There are reports of an uptick in cases of pneumonia in parts of China, especially among children. The WHO has asked for more information, and experts are watching. An email from ProMED seems to have kicked off initial interest. Here’s the initial report, followed by my impressions of what we might be dealing with here:
Thanks for the article. My 3yo was diagnosed with pneumonia 2 weeks ago. The pediatrician told me they are seeing far more cases of pneumonia this fall than in many years past. The next day her friend from class was also diagnosed with pneumonia. Her pediatrician said the same thing, that they are seeing unusually high cases right now. I’m not saying it’s the same as what’s happening in China, but it certainly made me wonder if it was out of the norm.
Thanks for the analysis. I now feel inoculated against premature panic. However, I'm confused about the whole "immunity deficit" concept. It seems that the old idea of deliberate exposure to foster immunity is not a 'one size fits all' proposition. I can understand when getting a disease as a child is no big deal compared to getting it as an adult, but what about other diseases? Covid-19? Does it make sense to deliberately get a disease to "build up immunity to keep you from getting the disease'?! Aren't you always better off to just not get it at all? What if you're using up limited resources like naive immune cells? Maybe okay for a child but progressively less wise as you get past youth? How much exposure to microbes promotes health versus degrading it? How clean/careful is "too clean" must surely depend on what you're likely to catch - "Good" Microbes vs pathogenic ones. I've read both that getting Covid provides immunity to it for weeks to months and that "the people most likely to get Covid are the ones who've already had it". Lifestyle? Circulating antibodies? What's your take?
"The concept of "immunity debt" has gained traction recently, suggesting that the reduced exposure to common infections during the COVID-19 pandemic has led to a weakened immune system, particularly in children. However, the concept of deliberately exposing individuals to diseases to build immunity is not a straightforward one, and it's important to consider the nuances and potential risks involved.
While it's true that exposure to certain infections during childhood can help develop immunity, this approach is not universally applicable. Some diseases pose significant risks, especially for young children or individuals with underlying health conditions. Deliberately exposing individuals to such diseases can be dangerous and is not recommended.
In the case of COVID-19, the idea of deliberately contracting the virus to gain immunity is particularly concerning. While some people may experience mild symptoms or even be asymptomatic, COVID-19 can be a serious and even life-threatening illness, especially for vulnerable populations. The risk of developing long-term complications, such as long COVID, also exists, even for those who initially experience mild symptoms.
Moreover, relying on natural infection for immunity is less predictable and reliable than vaccination. Vaccines provide a controlled and targeted exposure to the virus or its components, triggering a strong immune response without the risks associated with actual infection.
Regarding the concept of "using up" naive immune cells, it's important to note that the immune system is constantly adapting and producing new immune cells. Exposure to microbes can indeed stimulate the immune system, but there is no evidence to suggest that deliberate exposure to diseases depletes the immune system's reserves in a way that compromises overall health.
The balance between exposure to microbes and maintaining a clean environment is a complex one. While excessive cleanliness can reduce exposure to beneficial bacteria and potentially weaken the immune system, maintaining good hygiene practices is crucial for preventing the spread of harmful pathogens.
The notion that "the people most likely to get COVID are the ones who've already had it" is not entirely accurate. Re-infection with COVID-19 is possible, but prior infection does provide some level of protection, especially against severe illness. However, this protection can wane over time, and vaccination is still recommended for those who have had COVID-19 to maintain optimal immunity.
In conclusion, while exposure to certain infections during childhood can contribute to developing immunity, deliberately exposing individuals to diseases is not a recommended approach, especially for serious illnesses like COVID-19. Vaccination provides a safer and more effective way to build immunity and protect against preventable diseases."
Thanks for putting together this piece. I have to wonder if part of this is surveillance for HPAI and clearly it in the back of some folks mind. I, too, get the ProMED Digest in my e-mail and wanted to follow up (they also do a good job of follow ups). A note about your kids, welcome to the world of petri dishes as my RN sister likes to call them...
Thank you for this and I can add your five year old story. I teach pre-k and our class and school has sounded like what I think a “TB” ward would. It is terrible and it is lasting on and off for weeks and for me too! Tested for it all and nope- just respiratory fun. Hope you and yours had a wonderful Thanksgiving.
