Flu and colds are back with a vengeance
nature.com
nature.com
As pointed out elsewhere in the thread, RSV is more dangerous to younger children, so delaying infection is probably advantageous on a population level. I don't think there is any evidence that the severity of any of these diseases is higher when amortized over the years we had very low incidences, we are just seeing more disease total in a short period of time as restrictions are lifted.
That said, I did not take that to mean that restrictions would be the only active component. I don't see any reason to think we can isolate this down to just a single prime mover.
Granted "to question" is doing a lot of work in my last sentence there. I don't think it is a foregone conclusion. Would be very interested in seeing it explored. Closest my memory has to this is introducing kids to preschools. The new kids are always the ones getting most sick. Same for homeschoolers going to college. They will spend a ton of time catching up on sicknesses they missed out on.
That's not to say the "hygiene hypothesis" is completely false. There's good evidence that exposing children to low level pathogens early and often helps reduce autoimmune conditions like allergies, asthma, and arthritis. It just doesn't effect viral response.
I'll underline that I don't know exactly what the answer is. I think there is plenty to research on this, and excited on us knowing a bit more.
Reminds me of the somewhat silly phrase of "what doesn't kill you makes you stronger." Unless, of course, it leaves you much much weaker. Which is very possible.
I think this is more of an “it depends” situation than a hard and fast rule.
Boosters are a good option for many people (talk to your doctor). But using antibody levels as a basis for scheduling boosters is completely unscientific. As a society we can't boost our way out of the pandemic.
This panel discussion with a group of leading physicians goes into more detail on the issue.
Is this a "as far as I can tell based on my knowledge of immunology" or "as far as I can tell based off of personal experience and gut feeling"?
I mean, what you're saying sounds plausible, but on the other hand it also sounds plausible that maybe periodic exposure to random viruses and stuff does strengthen your immune system, so I'm curious if your take here is actually based in science or is just an off-the-cuff idea.
What's influenced/improved through (accidental or controlled/vaccines) exposure is it memory.
Although exposure can also have other consequences on the whole body, if the system is overwhelmed/can't cope.
* https://twitter.com/FurnessColin/status/1589103107048624129 (which has an additional interesting take about measles) * https://twitter.com/lisa_iannattone/status/15762315127179919... * https://twitter.com/unbiasedscipod/status/158891593499112652... * https://counterdisinformationproject.substack.com/p/immunity...
which is not necessarily intuitive as well, but still, at this point, makes way more sense than the "immune system is a muscle" discourse.
My comment was mainly to point up the analogy for seeing more infections today primarily because there were fewer infections before, not primarily because everyone's immune system is weakened. There are of course other concerns with disease burden and herd immunity overshoot. I do fear people are stretching the Windows Update analogy too thin, as your immune system isn't a computer and the dynamics are more complex (e.g. it doesn't matter if you avoid Covid Alpha and don't ever become perfectly immune to it, because there is hardly any of it circulating anymore, and your Omicron infection has some cross-immunity).
> You'll be slammed with updates when you turn it on.
For a computer that isn’t an issue. But consider the health impact of “getting slammed” with several months, or take to an extreme, several years of missed immunity “updates”
Even in theory, our bodies pay a non-zero cost for each “update”
https://www.fda.gov/vaccines-blood-biologics/consumers-biolo...
[1]https://news.yale.edu/2020/09/04/common-cold-combats-influen...
Some people treat "the immune system" like a muscle, where stress strengthens. Similar stressors can have cross-reactive effects, but unrelated ones do not.
This can go the other way too: people who have uncontrolled celiac disease (as in, they're still consuming gluten on a regular basis) can also have issues with avenin (a somewhat similar protein in oats) or even lactose. For a lot of folks those sensitivities disappear when they get their gluten consumption down.
I used to get injections to diminish my hay fever symptoms. I finally mostly grew out of hay fever around the age of forty, though I'm still allergic to horses and cats, if I have direct contact.
Don't those injections comprise increasing challenges to the immune system using the allergens themselves, to make it less prone to mount a histamine response (i.e. runny nose, itchy eyes)?
It’s bad even by ‘2 yr old at daycare’ standards.
5 ER trips and a hospitalization due to breathing difficulties bad.
...it reminds me of the phenomenon that, the longer you go between busts/economic recessions, the worse they tend to be, because you will tend to have more zombie companies ready to go under. Sometimes what seems like preventing a problem, is actually just storing up problems to experience all at once at a later date.
