“Anyone with young people will temporarily agree that our young people seem to be in poorer health and in poor health more than in the past,” said Rodney Russell, a professor of immunology and virology at Memorial University in Newfoundland.
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An early crushing of respiratory viral infections has again raised the specter of an “immunity debt,” a concept described by some as an accidental boomerang effect of distancing, masking, and other COVID containment measures used to slow the spread of SARS-CoV-2.
Experts disagree on whether “immunity debt” is a genuine phenomenon or a practical pseudoscience. But hospitals are reporting unprecedented increases in young people with severe viral infections that are causing traditionally long wait times and pushing extensive care beyond capacity.
Adult hospitals are encouraged to settle for adolescents 14 years of age and older who require intensive care to free up beds for young children. “The head of Ontario’s COVID-19 Intensive Care Command Centre wrote to the hospital’s executive directors in a memo received via The Canadian Press.
At CHEO Ottawa, “it’s heartbreaking to see so many young people and families waiting so long to be served,” said Dr. Anna S. Brown. Mona Jabbour, interim pediatric lead at CHEO, on a media call Thursday.
There is not one, but several points at play, adding the number one lack of attention on the net and the shortage of pain and fever medication for children that parents have been dealing with since last summer.
But it’s the volume and influx of young people with RSV (respiratory syncytial virus), influenza, COVID and other infections that overwhelm hospitals. .
Masks and school and daycare closures, lack of birthday parties, organized sports, and other interventions to thwart the spread of COVID and prevent hospital overcrowding have also slowed the spread of other pathogens.
“In recent years, younger young children would have had those diseases, and until the age of two, three, 4 years, they have some immunity to those viruses,” Jabbour said.
“Because we haven’t noticed those viruses in recent years, we see them come together and there’s not that immunity that we see in older kids. “
Babies get sick. Young children get sick. Older kids too. ” It’s all at the same time,” Jabbour said.
Some researchers believe that the immune formula needs constant stress, that exposure to germs and bacteria in the environment is vital for the progression of the immune formula. Without this incentive, the immune formula reacts more slowly to long-term infections.
Being exposed to seasonal viruses also acts as an immune booster, boosting antibody levels to fight the natural decline in immunity, Russell said.
“So if all of us, just kids, have had some ‘germ-free’ years, then it’s possible that we all have lower levels of antibodies than we could have had without wearing masks” and other public fitness interventions, he said. . .
The concept of “immune debt” warned when we started hiding from SARS-CoV-2, Russell said. French researchers reported last year that a lack of “immune stimulation” could lead to more intense outbreaks of RSV and flu in the coming years.
“The longer those periods of ‘low viral or bacterial exposure,’ the greater the likelihood of long-term outbreaks,” they wrote.
However, delaying the first infections through an insect of the respiratory tract has benefits. Infants and toddlers are at a higher risk of hospitalization with RSV than older children, because in infants, this first infection is more likely to penetrate deeper into the lungs.
Mucus begins to obstruct the small airways. Young children “come in for bronchiolitis, they come in for pneumonia, they may need oxygen therapy, they may need breathing to help them breathe,” said Dr. Jesse Papenburg, a pediatric infectious disease specialist at Montreal Children’s Hospital. So tired by the undeniable effort of breathing that they end up becoming dehydrated.
There was almost no RSV in the winter of 2020-21, and a short season last year that began in late summer and ended in late December.
If a pathogen like RSV or the flu necessarily goes away over a number of years, “all the other people who would have become inflamed in those years don’t become inflamed, and this organization of other vulnerable people accumulates,” said the infectious disease expert at McMaster University. . Mathieu Miller.
Release the brakes, lift public fitness measures, and a virus like RSV can spread quickly, with a higher attack rate. More people vulnerable to a disease means more infections. “It’s just a numbers game,” Miller said.
There is no “flaw” in children’s immunity, he and Papenburg said. Lockdowns and public fitness measures have weakened or broken our children’s immunity, they said.
“Other people use the term ‘immunity debt’ to refer to other things,” Miller said. “Some have a clinical basis. Other iterations are misinterpretations of the available data.
There are also considerations that the concept can simply be used to justify governments never imposing masks or other interventions. “I don’t see it that way,” Russell said.
“I still think many would have died unnecessarily, despite how boring, frustrating and psychological and/or economically painful the measures were for many of us who didn’t have to worry about dying from COVID. But of course, at first, we didn’t know our own COVID-19-like dangers. “
If there’s “immune debt,” Russell doesn’t think it’s vital and that, whatever it is, it will quickly balance out, “which is probably precisely what we’re seeing right now: kind of a waste of time” on the component. of pathogens and the immune system.
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