*The translation of this article in French and Portuguese has been made through machine translation and has not been edited yet. we apologise for any inaccuracies.
With an immunology lens, what preventative medicine practices are widely used around the world? Last month, we asked 4,445 M3 members about their opinions on various aspects of preventative medicine and immunology in the US, Europe, and the Nordics.
In the US, we asked our community about “playing virus catch-up”, whilst in the UK, Germany, France, Italy, and Spain, we asked “is COVID-19 now endemic?”. M3 Global Research panel members in Austria, Belgium, Switzerland, Denmark, Finland, Norway, the Netherlands, and Sweden were asked for their opinion on “bioelectronic medicine and immunology”. See what the results below tell us about different preventative medicine and immunology approaches, and regional differences:
• The immunity gap caused by the COVID-19 pandemic has been blamed by a number of experts for the recent spike in respiratory syncytial virus (RSV) in the US. Some immunologists however, disagree, and have debunked this concept as COVID-19 misinformation.
It´s widely recognised that preventative approaches in healthcare can optimise patient care, reduce healthcare costs, and foster more sustainable and effective healthcare systems that are proactive, instead of reactive. However, there are discussions about the types of preventative medicine that should receive funding and which should receive the most focus in order to yield the best financial results and public health benefits. Approaches vary vastly between different countries and groups of healthcare professionals, and opinions are split.
The COVID19 pandemic has highlighted the role of immunology, with recent discussions focusing on whether the pandemic and associated preventative measures to limit transmission has resulted in the so-called ‘immunity gap’, which is blamed by a number of experts for the recent rise in diseases such as RSV.
An Overview of Preventative Medicine Practices
What is preventative medicine?
Preventive medicine combines medical research with medical practices designed to avoid disease and illness. Rather than treating conditions once they arise, preventive measures focus on early screening, detection, and containment of diseases. There are several types of preventative medicine, but they often include promoting healthy lifestyle choices, and finding new solutions to reduce risk of developing disease in the first place.
Types of preventative medicine
The practice of preventative medicine corresponds with the five stages of disease (underlying, susceptible, subclinical, clinical, and recovery / disability / death) to prevent the onset of disease through risk reduction and downstream complications of a manifested disease. The preventative health measures for each stage are:
1. Primordial Prevention (underlying disease stage)
Primordial prevention is the earliest prevention measure and targets an entire population, often children or risk groups, to reduce risk of disease onset. The preventative health measure focuses on improving social and environmental conditions like promoting healthy diets and improve access to physical activity which can help decrease risk factors for obesity, cardiovascular disease, type 2 diabetes, etc.
2. Primary Prevention (susceptible disease stage)
Primary prevention aims to prevent the disease from occurring by targeting healthy individuals. Preventative activities include limiting risk exposure or increasing the immunity of individuals at risk. One example is mass immunization, where people are protected against a disease through vaccination.
3. Secondary Prevention: (subclinical disease stage)
Secondary prevention focuses on early disease detection and is most often seen in the form of screenings. For example, a Papanicolaou (Pap) smear is a form of secondary prevention aimed to diagnose cervical cancer in its subclinical state.
4. Tertiary Prevention: (clinical disease stage)
Tertiary prevention aims to reduce the severity of the disease in those who have already been diagnosed. While secondary prevention seeks to prevent the onset of illness, tertiary prevention aims to reduce the effects of the disease. Common measures include rehabilitation efforts.
5. Quaternary Prevention (stage of recovery / disability / death)
The focus of this stage is to take actions that protect individuals from medical interventions that are likely to cause more harm than good. The aim is to prevent overmedicalisation.
Some immunologists argue that this is unfounded, explaining that there is no evidence to show that the immune system is weakened in response to reduced exposure to illnesses, except in older people.
M3 Pulse Results About Preventative Medicine and immunology from USA, Europe, and Nordics
Read below what 4,445 physicians and other healthcare professionals in USA, Europe, and Nordic countries think about several aspects of preventative medicine and immunology, including:
- “Playing virus catch-up” in the US.
- Opinions from the UK, Germany, France, Spain, and Italy on “is COVID-19 now endemic?”
- Views on “bioelectronic medicine and immunology” from Austria, Switzerland, Belgium, Denmark, Norway, Sweden, the Netherlands, and Finland.