Wildfires are a problem in part because people, left to their own devices, build in places they probably shouldn't have. (Or plant eucalyptus in California. Whoops.)
Healthcare, unregulated, is where we get the term "snake oil salesman" and cocaine-based panaceas from; most of the places with more regulation of healthcare than the US like Europe have both cheaper healthcare and similar health outcomes. An entirely unregulated economy gets you something more like Somalia and Afghanistan's. etc. etc. etc.
What story is that? Are you sure you aren't misparaphrasing the fact that kids are not susceptible to severe outcomes?
I remember when the CDC quietly subtracted more than 72k alleged covid deaths, including some alleged pediatric covid deaths, from the tally and blamed a "coding error": https://www.theguardian.com/world/2022/mar/24/cdc-coding-err...
What do your fact checkers say about the leading cause of death in Canada?
https://www.google.com/search?q=%22kids+don%27t+catch+covid%...
The big shift happened when they lifted the mask mandate for schools here in early 2022: Our kids came back with a cold every 2 weeks, for approximately 2.5 months. That was not fun.
All of which is to say that it's not clear at all that we've been "storing up" a problem -- and if we have, much of it has already been let out of storage, so to speak.
> Our kids came back with a cold every 2 weeks, for approximately 2.5 months. That was not fun.
Noting also that frequent colds can lead to lifelong asthma conditions
Noting further that we really don't know the long-term effects of Covid on young people (both in the more frequent case of a speedy recovery and in the less frequent "long Covid").
Masks in school, and basic good hygiene (washing hands, having the school disinfect contact surfaces such as doorknobs multiple times per day, ...) go a long way to keeping everyone safe and healthy.
One of the things that doctors did was compare asthma rates between people who were already working from home to asthma rates of people who suddenly got thrown home due to Covid.
Asmtha went down more than expected in the people who suddenly got thrown home than in the folks who were already working from home. Since both groups faced roughly the same kind of environmental conditions (ie. pollution going down due to less driving), the excess decrease is posited to be purely due to pathogens.
Apparently, a not insignifcant chunk of asthma attacks are due to basically swimming around in continuous, low levels of pathogenic exposure.
Even if they did work, there is a cost / benefit that needed to be calculated that never was. All these “experts” myopically focused on one exact thing to the literal exclusion of everything else. And if you did raise objections or concerns you were (and still are) subject to a bunch of horrible retaliation.
But covid measures became irrational.
Lockdowns continued over a year after the vaccine was available
Then when those field hospitals closed virtually unused, instead of lifting restrictions and celebrating Covid wasn’t as bad as predicted, society decided to double down on the mitigations and continue them for two years.
"Two weeks to slow the spread [while we build hospital capacity]" is what we were sold on, then it just sort of kept going and people forgot what lockdowns were meant for.
In an ideal world, we'd vaccinate children against RSV. Acquiring immunity by suffering through an actual infection is always, always worse than acquiring it by a vaccine. About 100k children die from RSV each year!
Thankfully, there are vaccines in the pipeline [1], and I seriously hope that mRNA technology will increase both the development speed and the availability of vaccines in general.
[1] https://www.pfizer.com/news/press-release/press-release-deta...
say that to the whoever ends up coming down with narcolepsy, thrombocytopenia, acute peri/myo-carditis, shingles reactivation, etc.
There's enough discussion about this happening after vaccination: https://pubmed.ncbi.nlm.nih.gov/34579250/
"Conclusion: This study indicates that the occurrence of VZV reactivation is clinically relevant. However, our findings suggest that COVID-19 vaccination is safe, and remains strongly recommended." https://pubmed.ncbi.nlm.nih.gov/35931613/
Of course there's the obligatory, robotic, throat-clearing that vaccines should still be taken even when they find evidence of a side-effect.
Covid has only been around for a couple of years.
For example, see: "The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients-A Large Population-Based Study"
https://pubmed.ncbi.nlm.nih.gov/35456309/
Above-normal levels of myocarditis and pericarditis were associated with vaccination (Pfizer has been used in Israel where the study originates) but not with covid-19 infection.
You have my sincere sympathy with regards to your mother-in-law's condition.
I have heard similar and worse anecdotes in which covid vaccines (especially boosters i.e. nth shots) have been the culprits and seen some severe adverse reactions in close acquaintances.
