Dr. Lisa Iannattone Profile picture
Dec 2, 2023 31 tweets 9 min read Read on X
We’re in our *3rd* post-lockdown viral respiratory season and admissions for viral resp illness+pneumonia are 6 standard deviations above the historical average. I do not understand how so many reasonable people haven’t figured out that the “immunity debt” scapegoat is disinfo.🧵
It’s not the lockdowns, it’s the covid. Covid damages immune systems. Catching covid makes people more susceptible to catching other infections. Immunity theft, not immunity debt. A thread of evidence:
This study found that the risk of RSV infection needing medical attention was 40% higher in kids that had covid vs those that didn’t. Both in 2021 and 2022. Yes they checked twice.

pubmed.ncbi.nlm.nih.gov/37832975/
This study shows that the terrible 2022 RSV epidemic was not as simple as a “catch up” year. RSV was already back in 2021. The 2022 surge was driven by *more severe cases*. What happened between 2021 and 2022? Mass infection of children with omicron. And subsequent immune damage. Screenshot with this part highlighted: “Studies show that SARS-CoV-2 virus fragments can persist in the body and have the ability to stimulate tissue-specific immunity in children41 42 and children affected by long COVID may have a compromised cellular immune response.”
“the large buildup of COVID19-infected children and the potential long-term adverse effects of COVID-19 on the immune and respiratory systems may have contributed to the 2022 winter surge of severe RSV diseases that was not seen in 2021.”

2021: immunity debt
2022: immunity theft
Now let’s talk about cascading effects. This is a really interesting study that highlights the role of RSV as a cofactor in invasive pneumococcal disease.

jamanetwork.com/journals/jaman…
There is no pneumococcal immunity debt because people carry it around asymptomatically so it’s always around. And here they showed that while invasive disease dropped during the lockdowns, pneumococcal carriage rates were not significantly reduced.
But when RSV and influenza came back, so did invasive pneumococcal disease. So S. pneumoniae piggybacks on RSV/influenza to infect children.

So the cascading effect here is that covid increases susceptibility to RSV which increases susceptibility to this invasive infection.
I’m going to spend an extra minute reiterating that immunity debt to S pneumonia was formally disproved in this study.

“This decrease was initially believed to be associated with the ability of nonpharmaceutical interventions to reduce transmission of S pneumoniae,”
among other pathogens.6 However, the fact that pneumococcal nasopharyngeal carriage remained essentially unchanged, including in rates and density, strongly suggests no significant reduction in pneumococcal transmission in the community.”
You see that reference #6? Let’s click it.

Ah yes, the UKHSA notes a surge of invasive pneumococcal disease in kids in 2021 and immediately defaults to blaming the lockdowns and immunity debt even though that makes no everloving sense for S. pneumoniae.
ncbi.nlm.nih.gov/pmc/articles/P…
More covid = more RSV = more invasive pneumococcal infections.
Moving on. This study found more cases of shingles (a virus that can reactivate when your immune system is down) across all ages in those that had covid. Worse, the risk of severe shingles (disseminated zoster) was 2.8x higher for the post covid group.

onlinelibrary.wiley.com/doi/abs/10.100…
Table 2 showing hazard ratios for zoster ocular disease 1.31, disseminated zoster 2.8, zoster with other complications 1.46, zoster without complications 1.66 and figure 2 a line graph showing most cases of shingles in the covid group compared to the control group.
You see what the authors do here? They go over the already known biologic effects of covid (lower T cell counts persisting after recovery from the acute phase) and do an easy little 1+1=2. The math is mathing. No need to pretend this is a big ✨mystery✨. Screen cap of a paragraph in the discussion section of the article: Several potential mechanisms may explain our findings. Compared with control patients, patients with acute COVID-19 have more lymphopenia, including lower total lymphocytes, CD4+ T cells, CD8+ T cells, B cells, and natural killer cells.35 Moreover, a cytokine storm due to a dysregulated immune response may develop following acute infection.36 Studies have reported that some patients had sustained cellular immune dysregulation with decreased levels of circulating CD4+ and CD8+ T lymphocytes even after recovery from acute COV...
This right here is the real immunity gap: the gap between how well people’s immune systems performed before covid vs after.

Covid-naive immune systems outperform covid-infected ones. Even after vaccination. Figure 2 line graph again showing the higher cumulative incidence of shingles in the covid group vs control group with the gap between the 2 lines highlighted.
Another cascading effect here is strokes. It’s already well established that covid infections significantly increase your risk of stroke for months. The shingles virus is vasculopathic and also increases your risk of stroke post infection.
academic.oup.com/cid/article/76…
Strep infections are surging yet again. What does the data say?
Oh, it says it’s covid.

