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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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Taking the Stairs Could Cut Risk of Heart Disease Death, Study Finds

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Taking the stairs instead of using a lift could significantly reduce the risk of cardiovascular disease and premature death, according to a major study examining the health benefits of regular stair climbing.

Researchers from the University of East Anglia and Norfolk and Norwich University Hospital found that people who regularly climbed stairs had a 39 percent lower risk of dying from cardiovascular disease than those who rarely used stairs. They also had a 24 percent lower risk of death from any cause.

The study found that regular stair climbing was also associated with a lower risk of developing serious cardiovascular conditions, including heart attacks, strokes and heart failure.

The research team analysed health data from more than 480,000 people aged between 35 and 84. The findings were based on nine high-quality studies, with participants followed for a median period of 14 years.

Vassilios Vassiliou of Norwich Medical School at the University of East Anglia said stair climbing was a practical way to add physical activity to everyday routines. He described it as an activity that is often overlooked despite being easy to perform without special equipment or facilities.

Unlike structured exercise at a gym, climbing stairs can be included naturally in daily activities at home, at work or while travelling. Sophie Paddock, also from Norwich Medical School, said the activity could be particularly useful for people who have limited time or do not have convenient access to exercise facilities.

The researchers said even short periods of stair climbing several times a week could provide measurable health benefits. The activity can improve cardiorespiratory fitness and help lower cholesterol, both of which are linked to better cardiovascular health.

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The amount of stair climbing also appeared to matter. Some of the studies reviewed by the researchers found that people who climbed more stairs generally experienced greater health benefits. However, even smaller amounts of activity were associated with positive changes.

The findings are particularly relevant as more than a quarter of adults worldwide do not meet recommended levels of physical activity. The researchers said encouraging simple forms of movement in everyday environments could help address this problem.

Workplaces, homes and public buildings could all play a role by making stair use easier and more appealing. Choosing stairs over lifts when possible may provide an accessible form of physical activity without requiring people to set aside additional time for a workout.

The findings were presented at a scientific congress of the European Society of Cardiology. Researchers said the results highlight how small changes in daily routines can contribute to better long-term health and may help reduce the burden of cardiovascular disease.

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Children Who Play Alone May Still Feel Happy and Connected, Study Finds

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Children who spend much of their school day playing alone may not necessarily be lonely or unhappy, according to a new study from researchers at the University of Georgia in the United States.

The research suggests that some children simply enjoy their own company while maintaining satisfying friendships and a sense of belonging among their classmates. Researchers say the key factor may not be how often a child chooses to be alone, but whether they still feel connected to others.

The study involved 473 children aged between nine and 11 at several elementary schools in Georgia. Participants were asked to identify classmates who often played alone despite getting along with other students. They also answered questions about the importance they placed on belonging and their satisfaction with friendships and relationships within their classes.

Researchers found a clear difference between children who preferred solitude while still valuing social connections and those who placed little importance on belonging to a peer group.

Children who enjoyed spending time alone but considered belonging important generally reported being satisfied with both their close friendships and wider relationships at school. Researchers said these children may accept enough invitations to remain socially connected while choosing to spend some of their free time alone.

Rachael Pfanz, the study’s corresponding author and an elementary school psychologist, said these children can prefer doing their own activities without having difficulty getting along with classmates.

The findings were different for children who did not consider belonging important. They were more likely to report weaker relationships with friends and classmates.

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Researchers warned that repeatedly turning down invitations can eventually affect a child’s social opportunities. Classmates may stop asking them to join activities, potentially leaving them with fewer chances to develop or maintain friendships.

Michele Lease, a professor of educational psychology at the University of Georgia and a co-author of the study, compared social interaction with other activities that benefit people even when they may not always feel like participating.

The researchers said adults should avoid assuming that every child who plays alone needs to be encouraged to join a large group immediately. Pressuring a child into a busy activity could make the situation uncomfortable rather than helping them build connections.

Instead, adults could introduce children to smaller groups or classmates who share similar interests. A child who enjoys drawing, reading, building or another individual activity may find it easier to connect with peers who have the same interests.

Pfanz said joining a large playground game, such as soccer, may feel overwhelming for a child who already prefers playing alone.

The researchers said the findings are particularly relevant to fourth- and fifth-grade students, a period when friendship groups become more established and children become better at recognising whether classmates are choosing solitude or experiencing social exclusion.

The study suggests that solitude itself should not automatically be viewed as a problem. What may matter more is whether children have meaningful relationships and continue to feel that they belong.

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Good Vascular Health in Midlife Linked to Longer Dementia-Free Life

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Maintaining healthy blood pressure, avoiding diabetes and not smoking during middle age may help people spend more years of their lives free from dementia, according to new research.

A study of more than 12,000 participants found that people without the three major vascular risk factors between the ages of 48 and 68 could gain nearly 13 additional years without developing dementia compared with those who had all three conditions.

The findings highlight the importance of managing cardiovascular health during midlife as researchers continue to examine ways to reduce the growing global burden of dementia.

Dementia affects millions of people worldwide, with about 10 million new cases diagnosed each year, according to the World Health Organization. The number of people living with the condition is expected to exceed 150 million by 2050.

Researchers are increasingly examining factors that can be changed earlier in life, including smoking, high blood pressure and diabetes, because these conditions can affect blood vessels and contribute to problems affecting the brain.

The study, published in Neurology Open Access, defined good vascular health as having no diabetes, hypertension or smoking history during middle age.

Researchers found that participants with all three risk factors faced almost three times the risk of developing dementia compared with people who had none of them.

At age 55, people with no vascular risk factors could expect to live an average of 30 more years without dementia. Those with one risk factor had an average of 26 dementia-free years, while people with two had about 21 years.

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Participants with all three risk factors could expect just over 17 years without dementia. The difference between those with no risk factors and those with all three was therefore about 13 years.

The researchers said the results suggest that protecting vascular health during midlife could have a substantial effect on brain health later in life.

“Our findings argue that people need to actively avert these factors in midlife as a strategy for preserving brain health for more than a decade,” said senior investigator Josef Coresh.

The study also identified differences between men and women. Women generally had more dementia-free years than men across the groups. Among participants with all three risk factors, women averaged about 18 years without dementia, compared with 16 years for men.

The researchers said the findings reinforce the importance of preventing or managing high blood pressure and diabetes and avoiding smoking during middle age.

Coresh said the results could encourage people to pay closer attention to their vascular health from their late 40s onward, potentially helping them maintain cognitive health for longer as they age.

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