What Is Immunity Debt and How Can I Manage It?

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At the moment, colds[1] and other respiratory infections[2] seem to be increasingly prevalent and lingering more than usual. Americans have approximately 1 billion colds[3] each year, with the average adult experiencing an average of two to four colds yearly[4] and children catching a cold around six to eight times annually. Per CDC estimates[5], from October 2023 to early January 2024, between 14 and 26 million Americans had influenza[6]. Moreover, the illness resulted in approximately 150,000-320,000 hospital admissions and upwards of 9,400 fatalities. Nationally, hospitalizations have been up[7] for influenza, RSV[8] and COVID-19[9]. Some experts blame such disease increases on a phenomenon referred to as an immunity debt[10] or immunity gap.

Immunity Debt Overview

Most years, viruses tend to spread more over the winter months because of factors including lowered immunity because of colder temperatures[11], more indoor socializing[12], larger gatherings over the holiday season and lower humidity levels[13].

The immunity debt is based on the premise that people haven't been exposed to various germs much over the past couple of years due to social distancing and isolating. Some experts believe that this lack of exposure has weakened the body's immune response[14]; however, claims are hypothetical and largely relate to children. On the other hand, other medical professionals argue that spikes in respiratory infections aren't unusual given that people are engaging with the world[15] more than in recent years. Indeed, some experts see the phrase "immunity debt" as misleading[16].

Regardless of the terminology or whether scientific theories hold up, it's clear that many people are experiencing seasonal illnesses and a range of unpleasant symptoms.

How to Boost Immunity and Avoid Seasonal Sickness

Although there's no cure for the common cold[17], individuals can take supportive steps to ease the symptoms[18], including taking pain relievers, getting plenty of rest, staying hydrated and easing congestion. Similarly, although many people rely on home remedies[19] to ease symptoms of flu and other respiratory illnesses, it's important to monitor sickness levels and seek medical advice[20] if symptoms worsen or don't improve. This is particularly important for older adults[21] and children because of declining or underdeveloped immune systems.

There are also several ways people can minimize their chances of falling sick and prevent illness. These include:

• Practicing good hand hygiene and regularly washing hands with soap and water.
• Avoiding touching the mouth, nose and eyes.
• Disinfecting commonly touched surfaces of the home, such as door handles, light switches and work surfaces.
• Covering the mouth and nose with a clean tissue when sneezing and disposing of it immediately afterward.
• Maintaining distance from people who are sick.
• Opening windows[24] to allow fresh air to circulate.
• Using a humidifier[25] and air purifier indoors.
• Wrapping up warm.
• Avoiding communal dishes at seasonal events.
• Supplementing vitamins[26], such as vitamin C and D, if deficiencies are likely.
• Doing regular exercise.
• Getting adequate sleep[27] each night.
• Drinking plenty of liquids to stay hydrated and eating a nutritious diet.
• Managing stress levels.
• Keeping up to date with yearly flu shots[22] for people aged 65 and older and other individuals at risk.
• Speaking to a medical professional about the RSV vaccine[23] for adults aged 60 and above.

Following general health recommendations and preventative measures can help people avoid illnesses and, if they do fall sick, a better state of heath can reduce symptom severity and promote a faster recovery.

References

1. Mayo Clinic – Common Cold
2. NHS – Respiratory tract infections (RTIs)
3. National Institutes of Health – Understanding a Common Cold Virus
4. American Lung Association – Facts About the Common Cold
5. Centers for Disease Control and Prevention – 2023-2024 U.S. Flu Season: Preliminary In-Season Burden Estimates
6. Centers for Disease Control and Prevention – Key Facts About Influenza (Flu)
7. Centers for Disease Control and Prevention – Severe Viral Respiratory Illness
8. National Foundation for Infection Diseases – Respiratory Syncytial Virus (RSV)
9. Johns Hopkins Medicine – What Is Coronavirus?
10. National Library of Medicine – Immune debt: Recrudescence of disease and confirmation of a contested concept
11. National Library of Medicine – Roles of Humidity and Temperature in Shaping Influenza Seasonality
12. Johns Hopkins Medicine – Winter Illness Guide
13. Mayo Clinic – Mayo Clinic Minute: Why do people get sick with viruses in the winter?
14. Infectious Diseases Now – 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?
15. Everyday Health – Did Lockdowns and Masking Lead to ‘Immunity Debt'?
16. Chatelaine – Is Immunity Debt Real? Two Experts Debunk The Health Phenomenon
17. Yale Medicine – Colds: How to Prevent Them
18. Mayo Clinic – Cold remedies: What works, what doesn't, what can't hurt
19. WebMD – 10 Home Remedies for the Flu
20. Mayo Clinic – Flu symptoms: Should I see my doctor?
21. National Foundation for Infectious Diseases – Flu and Older Adults
22. National Council on Aging – What Older Adults Need to Know During Flu Season
23. Centers for Disease Control and Prevention – Frequently Asked Questions About RSV Vaccine for Adults
24. The Youth Clinic – Steps to Prevent Sickness This Winter
25. MedlinePlus – Humidifiers and health
26. Aavalabs – 5 Supplements You Should Be Taking in Winter
27. National Heart, Lung, and Blood Institute – How Much Sleep is Enough?