Centre for Research on Pandemics & Society (PANSOC)
An OsloMet Centre of Research Excellence studying the societal aspects of pandemics
PANSOC leader Professor Svenn-Erik Mamelund has been interviewed for an article in Forskningspolitikk about the value of basic research and PANSOC’s 2022–23 stay at the Center for Advanced Study (Senter for grunnforskning) at the Norwegian Academy of Science and Letters.
In a paper just published in Vaccine: X, Jessica Dimka uses survey data from Oslo to study differences in vaccine uptake and COVID-19 infection between people with chronic health conditions, disabilities, and those without medical risk factors.
Governments took a wide variety of prioritization approaches for COVID-19 vaccination, with some countries or territories giving priority to a people with many types of disabilities and pre-existing medical conditions, and other entities recommending a more narrow prioritization. There is also evidence that people with disabilities are less likely to be vaccinated, either because of vaccine hesitancy or difficulty accessing vaccination sites. In a survey jointly developed by PANSOC and the Pandemic Centre at the University of Bergen, respondents were asked if they had a chronic health condition or disability, whether they planned to take the vaccine, and about disease outcomes.
Analyzing the associations between these data, Dimka found that people with chronic health conditions were more likely to be offered and to accept the vaccine, while individuals with at least one disability were more likely to report a probable COVID case (all in comparison to individuals with no medical risk factors). Reporting probable cases (rather than confirmed) suggests that individuals with disabilities may have had less access to testing or willingness to be tested. The results also indicate that further research is needed to determine potential differences between people with different types of disabilities. In terms of vaccine hesitancy, people with chronic health conditions were less likely to express hesitancy, while people who self-identified as having at least one disability were more likely to be hesitant (than people with no chronic health conditions or disabilities).
Overall, Dimka argues that people with chronic health conditions either exhibited behaviors that might be expected for a group prioritized by public health bodies, or acted in ways accordant with their possible increased risk. In contrast, people with disabilities had little difference from people without risk factors, or slightly worse outcomes in terms of vaccination.
We are delighted to welcome Hampton Gaddy as an incoming researcher with the Center for Research on Pandemics & Society. He completed an MPhil in Sociology and Demography at Nuffield College, Oxford in 2023, and he is currently a PhD candidate in Economic History at the London School of Economics and Political Science. He previously graduated from Oxford’s uniquely interdisciplinary BA Human Sciences programme, and he presented his undergraduate dissertation in the Pandemics & Society Seminar series in 2021. The central question of his PhD work is how many people died in the 1918–20 influenza pandemic in the United States. In his progress towards answering that question, he is working to develop better methods for local-area excess mortality estimation in historical contexts and to better understand the sociodemographic correlates of both pandemic influenza mortality and death under-registration in the historical US.
He has a great interest in understanding the societal impacts of social and demographic shocks, both past and present. To that end, he has researched the effects of the 1918 influenza on global fertility trends, as well as some of the mental health impacts of the 1918 influenza pandemic in the United States and the 2016 Brexit referendum in England. While visiting Oslo, he will be working with the rest of the PANSOC team to extend his work on pandemics and baby busts to the 1889 influenza pandemic and to look at the effect of epidemics and other crises on psychiatric hospitals in Norway at the turn of the 20th century.
We at PANSOC have been a co-author with other Nordic colleagues writing about the impact of COVID-19 on mortality in Norway and Sweden 2020-22.
The lead author, Per Henrik Zahl, has been interviewed about the paper in Aftenposten: Forskere mener koronatiltak kostet 133 millioner kroner for hvert sparte liv (aftenposten.no)
You can read the paper full here: Mortality in Norway and Sweden during the COVID-19 pandemic 2020 – 22: A comparative study – ScienceDirect
Norway and Sweden picked two different ways to mitigate the dissemination of the SARS-CoV-2 virus. Norway introduced the strictest lockdown in Europe with strict border controls and intense virus tracking of all local outbreaks while Sweden did not. That resulted in 477 COVID-19 deaths (Norway) and 9737 (Sweden) in 2020, respectively.
Weekly number of COVID-19 related deaths and total deaths for 2020-22 were collected as well as weekly number of deaths for 2015-19 which were used as controls when calculating excess mortality. During the first 12-18 months with high rate of virus transmission in the society, excess mortality rates were used as substitute for COVID-19 deaths. When excess mortality rates later turned negative because of mortality displacement, COVID-19 deaths adjusted for bias due to overreporting were used.
