You Don't Have Immunity Debt

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You know how sometimes you catch someone in a lie, and so they tell an even bigger lie to try and cover up the first lie they told?

Well, that's happening right now.

Last winter, a handful of celebrity doctors went on mainstream news networks to assure us that Omicron was "mild." They carpet-bombed us with articles and tweets, doing their best to brainwash everyone.

They were wrong.

In the end, real science junked that idea. An article in the Journal of the American Medical Association showed that Omicron killed more people than previous variants, even when adjusting for other factors. Another study by doctors at Massachusetts General and Harvard Medical found that Omicron was just as deadly. In fact, "the risks of hospitalization and mortality were nearly identical." As it turns out, the entire idea of "mild" Omicron was based on an old, flawed idea known as the law of declining virulence, developed by a doctor who was studying tick-borne disease in cows. It was debunked decades ago.

Most epidemiologists know that viruses don't magically evolve to become milder. Virus evolution is random and chaotic.

In some cases, viruses evolve to become more deadly.

A handful of actual scientists tried to explain all this last winter, including disease experts at Johns Hopkins. A handful of other established experts spoke out against this myth. As a microbiologist at Penn State told Politifact, "You can’t just say it’s going to become nicer." They were largely ignored, because everyone already sort of believed the misinformation. If they knew it was based on a study about cows, they probably would've thought twice.

This year, the makers of "it's mild" are back.

They're selling "immunity debt."

We should be skeptical.

Schools and daycares are sending letters home to parents talking about this "immunity debt.” They’re saying that healthy children are getting sicker, even dying, because they weren't exposed to enough germs over the last two years. Newspapers and TV stations across the country are running with it, proposing it as a "possible reason" for this year's explosion in pediatric hospitalizations. Meanwhile, major medical organizations have sent a letter to President Biden urging him to declare an emergency over an “alarming surge of pediatric hospitalizations” due to a range of respiratory viruses, including Covid.

A lot of people are drinking the "immunity debt" kool-aid.

After all, Americans have believed for generations that getting sick is "good for you." We think our immune system behaves like a muscle. We worry that if we're not giving it a workout, we'll get weak.

It's a myth, just like the law of declining virulence.

Here's why.

Getting sick a lot hurts your immune system.

A recent article in The Financial Times talks about a new "revisionist narrative that Covid measures did more harm than good." The immunity debt theory is playing a major role here, and it's not supported by science at all. As one immunologist at Imperial College says, "we would still have open sewers and be drinking from water contaminated with cholera if this idea were followed to its logical conclusion." Another immunologist at the University of Surrey says, "The immune system is not viewed as a muscle that has to be used all the time to be kept in shape and, if anything, the opposite is the case."

Here's the truth:

Your immune system actually gets weaker the more pathogens you have to fight off. It's one of the big reasons why older people are more vulnerable to common illnesses. Eventually, your immune system gets worn down.

It wears out.

In that sense, comparing your immune system to a muscle holds up. You can wear out muscles, joints, and tendons by overusing them. Just talk to anyone who works a physically demanding job. You can wear out your knees. You can wear out your shoulders. You can wear out your wrists.

Most health experts will tell you that you're better off to avoid getting sick. We've simply accepted sickness as normal.

We've embraced the lore that it's "good for us."

It's not accurate information.

It's a coping mechanism.

There's no evidence behind "immunity debt."

Several medical researchers have tried to trace this phrase back to its origins. They've landed on an article from 2021 that ultimately offers a "hypothesis" that kids "may" get sicker as a result of pandemic protections.

Here's Jonathan Jarry, an acclaimed science writer at McGill:

The evidence presented for this immunity debt due to understimulation—advanced first as a certainty, then as a hypothesis—is lacking.

But this paper, boldly asserting the existence of an immunity debt in children, opened the floodgates, and soon it was being quoted in other papers and in media reports, and now we are led to believe that our immune system is just like a muscle: stop working it out and it will atrophy. 

This is the challenge of science communication. Simple analogies stick in people’s minds, even when they are wrong.

Basically, a clever analogy has gotten stuck in the cultural mindset. It's not true. It just sounds good. It builds on an idea a lot of us already sort of believed, that getting sick trains our immune systems to fight germs.

It's not real science.

It's dangerous.

Your body needs microbes, not pathogens.

Just like every convincing lie, there's a kernel of truth behind the idea of "immunity debt." It's about how your immune system functions.

