The broken equilibrium

The broken equilibrium

Ecological balance is a term used to describe the equilibrium between living organisms, such as the human being, other animals and plants, with their environment.

This balance is very important because it ensures survival and stability of nature!

Humans are the key in maintaining the balance, since it is very much dependent on their activities. Nevertheless, in a totally irresponsible behaviour, people often carry out activities that are harmful and destructive to nature. Because of this conflict between nature and humans, there is a need for a balance in nature that will ensure not only the survival of plants and animals but obviously also humans.

All ecosystems and biological systems on Earth are connected, no one functions on their own. All organisms rely on each other to be in balance and to maintain a healthy population and environment.

The disrupted equilibrium – immunity facts

The Covid pandemic disrupted the equilibrium of life that we used to know, all around the globe.

As the world rapidly discontinues most measures that were put in place to slow Covid spread, the old familiar annoying viruses and bacteria that were on hold are returning and behaving in unexpected ways.

Although the past two winters were amongst the mildest influenza seasons on record, flu hospitalisations are now up!

Adenovirus type 41, previously thought to cause innocuous bouts of gastrointestinal problems, may be responsible for triggering the recent cases of severe acute hepatitis in young children.

Respiratory syncytial virus, normally causing disease in the winter, created large outbreaks in children last summer and in the early autumn, both in Europe and the United States.

And now we have monkeypox, a virus generally only found in West and Central Africa, that is causing an unprecedented outbreak in more than a dozen countries in Europe, North America, Middle East, and Australia.

These viruses are not different from what they were before; we humans are. Because of unavoidable Covid restrictions, we have far less recently acquired immunity. Thus, as a group, more of us humans are now vulnerable. Experts suggest that the increase in susceptibility means we may possibly run into problems, as we are now entering a post-pandemic, totally new equilibrium with the bugs that usually infect us.

Larger waves of illness might hit us, bringing to light problems we did not know these bugs could trigger. Diseases might circulate at times, or in places, when and where they normally would not.

Petter Brodin, professor of paediatric immunology at the London Imperial College, said we can expect some presentations to be out of the ordinary, not necessarily really severe, but out of the norm.

The head of the department of virus science at the Erasmus Medical Center in Rotterdam, Marion Koopmans, said she believes we may be facing a period when it will be difficult to know what to expect from diseases that we thought we understood.

She suggested that the disruption of normal patterns of infections may be particularly pronounced for diseases where children play an important role in the dissemination of bugs, as children are normally germ magnets and germ amplifiers. Their lives were profoundly altered during the pandemic and most went without day care, or school, for long periods of time. Many had far less exposure to people outside their households and, when encountering others, those people were wearing masks and keeping the advised distance.

“Babies born during the pandemic may have entered this world with only few antibodies passed on by their mothers, because mothers may have been sheltered from several respiratory pathogens during their pregnancies,” said Hubert Niesters, professor of clinical virology at the University Medical Center, in Groningen.

“You really see that children in the second year of the pandemic have far less antibodies to a set of common respiratory viruses. They just were less exposed,” she said.

Such factors may help explain the recent unusual hepatitis cases in young children that may be caused by an adenovirus found in a significant number of the affected children. Surprising, because this virus has not been seen to cause this type of illness in the past.

The disruption of normal patterns induced by the pandemic means that even adults have not been generating the levels of antibodies that would normally be acquired through the regular exposure to usual bugs, thus creating larger pools of susceptible people.

Flu experts worry that when influenza viruses return in a serious way, a large group of people who have not had a recent infection could be seriously ill, leading to a very bad flu season. After a one- or two-year period in which flu transmission was low, there could be a large reduction in the number of people who have enough high levels of flu antibodies to be considered protective, potentially leading to a larger, more susceptible group in adults.

Some illnesses cause more serious symptoms if they are contracted when the person is older, so it is possible that we may see differences in severity of some illnesses because young children who were sheltered from bugs during the early stages of the pandemic may now catch them when they are older.

As some experts believe, the build-up of susceptible people is not the only way the pandemic may have affected patterns of disease transmission.

Respectful and cautious freedom

After two years of limited travel, social distancing and no public gatherings, people are tired of the Covid control measures and wanting to return to the freedom of pre-pandemic life.

David Heymann, chairman of the advising committee for WHO Health Emergencies Programme, said the lifting of pandemic control measures could have helped the spread of the current outbreak of monkeypox that could have been latent at low levels anywhere outside of Africa for quite a while.

It suddenly got to public attention when everything opened up and people began traveling and mixing.

Emerging coronaviruses have dramatically influenced human health. From the initial epidemic of Severe Acute Respiratory Syndrome (SARS) to the pandemic of COVID-19, diseases caused by emerging coronaviruses have caused high global morbidity and mortality.

Understanding the ecology and evolution of coronaviruses, and how these factors relate to human health, is of utmost relevance for prevention, preparedness and response to possible further pandemics.

The most relevant fact that humans should always keep in mind is not to contribute to a broken ecological balance, respecting, not trying to control nature according to their own desires.

Best healthy wishes,
Dra. Maria Alice Pestana Serrano e Silva
|| [email protected]

Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Administration Assessor – Grupo Hospital Particular do Algarve