Centre for Research on Pandemics & Society (PANSOC)
An OsloMet Centre of Research Excellence studying the societal aspects of pandemics
We are happy to be back at CAS for a Short Term Residential Fellowship in November and December 2025 to work on a New CAS-project: Indigenous Peoples & Pandemics: Data Completeness & Vaccine Access Disparities – Centre for Research on Pandemics & Society (PANSOC). This current project is based on our 2022-23 stay at CAS doing research on Social Science Meets Biology | CAS.
Abstract:
The COVID-19 pandemic disrupted global tuberculosis (TB) control efforts, leading to a surge in TB-related excess mortality, particularly in low- and middle-income countries. Pandemic mitigation measures, such as lockdowns, reallocation of healthcare resources, and reduced access to diagnosis and treatment, contributed to delayed TB care and disease progression. Quantifying this collateral damage is crucial to bolstering health system resilience.
We estimated country-level excess TB mortality between 2020 and 2023 using annual TB mortality data reported by the World Health Organization (WHO). Our approach leverages the SubEpiPredict toolbox of the ensemble n-sub-epidemic modeling framework, calibrated to pre-pandemic trends (2010–2019) to forecast expected TB deaths in the absence of COVID-19 disruptions. We selected the best-fitting model based on AICc and compared projected and reported deaths to quantify excess mortality, incorporating both normal and Poisson error structures. We further examined associations between excess TB mortality and country-level indicators, including the COVID-19 Stringency Index, Global Health Security (GHS) Index, and Socio-demographic Index (SDI). It is also noteworthy that for each estimate of excess TB deaths, we provide an associated uncertainty.
Our global estimate of 755,876 excess TB deaths (95%CI: 591,099 to 965,015) aligns closely with the WHO estimate of approximately 700,000 excess deaths. Therefore, it can be estimated a global relative excess mortality of 12.8% (95%CI: 11.6% to 14.2%), compared to the WHO estimate of 14.6% (95% CI: 5.9% to 26.7%). We found substantial geographic heterogeneity, with the highest TB excess mortality rates observed in southern Africa, South Asia, and parts of South America. Countries with high GHS or SDI scores did not necessarily exhibit lower excess TB mortality, suggesting that pandemic-specific disruptions and competing priorities may have overridden structural advantages. Weak-to-moderate correlations were observed between excess mortality and pandemic stringency, peaking in 2021 and waning by 2022, possibly reflecting health system adaptation.
This study presents a systematic, model-based analysis of global excess TB mortality during the COVID-19 pandemic, emphasizing disparities in pandemic response impacts across countries. The findings highlight the need for integrated and resilient public health systems capable of maintaining essential services amid global crises. Our methodology can support real-time monitoring of collateral effects of pandemics on endemic diseases and guide strategic investments in TB surveillance and care continuity.
You can read the paper here: Global excess tuberculosis mortality during COVID-19: a country-level modeling study of policy and development correlates | BMC Public Health
This paper is part of the MERIT-project and collaborations with Portuguese colleagues : Balancing Work and Parenthood – A Comparative Analysis of Policies across European Countries | Journal of Child and Family Studies
Absract: Across Europe, changes in the labour market structure and fertility rates have been pressuring countries to adopt policies that support parenthood. Previous research has analysed parental leaves but has not compared other types of family support, such as access to childcare services or work arrangements. This study aimed to conduct a comparative analysis of the public policies implemented in 2022/2023 across 12 European countries through document analysis. Despite the international regulations, high heterogeneity was found. Some countries, such as Sweden and Norway, promoted well-compensated individual parental leaves, higher leave take-up rates among mothers and fathers, working time flexibility, and full-time childcare services. Conversely, others, such as Italy, Spain, and Portugal, showed limited public spending, fragmented public childcare services, short well-paid parental leaves, and an imbalance in leave take-up rates among mothers and fathers. This comparative analysis highlights and discusses the existing policy options according to countries’ economic, social, and demographic outcomes.
For the fifth Pandemics & Society Seminar of our Fall 2025 series we are pleased to welcome Florian Bonnet (INED). The seminar will be held on Thursday, 30th October at the normal time (1600 CEST). More information about our speaker and the presentation is below. You can sign up for email notifications about the seminar series, including the Zoom details, here.
