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Post-Pandemic Surge in Infections Linked to ‘Immunity Debt’ Across Europe

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Although the COVID-19 pandemic has subsided, European countries are facing a rise in non-COVID infections, including respiratory illnesses. Health experts point to a phenomenon known as “immunity debt” as a major factor behind the increased number of cases.

In Denmark, cases of Mycoplasma pneumoniae, a bacterium that causes respiratory infections, have tripled during the 2023-2024 season compared to pre-pandemic years. Hospitalizations among children and teenagers in Denmark have also risen, up by 2.6 times. Despite this surge, Danish health authorities report that the severity of these infections remains unchanged compared to previous years, indicating that while more children are falling ill, they are not becoming more seriously sick than before.

The situation is not unique to Denmark. Other countries, including England, Germany, and France, have reported unusually high levels of respiratory illnesses such as Respiratory Syncytial Virus (RSV) since the pandemic.

“There has been quite a bounceback in a number of these infections which were not circulating significantly for a good winter or two, and they came back with quite a vengeance,” said Dr. Peter Openshaw, a respiratory specialist from Imperial College London.

What is Immunity Debt?

Immunity debt refers to the reduced exposure to common viruses during the height of the COVID-19 pandemic, when public health measures such as lockdowns, social distancing, and frequent handwashing significantly lowered transmission rates of various non-COVID infections. While these restrictions helped curb the spread of viruses and eased the burden on healthcare systems during the pandemic, they also led to a drop in natural immunity among the population.

Many viruses, like certain flu strains, disappeared almost entirely, while others, like RSV, resurged once restrictions were lifted. As more people began socializing and mixing again, these dormant viruses found a susceptible population to infect, particularly among younger children who had not been exposed to them during the pandemic.

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According to Dr. Amesh Adalja, an infectious disease expert from Johns Hopkins University, immunity debt was an “inevitable” consequence of pandemic-era measures, but those restrictions were crucial in saving lives. “Decreasing burdens on hospitals during the height of COVID, it was good to go in debt for that,” he explained.

Why the Term is Controversial

While the term “immunity debt” accurately describes the resurgence of infections post-pandemic, it has become controversial. Some argue that it implies natural infections are better for the immune system than vaccines, or that pandemic restrictions were unnecessary. However, experts, including Dr. Openshaw, reject these notions, emphasizing that public health measures saved thousands, if not millions, of lives.

RSV, for example, is a common virus that typically causes mild symptoms in young children. However, due to pandemic restrictions, many babies who would have been exposed to RSV were not, leading to a larger pool of susceptible individuals once the restrictions were lifted.

Looking Ahead

To address immunity debt, health experts are advocating for stronger vaccination efforts. Since 2023, RSV vaccines have been made available to pregnant women and older adults in the European Union and the UK, in an effort to protect the most vulnerable populations.

Despite these measures, hospitals across Europe are facing significant challenges. Ongoing staffing shortages and limited capacity are making it difficult to handle surges in common childhood infections and pneumonia among adults. As Dr. Openshaw noted, “We’re still seeing a lot of hospital attendances and serious illness with these viruses because they’re circulating at a higher-than-previous level.”

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With winter approaching, the strain on healthcare systems is expected to grow, making it crucial for governments to bolster public health measures and vaccination programs to mitigate the effects of immunity debt.

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France Records 5,764 Excess Deaths During Deadliest Heatwave Since 2003

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At least 5,764 excess deaths were recorded in France during last month’s record-breaking heatwave, making it the country’s deadliest heat event since 2003, according to new figures from the national public health agency.

Between June 17 and July 2, 21,674 people died in France, compared with an estimated 15,910 deaths expected under normal conditions, Santé publique France said in a bulletin published Wednesday.

The agency described the figure as the highest excess all-cause mortality recorded during a heatwave since 2003. That year’s extreme heat event caused nearly 15,000 deaths across France.

The latest heatwave was notable for its timing, intensity and duration. It struck early in the summer, when schools and workplaces were still operating normally, and exposed almost the entire French population to extreme temperatures.

For the first time, the public health agency recorded excess all-cause mortality across every age group from 15 years old and above. The agency said the pattern demonstrated the exceptional intensity and prolonged nature of the heat exposure.

People aged 75 and over accounted for around two-thirds of the provisional death toll, with at least 3,719 excess deaths recorded in that age group. However, deaths also increased among younger adults, making the event different from many previous heatwaves, when the impact was concentrated mainly among the elderly.

Mortality rose in hospitals, private homes and nursing homes. Almost half of the excess deaths occurred in hospitals, according to the preliminary data.

Santé publique France stressed that the excess deaths cannot yet be directly attributed to heat in every individual case. However, the scale and distribution of the increase point to the wider health impact of the extreme temperatures.

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The agency said the findings showed the need for governments and health authorities to introduce prevention and response measures before temperatures reach crisis levels.

“These impacts highlight the importance of implementing management and prevention measures to reduce the impact of heat on the population without waiting for health impacts to become apparent,” the agency said.

The French figures came as other Western European countries reported thousands of additional deaths during a heatwave in early July. Preliminary estimates suggested more than 4,000 people died across the region during that period.

