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Re:Flu and colds are back with a vengeance by lsy on Thursday November 10, 2022 @11:14AM (#33548629)
People seem to think that there's an effect where the individual immune system gets weaker with disuse. AFAICT this isn't the case. The "debt" here is the same debt you incur if you have a Windows PC you only boot up every few months: You'll be slammed with updates when you turn it on, but you aren't getting any more updates than before, in fact you may even get fewer as point upgrades are skipped (e.g. someone who avoids Covid Alpha-Delta but gets Omicron). But since they are all coming quickly it feels extreme.

As pointed out elsewhere in the thread, RSV is more dangerous to younger children, so delaying infection is probably advantageous on a population level. I don't think there is any evidence that the severity of any of these diseases is higher when amortized over the years we had very low incidences, we are just seeing more disease total in a short period of time as restrictions are lifted.

Re:Flu and colds are back with a vengeance by NickM on Thursday November 10, 2022 @11:32AM (#33548969)
AFAICT this isn't the case

Is this a "as far as I can tell based on my knowledge of immunology" or "as far as I can tell based off of personal experience and gut feeling"?

I mean, what you're saying sounds plausible, but on the other hand it also sounds plausible that maybe periodic exposure to random viruses and stuff does strengthen your immune system, so I'm curious if your take here is actually based in science or is just an off-the-cuff idea.

Re:Flu and colds are back with a vengeance by Juliate on Thursday November 10, 2022 @11:50AM (#33549298)
The strength of your immune system is the energy your body has to provide.

What's influenced/improved through (accidental or controlled/vaccines) exposure is it memory.

Although exposure can also have other consequences on the whole body, if the system is overwhelmed/can't cope.

Re:Flu and colds are back with a vengeance by lostmsu on Thursday November 10, 2022 @12:40PM (#33550194)
You are not answering the important question in the parent: is this "as far as I can tell based off of personal experience and gut feeling"?
Re:Flu and colds are back with a vengeance by peyton on Thursday November 10, 2022 @12:48PM (#33550321)
The past two years have demonstrated the state of the art w.r.t. infectious disease may not be as great as advertised. So likely gut feeling.
Re:Flu and colds are back with a vengeance by Juliate on Thursday November 10, 2022 @01:08PM (#33550626)
It's more like a current understanding of various takes of professionals on the "immunity debt" concept, especially in children:

* https://twitter.com/FurnessColin/status/1589103107048624129 (which has an additional interesting take about measles) * https://twitter.com/lisa_iannattone/status/15762315127179919... * https://twitter.com/unbiasedscipod/status/158891593499112652... * https://counterdisinformationproject.substack.com/p/immunity...

which is not necessarily intuitive as well, but still, at this point, makes way more sense than the "immune system is a muscle" discourse.

Re:Flu and colds are back with a vengeance by timmytokyo on Thursday November 10, 2022 @12:56PM (#33550440)
As far as I can tell based off of personal experience, HN is full of armchair experts on topics outside their realm of expertise. Heck, I even play one myself now and then.
Re:Flu and colds are back with a vengeance by spookthesunset on Thursday November 10, 2022 @01:22PM (#33550842)
Appeals to authority only get you so far.
Re:Flu and colds are back with a vengeance by zasdffaa on Thursday November 10, 2022 @02:26PM (#33551727)
Yup. And the more strongly opinions are given, the more uptight they get when you ask for a cite or two (with a few honourable exceptions).
Re:Flu and colds are back with a vengeance by lsy on Thursday November 10, 2022 @01:01PM (#33550538)
This is what immunologists are saying pretty much everywhere you look. I thought "AFAICT" was clear enough that 1) I have tried to find this out and 2) from what I can tell the preponderance of opinion from people who seem qualified to say so is that your immune system doesn't "weaken" because you are avoiding infection. Even TFA quotes an immunologist calling the idea of individual-level immune system weakening "nonsense". I could also be wrong or looking at the wrong sources. I don't want to stop anyone from looking this up themselves, finding out what experts are saying, and making a judgment of their own. We don't have to stick with folk science or what "sounds plausible".

My comment was mainly to point up the analogy for seeing more infections today primarily because there were fewer infections before, not primarily because everyone's immune system is weakened. There are of course other concerns with disease burden and herd immunity overshoot. I do fear people are stretching the Windows Update analogy too thin, as your immune system isn't a computer and the dynamics are more complex (e.g. it doesn't matter if you avoid Covid Alpha and don't ever become perfectly immune to it, because there is hardly any of it circulating anymore, and your Omicron infection has some cross-immunity).

Re:Flu and colds are back with a vengeance by taeric on Thursday November 10, 2022 @11:21AM (#33548752)
This feels like a distinction without a difference? Since much of your immune system is not replacing old protections, but modifying them, I think it is fair to question if skipping some exposure is possibly dangerous?

