Pandemics not new to Norway

Profiles of Norwegian science

Photo: Ilan Kelman
How can we avoid a piglet flu pandemic?

Agder, Norway

Pandemics are not new to the world. Norway, too, has been afflicted before.

The influenza pandemic of 1918-1920 might have infected a quarter of the world’s population, killing millions. In Norway, out of a population of around 2.6 million, perhaps 20 to 45% were infected, and estimates of deaths range from just over 7,000 to just under 15,000.

One intriguing outcome was the major, long-term changes to Norwegian society. A 2016 master’s thesis by Magnus Røthe Bakken and Sigrid Johanne Husøy at the Norwegian School of Economics analyzed the impacts on those who were in the womb when their mothers caught the flu. Matching up records from the pandemic with the census from 1960, the students were able to check life outcomes of flu fetuses.

Employment did not seem to be affected by pre-birth flu exposure, but men did end up with fewer years of education. This effect on men’s education was particularly pronounced in poorer locations. The authors explain that women’s education might not have been affected, because women didn’t often complete extensive education at that time anyway. When exposed to flu while their mothers were pregnant, women were slightly less likely to marry, and men were slightly more likely to marry.

Interventions, though, should be able to assist. Knowing that a group experienced pre-birth flu could lead to supporting them from early childhood and throughout their education to avoid any further disadvantages in life.

But the flu pandemic’s effects might not have been only after conception. The University of Oslo’s Svenn-Erik Mamelund published a paper in 2004 about the pandemic and a reduction in Norway’s fertility rates. As evidence, he points to low birth rates in 1919 followed by a baby boom in 1920, which cannot be explained by only World War I, especially for neutral countries such as Norway.

He discusses how the flu seems to have suppressed conception for several reasons, including the high rate of mortality among those who might want children, social norms of not remarrying for at least a year after a spouse’s death, and less chance to conceive while sick. Then, after the flu, couples were back on track for having families, including replacing children who died. Mamelund concludes that the pandemic caused the 1920 baby boom in Norway.

Mamelund also led a paper in 2000 analyzing a pandemic flu plan and risk analysis, which had just been published by Norway. They suggest a worst-case scenario of 29,000 deaths. How much did this older plan and the scientific analysis influence current-day preparations and responses?

And how much did this work influence another pandemic in Norway, the 2009 influenza A (H1N1)? A consortium of researchers in and around Bergen surveyed patients complaining of symptoms that might be from this flu. They focused on people visiting their doctor, rather than hospitals, showing that in this setting, it is not easy to differentiate between the pandemic flu and some other illnesses. They also demonstrated that women were more willing than men to listen to advice about prevention and to follow recommended measures.

Meanwhile, a scientist group headed by the National Veterinary Institute in Oslo and Trondheim identified human-to-pig transmission of the virus. They became concerned about this observation as a step change, since Norwegian pigs had previously not had swine flu. The animals could now potentially transmit it back to humans, while retaining the virus through the non-flu season in order to infect people during flu season.

And now COVID-19. Scientists at the University of Agder’s Centre for Integrated Emergency Management (CIEM) and the Norwegian Institute of Public Health (NIPH/FHI) have been mobilizing to apply their expertise. The Research Council of Norway issued a rapid response call for applications for funds to research the current coronavirus and the pandemic’s impacts.

One result will be cutting-edge papers in scientific journals demonstrating the importance of Norwegian pandemic research. The real importance is that this science has been informing and serving society.

The publications mentioned here, in order, may be found here:–.htm

This article originally appeared in the April 17, 2020, issue of The Norwegian American.

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Ilan Kelman

Ilan Kelman is Professor of Disasters and Health at University College London, England, and Professor II at the University of Agder, Norway. His overall research interest is linking disasters and health, including the integration of climate change into disaster research and health research. Follow him at and @ILANKELMAN on Twitter and Instagram.