Blurb: Why were some regions hit much harder by COVID-19 than others—and how new was this geography of mortality? In this talk, I will examine regional excess mortality during the pandemic in 2020 and 2021 across more than 500 regions in France and Europe, highlighting which areas were most affected and how spatial patterns evolved over time. I will then compare these recent patterns with four major mortality crises of the 20th and 21st centuries: the Spanish flu, the 1911 and 2003 heatwaves, and the Hong Kong flu. Using harmonized regional mortality data from the French Human Mortality Database, I will explore how the magnitude and spatial structure of excess mortality during COVID-19 fit within a longer historical continuum of longevity shocks.
Biography: Florian Bonnet is a tenured researcher at the French Institute for Demographic Studies (Ined). His work lies at the intersection of demography, economics, history, and geography, with a focus on the long-term evolution of social and spatial inequalities in longevity and economic development in France and across Europe. He combines historical data reconstruction with spatial and statistical analysis to uncover how regional disparities in mortality and living standards have emerged, persisted, and transformed over time. All his works can be found there: https://sites.google.com/view/florianbonnet/recherche?authuser=0
The talk by Andrea Kifyasi (University of Dar es Salaam) titled “From China to Africa: A History of the 1957 Asian Influenza Pandemic in Colonial Tanganyika” originally scheduled on the 23th of October is moved to 13th November.
The next Pandemics & Society Seminar of our Fall 2025 series will take place 30th October: Florian Bonnet (INED), Contextualizing the Global Burden of COVID-19 Pandemic: A Historical and Geographical Exploration of Excess Mortality in France, 1901–2021.
Information on rest of our Fall 2025 webinar series including how to sign up for our mailing list is found here: Fall 2025 seminar series – Centre for Research on Pandemics & Society (PANSOC)
For the fourth Pandemics & Society Seminar of our Fall 2025 series we are pleased to welcome Hampton Gaddy (London School of Economics & University of Oxford). The seminar will be held on Thursday, 9th October at the normal time (1600 CEST). More information about our speaker and the presentation is below. You can sign up for email notifications about the seminar series, including the Zoom details, here.
Blurb: A large body of social science and health research uses measures of the 1918 influenza pandemic’s mortality to estimate what the biosocial effects of the pandemic were. However, many of the pandemic measures used in this research either exhibit very high rates of error; are systematically correlated with pre-pandemics determinants of the effect of interest; or are a poorly chosen estimand for testing the causal chain of interest. Additionally, even though pandemics have wide-ranging impacts on society, many existing studies do not attempt to rule out plausible alternate channels linking the pandemic to the effect of interest. Each of these four methodological problems can produce false negative results, false positive results, and false positive results of the incorrect sign. We illustrate the extent of these problems using a series of helpful case studies from the 1918 context. In doing so, we make methodological contributions that stress the importance for causal research on pandemic of conducting sensitivity analyses on the calculation of excess mortality, accounting for omitted variable and collider bias, and measuring pandemic severity for the most theoretically appropriate time period and point-of-view.
Biography: Hampton Gaddy is a PhD researcher in demography and economic history at the London School of Economics and an affiliate at the Leverhulme Centre for Demographic Science at the University of Oxford. He works primarily on the 1918 influenza pandemic, the determinants of its mortality, and its social consequences.
At PANSOC we have for several years hosted international guest researchers from all over the world. This time we are thrilled to welcome Katarina Matthes from the University of Zurich to Oslo 10-13 October 2025. While at PANSOC, Katarina will present some of her ongoing work and projects (see below) and we will discuss future collaborations.
Katarina Matthes | Institute of Evolutionary Medicine (IEM) | UZH is a senior researcher at the University of Zurich. Her research focuses on past pandemics, particularly influenza, and addresses various dimensions of a pandemic, including immediate effects such as mortality, morbidity, and birth outcomes, as well as long-term health effects due to exposure in-utero or early childhood.
In addition, she investigates social inequalities in mortality trends in Switzerland, where she is currently PI of the SNSF project “Socio-demographic inequalities in the causes of death in Switzerland, 1877–2024.” In this project, individual-level historical causes of death from the city of Zurich (1877 – 1968) are transcribed for the first time in Switzerland. This enables analyses of sociodemographic and socioeconomic differences in mortality over time, as well as in-depth studies of mortality during the 1890 and 1918 influenza pandemics.
For the third Pandemics & Society Seminar of our Fall 2025 series we are pleased to welcome Katarina Luise Matthes (University of Zürich). The seminar will be held on Thursday, 2nd October at the normal time (1600 CEST). More information about our speaker and the presentation is below. You can sign up for email notifications about the seminar series, including the Zoom details, here.