There were 17521 COVID-19 deaths in Sweden and 4272 in Norway in the study period. The rate ratio (RR) of COVID-19 related deaths in Sweden vs. Norway to the end of week 43, 2022, was 2.11 (95% CI 2.05-2.19). RR of COVID-19 related deaths vs. excess number of deaths were 2.5 (Sweden) and 1.3 (Norway), respectively. RR of COVID-19 deaths in Sweden vs. Norway after adjusting for mortality displacement and lockdown, was 1.35 (95% CI 1.31-1.39), corresponding to saving 2025 life in Norway. If including all deaths in 2022, RR=1.28 (95% CI 1.24-1.31).
Both COVID-19 related mortality and excess mortality rates are biased estimates. When adjusting for bias, mortality differences declined over time to about 30% higher mortality in Sweden after 30 months with pandemics and at the cost of 12 million € per prevented death in Norway.
For the penultimate Pandemics & Society Seminar of our Fall 2023 series, we are pleased to welcome Lauren Steele (University of Queensland). The seminar will be held on Thursday, 9 November at the normal time (1600 CET). 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.
Abstract
During the 1918 influenza pandemic, individuals aged ~15-40 years of age were more susceptible to severe disease and death. Similar age patterns have been recorded during the 1957 and 1968 influenza pandemics, however no geographically wide-scale age curves have ever been calculated for these pandemics. Data from at least five countries will be analysed to construct age curves to identify age-related mortality during the influenza pandemics of the 20th century. Data will be collected from vital statistics and the Human Mortality Database. To further elucidate the role of age in influenza disease outcomes during pandemics, lungs taken from young adults (aged 17-30 years) who died of influenza-like illnesses during pandemic years will be analysed using a spatial transcriptomics assay to determine gene expression at the moment of death. These data will inform on why younger age groups are uniquely susceptible to severe disease during influenza pandemics.
About the Speaker
Lauren Steele is a second-year PhD candidate at the University of Queensland, Australia. She is completing her thesis on host factors which influence disease outcomes during past influenza pandemics to inform on future influenza pandemic preparedness measures.
Nå har en gruppe forskere i USA gransket 369 skjeletter etter personer som døde i årene før og etter spanskesyken.
Det var ikke de unge med god helse som døde, konkluderer forskerne. En av disse er Amanda Wissler. Hun var gjesteforsker i vårt 2022-23 CAS-prosjekt Social Science Meets Biology | CAS (cas-nor.no)
De unge som døde under influensapandemien i 1918 og 1919, var allerede svekket av sykdommer som tuberkulose.
Det var de mest sårbare i samfunnet som gikk bort. Ikke de friske. Disse funnene stemmer godt med vår egen forskning.
Senterleder har blitt intervjuet om den nye studien. Les mer her:
Har forskere tatt helt feil om spanskesyken i 1918? (forskning.no)
For the seventh Pandemics & Society Seminar of our Fall 2023 series, we are pleased to welcome Dr Natalie Bennett (Newcastle University). The seminar will be held on Thursday, 2 November at the normal time (1600 CET). For attendees outside of Europe, please note that daylight savings time has ended. 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.
Abstract
The effectiveness of vaccination against severe COVID-19 infection and mortality is well documented, but there are inequalities in both vaccination uptake and COVID-19 mortality. Understanding whether more equal vaccination uptake might reduce socioeconomic inequalities in COVID-19 mortality is necessary for planning for future pandemics. Limited evidence available suggests that COVID-19 vaccination may have reduced inequalities in mortality. However, existing studies typically employ data covering a short time series and do not explicitly model inequalities. Using national data from the first recorded deaths through to December 2022, this study investigates whether the national vaccination program in England reduced inequalities in COVID-19 mortality associated with area-level deprivation. Descriptive analyses demonstrated that, though vaccination uptake was generally high, there was a widening gap between the most and least deprived areas in England in uptake by dose. New mortality inequality gradually declined as vaccination uptake and doses increased, and remained low throughout 2022. However, cumulative mortality inequalities rapidly grew from the start of the pandemic continued to grow throughout the entire period of observation. We estimate that more equitable vaccine uptake may have reduced, but not eradicated deprivation-based inequalities. We argue that preparation for future pandemics should include a comprehensive strategy for minimising deprivation-based inequalities.
About the Speaker
Dr Natalie Bennett is an Inequalities Research Fellow in the Applied Research Collaboration for the North East and North Cumbria at Newcastle University, England. Natalie is a Social Epidemiologist and works across a variety of interdisciplinary health inequalities projects. Her primary area of research is that of geographical inequalities in health and much of her more recent work has been in applying this focus to the COVID-19 pandemic.
For the sixth Pandemics & Society Seminar of our Fall 2023 series, we are pleased to welcome our colleague Uddhav Khakurel (PANSOC). The seminar will be held on Thursday, 19 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.