Studies in the UK [1] and US [2] have shown that while, yes, there is an increased risk for myocarditis in vaccinated people, the risk of myocarditis in infected people is way higher.
[1] https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA....
https://doi.org/10.1093/cid/ciab941
... What? Here in Germany, that's like one of the basic things that people who deal with needles on anything alive learn.
https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/admi...
In practice there is a wide variance between US healthcare providers depending on where they work and how they were trained. Some aspirate, some don't, some try but use the wrong technique.
From the first one, it actually says for men younger than 40, myocarditis is actually higher in vaccinated, whereas for women it's similar to infection:
"In men younger than 40 years old, the number of excess myocarditis events per million people was higher after a second dose of mRNA-1273 than after a positive SARS-CoV-2 test (97 [95% CI, 91–99] versus 16 [95% CI, 12–18]). In women younger than 40 years, the number of excess events per million was similar after a second dose of mRNA-1273 and a positive test (7 [95% CI, 1–9] versus 8 [95% CI, 6–8])."
That supports my belief that vaccination should be voluntary for everyone but especially young people.
I haven't read it beyond the abstract.
We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test.
In other words, all of the participants received covid vaccines.
The second paper you've linked studied unvaccinated persons (mRNA-vax recipients were specifically excluded) and its claim of higher rates of myocarditis for covid infection is based other researchers' values of myocarditis incidence post-vax and, as alluded to in the Discussion section, skewed by relatively low 2nd-shot uptake among the American participants (myocarditis risk associated with mRNA shots goes up with each successive dose).
The Israeli paper looks at myocarditis in persons before the vaccines became available (March 2020) and then afterwards. In Israel, 2nd shot and further shot uptake was much higher than in many other places.
I do not deny that vaccines can cause adverse effects - but outside of vaccine trials and Army experimental vaccines, the rate of adverse effects is vastly lower than the rate of the same adverse effect that people experience who get infected.
I mean, yes, but only because that's one of our criteria for approving a new vaccine.
https://www.frontiersin.org/articles/10.3389/fimmu.2022.8266...
lets lock kids in solitary confinement until it's safe to leave, good plan /s
I'd love to see schools take a serious look at air movement and filtration.
Deeming it "irrecoverable" requires a time machine; one of the most frustrating parts about dealing with child development is the impacts take decades to sort out, in sometimes surprising fashion.
Europe apparently operated a lot less draconian wrt schools, never really closed down & things worked out pretty well. The science was pretty clear even from early on but democrats in US said georgia reopening schools was "an exercise in human sacrifice." You don't need a middle ground for the least vulnerable age-range for covid.
> Deeming it "irrecoverable" requires a time machine
what? it's irrecoverable because you never get back lost time, the past is settled and kids lost out on crucial brain development windows
I certainly would've preferred this; here we kept the bars open, but closed the schools. Both are middle grounds, I preferred Europe's prioritization. At the time these decisions were being made, some folks talked about R0 being like a budget - you want it under one, and each mitigation gets you part of the way there. I was disappointed to see the US prioritize economy over kids; much of the world made the opposite choice, and provided more income supports to keep kids in school.
> You don't need a middle ground for the least vulnerable age-range for covid.
This would be a great point if kids lived alone, with no vulnerable folks at home.
> it's irrecoverable because you never get back lost time
People recover from lost time frequently. If your teacher is sick and you have a substitute teacher for a couple days, that time gets made up. There's summer school, enrichment programs, etc. Very little of what kids learn in school has to be learned in one specific set of months; there's a pretty large range in exact ages within a single grade, even.
It'll be years, maybe decades before we know how plastic child development is in this regard. Right now, there are massive unknowns in evaluating all of this.
Nope. They fall behind and don't catch up. https://www.edweek.org/education/students-who-struggle-early...
Kinda hard to do if you are trapped at home with an abusive family. For many kids school is not just education but a sanctuary from a broken home.
It takes a lot of privilege to support closing schools for any duration of time—especially two years.
yea the young kids who are forming hobbies, instead of say learning to read or talk
To start, kids don't learn how to talk in the school. Not normally and if they are so young as to not being able to talk still, school is basically a convenience parking for toddlers.
We shouldn't adjust the laws to the saddest history that we can find. Treating everybody in a population as if all of them were outliers does not give the desired results.
Children are able to learn in lots of places apart of the school. Yes, is a fact. They can learn a lot for example from their grandpas and grandma. Of course, as long as their grandparents are alive because they were smarter than the fake news and the 'magufo' crew.
