Is everyone around you getting sick?

This winter seems to be the winter  of colds and flus and aches, sick leaves and sniffles. This feel unfair: three years into the pandemic, 2022 was the first time the UK and the US didn’t experience a significant “autumn wave” and didn’t reintroduce restrictions. You’d almost feel we've earned some robust good health all around. Instead, anecdotes proliferated of more of us feeling sicker than ever before. Speaking for myself, I developed a nasty cold once a month, every month, for four months. Each bout involved sneezing and coughing so much that when I went out, strangers would stare at me in uncomfortable judgment. But it wasn’t COVID, on any of those occasions. It was usually after I’d been at the gym, or at a social event, surrounded by people – something I no longer did in my work-from-home job – that would bring on this kind of illness. My pandemic body, and the newly sensitive immune system that came with it, seemed to bear the blame.

There have been plenty of testaments on social media of cold-like symptoms that were not due to a COVID-19 infection, but which, people said, nevertheless absolutely wiped them out. Government data showed flu activity continued beyond week 14 of 2022, representing late-season activity. Particularly in the lead up to Christmas, many were left exhausted, with a cough, fever, sneezing and more. While it’s easy to pass it off as the seasonal flu ‘just doing the rounds’, there does seem to be an alarming number of people who can attest to having a cold throughout the year, even the warmer months, and many report it being worse than sicknesses before the pandemic. 

So, what’s the reason behind it all? Is it a consequence of COVID-19, or is it just our tired, burnout, sensitive new bodies, suddenly unaccustomed to illnesses that used to be routine? 

For 33-year-old David Novak, a multimedia store assistant from New Jersey, this certainly rings true. "In health terms, 2022 was what I called my ‘sick year'," he says. "I got sick more than usual. I got a cold that led to a middle ear infection, I got the flu shortly after, got COVID  again, got tonsillitis, and then another cold that just turned into bronchitis.’

David isn’t someone who used to be  prone to illness. He adds: “Compared to previous years, particularly 2020-21 where I only got one cold in 2020 and COVID in 2021, last year was sick-ridden. In 2022, as more people started taking the masks off, myself included, I got sick way more than usual for me pre-pandemic. The first cold I had last year was the worst cold I had in a long time. It lasted a little over a week and led to a middle ear infection which I still feel the effects of today (I have tubes in my eardrums).”

Chandni Sembhi, 25, a writer from London, also saw her health decline over the past year. She tells us: ‘"Pre-COVID, I never got sick, I've always had a pretty good immune system. But then last year, as things opened up more, and I was going out again, I was ill quite badly four times in 2022 – which for me is a lot as I only used to get ill once a year, if that."

She  also remembers being more affected by illness then in earlier years. "I'm not sure how I got sick, but each time, I was wiped out. Headaches, nausea, awful flu symptoms, basically bedridden for days at a time. Until 2022, I never had to take more than one sick day off in a row. Then I got COVID  for the first time at the end of 2022, and although the severe symptoms subsided after about five days, I've felt constantly headache-y and sniffly since, and feel like I could do with a couple more sick days just three weeks after I first tested positive.” 

“I think part of it is that I was inside for so long, like we all were, for 2020 and most of 2021,” she adds.  “So maybe now I’m  being overly-social and exposing myself to more germs?’ 

While overexposure to germs, which we largely avoided in previous years, might be one cause, there could also be other reasons. Loneliness and isolation, of which we got plenty of early on in the pandemic, can lead to weaker immune systems. A 2017 study showed that people who perceived themselves as more lonely also reported more cold symptoms. Those who felt lonelier also reported worse physical health overall, and were more likely to develop serious health conditions - such as coronary heart disease - than their less lonely counterparts. 

There might be age differences too, with mostly young people (under 50s) self-reporting respiratory illness. This might be explained by those aged 50 and above being more likely to take their flu jabs, as well as children in school. However, not all children might be inoculated – and vaccine uptake in children was lower in 2021/2022 compared to the year prior – which meant it spread easily in schools and nurseries. And adults who are in contact with children tend to get more colds than those who are not.

It is hard to put down the reason for our sickness to just one factor, says Paul Hunter, a professor of medicine who works on the ZOE COVID app, as there is scarce data on less severe respiratory conditions such as colds, but he concurs that looking at the Zoe App, cold-like symptoms are certainly more common than they have been for over two years.” 

It comes down to what our immune system has been exposed to, he says.

"The balance of evidence is that as people haven’t been exposed to many respiratory infections for two years, there was lower levels of population immunity. So as people have started getting exposed they are more likely to develop an infection if exposed."

He also notes that if it’s been a while since your last illness, you may feel sicker as the immunity you’d built up against it wanes. “There is also the issue of how sick people will get once they are exposed and there is plenty of evidence that for infections that recur throughout life the longer between infections the more sick you can get. You can see this for COVID, where immunity to infection drops within months.”

Molecular biologist Edward Hutchinson, who specialises in influenza viruses, explains that it’s more to do with what our bodies weren’t exposed to during early on in the pandemic. 

He explains: “Before the widespread use of COVID  vaccines, we had to control the spread of SARS-CoV-2 using general measures such as social distancing and masking. These are effective against lots of different viruses and bacteria. In fact, these ‘non-pharmaceutical interventions’ (NPIs) were often rather better at slowing the spread of infections other than COVID-19, influenza infections fell really dramatically, for example.”

So, our bodies grew accustomed to not being exposed to the usual spread of infection during peak seasons. Then, as we began coming back out, our systems were jolted by its presence. Hutchinson adds: "As we relaxed these measures, those infections have come back. Respiratory viruses change rapidly to evade our immune responses, but in a normal winter most of us have at least some immunity to them because we’ve encountered something similar in previous years. But because we saw so little of them during the pandemic, we don’t have as much of this ‘background’ immune protection. This means that these infections can now spread faster than normal." 

Should we go back to restrictions, especially as rising COVID cases in China have seen the US and some countries in the EU, opt in for requiring some visitors to test on arrival? Professor Hunter says possibly not, given how unpopular restriction s  are. “Non-pharmaceutical interventions like travel restrictions, school closures, restrictions on meetings and mask-wearing always have to be balanced against their downsides. In general NPIs only really delay the inevitable. “ He explains that the onus has now shifted to vaccination programs and treatment.

While government sanctions such as lockdown now feel excessive,   considering successful vaccine drives, we can’t ignore that COVID  and other infectious diseases can still be a serious risk,  particularly for the immunocompromised. So, if the government isn’t going to introduce any policies to protect against upcoming viruses, what shall we do as individuals to avoid getting sick and infecting others? 

Hutchinson adds we can draw our lessons from the restrictions and maintain at least some low-key habits to protect ourselves and others. by going through that experience we’ve learned to do things that are more manageable and still offer some protection. If we feel like we’re unwell, we can now consider masking to protect others and where possible, working from home until we’re better. 

“If someone is particularly concerned about the impact of getting ill, we now know more about what does and does not help in terms of masking, handwashing and contact with others. And – in addition to influenza vaccines, which are already widely available and in the UK can be bought in pharmacies for people who can’t access them for free – the knowledge gained from developing COVID vaccines is likely to lead to the development of new and better vaccines for several of the common winter illnesses. None of these measures offer 100% protection, but together they build up layers of protection for us and for the people around us.”

For the year ahead, it might be time to get all the vaccines we’ve been putting off - and stock up on some First Defence.