Granted "to question" is doing a lot of work in my last sentence there. I don't think it is a foregone conclusion. Would be very interested in seeing it explored. Closest my memory has to this is introducing kids to preschools. The new kids are always the ones getting most sick. Same for homeschoolers going to college. They will spend a ton of time catching up on sicknesses they missed out on.

Re:Flu and colds are back with a vengeance by sanedigital on Thursday November 10, 2022 @01:17PM (#33550765)
There's a difference. In the "hygiene hypothesis" model—the one where your immune system weakens without exposure—getting a cold makes you less likely to get the flu. That doesn't appear to be true. In reality, since the cold and the flu aren't biologically related, one does not confer immunity for the other.

That's not to say the "hygiene hypothesis" is completely false. There's good evidence that exposing children to low level pathogens early and often helps reduce autoimmune conditions like allergies, asthma, and arthritis. It just doesn't effect viral response.

Re:Flu and colds are back with a vengeance by taeric on Thursday November 10, 2022 @03:43PM (#33553026)
I feel this is still framing it off? The hygiene hypothesis isn't just that your immune system weakens. It is also that you did not strengthen it. Not quite the same. And there is more to it than just getting targeted immunity to things. It could be that you get stronger nasal passages and lungs. Or whatever.

I'll underline that I don't know exactly what the answer is. I think there is plenty to research on this, and excited on us knowing a bit more.

Re:Flu and colds are back with a vengeance by sanedigital on Friday November 11, 2022 @10:21AM (#33561890)
The cold & flu were bad examples since they do share some similarities. A better example would be food poisoning and the flu: eating spoiled food doesn't make you less likely to catch a respiratory virus.
Re:Flu and colds are back with a vengeance by taeric on Friday November 11, 2022 @10:34AM (#33562073)
I think I agree with what you are saying. Paraphrased/simplified, the problem is that the extreme end of the hygiene hypothesis is to have a non clean area at all.

Reminds me of the somewhat silly phrase of "what doesn't kill you makes you stronger." Unless, of course, it leaves you much much weaker. Which is very possible.

Re:Flu and colds are back with a vengeance by TheBlight on Thursday November 10, 2022 @11:20AM (#33548739)
I don't think it has much to do with restrictions being lifted. They didn't seem to impede the spread of sars-cov-2. What was stopping the spread of more familiar respiratory viruses was likely viral interference with sars-cov2. The now much higher level of naturally acquired immunity to sars-cov-2 is most likely why other viruses are coming back.
Re:Flu and colds are back with a vengeance by taeric on Thursday November 10, 2022 @11:22AM (#33548770)
Maybe? Schools being closed was a real thing that put a pretty heavy stop on spread.
Re:Flu and colds are back with a vengeance by TheBlight on Thursday November 10, 2022 @11:24AM (#33548807)
They haven't been closed in most places for well over a year. And these kids still co-mingled. It's not like they just hung out alone in their rooms.
Re:Flu and colds are back with a vengeance by taeric on Thursday November 10, 2022 @11:27AM (#33548886)
You aren't wrong. But, the question is how many viral seasons they have been open. You don't expect 100% spread in a single season.
Re:Flu and colds are back with a vengeance by TheBlight on Thursday November 10, 2022 @11:54AM (#33549397)
We're also not seeing sars-cov2 spiking to high levels now along with RSV/et. al. This further suggests restrictions being lifted doesn't adequately explain all of the apparent phenomena.
Re:Flu and colds are back with a vengeance by taeric on Thursday November 10, 2022 @12:01PM (#33549557)
Are we not, though? Covid hasn't gone away, and it seems to grow every season. Deaths are down, so that is very very good.

That said, I did not take that to mean that restrictions would be the only active component. I don't see any reason to think we can isolate this down to just a single prime mover.

Re:Flu and colds are back with a vengeance by nradov on Thursday November 10, 2022 @02:25PM (#33551708)
Deaths from COVID-19 are way down because at this point almost everyone has already been infected at least once. The patients who were going to die from it are mostly already dead. Those deaths were tragic, but for the rest of us the combination of vaccination, natural immunity, and general health status makes it no longer a serious concern (or at least not much more serious than other endemic respiratory viruses).
Re:Flu and colds are back with a vengeance by wrycoder on Friday November 11, 2022 @12:00PM (#33563314)
Deaths are down because we learned how to treat the critical cases.
Re:Flu and colds are back with a vengeance by duxup on Thursday November 10, 2022 @11:28AM (#33548900)
Doesn’t immunity fade over time for some diseases if you’re not exposed?

I think this is more of an “it depends” situation than a hard and fast rule.

Re:Flu and colds are back with a vengeance by chedca21 on Thursday November 10, 2022 @11:46AM (#33549225)
If T-cell count and function is normal immunity should last. The idea that immunity wanes is coming from universities looking at antibodies (a different immune cell) as markers for vaccine efficacy. Industry prefers that way because waning antibodies means they'll sell more "boosters"
Re:Flu and colds are back with a vengeance by nradov on Thursday November 10, 2022 @02:18PM (#33551607)
You shouldn't be down voted. This is mostly correct. Cellular immunity is durable in most recovered patients. People can expect to get reinfected occasionally but subsequent infections typically have less severe symptoms.