“The hazard ratio for streptococcal tonsillitis was elevated in SARS2 positive patients from 4 to 8 months after diagnosis, peaking at 6 months (hazard ratio 1.27).”
bmj.com/content/380/bm…
Figure 5 from the study highlighting the increase in strep tonsillitis post covid in the 5-11 and 12-18 groups both at 30-180 days post covid and 180-360 days.
We’ve known covid increases your risk of bacterial infections for a long time. Long before the immunity debt fairy tale went mainstream.

In this 2021 study, the 6 month hazard ratio of bacterial infections post covid was 1.43. (supplementary table 5)
nature.com/articles/s4158…
I’m sure by now you’ve seen multiple headlines about the rise in tuberculosis. Similar to shingles, TB gets reactivated when your immune system is down. If covid damages your immune system, then if someone were to study what happens after covid, they’d find more TB right?
Someone did study it. They found a 7x increased incidence of tuberculosis post-covid pneumonia and a 3.85x increased risk of TB ipost-symptomatic covid without pneumonia. This graph is pretty telling. It’s not the lockdowns. It’s the covid.
thelancet.com/journals/eclin…
Figure 3 from the study, a line graph showing the incidence of tuberculosis in the 270 days post covid with very increased incidence in the covid pneumonia and covid with symptoms but no pneumonia groups compared to negative controls + a trend towards higher incidence of TB in asymptomatic covid.
There’s that immunity gap again. The gap in outcomes between covid-damaged immune systems and covid-naive immune systems. The covid-naive once again fare better. Huh. Same graph with the gap between TB incidence in covid negative controls and covid positive patients highlighted.
“Additionally, a study in China reported that 73.6% of patients with pneumonia could recover their T-cell numbers within approximately 30 days, whereas the remaining 26.4% had prolonged T-cell depletion.”
“Decreased cellular immune response due to T-cell depletion could mediate the increased risk of getting active TB. These findings could explain why patients with COVID-19 pneumonia may be at increased risk of subsequent PTB even if their COVID-19 symptoms are cured.”
It’s more than just associations. There’s a mountain of research on the mechanisms that explain the increased susceptibility to other infections after covid. So. much. research. I’ll wrap up this thread with a quick, very partial tour of publications on immune system damage:
Covid infections damage the CD8 T cell response. 2 NIH studies:


ncbi.nlm.nih.gov/pmc/articles/P…
nih.gov/news-events/ne…
Naive T cells missing and higher markers of T cell exhaustion post covid:
frontiersin.org/articles/10.33…
This one found that the immune dysfunction (including lack of naive T and B cells) did not resolve after 8 months (study done on patients that developed LC after mild/moderate infections):
nature.com/articles/s4159…
Long lasting reduction in number and function of dendritic cells:


journals.plos.org/plospathogens/…
frontiersin.org/articles/10.33…
Covid directly infects monocytes:
nature.com/articles/s4158…
There are so. many. papers. on this. Here’s a thread that goes through several more studies:
It’s not the lockdowns. It’s the covid. And honestly any expert that’s talking about the surges in infections we’re seeing without saying anything about covid immune damage in December 2023, with all this published data, is either woefully uninformed or outright dishonest.