The World Health Organization’s European office called on governments at the end of June to treat extreme heat as a major health crisis and strengthen the ability of health systems to respond.

Public health officials have warned that longer and more intense heatwaves are placing growing pressure on hospitals, care facilities and emergency services, increasing the need for early warnings and stronger protection measures.

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Up to Five Cups of Coffee a Day May Be Safe for Most Adults, Review Finds

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Drinking up to five cups of coffee a day may be safe for most adults and could be associated with a lower risk of several health problems, according to a major review by the American Heart Association.

The review found that consuming up to 400 milligrams of caffeine a day, roughly equivalent to five cups of caffeinated coffee, does not generally increase cardiovascular risk for most adults. Moderate consumption, particularly between two and four cups daily, was also linked to the lowest risk of death in the research examined.

“The equivalent of up to five cups of caffeinated coffee per day without added sugars or fillers is safe and does not increase cardiovascular risk,” said Gregory M. Marcus, a co-author of the paper and professor of medicine at the University of California, San Francisco.

The analysis found that moderate coffee consumption may be associated with better heart health and a lower risk of conditions including heart failure, heart disease and stroke. Some individuals also appeared to have a lower risk of high blood pressure and type 2 diabetes.

Coffee is the main source of caffeine for many adults, but daily intake can also come from tea, chocolate, fizzy drinks and some over-the-counter and prescription medicines. The researchers said less is known about the effects of caffeine from these sources, particularly at high levels.

Energy drinks were highlighted as an area requiring further study because large amounts of caffeine and other ingredients may pose cardiovascular risks.

Caffeine is processed by the liver and usually reaches its highest concentration in the blood within about an hour of consumption. The way people respond to it varies widely, however, depending on genetics, metabolism, age and previous caffeine intake.

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Regular coffee drinkers may develop some tolerance, while others can experience strong effects from relatively small amounts.

“Although research suggests that caffeine consumption may be associated with certain cardiovascular benefits for some people, it’s important to remember that there is no ‘one-size-fits-all’ strategy for safe caffeine consumption,” Marcus said.

He added that an amount that is reasonable for one person could cause side effects such as heart palpitations, anxiety or sleep disruption in another.

The researchers also warned that the way coffee is prepared can affect its overall health impact. Large amounts of added sugar, flavoured syrups and high-calorie dairy products can significantly increase calorie intake and may reduce the potential benefits associated with coffee itself.

The findings suggest that moderate, unsweetened coffee consumption can fit into a healthy lifestyle for many adults, but individual tolerance remains an important factor when deciding how much caffeine to consume.

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Summer Heat Linked to Seasonal Depression as Mental Health Concerns Rise Worldwide

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Seasonal depression is commonly associated with the short, dark days of winter, but health experts are warning that hot weather and prolonged heatwaves can also trigger a lesser-known form of the condition during the summer months.

Medical professionals say Summer Seasonal Affective Disorder (SAD) is a recognised type of depression that follows a seasonal pattern and can significantly affect daily life. Although far less common than winter SAD, experts stress that it should be treated as a serious mental health condition.

According to a recent study, summer SAD affects around 0.57% of the global population, compared with about 5% for the winter form of the disorder. Rising temperatures, frequent heatwaves and tropical nights have been identified as factors that can contribute to symptoms in vulnerable individuals.

Unlike winter depression, which is often linked to reduced daylight and social isolation, summer SAD is associated with excessive heat, disrupted sleep and physical discomfort. Symptoms may include insomnia, loss of appetite, anxiety, agitation and persistent low mood. In severe cases, the condition can interfere with work, relationships and everyday activities.

Adam Borland, a clinical psychologist at the Cleveland Clinic, said people experiencing symptoms may benefit from maintaining a regular daily routine, limiting exposure to extreme heat and making sleep a priority. He added that anyone with severe or persistent symptoms should seek professional medical care.

The warning comes as mental health conditions continue to rise across the world. A recent analysis from the Global Burden of Disease Study, published in The Lancet, estimated that approximately 1.2 billion people, or around 15% of the global population, were living with a mental health condition in 2023.

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The study found that the number of people affected by mental health disorders increased by 95% between 1990 and 2023. During the same period, mental disorders climbed from the 12th to the fifth leading cause of health loss worldwide.

Major depressive disorder and anxiety disorders recorded some of the sharpest increases. Cases of major depression rose by 131%, while anxiety disorders increased by 158%, making them the two most common mental health conditions globally.

Researchers behind the Global Burden of Disease Study said meeting the growing demand for mental health services should be regarded as a public health priority, particularly for vulnerable groups.

The situation is also a concern across Europe. The World Health Organization estimates that one in six people in the European region, around 140 million individuals, lives with a mental health condition. Despite the high number of cases, only one in three people suffering from depression receive the treatment they need.

Health experts have also highlighted the lasting impact of the COVID-19 pandemic. Depression and anxiety among young people have increased by an estimated 25% since the pandemic, while suicide has become the leading cause of death among people aged 15 to 29 in the European region.

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