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By Casey De Farria
Casey De Farria
01 Nov, 2021

‘Immunity debt’ – what you need to know and how it may affect your family post-lockdown.

You may have heard the term ‘immunity debt’ popping up around the place, especially in regards to life post-lockdowns.

‘Immunity debt’ occurs when people don’t develop immunity to viruses that are suppressed by COVID lockdowns, causing a potential spike in cases once lockdowns are lifted.

The ‘immunity debt’ phenomenon occurs because measures like lockdowns, hand-washing, social distancing, and masks, suppress the spread of viral and bacterial infections. There has been a reduced incidence of many viral and bacterial infections in children, including bronchiolitis, influenza, gastro, pertussis (whooping cough) and varicella (chicken pox).

There is a great metaphor from Epidemiologist and Public Health Professor Michael Baker using bushfires to explain immunity debt: if a year or two have passed without fire, there is more fuel on the ground to feed the flames. When a fire finally comes, it burns much more fiercely. “What we’re seeing now is we’ve accumulated a whole lot of susceptible children that have missed out on exposure – so now they’re seeing it for the first time.”

New Zealand hospitals are currently experiencing the payoff of ‘immunity debt’ created by COVID lockdowns, with wards reportedly flooded by babies with respiratory illnesses. Over June and the first week of July, there were nearly 1,000 RSV cases reported, according to the Institute of Environmental Science and Research. The usual average is 1,743 over the full 29-week winter season.

‘Immunity debt’ is still a relatively new concept, and we are only now learning what this means along with the future implications.

Brett Finlay, a professor of microbiology at the University of British Columbia, has suggested that the best course of action for parents is to continue with proper hygiene as lockdowns lift – washing hands, coughing into your elbow, and even continuing to wear a mask once it is no longer compulsory if this will make you feel more comfortable and protected. Continuing to stay up to date on your child’s vaccinations is also key to keeping serious illnesses, such as measles, at bay. Make sure you check that your children’s immunisations (and your own!) are up to date.

If your child does become unwell, know the ‘red flags’ to look out for that indicate your child is unwell, and trust your instinct –  don’t hesitate to get help if you feel like something isn’t right. You can always call Health Direct, Nurse on Call (or the right health care advice line for your state or territory) to seek advice. 

Another important action is to keep your kids home from daycare or school when they are sick, and until they are better. We understand how tricky this is when you are working and/or stretched with other family commitments (we get it, we are working mums too), but we just have to do it. If you see your little one is sick with any symptoms of Covid, get them tested right away and follow instructions to isolate until you receive a negative result. If you or your little one receives a positive result, it can be hard to know how to handle it. Check out this important article on how to get through a positive diagnosis.

Even though (particularly during a pandemic) having a sick child can cause a great deal of anxiety, we need to remember that having mild viral illnesses such as the common cold (and usually lots of them – 8-10 per year) is completely normal, and essential for our children to build a strong immune system.

References and further reading:

Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap? Robert Cohena, Marion Ashmana, Muhamed-Kheir Tahag, Emmanuelle Varonh, Francois Angoulvant, Corinne Levy, Alexis Rybak, Naim Ouldali, Nicole Guisol, Emmanuel Grimprele: Infectious Diseases Now 51 (2021) 418 423:
https://www.sciencedirect.com/science/article/pii/S2666991921001123?via%3Dihub

https://www.theguardian.com/world/2021/jul/08/new-zealand-children-falling-ill-in-high-numbers-due-to-covid-immunity-debt

https://news.sky.com/story/covid-19-why-is-there-a-surge-in-winter-viruses-at-the-moment-12354845

https://globalnews.ca/news/8023737/canada-babies-covid-immunity-debt/

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