Over time, your body develops a complex biome with trillions of microbes including bacteria, fungi, and even beneficial viruses.

Think of it as a rainforest in your gut.

They don't make us sick.

They live in us.

These microbes inhabit your digestive tract, and they play a key role in your immune system. They stimulate the production of immune cells that fight off viral infections, but not by making you sick. Here's Ana Maldonado-Contreras, a doctor at the University of Massacutes Chan Medical School:

Bacteria in our guts can elicit an effective immune response against viruses that not only infect the gut, such as norovirus and rotavirus, but also those infecting the lungs, such as the flu virus. The beneficial gut microbes do this by ordering specialized immune cells to produce potent antiviral proteins that ultimately eliminate viral infections. And the body of a person lacking these beneficial gut bacteria won’t have as strong an immune response to invading viruses. As a result, infections might go unchecked, taking a toll on health.

So, that explains a lot.

Your body needs a rainforest of microbes to stay healthy. You can wreck your body's natural biome through lots of unhealthy habits. The absence of these microbes can even mask the normal symptoms of an infection. In other words, you feel "fine" until your body totally caves in on itself.

Does that sound familiar?

In fact, one of the best ways to nurture your body's natural biome is to eat a diverse diet and spend time outside. Wearing a mask and installing proper ventilation don't interfere with either of these things.

Yes, there's some evidence that overusing hand sanitizer and disinfectant can hurt us long term, because they kill all microbes. As an article in Popular Science says, "antibacterials don’t discriminate bad from good." This logic doesn't apply to masks and distancing, though. Even if you're staying away from people, you're still coming into contact with lots and lots of microbes. Basically, you'd have to live in a literal bubble not to interact with them.

Most of us didn't do that last year.

So, your body does need microbes. It does not benefit from constantly exposing yourself to pathogens.

It's not the same.

There's a number of other reasons why "immunity debt" doesn't explain what's going on, and we should regard it as pseudoscience.

For starters:

We never really had lockdowns.

Americans seem to remember 2020 like it was some kind of prison sentence. It's just not true. Almost nobody went into actual "lockdown," except maybe for a couple of weeks at the very beginning of the pandemic. After that, a majority of Americans went back to work and school in some fashion.

Businesses reopened. Offices reopened.

We got plenty of microbes.

If there were such a thing as "immunity debt," we would've paid for it last year. That was the year we all got herded back to normal.

This year is different.

Children have definitely been exposed to germs.

Most schools returned to normal instruction in the fall of 2021. They dropped mask mandates halfway through the school year. A lot of schools, especially in red states, never really imposed mandates in the first place.

The idea that kids weren't exposed to germs is ridiculous.

Almost nobody has kept their kid in a bubble for the last year. They've been out in the world, trading bugs and getting sick. Even the CDC tells us that most kids were infected with Covid-19 last winter.

There's something else going on.

We did a bad job wearing masks.

As anti-maskers are so fond of pointing out, masks don't completely stop the transmission of pathogens, especially if you don't wear them right. Mask slipping was so common last year we gave it a name.

For every person who wore a properly fitting N95 mask, two or three wore cloth or surgical masks with all kinds of gaps. They wore them under chins and noses. They took them off all the time.

In short, we never really gave masks a chance to work. Instead, Covid kept circulating. It kept mutating and becoming more infectious. That's why we had to give everyone boosters on top of boosters.

It sounds like the "immunity deficit" crowd wants to have it both ways. They want to say masks don't work, but they also want to believe that masks and distancing worked so well that they weakened our immune systems.

That doesn't make any sense.

Some viruses do wipe out immunity.

We've seen growing evidence that Covid exhausts T Cells and makes people more vulnerable to other diseases. We also have evidence that viruses like measles hurt our immune system's ability to function.

Just like measles, Covid weakens our immune systems.

So, tell me what's more plausible:

Are children getting sicker this year because their immune systems got lazy? Or are they getting sicker because they were infected with a virus that we know causes damage to their immune systems?

The evidence points to the latter idea.

The first has none.

They already fooled us once.

Last year, millions of us believed a lie that Covid was "mild." This year, we're being sold a new lie to cover up the old one.

That lie is "immunity debt."

Fool me once...

Healthy children are getting sicker than ever. Some of them are dying. Hospitals across the country are out of beds. They're out of medicine. Major health organizations are pleading with politicians to declare an emergency. If we stay on this road, it's going to be another horrible winter.

There's no such thing as immunity debt.

You know what they say.

Fool me once…