25% of respondents from the US agreed that an immunity gap exists, caused by the lack of “immune simulation” during the lockdown period, resulting people becoming more vulnerable to viruses such as RSV. The most effective infection prevention and control strategy according to respondents from our panel in the UK, Germany, France, Spain, and Italy is to “continue to educate people in terms of good hygiene” – with 34% choosing this option. Interestingly, respondents from Austria, Switzerland, Belgium, Denmark, Norway, Sweden, the Netherlands, and Finland thought that more immunology research will have a significant future impact in their medical field – with 35% choosing this answer.
Full results for each of the three questions asked in November’s M3 Pulse below.
Opinions in the US on “playing Virus Catch-Up”
As we enter the winter season, the healthcare industry is yet again dealing with a surge in viral respiratory infections in children, such as the respiratory syncytial virus (RSV). Experts have suggested it could be due to an immunity gap – when immune systems have had reduced exposure to infectious pathogens, making you more likely to become unwell. However, some immunologists have claimed this concept to be COVID-19 misinformation, which forms a narrative blaming public health measures like masking and social distancing for the current surge. They explained that the immune system is not like a muscle – which weakens when you are not using it; instead, it is likened to a collection of photographs – which don ‘t fade over time just because they aren’t looked at regularly. Immunologists explain that there is no evidence to show that the immune system is weakened in response to reduced exposure to illnesses, except in older people.
Question: As a medical professional, do you think that there is a scientific basis for the immunity gap?
Participants: 1,486 healthcare professionals in the US.
Despite what some immunologists suggest, 25% of respondents from our US panel believe that the lack of “immune simulation” during the lockdown period made everyone more vulnerable. A further 24% think that we should continue with infection prevention control measures to stop the spread of the virus. 20% state this is the first time the world has seen widespread global interventions due to a pandemic. 11% of respondents believe that the sudden surge in respiratory illnesses could be caused by various factors, including current pressures on the healthcare system, and a further 10% state that lockdowns and public health measures do not affect our children’s immunity negatively. Other answers from respondents included: “masking and social distancing seem to have helped prevent the spread of COVID-19, yet at the cost of a less effective immune response to other infectious diseases such as RSV. More data may be needed to accurately judge how effective recent public health measures have been.”
Opinions From the UK, Germany, France, Spain, and Italy on “is COVID-19 Now Endemic?”
Responses are split between governments looking to maintain tight restrictions and those who believe easing the rules will benefit them in the long run. China had previously confirmed it will maintain its zero-Covid policy , however changed its outlook in December 2022, reversing most restrictions. In Germany, new regulations came into force in October renewing mandatory wearing of masks and updated vaccine programmes. Italy, on the other hand, has recently lifted rules requiring masks on public transport, continuing to ease regulations whilst fighting against coronavirus.
Question: As a medical professional, what do you think is the most effective infection prevention and control strategy?
Participants: 2,680 Healthcare Professionals
The most effective infection prevention and control strategy, according to respondents from our panel in the UK, Germany, France, Spain, and Italy is to “continue to educate people in terms of good hygiene” – with 34% choosing this option. 28% want to see further improvements to vaccine programmes and better promotion of them, and 16% believe that wearing masks in public should be mandatory. 10% of all respondents think easing rules to build up herd immunity is the best way to proceed, compared to 9% who think tightening rules to stem outbreaks at peak times is required. Due to differing regulations in each of the countries surveyed, other answers varied from “further measures are no longer necessary, all regulations should be converted into recommendations” in Germany to “initiate prevention from an early age and develop medical and paramedical centres” in France, and “mandatory masks in the workplace and indoors” in Italy.
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Opinions From Austria, Switzerland, Belgium, Denmark, Norway, Sweden, the Netherlands, and Finland on “Bioelectronic Medicine and Immunology”
Question: As a healthcare professional, to what extent do you believe that more immunology research could one day lead to more impactful preventative medicine solutions in your area of specialty / medical field?
Participants: 279 Healthcare Professionals
Respondents from countries including Austria, Switzerland, Belgium, Denmark, Norway, Sweden, the Netherlands, and Finland believe that more immunology research will have a significant future impact on their medical field – with 35% choosing this answer.
A further 30% believe that yes, it will have a significant impact, but it should not be the only area of research focus, whilst another 20% think it will have an impact, not in their medical field, but in many others. 5% of respondents think that research should focus on other more critical areas of preventative medicine, and another 2% believe that immunology research is irrelevant to the future of preventative medicine. A fraction of respondents (0.4%) believes that there has already been enough recent research in immunology.
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