Abstract
Labrador, part of the British Empire at the time but under the control of the Dominion Government of Newfoundland, was one of the most severely affected regions in the world during the 1918 influenza pandemic, with mortality ranging from 1 to 78 percent within communities. During the time of the pandemic, healthcare needs in the southern two-thirds of Labrador were provided by the Grenfell Mission, led by Dr. Wilfred Grenfell. This study explores the role played by the Grenfell Mission during the 1918 influenza pandemic. In addition, this analysis seeks to deepen our understanding of the factors that influenced the Mission’s response during the pandemic. This study was conducted using archival and secondary sources. Historical archives were collected from the digital archives of the Memorial University of Newfoundland and Yale University between the period of 1918 to 1959. Our findings suggest that despite the long presence of the Grenfell Mission from 1893 in Labrador, it faced a formidable challenge in providing health care during the influenza pandemic. The Mission had only one doctor and two nurses for 800 square miles. Their work in Labrador was further constrained by geographical isolation, weather conditions, shortage of healthcare workers, and its relationship with the Newfoundland Government. These factors help to explain the high level of heterogeneity in mortality within communities in Labrador.
About the Speaker
Uddhav Khakurel is a master’s student at Oslo Metropolitan University and is currently working as a research assistant at the Center for Research on Pandemics & Society. He has a background in public/global health. For his master’s thesis, he is looking at the role of non-pharmaceutical interventions in the 1918 influenza pandemic in Alaska. He is particularly interested in understanding the roles played by different actors in response to the disease outbreak.
By Vibeke Narverud Nyborg (Associated Professor 2 at PANSOC, with research financed by University of South-Eastern Norway).
The conference from the European Association in the History of Medicine and Health (EAHMH) has just taken place at the University of Oslo. The theme for this conference was “Crisis in Medicine and Health,” a timely theme considering the recent experiences with COVID-19. However, being a conference in history most sessions drew on experiences occurring far earlier than the last pandemic, leaving to the participants to also reflect upon how historians can apply their research to the present and what the role and responsibilities historians have when a new crisis in medicine and health occurs.
Firstly, historians in medicine and health, like most other people and scholars do not agree upon how their research can be applied and to what extent historians have a role and a responsibility to act and share their knowledge of past events in time of crisis. These are hence my own reflections based on my own experiences together with insight gained through this recent conference and discussions with colleagues presenting here.
Historians work with the past. When it comes to dealing with crisis this can be considered a blessing, as both time and space give us the necessary space to reflect and see a broader picture when dealing with the actual crisis. The past and past events differ from the present despite some trajectories and pathways to some extent appears remarkably similar. This leads us to the question; can we learn anything from history? Is it possible to draw knowledge from historical lessons? Historians disagree on this too. While some will deny the possibility of any lessons to be learned other simply state that it is impossible not to take advantage of history, as we are all results of the historical context and past society is based upon.
My view in this is that lessons cannot be drawn from history in the sense that 1 = 1, that is this event happened before, therefor the same event will lead to the same consequences again. The past is different, knowledge, people and society develop. However, historical knowledge will contribute to see patterns, contribute with significant contextual framing which can make us point to consequences of decisions, stories that became invisible, people not heard, different responses to the same medical threats and risks taken by individuals and/or society to cope with the threats opposed by medical and health issues. Historians can also contribute with reflections concerning consequences in the aftermath of crisis, because they are trained in understanding how continuity and change appear and what factors that can be seen as plying into what prevails and what changes after specific events.
Dealing with past epidemics and pandemics in my research, working together with knowledgeable colleagues in an interdisciplinary team and living through a medical crisis such as COVID-19, my experience is that historians have a lot to offer concerning knowledge about past medical crisis, if people are willing to listen. We can use this knowledge to contribute with understanding and contextualizing, framing a current crisis within a broader picture. What we cannot do is to predict the future based on our past knowledge, which often seem to be what people expect. Historians deal with the past, we do not predict for the future.
The Centre for Research on Pandemics and Society (PANSOC) is quite unique in its approach to investigate and research historical epidemics and pandemics, exploring societal consequences, both short and long term on past pandemics. The variety of approaches involving, social inequalities, disparities, economic, minorities, legislative, political and individual experiences on medical crisis give a unique knowledge relevant to the present as well as future pandemics if we do not let these experiences be part of the crisis memory gap, but continuously contribute to claim our relevance and advocate the knowledge we gain from our research to other academics, politicians and policy makers.
EAHMH 2023 was hosted by University of Oslo, 30 August to 2 September. For more information about the conference visit the website: https://www.eahmh23.org/
