Thread by @Aaron_Derfel

1) In light of a surge in pediatric deaths following Group A Streptococcus infections, some observers have tried to link this tragic trend with #pandemic lockdowns and other precautions. In this thread, I will try to explain why that is not the case.

montrealgazette.com/news/local-new…

2) Those blaming #pandemic protections for a spike in scarlet fever and invasive Group A strep infections argue children's immune systems were not "challenged" sufficiently during lockdowns. Once precautions were lifted, many kids got sick as a result, according to this theory.

3) "You can get really sick, perhaps more so than you would have normally because your immune system really hasn't been challenged as much recently," pediatric specialist Priya Soni told the New York Times. Makes sense right? Many politicians are now toeing this line.

4) But one only need look to the experience in Sweden — which implemented few protections and no lockdowns during the #COVID pandemic — to disprove this "immunity debt" theory. If this theory holds true, Sweden should now be mercifully spared a spike in Strep A infections.

5) Except that it isn't. From October to Dec. 7, 16 Swedish children under age 10 were infected with invasive Group A Streptococcus (iGAS). But in the two years before the pandemic, seven cases were reported in this same age group for the same months in 2018 and 10 cases in 2019.

6) In fact, the World Health Organization has noted that there were more cases in Sweden of iGAS before the #pandemic, suggesting that the few #COVID public health precautions in that country likely protected the #pediatric population, if anything. Please see below.

7) Well, some might argue, this only applies to Group A Strep. Because it imposed no #COVID lockdowns and few other #pandemic precautions, Sweden is likely now being spared infections of Respiratory Syncytial Virus (RSV). Except that it isn't.

8) Sweden is now on track to record more cases of RSV in 2022-2023 than it did in the years leading up to the #pandemic. Please review the surging red line in the chart below, courtesy of @DrJohnHhess.

https://twitter.com/DrJohnHhess/status/1603800241920413696

9) Perhaps there are other reasons for this spike in pediatric influenza, RSV, scarlet fever and iGAS. One possible explanation is #COVID itself, suggesting that this pathogen may be causing immune dysregulation in children.

10) Of course, more research is needed to confirm or rule out whether, in fact, #COVID is causing immune-system dysregulation among children. But prudence should at the very least dictate that people wear masks again in closed settings to limit the spread of respiratory viruses.

11) Another possible explanation is the rise in co-infections in jurisdictions around the world that have lifted #COVID protections, despite the fact the #pandemic is still far from over. This shortsighted policy has allowed the flu, RSV and other viruses to co-circulate freely.

12) Indeed, a Lancet study in April warned "as public health restrictions are lifted,...virus co-infections are more likely to occur during future winters. It concluded "SARS-CoV-2 co-infections with influenza viruses were...significantly associated with increased odds of death."

13) Okay, some might argue, this is only occurring in the adult population, not among kids. However, the World Health Organization is suggesting co-infections might also be causing some Group A Strep (GAS) infections in children. Permit me to quote the W.H.O. on this in full:

14) "The observed increase may reflect an early start to the GAS infection season coinciding with an increase in the circulation of respiratory viruses and possible viral coinfection which may increase the risk of invasive GAS disease," the W.H.O. declared in a Dec. 15 statement.

15) The W.H.O. goes on to suggest this is occurring following the lifting of precautions, resulting in "population mixing." Let me quote in full: "This is in the context of increased population mixing following a period of reduced circulation of GAS during the COVID-19 pandemic."

16) What many countries are now going through is a #Syndemic, defined in Wikipedia as "the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions, which exacerbate the prognosis and burden of disease."

17) What some infectious diseases experts had long feared in the past two years has now arrived: the #COVID pandemic coinciding with a much more virulent flu season, plus RSV and other pathogens thrown into the mix at a time when few public health protections exist.

18) The spike in pediatric flu, RSV, scarlet fever and Group A Strep is not the result of lockdowns or masks. It's likely because politicians naively assumed the #pandemic was over (think of the term "post-pandemic" being bandied about) and foolishly lifted precautions. The End.