Boosters are a good option for many people (talk to your doctor). But using antibody levels as a basis for scheduling boosters is completely unscientific. As a society we can't boost our way out of the pandemic.

This panel discussion with a group of leading physicians goes into more detail on the issue.

https://youtu.be/jAjKQY0_BQA

Re:Flu and colds are back with a vengeance by _aavaa_ on Thursday November 10, 2022 @11:45AM (#33549201)
Except the issue with the delay is captured by your analogy perfectly:

> You'll be slammed with updates when you turn it on.

For a computer that isn’t an issue. But consider the health impact of “getting slammed” with several months, or take to an extreme, several years of missed immunity “updates”

Re:Flu and colds are back with a vengeance by IMTDb on Thursday November 10, 2022 @11:57AM (#33549461)
Even for computers; for a critical system I'd rather plan some small incremental updates regularly to keep it healthy and under control rather than do nothing for a few years and suddenly go a mega-update of the whole kernel + shared lib + dependencies in one go, hoping that everything is going to be OK.
Re:Flu and colds are back with a vengeance by _aavaa_ on Thursday November 10, 2022 @12:23PM (#33549927)
But in theory a computer should not have those issues. It’s just in practice.

Even in theory, our bodies pay a non-zero cost for each “update”

Re:Flu and colds are back with a vengeance by osigurdson on Thursday November 10, 2022 @12:30PM (#33550029)
There are definitely datapoints that suggest lack of exposure leads to lower functioning immune system. The story of the Lykov hermits is a fairly compelling anecdote as many of them died once reintroduced to others. Of course, it could have been something else.
Re:Flu and colds are back with a vengeance by themitigating on Thursday November 10, 2022 @12:53PM (#33550387)
Native Americans
Re:Flu and colds are back with a vengeance by Barrin92 on Thursday November 10, 2022 @12:30PM (#33550039)
Epidemiologists are gathering more and more evidence for what has been dubbed the "hygiene-hypothesis", namely that lack of education of the immune system at an early age increases the risk for several diseases including asthma, IBS, several auto-immune disorders among others.

https://www.fda.gov/vaccines-blood-biologics/consumers-biolo...

Re:Flu and colds are back with a vengeance by sanedigital on Thursday November 10, 2022 @01:18PM (#33550776)
Right, but that has no bearing on response to viruses. Having the cold doesn't make it less likely for you catch the flu, for instance.
Re:Flu and colds are back with a vengeance by Barrin92 on Thursday November 10, 2022 @01:44PM (#33551148)
definitely does, a cold infection can protect the airways from a flu infection[1]. Cross reactivity of T cells very much exists. Another case is particular variants of covid-19 which is a corona virus granted partial immunity to influenza (one reason people suggested why both cold and flu seasons during covid peaks slowed considerably, apart from containment measures), and certain corona viruses that cause the common cold in turn also granted partial immunity against covid.

[1]https://news.yale.edu/2020/09/04/common-cold-combats-influen...

Re:Flu and colds are back with a vengeance by sanedigital on Friday November 11, 2022 @10:20AM (#33561874)
Cold & flu weren't the best examples. Here's a more obvious one: getting food poisoning doesn't make you less likely to catch the flu.

Some people treat "the immune system" like a muscle, where stress strengthens. Similar stressors can have cross-reactive effects, but unrelated ones do not.

This can go the other way too: people who have uncontrolled celiac disease (as in, they're still consuming gluten on a regular basis) can also have issues with avenin (a somewhat similar protein in oats) or even lactose. For a lot of folks those sensitivities disappear when they get their gluten consumption down.

Re:Flu and colds are back with a vengeance by wrycoder on Friday November 11, 2022 @11:56AM (#33563263)
Interesting comment on gluten consumption. In my case, it appears cumulative. (I'm not celiac, so far as I know.) I've been following a non-gluten diet for fifteen years at this point, and I can now tolerate at least a small amount of gluten without the effects I used to have.

I used to get injections to diminish my hay fever symptoms. I finally mostly grew out of hay fever around the age of forty, though I'm still allergic to horses and cats, if I have direct contact.

Don't those injections comprise increasing challenges to the immune system using the allergens themselves, to make it less prone to mount a histamine response (i.e. runny nose, itchy eyes)?

Re:Flu and colds are back with a vengeance by lazide on Thursday November 10, 2022 @12:52PM (#33550370)
My youngest has gotten RSV twice this year, which is hard to do, among about 15 other illnesses, including COVID multiple times, flus and cold, etc.

It’s bad even by ‘2 yr old at daycare’ standards.

5 ER trips and a hospitalization due to breathing difficulties bad.

Re:Flu and colds are back with a vengeance by joshhart on Friday November 11, 2022 @12:24AM (#33557584)
Sorry to hear that. I’m a parent and that sounds scary and awful