Blurb: This talk explores the short and long-term health and mortality effects of the 1918-19 pandemic cohorts. I will first discuss neonatal health during the 1918-19 influenza pandemic in a Swiss city and second the mortality risk across the lifespan. Previous studies have shown that individuals born during the 1918/19 pandemic exhibit reduced life expectancy compared to adjacent birth cohorts. However, the specific causes of death contributing to the elevated mortality risk over the life for those cohorts remain unexplored. This study addresses that gap by decomposing all-cause excess mortality into cause-specific contributions across the lifespan of the 1918-19 pandemic cohorts in Switzerland.
Biography: Katarina Matthes is a senior researcher at the Institute of Evolutionary Medicine, University of Zurich. Her research focuses on past pandemics, particularly influenza, and addresses various dimensions of a pandemic, including immediate effects such as mortality, morbidity, and birth outcomes, as well as long-term health effects due to exposure in utero or early childhood. In addition, she investigates social inequalities in mortality trends in Switzerland, where she is currently PI of the SNSF project “Socio-demographic inequalities in the causes of death in Switzerland, 1877–2024.”
Our Centre leader Mamelund has co-authored a new paper in GeroScience.
You can access the paper here: Cognitive function, physical function, and mental health in older adults amid reduced primary and specialist healthcare service use during COVID-19: the HUNT study | GeroScience
Abstract:
COVID-19 containment measures reduced older adults’ healthcare access, with uncertain long-term effects on cognitive, physical, and mental health. To investigate whether reductions in primary and specialist healthcare service use during the pandemic were associated with changes in cognitive, physical, and mental health in community-dwelling older adults, with attention to sex differences. Data from the Norwegian Trøndelag Health Study collected before (HUNT4 70 + , 2017–2019) and after the pandemic (HUNT AiT, 2021–2023) included 5387 participants (53% women) aged 70 + . Propensity score matching, accounting for baseline confounders, was used to examine associations between reduced healthcare service use and cognitive, physical, and mental health changes from pre- to post-pandemic. Reduced contact with general practitioners was associated with greater cognitive decline among women (MoCa-change − 0.32 [95% CI − 0.62, − 0.32]). No differences were observed in physical or mental health. Reductions in other primary care services (e.g., in-home nursing, practical assistance) were associated with greater decline in cognitive function (MoCa-change − 0.94 [− 1.53, − 0.36]), particularly among men (MoCa-change − 2.12 [− 3.13, − 1.11]). Men also had a decline in physical function (SPPB-change − 1.06 [− 1.79, − 0.33]). No differences in mental health were observed. Reductions in specialist healthcare services were unrelated to health changes in the overall sample but linked to improved physical function in women (SPPB-change 0.32 [0.11, 0.53]). Although associations between reduced healthcare service use during the pandemic and cognitive, physical, and mental health were limited, findings highlight the importance of sustaining access to primary care for older adults during public health crises.
Together with two of our prior post-doc’s, Margarida Pereira and Jessica Dimka, our Centre leader S-E Mamelund has written a chapter in a new book: Pandemics and Urban Planning: Multidisciplinary Perspectives on Cities, Planning and Disease | SpringerLink. The book
Our chapter (chap 10) is titled The New Syndemic of Obesity and COVID-19 in Urban Areas | SpringerLink
Abstract: Soon after the emergence of the COVID-19 pandemic, clinicians and scientists warned that individuals with obesity developed more severe cases of COVID-19, needed more intensive healthcare, and had higher chances of dying. Currently, nearly 40% of the world’s adult population is overweight and 15% has obesity. Obesity rates are higher in urban areas, which were the locations where the first large outbreaks of COVID-19 occurred. However, obesity is more than a risk factor for COVID-19 and addressing it as such underestimates the negative effect of the interaction between both diseases on social, health and gender equity. Obesity prevalence is higher in women, unemployed individuals, and those with lower socioeconomic status. The emergence of this new syndemic adds evidence on how poor health outcomes tend to cluster spatially and increase health inequities, particularly in urban areas. Hence, urban planning plays an important role in preventing social, health, and gender disparities. The ability to create healthier urban configurations for all is an important means to protect vulnerable populations and urban neighbourhoods during a pandemic. An equity lens is needed to address the major planning, namely land use, mobility, accessibility, and housing, as a strategy to tackle this new syndemic.