The effects are especially clear for the disadvantaged who struggled before.
Immunology is really tricky because the human immune system is quite complex. These kinds of findings sadly need to be taken with a grain of salt.
Evidence with a sample size of 1: I have a pandemic toddler and a baby. Toddler was not sick once in first 18 months. Both just got RSV. Toddler was fine after a couple days. Infant was in ER and is still having effects weeks later.
None of that is to downplay the potentially fatal seriousness of RSV. The immune system is imperfect after all. The NICU is maybe the most depressing place I’ve ever been in my life and my heart goes out for every parent who has or has had a child there or in any pediatric ICU.
For example, if your toddler has a stuffy nose, you can help them to blow it. For an infant, you need a tool to suction their nose which can be difficult to do. That same stuffy nose might cause poor feeding and dehydration which on top of the general breathing issues caused by RSV can lead to a rapid deterioration in the infant's health.
Even with all the supportive care (oxygen, regular suctioning, a feeding tube), it took a full 5 days in the hospital for our infant to recover.
My first-hand experience with this seems to be consistent with larger trends as well. A recent CDC presentation shows that children age 0-5 months are hospitalized by RSV at far higher rates than any other age group. [1]
[1]: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-...
https://www.google.com/search?q=site%3Anews.ycombinator.com+...
Ozone Generators that are Sold as Air Cleaners : https://www.epa.gov/indoor-air-quality-iaq/ozone-generators-...
Ideally, don't use ozone-generating or other gimmicky devices. Ventilate the space instead. Usually, unless there is a high pollution event or it is peak allergy season, the air outside is lower in contaminants than indoor air.
Vacuum frequently using a machine with a HEPA filter and run your home's air circulation system with a MERV13 filter, or get/make an air filter. (https://www.youtube.com/watch?v=aw7fUMhNov8)
If you feel you must use an ozone generating device, don't use it if the spaces are occupied and ventilate them thoroughly before occupying them again.
Definitely don't use them along with other cleaning/deodorizing chemicals, as the result of mixing those with ozone is complex and poorly understood.
It is not true though that the air will become amazingly clear based on the presence of the filter. I used a 11 for a long time and it certainly didn't stop everything from getting covered in dust anyway. My place is not airtight.
A dirty filter (do you know how many people don't ever change their filter?) will put far more load on a blower than a better filter.
A MERV11 is significantly less effective, and wouldn't affect dust production anyway since it is created mostly by your skin, clothing fibers, etc.
During the California wildfires I bought several air sensors and placed them around my house and experimented with different filters. a MERV16 with a carbon layer reduced VOCs, PM2.5, etc all down to extremely low levels in every room.
High MERV ratings put more load on the blower equipment.
A high MERV filter will remove bacteria/viruses as well as a bunch of other stuff.
https://twitter.com/unbiasedscipod/status/158891593499112652...
https://nitter.net/unbiasedscipod/status/1588915934991126529
These are scenarios where I really want an expert to summarize the current state of what's known rather than trying to figure it out from a PubMed search, especially when there seem to be competing opinions.
I'm tired of everyone being an "expert". A true expert should have no problem presenting proof to their claims.
For example, "debt" could be referring to the fact that many people might've already gotten [insert infection name here] over the last couple of years, but they did not, and now there's an increased number of people who don't have immunity to it compared to a world where there not been a pandemic. The fact that this was ignored almost seems misleading given that she claims to be an immunologist.
- I have a ~20-month-old in daycare. He brings something home every couple weeks. This is our first child so I have no idea if this is normal or unique to this time period.
- Coworkers with children seem to be dealing with a lot more "wow that wiped us out for a week" type of symptoms versus the typical "sniffles and sore throat" symptoms associated with the common cold.
- I have had two cold/flu type bugs this year (not COVID, confirmed by at-home tests) that put me on my ass for a few days. I haven't had that happen in 10+ years.
Extra context: I am vaccinated for COVID, yet I still had COVID this past year. COVID was mild, mostly achy/headache-y that lasted about 2 days. No breathing issues or loss of smell/taste. I attribute that to the vaccination. I did not get my flu shot yet this year but am planning to do so.
Stay safe out there, friends.
2. You also have a kid and have more co-worker kid talk, so that's just something you wouldn't be aware of before
3. You've been getting less sleep as a new parent and you've also got a little petri dish living in your house now.
https://www.statnews.com/2021/06/02/pandemic-upside-flu-viru...