Thanks for the article. My 3yo was diagnosed with pneumonia 2 weeks ago. The pediatrician told me they are seeing far more cases of pneumonia this fall than in many years past. The next day her friend from class was also diagnosed with pneumonia. Her pediatrician said the same thing, that they are seeing unusually high cases right now. I’m not saying it’s the same as what’s happening in China, but it certainly made me wonder if it was out of the norm.
I think we’re still seeing catch up as well. In the fall and winter of 2020 and 2021 there was so much less flu and rsv than usual.
Thanks for the analysis. I now feel inoculated against premature panic. However, I'm confused about the whole "immunity deficit" concept. It seems that the old idea of deliberate exposure to foster immunity is not a 'one size fits all' proposition. I can understand when getting a disease as a child is no big deal compared to getting it as an adult, but what about other diseases? Covid-19? Does it make sense to deliberately get a disease to "build up immunity to keep you from getting the disease'?! Aren't you always better off to just not get it at all? What if you're using up limited resources like naive immune cells? Maybe okay for a child but progressively less wise as you get past youth? How much exposure to microbes promotes health versus degrading it? How clean/careful is "too clean" must surely depend on what you're likely to catch - "Good" Microbes vs pathogenic ones. I've read both that getting Covid provides immunity to it for weeks to months and that "the people most likely to get Covid are the ones who've already had it". Lifestyle? Circulating antibodies? What's your take?
This is what Bard had to say on the subject,
"The concept of "immunity debt" has gained traction recently, suggesting that the reduced exposure to common infections during the COVID-19 pandemic has led to a weakened immune system, particularly in children. However, the concept of deliberately exposing individuals to diseases to build immunity is not a straightforward one, and it's important to consider the nuances and potential risks involved.
While it's true that exposure to certain infections during childhood can help develop immunity, this approach is not universally applicable. Some diseases pose significant risks, especially for young children or individuals with underlying health conditions. Deliberately exposing individuals to such diseases can be dangerous and is not recommended.
In the case of COVID-19, the idea of deliberately contracting the virus to gain immunity is particularly concerning. While some people may experience mild symptoms or even be asymptomatic, COVID-19 can be a serious and even life-threatening illness, especially for vulnerable populations. The risk of developing long-term complications, such as long COVID, also exists, even for those who initially experience mild symptoms.
Moreover, relying on natural infection for immunity is less predictable and reliable than vaccination. Vaccines provide a controlled and targeted exposure to the virus or its components, triggering a strong immune response without the risks associated with actual infection.
Regarding the concept of "using up" naive immune cells, it's important to note that the immune system is constantly adapting and producing new immune cells. Exposure to microbes can indeed stimulate the immune system, but there is no evidence to suggest that deliberate exposure to diseases depletes the immune system's reserves in a way that compromises overall health.
The balance between exposure to microbes and maintaining a clean environment is a complex one. While excessive cleanliness can reduce exposure to beneficial bacteria and potentially weaken the immune system, maintaining good hygiene practices is crucial for preventing the spread of harmful pathogens.
The notion that "the people most likely to get COVID are the ones who've already had it" is not entirely accurate. Re-infection with COVID-19 is possible, but prior infection does provide some level of protection, especially against severe illness. However, this protection can wane over time, and vaccination is still recommended for those who have had COVID-19 to maintain optimal immunity.
In conclusion, while exposure to certain infections during childhood can contribute to developing immunity, deliberately exposing individuals to diseases is not a recommended approach, especially for serious illnesses like COVID-19. Vaccination provides a safer and more effective way to build immunity and protect against preventable diseases."
Thanks for putting together this piece. I have to wonder if part of this is surveillance for HPAI and clearly it in the back of some folks mind. I, too, get the ProMED Digest in my e-mail and wanted to follow up (they also do a good job of follow ups). A note about your kids, welcome to the world of petri dishes as my RN sister likes to call them...
Glad it was useful! I wonder the same. I am not an expert in how China monitors for outbreaks, but I think it makes sense.
Thank you for this and I can add your five year old story. I teach pre-k and our class and school has sounded like what I think a “TB” ward would. It is terrible and it is lasting on and off for weeks and for me too! Tested for it all and nope- just respiratory fun. Hope you and yours had a wonderful Thanksgiving.
Tracks with all I am seeing/hearing.
And you too!