Still with the Immunity Debt Claims?

Two competing claims were made in the past few days on whether Long Covid should be a concern for parents of children or if children actually develop greater immunity from getting sick. Still.

In one corner, two Canadians and an American:

Dr. Lyne Filiatrault, Arijit Chakravarty, and T. Ryan Gregory wrote this week on immunity debt: 

"Infections do not build a stronger immune system. There is no lasting immunity to RSV. If you get infected one year, it does not mean you avoid it the next. ... With influenza, the virus in circulation this year is not the same as last year. ... You can get infected over and over with SARS-CoV-2. ... In the absence of public health measure to limit transmission, repeated waves of infection will continually surge through the population driven by the evolution of new variants and the waning population immunity from infection and vaccines. If you are lucky, your most recent vaccine will offer you some protection against being infected, but this protection varies from one person to the next and lasts only for a few months. ... Long-term effects [of SARS-CoV-2] are shockingly common. ... Evidence is accumulating that the virus damages our immune system."

They recommend cleaner air and respirators, like N95s and KN95s that seal well to the face. 

Side note: I kinda wish they just said "well-fitting masks" but I understand why they didn't. For some people, the term "masks" translates to "surgical masks" which do very little to stop airborne viruses because they fit so loosely and have fewer layers. They're made for stopping droplets of bodily fluids. But the term "respirators" can conjure images of gas masks or people on a ventilator in the hospital. "Respirator" is more accurate, but might create more aversion in the general public, so I lean towards "well-fitting mask."    

In the other corner, two Australian epidemiologists: 

Michael Mina wrote that he doesn't have a greater concern about Covid than RSV or flu because the latter two are more aggressive viruses, and he indicated that both of his kids currently have RSV. But then he says this very questionable bit:

"None are good [RSV, flu or Covid]. All we need to gain immune memory against, and the only way we do that for RSV is through infection (unfortunately) and for Covid and flu is vaccination and infection. Young children are considered vulnerable to infectious diseases not because their bodies are more frail or vulnerable, quite the contrary, but because they do not yet have robust immunological protection."

I'm gobsmacked by this. Kids need exposure to commensal microbes (i.e. the microbiome) but not pathogenic microbes that make them sick. This was well understood and widely known until Covid lockdowns, when suddenly some players in the game started suggesting that kids need to be infected with viruses. It's simply not how that works. I collected studies and articles on it for a few years. Now I just shake my head that it needs to be re-proven to people. 

Gideon M-K agreed with Mina's sentiment but not the science,

"As with any disease, it is always better not to get Covid-19. There is no disease that we have discovered where an infection is good for your health. By definition, any infection that results in symptoms -- and many that don't -- is net negative. Ideally we should be taking reasonable actions to reduce the likelihood of kids getting any diseases at all. However, I'm personally no more concerned by Covid-19 than anything else that she's likely to pick up at daycare. ... Repeat infections are much lower risk than initial ones. ... Existing immunity reduces the risk of all the negative outcomes including Long Covid."

First of all, that's completely contrary to studies that show that the number of prior infections is strongly correlated to having Long Covid, with each acute infection increasing the risk.

Then he dismisses Long-Covid in children as a risk to be concerned about, linking to a study from October 2023 that found just 1 in 20 had symptoms for over a year. That's 5% of infection people. They found the variant, initial severity, and pre-existing health conditions were the biggest risk factors for Long Covid, not age. That is, it can strike any age. In fact they found lower reporting of persistent symptoms in older ages, contrary to what M-K suggests. 

They both clarify a few times that they're still concerned about Covid, just not more concerned than RSV or flu despite long-term conditions associated with it. 

Danilo Buonsenso responded:

"I'm a pediatrician, a pediatric ID doctor, PhD and MSc, and a father. I've seen hundreds of kids never returning to their pre-Covid health after getting Covid, from all over the world."

The big question is, how many is too many to catch a preventable disease that can have long term consequences for 5% of those infected before we take precautions? That's ten times the risk of paralysis from a polio infection (0.5%)--but more people seem to be okay with that too. 

Michael Mina also has credentials, but he has been a professor and researcher (he researched and advised on Covid tests), not someone on the front lines of treating children. It seems stats aren't enough for some, and it might require seeing the effects first hand before people start to take some precautions. I don't really understand any other reason for someone in the field to disagree on something that seems foundational. We know that cleaning the air with ventilation, filtration and/or UV light can pretty much end viruses, but that's not happening any time soon. Not for us at least. When Covid hit, the White House and the Davos Congress Center and other places inhabited by the elites jumped into action to get better filtration systems and put HEPA filters everywhere. Meanwhile, schools in Ontario still aren't allowed to accept donated CR boxes. But we're still, so far, allowed to wear well-fitting masks. 

ETA January 24: