physical health burdens of repeated displacement and recovery. That means modeling the health effects of mold exposure after repeated inundation, planning clinically for populations that experience flooding and extreme heat within weeks of one another, and treating the psychological toll of chronic disaster exposure as a first-order public health concern rather than an afterthought. The tools exist — epidemiological surveillance, seasonal forecasting, and increasingly sophisticated artificial intelligence-based forecasting and digital simulation systems that Chinese cities are already deploying — but they must be aimed at the compound problem, not the singular one.

Experts and meteorological authorities have officially acknowledged the warming trend and the rising frequency of extremes, and there are encouraging signs of technical adaptation in forecasting and alerting. Public health guidance and infrastructure standards, however, continue to speak as if these events remain rare. This summer made the mismatch impossible to ignore. Flood warnings in the northeast and heat alerts in the northwest arrived in the same week, and a city rebuilt to absorb the once-unthinkable watched the once-unthinkable return within a political term. The climate has changed. The language, and the standards built upon it, need to change with it.

Subject of Research: Compound climate extremes and the obsolescence of once-in-a-century risk communication

Article Title: Compound climate extremes and “once-in-a-century” risk communication

Article References: Ji, J. S., & Deng, Q. (2026). Compound climate extremes and “once-in-a-century” risk communication. The Lancet Regional Health – Western Pacific, 74, Article 101973. https://doi.org/10.1016/j.lanwpc.2026.101973

Image Credits: AI Generated

DOI: 10.1016/j.lanwpc.2026.101973

Keywords: compound climate extremes, once-in-a-century flood, risk communication, non-stationary risk, sponge city, Zhengzhou rainfall, Typhoon Bavi, Tropical Storm Maysak, public health preparedness, extreme heat, climate change, flood resilience

As public health officials scramble to prepare for the next inevitable outbreak, insights gleaned from past responses present both opportunities and pitfalls. The study emphasizes that healthcare settings are often ill-equipped to handle surges in patient volumes during crises. Issues like staff shortages, inadequate training, and insufficient supplies exacerbate the strain on these facilities. By analyzing various case studies of past outbreaks, ranging from the Ebola virus to the Zika epidemic, the authors reveal a pattern of recurring failures that could have been mitigated through better planning and preparation.

One significant finding of the review centers around the importance of cross-disciplinary collaboration. The authors argue that effective responses require not just medical professionals but also the input of sociologists, psychologists, and public health experts. This multifaceted perspective is vital for understanding the full scope of an outbreak’s impact on communities. The study highlights instances where lack of communication between different sectors led to delayed responses and exacerbated the crises. In many instances, establishing a unified command structure could have led to more timely and effective intervention measures.

Moreover, the review underscores the importance of real-time data collection and analysis in informing healthcare responses. The COVID-19 pandemic illustrated the challenges associated with data availability and accuracy. In their analysis, Rubini and colleagues point out that many healthcare facilities did not have adequate systems in place for capturing data on infection rates, resource availability, and patient demographics. Without reliable data, decision-makers can struggle to implement evidence-based strategies. The study advocates for the integration of advanced data analytics and information technologies in healthcare facilities to improve situational awareness during outbreaks.

Additionally, the authors discuss the psychological impacts on healthcare workers in crisis situations. High levels of stress, burnout, and trauma can manifest, affecting staff performance and patient care quality. Despite this, many healthcare facilities previously overlooked the mental well-being of their employees during crisis planning. The review urges a paradigm shift toward holistic approaches that prioritize mental health resources for healthcare workers, thereby enhancing resilience within the workforce. Ensuring frontline staff are supported can lead to improved patient outcomes during public health emergencies.

Another critical aspect highlighted in this review is the role of community engagement in outbreak response. The authors emphasize that most successful responses involved working closely with local communities to build trust and encourage participation in prevention efforts. Misinformation can proliferate rapidly during outbreaks, leading to public panic and non-compliance with health measures. Healthcare facilities should prioritize outreach initiatives that educate the public about risks and preventive measures. Moreover, fostering partnerships with community leaders can help bridge gaps between healthcare providers and the community.

The implications of this research extend to healthcare system planning and policy development. By summarizing the key challenges identified in previous outbreaks, the study provides actionable recommendations for policymakers. Investments in infrastructure are needed, not just to withstand the immediate impacts of an outbreak but to promote long-term resilience in healthcare systems. Implementing robust contingency plans, ensuring adequate stockpiling of vital supplies, and sustaining funding for public health initiatives are critical steps moving forward.

