COVID-19's Connection to the Recent Rise in Respiratory Infections

January 11, 2024

An article published yesterday in JAMA Network discusses the surge in respiratory illnesses (particularly respiratory syncytial virus (RSV) infections) in children in the US, China, and other regions during 2021 and 2022. The unusual timing and increased cases have sparked a debate on how the COVID-19 pandemic may have influenced the rates of other infectious diseases. Terms like “immunity debt” and “immunity theft” have been coined to describe potential explanations for this correlation.

Immunity debt* refers to the potential negative consequences of reduced exposure to pathogens and decreased vaccination rates during interventions like lockdowns.

Immunity theft, a term not found in scientific literature**, suggests the concept that a specific infectious agent, like the SARS-CoV-2 virus causing COVID-19, may compromise or “steal” a person’s immunity, potentially leaving them more susceptible to other infections. Infectious disease specialist Nathaniel Erdmann stated that “a period of increased vulnerability following an acute process is not only possible but probable” but that “postviral infection “ripples in the immune system” are transient, usually resolving in 20 to 30 days.”

* Some experts in the field prefer the term ‘Immunity Gap.’

** It is important to note that this term is not scientifically established and may be more of a metaphorical or rhetorical way to express complex interactions within the immune system.

study published in a December research letter in JAMA Pediatrics suggested that children hospitalized with them have been sicker than before the COVID-19 pandemic. The authors noted that the “COVID-19 pandemic provides a unique scenario with which to explore the shift in RSV epidemics and age of hospitalization because of lack of previous RSV exposure.”

Also discussed were the potential beneficial effects of pandemic-related measures, such as a decrease in asthma attacks and the apparent extinction of a specific strain of flu. The influenza B virus strain known as the Yamagata lineage, discovered in the 1980s, has not been identified since March 2020, leading researchers to believe it may no longer exist. A national survey study published as a research letter revealed that asthma attacks among Black adults in the United States, who historically experience higher rates than Hispanic or White adults, decreased from 29.3% to 22.1% between 2019 and 2022. The authors attributed the decline in chronic airway disease exacerbations, at least in part, to the reduced prevalence of common respiratory viruses during this period.

Overall, the article presents various perspectives on the interplay between COVID-19 and other respiratory infections, highlighting the need for continued research to better understand the complex dynamics influencing disease patterns. While thought-provoking and worthy of further investigation, one must remember that the immune system’s response is vastly complex, and it is imperative not to oversimplify the reasons behind any observed trends.