Two years on from our ‘immune holiday’, it’s party time for germs. Here’s why – Stuff

Im the mother of two young children. Ive lost the past month to vomiting, sneezing, up-all-night coughing, snot, snot, and more snot. Its not Covid. And thats before I even get to the kids.

You know its true, you can feel it. The signs are everywhere you look. Parents and the child-free alike are dropping like flies. It has felt like the end of days.

Some are calling it the twindemic. I argue that term is too light. Germs are running rampant, partying all night, rocking out at the premiere of 2022: The Winter The Cold Came Back.

Now I can see the email was a portent. It arrived in July. On top of the rona, my two-year-olds daycare advised of the circulation of a tummy bug, conjunctivitis, and hand foot and mouth disease.

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A week later, my youngest started vomiting at 2am, because of course it begins in the dead of night when youre in your deepest, cosiest sleep, as per the rules of parenting. The next seven days were punctuated by flushing toilets, washing, the changing of sheets, and apologies to supermarket staff for the clean up in aisle five (or more accurately, the checkout area).

The next week, the first of the school holidays, our seven-year-old started coughing and was a sweaty, clinging snot-fest for the next three days. The two-year-old got it next and then so did I. If you dont have kids, its hard to express the misery of being sick yet not being able to be properly sick as you try and comfort and entertain a tiny, overheated disease vector, without leaving the home.

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Ahikroa Duff Witehira, 2, and Nukutawhiti Duff Witehira, 7, enjoy a moment of brotherly peace. Don't let this picture fool you.

By week three the kids were better but I was in hell. RATs said it wasnt Covid, which Id already had. I coughed all night. I was headachey. The snot came in rivers. Was this what a cold was like and Id just forgotten? I slept all day. There were no doctor's appointments for two weeks.

By the time I came right, with the help of antibiotics from the emergency doctor for what ended up turning into a sinus infection, it marked four weeks of family illness. I dont even know how much sick leave my husband and I took. Days. Weeks.

When your kid has a tummy bug, they cant go back to childcare for 48 hours after their last incident. Some daycares now send children home with a runny nose. And when your child doesnt go to daycare, you cant work, and you still pay the fees. Kiwis took double the amount of sick leave in June than the previous month and there are plenty of whnau who dont even have that.

Everywhere you look someone else is muting their microphone to have a coughing fit. After two years of little to no winter illnesses, is it that we have no immunity to fight off even the most pathetic of viruses? Have we all just become kind of wimps, or are we being slammed with some particularly virulent version of a super-flu?

In the public interest but also to validate myself, I call virologist Dr Sue Huang, principal investigator at the Institute of Environmental Science and Research (ESR). Is everyone sick? Is it as bad as we think?

The short answer: yes. And maybe a bit worse.

Dr Huang digs out as-yet-unpublished data that suggests that this year, our level of respiratory illness which includes the common cold is more than twice what it was last year.

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Dr Sue Huang, principal investigator and virologist at ESR, says this year there are more colds around, and theyre hitting us harder.

The WellKiwis study, a yearly research project that in 2022 involves more than 3000 Wellingtonians, has double the number of people reporting cough, fever, illness, runny nose, sore throat or other respiratory symptoms than in 2021. It is a snapshot of what can be expected in the community, Dr Huang says.

At the peak of the survey, done weekly, the rate of reported illness was 102 per 1000. When people report symptoms, they are then asked to do a test to see if its the flu.

Those results suggest when it comes to influenza, we are a startlingly seven times sicker this year than we were pre-pandemic. When you look at those who tested and had the flu, thats extremely high, says Dr Huang. This winter is quite a heavy winter, with so much illness going on.

In 2020 and 2021, there was no influenza or Covid-19 detected among those in the survey. (Delta, ravaging Auckland last year, had not yet reached Wellington due to lockdown measures.)

At this years peak, 22 per 1000 tested positive for flu compared to 3.3 per 1000 in 2018-19.

This was at comparable levels to Covid, which measured around 27 per 1000.

The only other significant illnesses during the testing period were RSV, which peaked at 18 per 1000 in 2021 following the brief quarantine-free period with Australia in July, when it was imported.

At the more severe end, at its peak this year, influenza-associated hospitalisations were the highest New Zealand has seen for a decade, and almost three times worse than pre-pandemic levels, Dr Huang says.

That happened in mid-June, which is also much earlier than previous years typically, the flu season is the worst around August.

In the last two years, weve had almost no flu. In those years combined ESR reported only 19 cases nationwide, compared to around 5000 pre-pandemic and almost 5500 so far this year. (These are just the cases that get reported to ESR from hospitals and other laboratories, so represent a small proportion of the total number.)

Were not imagining it, then. The next question is why?

Its a combination of three factors.

In late February, New Zealand dropped its quarantine measures and began re-opening the border. Along with Covid-19, that opened the floodgates to strains of influenza, rhinoviruses (the common cold) human metapneumovirus and respiratory syncytial virus (RSV).

While we are still in the orange traffic light setting, the restrictions are nothing compared to the months of lockdowns, working from home and social distancing of the previous two years.

So the first two reasons we are sick are the most obvious there are more germs around, and because were all mingling again, they are spreading more easily.

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Our natural immunity to even the common cold has been depleted in recent years, as there have been fewer viruses entering the country and weve been social distancing.

The next is immunity.

Typically, our bodies are exposed to various germs, or microbes, which build up our defences as a population to the spread of disease.

This season is, immunologist Helen Petousis-Harris says, payback for the immune holiday we have been on over the last two years.

Youre normally exposed to a lot of viruses, and a lot of the time you dont notice, but what youre doing is maintaining immunity and cross-protection.

With a build up of immunity, people might not get sick at all, or expect to get a more mild case.

This year, when we come across a virus, we dont have that ready-to-go, resistance, she says. So we're more likely to get hit and does that mean we get hit harder? If you have never been exposed to something, youll get a more severe infection, Dr Huang confirms.

Infants and toddlers are among the most vulnerable. While the peak of respiratory illness has declined for adults, ESR figures show hospitalisations of under fives have surged in recent weeks. Dr Jin Russell, a community paediatrician in Auckland, says hospitals have treated far more children with the flu.

This is because pandemic babies have barely any natural protection. We have a crop of very young children who havent been exposed to influenza and have no immunity to it, Dr Russell says. This has been a particularly difficult winter.

The best way to protect against the flu is vaccination. It helps boost antibodies so when you encounter the virus, you have a self-made army ready to fight it.

Yet the government was slow to fund flu vaccinations for children aged three and above, doing so from July 1.

And people got vaccinated later than last year figures are higher now, with almost 25 per cent of the population vaccinated, but were lagging in June, when the peak hit.

This year we got sicker, earlier also because we were less equipped to fight it off but its not too late. University of Otago immunologist and senior lecturer in pathology and molecular medicine Dr Dianne Sika-Paotonu says its still important to get a flu vaccine, as there could be a resurgence later in the year, and hospitals are already under strain.

That goes for childhood vaccinations for other diseases too: A drop in coverage has increased the risk of outbreaks for whooping cough, measles and other preventable illnesses.

There's also one last purely sociological theory about why this winter feels particularly rough.

Psychology teaches us human memories can be short, and selective. Thats why we have more babies, remember the good things about ex-partners, and repress trauma.

Have we all just forgotten how bad colds are?

Combined with general illness fatigue, the state of some of our housing and the rising cost of living, its no wonder these past few months (if youre really going for gold, the past two years) have felt, quite literally, like the dark ages.

Bring on the sun.

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Two years on from our 'immune holiday', it's party time for germs. Here's why - Stuff