Furthermore, the review highlights that although significant strides have been made in vaccine development and distribution during outbreaks, logistical challenges remain persistent. The authors discuss various case studies where vaccine rollout was hampered by supply chain issues, regulatory hurdles, and public hesitancy. Addressing these challenges requires not just scientific ingenuity but also political will and effective communication strategies. Coordination among different stakeholders, including government bodies, pharmaceutical companies, and healthcare providers, is crucial for ensuring timely vaccine availability during emergencies.

As we navigate the complexities of modern healthcare, learning from the past becomes imperative. The authors encourage a culture of continuous improvement in healthcare systems. This involves conducting regular drills, simulations, and post-outbreak evaluations. These activities can foster a climate of preparedness, allowing facilities to adapt and respond quickly when facing potential outbreaks. Furthermore, systemic evaluations can provide critical insights for ongoing enhancements in emergency response protocols.

Additionally, mental health considerations for the community during outbreaks should not be ignored. The study sheds light on the importance of providing psychological support services to affected populations. Public health messaging should include information on coping strategies and accessing mental health services. Ignoring the psychological dimensions can lead to long-term consequences for communities already grappling with the challenges posed by outbreaks.

In conclusion, the systematic review by Rubini and colleagues serves as a vital resource, encapsulating the multifaceted challenges healthcare facilities face during infectious disease outbreaks. By dissecting past responses, the authors shed light on critical areas for improvement, thereby paving the way for more robust and resilient healthcare systems. These findings underscore the need for an integrated approach, incorporating various disciplines and sectors, to effectively manage outbreaks. Ensuring the health of communities is not merely a function of medical capacity; it is contingent upon a holistic understanding of health—a lesson that resonates profoundly in today’s global landscape.

The findings of this study not only inform future research efforts but also catalyze immediate actions that healthcare facilities can implement to enhance their readiness for the next outbreak. By embedding these lessons into policies and practices, we can forge a path toward a more resilient global health system, fully equipped to tackle the unprecedented challenges that lie ahead.

Subject of Research: Challenges in healthcare facilities’ response to past outbreaks

Article Title: Challenges in healthcare facilities’ response to past outbreaks: a systematic review of reviews

Article References:
Rubini, E., Trentin, M., Maffi, P. et al. Challenges in healthcare facilities’ response to past outbreaks: a systematic review of reviews. BMC Health Serv Res (2026). https://doi.org/10.1186/s12913-025-13934-9

Image Credits: AI Generated

DOI:

Keywords: Infectious disease outbreaks, healthcare facilities, systematic review, public health, community engagement, preparedness, mental health, vaccine distribution, data analytics, health policy.

Dr. Morse’s academic and professional career has been profoundly rooted in infectious disease epidemiology and risk assessment, focusing intensively on emerging infections and the enhancement of early warning systems for disease outbreaks. His research has consistently sought to bridge the gap between theoretical epidemiological models and practical applications in public health emergency preparedness. This appointment underscores the journal’s ongoing commitment to maintaining scientific rigor and relevance in confronting complex disaster scenarios on a global scale.

Having served as Deputy Editor of DMPHP, Dr. Morse was thrust into a pivotal leadership position during the COVID-19 pandemic, acting as Guest Editor-in-Chief at a time when the world witnessed an unprecedented surge in scholarly submissions. During this period, he managed nearly two thousand manuscripts, navigating an immense influx of scientific articles dedicated to understanding and combatting one of the most consequential public health crises in modern history. His editorial stewardship ensured the timely dissemination of critical information to a diverse readership comprising clinicians, researchers, and policymakers.

Dr. Morse’s succession of Dr. James J. James, the founding Editor-in-Chief since the journal’s launch in 2007, signifies both a continuity of vision and the infusion of new perspectives necessary for addressing future challenges. Dr. James’ foundational work established DMPHP as a premier platform in disaster medicine and public health, elevating it into a resource indispensable for practitioners worldwide. Building on this legacy, Dr. Morse is poised to expand the journal’s scope, integrating emerging areas such as biosafety, technological innovation, and global health diplomacy.

