A1 Refereed original research article in a scientific journal

Pandemic response during the 1918 influenza pandemic: exploring non-pharmaceutical interventions in Norway




AuthorsNyborg, Vibeke Narverud; Orderud, Hilde; Mamelund, Svenn-Erik

PublisherBMJ

Publication year2026

Journal: Medical Humanities

ISSN1468-215X

eISSN1473-4265

DOIhttps://doi.org/10.1136/medhum-2025-013495

Publication's open availability at the time of reportingNo Open Access

Publication channel's open availability No Open Access publication channel

Web address https://doi.org/10.1136/medhum-2025-013495


Abstract

This study investigates the relationship between non-pharmaceutical interventions (NPIs) and influenza morbidity during the 1918 pandemic, with a focus on urban and rural medical districts in Norway. By integrating published secondary statistical data from 1918 from Statistics Norway with primary medical records from the Norwegian National Archive, the paper offers a novel historical data set to explore the timing and frequency of NPIs in relation to monthly reported influenza and pneumonia morbidity cases. Despite inherent limitations in the historical data, the findings suggest that a greater number of NPIs may have contributed to a delay in the onset and/or a reduction in the intensity of influenza morbidity. These results support the premise that the combined implementation of multiple NPIs was more effective in delaying and flattening the epidemic curve. The findings underscore the importance of early, coordinated and sustained non-pharmaceutical responses in mitigating the spread of infectious diseases, especially in the absence of pharmaceutical treatments or vaccines.


Funding information in the publication
This paper is funded by University of South- Eastern Norway, Department of Nursing and Health Sciences, Oslo Metropolitan University ‘Storbyuniversitetet’, Centre for Research on Pandemics and Society and University of Turku, Research Flagship Centre.


Last updated on 03/08/2026 12:23:56 PM