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T. Ryan Gregory

@TRyanGregory

Dec 20

A major increase in RSV and flu *cases* is certainly expected based on reduced population immunity (i.e., more than the usual number of previously unexposed hosts).

What immunity debt by itself does NOT predict is a major increase in the proportion of severe infections.

1/

So, are we just seeing a numbers game with total cases going up but typical percentage of those being severe? Or is there more going on? That's an empirical question.

2/

Some more questions that need to be answered with data:

* How many of the kids with severe RSV/flu/strep had COVID in the past 6-12 months?

* How many kids have a severe infection again, after having one last year?

3/

Read 5 tweets

T. Ryan Gregory

@TRyanGregory

Dec 20

About Sweden, RSV, and "immunity debt".

* They did not have lockdowns or mask mandates.

* They did not close schools or vaccinate kids under 12.

* There was still some voluntary masking, distancing, and isolating.

* Neighbouring countries did have stricter measures.

1/

krisinformation.se/en/hazards-and….

2/

* Like many countries, Sweden had a winter without RSV (2020-2021).

* They had a big surge of RSV last winter (2021-2022).

* They're having a worse surge this year (2022-2023).

3/

Read 11 tweets

T. Ryan Gregory

@TRyanGregory

Dec 17

Again, I'm not saying the trivially true version of "immunity debt" is not involved (it surely is, but that's a terrible name for it). I'm saying we need to seriously consider the *potential* additional impact of most kids being infected with COVID over the past year.

🧵

Those *possible* COVID-related factors include:

1) Co-infection.

2) Effects on the lungs after infection in children.

3) Effects on fetal lung development of infection during pregnancy.

4) Immune effects, such as on mucosal immunity, dendritic cells, and/or T cells.

Severe acute respiratory syndrome coronavirus 2 and respiratory syncytial virus coinfection in children

ncbi.nlm.nih.gov/pmc/articles/P…

Read 20 tweets

T. Ryan Gregory

@TRyanGregory

Dec 13

Well look at that. Dendritic cells are involved in defense against both RSV and strep and they are affected by COVID infection.

Some bog standard epidemiologists might call the suggestion of any connection a conspiracy theory, of course.

journals.asm.org/doi/10.1128/IA…

ncbi.nlm.nih.gov/pmc/articles/P…

frontiersin.org/articles/10.33…

Read 4 tweets

T. Ryan Gregory

@TRyanGregory

Dec 13

A few things about MERS:

* Media are calling it "camel flu". That seems a) designed to minimize and b) sure to confuse people.

* "MERS" stands for "Middle East Respiratory Syndrome". Both "MERS" and "camel flu" are problematic names that encourage xenophobia.

* MERS is not caused by an influenza virus. It is caused by MERS-CoV, which is a coronavirus related to SARS-CoV (SARS) and SARS-CoV-2 (COVID-19/SARS2).

* MERS-CoV isn't a brand new virus. It was first identified in Saudi Arabia in 2012.

who.int/news-room/fact…

* MERS is much deadlier than COVID-19. It kills about 1 in 3 of those who are infected.

* Human to human transmission of MERS-CoV is far less efficient than with SARS-CoV-2.

* There have been about 2,600 cases of MERS in 27 countries since 2012.

emro.who.int/health-topics/…

Read 5 tweets

T. Ryan Gregory

@TRyanGregory

Dec 9

A massive surge of a common virus that lands people in the hospital (or worse) can be explained by one or more non-mutually-exclusive factors:

1) The virus has changed (is more virulent and/or transmissible).

2) The host population has changed (⬆️ # of susceptible hosts).

1/

3) Individual hosts have changed (immune systems weakened).

4) Interactions among viruses (co-infection, reactivation of latent infections, temporary ⬆️ susceptibility to others pathogens after infection).

2/

The simplistic "immunity debt" hypothesis (the population-level version, not the nonsensical "immune system needs exercise through infection" version) *assumes*, without being clearly articulated or tested, that only factor #2 is involved right now.

3/

Read 5 tweets

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