A notable aspect of Dr. Morse’s profile is his longstanding association with public health agencies and institutes central to infectious disease control. As a founding Section Editor of the Centers for Disease Control and Prevention’s (CDC) journal Emerging Infectious Diseases, and as a member of the Editorial Board for Health Security, he has deep insights into issues at the confluence of epidemiology, bioterrorism, and health security policy. These affiliations enhance his editorial acumen and strategic positioning for advancing DMPHP’s role in shaping evidence-based disaster medicine practices.

Dr. Morse’s appointment will officially commence on July 1, 2025, at which time he will be supported by a highly skilled editorial team. The journal has designated Eric S. Weinstein, MD, MScDM, as Lead Senior Deputy Editor. Dr. Weinstein’s expertise in emergency medicine and mass casualty simulation complements the journal’s multidisciplinary approach, particularly in assessing educational strategies and operational readiness in disaster response. His role includes overseeing initial manuscript triage, ensuring that submissions align with the journal’s rigorous standards before proceeding to peer review.

Supporting these efforts are Senior Deputy Editors Attila J. Hertelendy, PhD, and Amir Khorram-Manesh, MD, PhD. Dr. Hertelendy’s leadership in disaster medicine research at Beth Israel Deaconess Medical Center is marked by a focus on artificial intelligence, advanced technology, and the implications of climate change on health systems resilience. His editorial stewardship is anticipated to promote the integration of cutting-edge scientific discoveries into disaster medicine scholarship. Dr. Khorram-Manesh, based at the University of Gothenburg, Sweden, brings an international dimension by managing submissions from the ASEAN region, ensuring that the journal remains globally representative and responsive to diverse disaster contexts.

Disaster Medicine and Public Health Preparedness stands as the foremost comprehensive publication emphasizing multidisciplinary aspects of disaster response, public health preparedness, and global health security. It serves healthcare professionals, researchers, policymakers, and all stakeholders involved in mitigating the impact of emergencies. The journal’s mission is to translate scientific findings into actionable practice, fostering integration across medical, public health, and emergency management sectors worldwide.

Published under the auspices of the SDMPH and produced by Cambridge University Press, DMPHP reflects the society’s commitment to fostering a distinct discipline that marries disaster medicine with public health. This integration is vital as disasters increasingly challenge the resilience of health systems and demand coordinated responses that transcend traditional boundaries. The appointment of Dr. Morse aligns with this vision, positioning the journal at the forefront of scholarly innovation and dissemination.

The SDMPH itself is dedicated to advancing global health security through robust education, training, and research geared toward effective disaster response. Its initiatives aim to empower health system responders with evidence-based knowledge and best practices, grounded in scientific evidence and sound educational principles. The society’s stewardship of DMPHP as a scholarly medium epitomizes this mission, providing a platform where knowledge dissemination and professional development converge to save lives and enhance preparedness.

Dr. Morse, upon taking the helm as Editor-in-Chief, expressed deep humility and honor, acknowledging the foundational leadership of his predecessor and emphasizing the collective effort of a global community of scholars and practitioners. His forward-looking editorial agenda includes not only maintaining the journal’s standards but also expanding its influence in emerging fields such as biosafety governance, climate change impacts on public health crises, and the role of artificial intelligence in disaster risk reduction.

The intricate responsibilities that accompany leading such a crucial journal underscore the evolving nature of disaster and public health scholarship in the 21st century. As threats become more interconnected and complex — spanning infectious diseases, technological disasters, and climate-related emergencies — journals like DMPHP must evolve to provide timely, scientifically robust content that informs policy and operational decisions worldwide. Dr. Morse’s appointment heralds a renewed commitment to this transformative journey.

In closing, the Society’s strategic decision to elevate Dr. Morse to Editor-in-Chief sets a progressive tone for the future of disaster medicine publishing. His expertise in epidemiology, commitment to interdisciplinary collaboration, and editorial leadership during the unprecedented COVID-19 pandemic position him uniquely to guide the journal toward greater scientific impact and practical relevance. The global community of health professionals and scholars eagerly anticipates the innovative directions and critical discourse that will emerge under his tenure.

Subject of Research:
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Article Title:
Stephen S. Morse, Ph.D., Appointed Next Editor-in-Chief of Disaster Medicine and Public Health Preparedness

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Keywords:
Epidemiology; Public health; Scientific journals; Scientific organizations; Education research; Climate systems; Life sciences; Artificial intelligence