Synergistic Effects of Behavioral Feedback and Seasonality Generate Chaos in Cooperative Multi-Pathogen Systems

RESUMO

Infectious diseases may interact by competing for the same hosts or by facilitating subsequent infections. Understanding the dynamics of such multi-pathogen systems, particularly those subject to endemic seasonality and mitigation, is essential for designing robust public health interventions. We propose a three-stage modeling framework to disentangle the interplay between seasonality and behavioral feedback as a way of mitigation. First, we analyze a coupled susceptible-infectious-recovered-susceptible (SIRS) system without external forcing and show that the abrupt transition between the disease-free and endemic equilibria arises from a backward bifurcation-induced first-order phase transition. Second, we independently examine seasonality and behavioral feedback, characterizing where and when oscillatory behavior is induced near critical tipping points. Third, we demonstrate that their combination generates complex multi-annual wave patterns, with high-incidence cycles driven by seasonality and low-incidence intervals driven by behavioral feedback. By mapping stability as a function of seasonal forcing, mitigation strength, and cooperativity, we identify distinct period-doubling cascades with chaotic signatures arising from different mechanisms: the interplay between seasonality and behavior, and inter-pathogen cooperativity with the backward bifurcation it induces. We then analyze how these mechanisms interact across parameter ranges. Altogether, we show that cooperation fundamentally expands the spectrum of possible epidemic patterns, highlighting the importance of considering multi-pathogen interactions in epidemic modeling and control strategies.