Despite misinformation, we can do more to protect against Covid, RSV and flu | Opinion

Public health misinformation is running rampant and inhibiting our ability to control the triple viral epidemic of seasonal flu, RSV and COVID-19. To lessen the chances of contracting these illnesses, I have encouraged many to wear well-fitted N95 masks when going into public indoor venues. All too often I received a curt retort to this advice, similar to the one stating “Masks are proven to destroy your immune system and do more harm than good.”

This misinformation has its genesis from the newly concocted explanation of “Immune Debt.” This construct theorizes that the critical rise in hospitalizations we are seeing are from lack of exposure of our immune system to these pathogens. And that this lack of exposure was caused by masking and social isolation. An advisement from the CDC even stated“And so these children, if you will, need to become infected (with RSV) to move forward because it’s a disease very common in children.”

Unfortunately, mounting evidence indicates this is not the case. A more concerning process may be taking place. First, let’s be honest here. We live in Kentucky. Last year few wore masks, schools were open, and we had no lockdowns. Thus, the premise for the argument is not valid. In fact, before this fall, I had never heard of the problem of “Immune Debt.” In Africa and Southeast Asia, masks and social mitigation measures have been used for decades to blunt the epidemics of SARS, MERS, and Ebola without any observed ill effects.

At the beginning of November 2022, pediatric hospitals in the United States were filling to critical levels with RSV infections and “immune debt” was the common explanation. But we had a large peak of RSV infections the year before, totaling even more than we had as of November. Thus, the explanation did not fit.

The other more ominous possibility is “immune theft” resulting from an immunodysfunction caused by previous COVID-19 infections. A non-peer reviewed preprint recently reported that children who contracted RSV were twice as likely to have had a previous COVID-19 infection than those who did not develop an RSV infection.

Finally, a landmark study in Nature Immunology found immunological dysfunction in individuals with Long COVID at 8 months (longest time studied) after the initial infection. The study found patients with Long COVID had “highly activated innate immune cells and lacked naïve T and B cells.”

All of the above should sound an alarm. The incidence of immune dysfunction does not have to be high to fill hospitals. And even if low, reinfections with the additive damage of long COVID, make even a low incidence problematic over time. Currently, the United States is undergoing a XBB surge. The XBB variant is adept at avoiding both natural and vaccine immunity along with having a high resistance to monoclonal antibody treatments.

COVID vaccines and boosters are expected to significantly help avoid hospitalizations and death, but with the XBB variant they are unlikely to reliably prevent symptomatic illness. Being up to date on flu vaccinations is also important. In addition, we need to take steps against other spreading pathogens, such as invasive Group A Strep infections which are increasing in children.

Further common sense measures need to be taken during this winter surge. For patrons, high-quality N95 masks should be worn when one enters indoor venues. For business, to the extent possible, make available curbside pickup and online purchasing options. All workers who come in contact with customers should be wearing high-quality well-fitted masks. Also, have a few hours each week, early in the morning, where masks are required so high-risk patrons can be as safe as possible. All buildings need to have improvement in ventilation. Patrons can screen for adequate air quality using a portable CO2 monitor. Finally, all who can should become vaccinated and boosted.

These steps do not infringe on one’s “rights” but will help to keep workers and patrons safe along with relieving stress on our healthcare system, during this winter COVID-19 surge. Kentucky has a long history of hospitality and caring for others, let us not abandon these values during this pandemic.

Kevin Kavanagh is a physician and the founder of HealthWatch USA.

This story was originally published January 6, 2023 at 9:32 AM.