2 steps forward, 1 step back.
There's something that's just not sexy about RSV - it's far more dangerous to children than COVID is, yet there's hardly any coverage. If this many kids were getting COVID, I would wager we'd be seeing a high volume of alarmist coverage.
Yes, there have been a few cases where healthy children suffered serious symptoms but the absolute numbers are tiny.
https://www.cdc.gov/mmwr/volumes/71/wr/mm7145a3.htm?s_cid=mm...
> Among 473 infants aged <6 months hospitalized during the Omicron BA.2/BA.5 variant-predominant period, 397 (84%) had COVID-19–related symptoms. Among all 473 infants, 174 (38%) were aged <1 month; 69 (39%) of these were birth hospitalizations (Table 2). Among infants who received a positive SARS-CoV-2 test result during the birth hospitalization, 60 (87%) were asymptomatic
84% of all hospitalizations for <6 months seems less than ideal.
There probably are this many kids getting COVID.
Reporting on the facts can go quickly, but reporting that includes recommendations and impacts gets really risky as we now know.
Also, a lot of people haven't had the flu in years - it's not mild. It's often a week of being miserable in bed, not two days of sniffles. Mild COVID can feel like a cold, but COVID is more contagious and (I believe) more prevalent at this point. If you have any of those symptoms, you should probably assume it is COVID and take a test if you need to be around others.
https://www.cdc.gov/flu/weekly/WeeklyArchives2022-2023/WHONP...
Going back to the 2021 year, that's where the pattern returns to normal, i.e. early 2021 had very few positive influenza tests, but then it starts climbing again in late 2021 (Nov 2021 report):
https://stacks.cdc.gov/view/cdc/111914
Interestingly, rates of co-infection (COVID + flu) seem to be all over the place, this study found a ~50% coinfection rate in 2021-2022 (others are much lower, maybe people with Covid were not also being tested for flu?
https://medicine.missouri.edu/news/study-finds-high-prevalen...
I don't think her situation is all that uncommon. Not every kid went straight to daycare prepandemic. Is there any evidence that children with relatively closed social groups get these severe symptoms when they do get exposed?
I don't have a great answer for what is going on, if not this "immunity debt" thing. It just seems a bit flimsy to me.
For what it's worth, I've had ER trips for 2 of my toddlers in the past month with rhinovirus/enterovirus, the other pathogen besides RSV that's slamming toddlers currently. They both made pretty quick recoveries with prednisone for one of them and an albuterol nebulizer for the other.
Cold showers, don’t drink too much, get enough sleep, don’t stress too much, do some exercise to get the blood pumping - good recipe for health
Current data shows that influenza is back, but not yet with a vengeance. Predominant type is H3N2 and mainly children 0-4 are affected. SARS-CoV-2 only has a small share.
It's my understanding some candidates are in trials now.
I guess making up analogies doesn't work....
Your immune system actually never takes a break: it's continually working intensely, that's why/when you're not ill most of the time.
Case in point: your body _constantly_ gets "agressions" from bacterias, viruses, germs from the air your breathe, the things/people you touch, the scratches you make, what you eat.
When you get symptoms (a flu, a cold, whatever disease), it's because your immune system gets overwhelmed, is working even harder, has a hard time to keep up.
When you get exhausted for other reasons (not enough sleep, too much exercise, stress, etc.) your body has less energy for your immune system to work properly. This explains why you easily catch an infection you wouldn't when you're not exhausted.
It's a matter of preventing it (washing hands often, masking in crowded areas, ventilating rooms properly) and helping our body system to be rested/strong (getting enough sleep/rest, dressing warm, drinking enough). And of our own conditions. And luck.
Yes, immune system memory is at play, but even with the exact same virus, getting the flux in year 1 doesn't mean you'll not get it in year 2 if your body is unwell already.
Moreover, getting the flu (or any infection really) is not a small thing: it can break you down for days, weeks, months and even kill you. Best to avoid it when you can, and be happy when you avoided it.
The pseudo darwinist thing of "getting infected trains your immune system / makes you stronger" or "what doesn't kill you makes you stronger" is bs on the other hand.
Please don't propagate that our immune system is a muscle we need to train (in that simplified way).
Polio disproves that conclusively.
Your explanation agrees with me here; describing it as a problem with the immune system is inaccurate. Relatively rapid immune escape is a feature of certain viruses.