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More from @lisa_iannattone

Mar 4
Public health has changed a lot since covid. Here’s a really concrete example of that. In 2019, PH in Montreal published a really detailed list of places people were exposed to measles: bus routes, malls, walmart, etc. In 2024? The list is just healthcare, schools + the airport.
From a 2019 Montreal Gazette article:  Those sites include the Walmart store on the Chomedey autoroute; the Second Cup outlet as well as common areas near Gate 2 at Carrefour Laval; the Laval Excellence gymnastics club on St-Martin Blvd. E.; the Oeufrier restaurant, the Dollarama store and Proxim pharmacy on Laurentides Blvd.  Buses running on the No. 20 and 70 routes in Laval at specific times on June 26 are also deemed as at-risk areas.  The areas and precise exposure times are available at the ministry’s website. A person considered contagious visited the mall on June 26.  The call for v...
The list of measles exposures from the 2024 Montreal outbreak which includes on healthcare facilities, childcare/school and the airport.
Why the sudden change in what information is made public? I highly doubt that *none* of these measles cases exposed people anywhere else. Did any of them go to a pharmacy or grocery store or coffee shop or hockey rink? And if so, why aren’t any of these locations being published?
Not publishing these locations means 1. people don’t have the opportunity to protect themselves and others post-exposure and 2. the fact that people are actively being exposed in the community (not just clinics and airports) is not being made explicit for the public.
Read 6 tweets
Dec 15, 2023
@Penelope19920 @jvipondmd As soon as the IPAC email goes out letting everyone know they need to wear masks, everyone wears masks. If IPAC decides everyone has to wear respirators, then everyone wears respirators. This actually isn’t hard at all. Why leadership would make it seem like it is, is baffling.
@Penelope19920 @jvipondmd They lean on hand wave-y concepts like mask fatigue when I have never once received a survey asking me how I felt about masking. None of this is evidence based. Since 2022, they seem to be making decisions based on “feels”.
@Penelope19920 @jvipondmd Do you know what happens in hospitals when HCWs get hand washing fatigue? They hire people to patrol the wards and make sure we’re washing our hands when we’re going in and out of patient rooms. They don’t give us hand washing breaks and just let c.diff run wild for a while. 😒
Read 4 tweets
Dec 8, 2023
StatCan just dropped a bombshell report on LC. This is the most important figure. It highlights that the risk of long term symptoms is cumulative, it increases with increasing number of infections. By 3+ infections, 38% report long term symptoms — that’s 1 in every 2.6 people. 🤯 Data table for Chart 2 — Percentage of Canadian adults with long term symptoms, by number of self reported covid-19 infections, June 2023 1 infection — 14.6% 2 infections — 25.4% 3 or more infections — 37.9%
Right now 1 in every 9 Canadians has long covid. 80% have symptoms for longer than 6 months and 50% just never recovered.

Full report here:
www150.statcan.gc.ca/n1/pub/75-006-…
How long before the majority of the population is at 3+ infections and 1 in every 2-3 people is suffering from long covid?

What’s the plan @GovCanHealth? Full speed ahead or? 🚆
Read 8 tweets
Nov 17, 2023
“We report a consistent increase in the risk of persistent symptoms after reinfection compared to first infection. All post-acute symptoms mentioned in the WHO clinical case definition appeared more common after reinfection than after a 1st infection”

‘RoBuSt HyBriD iMmuNiTy’ 🤪 Screenshot of the article linked in the next tweet “The burden of post-acute COVID-19 symptoms in a multinational network cohort analysis”
Yet another study showing that more infections = more morbidity. Can we like warn people maybe? Feels like something people might want to know.
nature.com/articles/s4146…
“Escalation of commitment: A human behavior pattern in which an individual or group facing increasingly negative outcomes from a decision, action, or investment nevertheless continue the behavior instead of altering course.”

¯\_(ツ)_/¯
Read 9 tweets
Nov 14, 2023
I’m very optimistic that vaccine/treatment breakthroughs + better air hygiene standards will change the game at some point. But I’d also like to point out that preserving one’s short and long term health is an endgame in and of itself. It’s the endgame for so many things we do…
The endgame of exercise? Health.
The endgame of limiting alcohol? Health.
The endgame of treated tap water? Health.
The endgame of tossing spoiled food? Health.
The endgame of cooking meat to temp? Health.
The endgame of washing your hands? Health.
The endgame of screening and checkups? Health.
The endgame of carseats and seatbelts? Health.
The endgame of helmets? Health.
The endgame of brushing your teeth? Health.
The endgame of condoms? Health.
The endgame of indoor smoking bans? Health.
Read 7 tweets
Nov 4, 2023
If I said you had a 1 in 10 chance of winning the lottery each time you play, do you like those odds? How many times would you play?

If I said you have a 10% chance of winning chronic health issues each time you catch covid, do you like those odds? How many times would you play?
Covid isn’t a one a done disease. Every time you catch the virus, you’re risking your health again. The spectrum of post acute sequelae is wide and includes heart problems, strokes, autoimmune diseases, immune system dysfunction, viral brain injury, POTS… the list is long.
Disability rates haven’t stabilized since the great mass infection event of early 2022. They’re still rising. These are the rates for the US and the UK.

How many times do PH leaders plan to have everyone mindlessly play the chronic disease/ disability lottery? What’s the plan?
US bureau of labor statistics graph of civilian labor force 16+ with disability showing a continuous rise since 2020 that hasn’t leveled off.
UK ONS labour market survey graph of number out of the workforce due to long term sickness showing a continuous rise since 2020 that hasn’t leveled off.
Read 10 tweets

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