Some thoughts on immunity debt vs. immunity theft. 🧵
First, I don't think the newly-coined (2021) term "immunity debt" is useful or well chosen. It is being used to refer to two very different ideas and is prone to confusion or equivocation. It doesn't help that one of those ideas is trivially true and the other is nonsense.
The version that is trivially true occurs at the population level. If a lot of people avoid infection in one season, then there will be less immunity in the population and larger numbers of susceptible hosts in the following season. Obviously.
This population-level version of "immunity debt" is very unlikely to actually account for what we're seeing right now, but at least it isn't nonsensical. "Debt" would not be the right term for this in any case.
The other version of immunity debt refers to the individual level rather than the population as a whole. It assumes that the immune system is like a muscle, and not using it against pathogens weakens it, making individuals more prone to severe infections.
The immune-system-as-muscle idea is a corruption of the (still debated) "hygiene hypothesis", which does NOT say that kids need to be exposed to *pathogens*. Let your kids play in the dirt, yes. Don't let them run around in a biohazard lab.
If we are stuck with the term "immunity debt", then the alternative idea to explain what is happening is "immunity theft" (same idea as "immunity robbery" coined by @FurnessColin).
The concept of "immunity theft" is simply that COVID infection (let alone repeated infections) may rob people of a working immune system, which puts them at risk for other infections.
How can COVID damage immune function? Here is a very good explainer:
thetyee.ca/Analysis/2022/…
How can COVID damage immune function? Here is a very good explainer:
thetyee.ca/Analysis/2022/…
This is not merely an academic debate. Proponents of immunity debt tend to be the same people who advocated against efforts to mitigate COVID in schools. They are now blaming remote learning and masks for surges in other viruses like RSV and flu in kids. They still oppose masks.
On the other hand, *IF* immunity theft is the cause, then letting COVID rip in schools was a disastrous idea, and we urgently need to prevent further immune-depleting infection with COVID and with other viruses that will now be having more severe effects than they usually would.
So which is it? Immunity debt or immunity theft? We don't know, and it's not either-or (at least, it could be the population version of immunity debt and/or immunity theft).
However, it has to be noted that immunity debt, even the non-ridiculous version, is not being used in a logically consistent way.
Do masks block RSV and flu so well that they cause immunity debt? If they work, why not use them now to keep kids out of hospitals?
Do masks block RSV and flu so well that they cause immunity debt? If they work, why not use them now to keep kids out of hospitals?
If recommendations to wash hands are effective at stopping RSV and flu, why doesn't this cause immunity debt?
RSV and flu immunity do not last long, so how are "lockdowns" from 2 years ago still having this effect?
RSV and flu immunity do not last long, so how are "lockdowns" from 2 years ago still having this effect?
Also, many of the proponents of immunity debt have a terrible record when it comes to COVID claims.
https://twitter.com/TRyanGregory/status/1589399809047564289?t=vEd2f_kXYK19lqy4sv8VJw&s=19
Further reading:
https://twitter.com/lisa_iannattone/status/1591559665875574784?t=xQWBu0k774yre7UwvvBtFg&s=19
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