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Comment by tuyiown | Hacker News Reader

> The thing I don't miss is that I got sick every single Winter. All it takes is one inconsiderate person to not cover their mouth and everyone is getting ill. And it happened all the time.

Give it a few years without exposure, and you will have very hard time if you have to get exposed again. I did 2 years for remote work with a single day with long exposure each week, after a few years with low exposure.

I then had a kid, it took at least 3 full years once it got to day care for my immunity to get trained back to normal. Middly sick at least 4 months total per year, strong fever and/or weakness 4-5 times per year.

I'm all for limited exposure to dangerous infections, but for the sake of everyone, we have to keep our immunity active to stay healthy, and this happens by getting sick times to times.

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Nah, its just what happens when you have a kid. I was exposed all the time commuting to work on public transit. Once my kid got into preschool I was sick for months at a time.

It's hard to explain the near exponential increase in pathogen exposure when 20+ kids are in a room doing the least hygienic things imaginable for 4-8 hours a day.

I rode the subway every day for years and rarely got sick, but a few weeks of a kid in daycare and it was all coming at me at once.

The running joke among my doctor friends is that pediatricians are immune to disease. Sick like a dog for the first couple years but then they become bullet proof.

And everything, literally everything, is going straight in the mouth unless you tackle them to break up the play.

Immune systems don't weaken from a lack of exposure. It's not a muscle that needs to be worked out. Besides which, your immune system is pretty much constantly at work with relatively benign foreign tissue regardless of whether you're wearing a mask or not.

Some things like the uptick in RSV can be explained by children being initially exposed to RSV a bit later than usual, but for your average adult that's not really relevant.

I think this is based on a misinterpretation of the hygiene hypothesis... exposure to germs helps when you're a child yourself but not after becoming an adult (AFAIA). This is supported by https://medical.mit.edu/covid-19-updates/2020/05/all-social-...

But don't parents getting sick at work and bringing it home to their kids help the kids get exposed?

Or do you think kids get enough exposure at school? (assuming schools don't keep going remote too)

Based on how consistently my niece has been sick since starting school this year, I'd say they get enough exposure at school.

I understand I have no authority on the subject, but, aren't we well aware that immunity wears off at different rates depending on the strain ? A lot of sickness only affect the children, and once for their lifetime, but there is at least covid for we know the immunity wears off. Surely there are many others.

edit: I suspect the article only states that life long immunity does not wears off. I don't challenge that at all.

This isn't really as simple as a linear decrease in immunity though - certain tools that your immune system uses like antibodies decrease over time but other tools like T-cell responses are long lasting. Thinking of it in terms of an acute response where you're very strongly protected and a persistent response where you have a slower but still effective protection is a better model.

That's one of those sciencey articles that is only technically correct within a specific context, otherwise why are elderly people advised to get the flu vaccine every year?

There is no scientific basis for this assumption (the idea that you rake in immunity "debt" by not getting sick, leading to worse symptoms /when/ you get sick).

It seems plausible that the immune system requires stressors to function well, and the absence of stressors may reduce immune system "strength". Selye's general adaptation syndrome seems applicable here as a first approximation. Muscles atrophy from disuse. Why not also immune systems?

"Immunology Is Where Intuition Goes to Die"

https://www.theatlantic.com/health/archive/2020/08/covid-19-...

The immune system is never dormant. It is constantly engaged. We don't live in a sterile environment, don't eat perfect sterile food, don't breathe perfect air, etc. There are multiple aspects to our immune system, and a lot of them are being stressed daily.

It's not "immunity debt" but rather that immunity for seasonal diseases is not permanent - you lose it if you don't use it, basically, with "refresh period" about the same length as the disease cycle.

I don't have citations handy, it's just something I've seen mentioned here and there some months ago, as a possible explanation why after 2 years of lockdowns, many more people seem to catch the common seasonal diseases.

I went to work every day when my kids were small and taught roomsful of college students. I still got poisoned by my little vectors who were a magnet for every virus in the Metro DC area.

> Give it a few years without exposure

> we have to keep our immunity active to stay healthy, and this happens by getting sick times to times

Is going to the grocery store, out to dinner, having friends/family over not enough exposure? Genuinely curious about the science if you need to be around kids (directly or indirectly via co-workers) to build or maintain a "strong immune system".

If anything I'd expect the lack of activity to cause your immune system to be hyper-aware and you'd get less sick. Trade-off is allergies and autoimmune disease.

>If anything I'd expect the lack of activity to cause your immune system to be hyper-aware and you'd get less sick

That's not really how it works afaik. The immune system can only respond quickly and effectively to the things it knows. If you spend 3 years outside society and you come back, your system will be 3 years behind on disease evolution. When you finally do get exposed, you'll have a much stronger immune response because it's an unknown threat.

Compare this to a immune system that has also never seen the latest variant, but has seen the one before -- it'll be much more effective at recognizing and fighting the threat early, and the person might not even notice they were exposed.

> The immune system can only respond quickly and effectively to the things it knows.

Is that true? I'm not sure. Another question is what does it mean to be "known". I'd get a cold or a flu every year. At what point has the virus mutated sufficiently so that I don't have an effective immune response? This is also a great point to get vaccines. Best of both worlds.

>At what point has the virus mutated sufficiently so that I don't have an effective immune response?

I don't think anybody really knows, this is an active area of research. What is known is that, the more similar a virus is to something you already had, the more likely your immune system is to be able to respond quickly enough that you don't show any symptoms and don't even realize you were exposed. And if you do show symptoms, it'll be more likely that they will be much milder than for somebody who wasn't exposed previously to something similar.

I mention the kid only because it was the the main change to sickness exposure. I suspect public transport and office work would have been enough.

Given what we could read about covid, exposure is a combination of length and probability of sharing air with sick people. Public transport is a short exposure with many people, evening with friend, long exposure, but less people. Kid: well for all the sickness they have bad immunity for, and the long length of exposure, you have good chances ti get something that you never had or have no immunity for anymore.

My experience is that I now use public transport every day and I have two kids, I get sick time to times, but much less than a few years ago.

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