Bianca Andreescu admits she sometimes surprises herself with her ability to chase down tough shots.
“Sometimes I literally feel like I’m an octopus out there, running side to side,” the Canadian tennis star said early Friday morning. “I feel like I have eight legs. It’s insane, sometimes I don’t even know how I get to some shots. It’s that fighting spirit that I’ve always had in me, never giving up.”
That competitive drive has been front and centre this week with Andreescu back in the spotlight in a hurry following 16 months off.
The 20-year-old Andreescu, in her third tournament back after the layoff, has won four three-set matches in a row to reach the final of the Miami Open. She will play top-ranked Ash Barty of Australia on Saturday in the championship of the WTA 1000 event — the level directly below Grand Slams in women’s tennis.
In her return after a knee injury and a decision to stay off the courts later in the pandemic, the 2019 U.S. Open champion was well off top form and exited in the second round of the Australian Open in February. A trip to the semifinals of a smaller event in Australia followed, but Andreescu injured her leg there and didn’t play again until starting in Miami last week.
Now, the native of Mississauga, Ont., is producing a run that has similarities to her journey to the title at the Rogers Cup in Toronto in 2019. Andreescu won four three-setters in a row at her hometown event, too.
A day off Friday was a nice break for Andreescu after 12 hours 12 minutes of court time in five matches over seven days in Miami. The third-set semifinal tiebreaker against Greece’s Maria Sakkari ended at 1:35 a.m. ET and Andreescu didn’t wrap up her press conference until close to 3 a.m.
“I found a way somehow and I’m super proud of myself with how I dealt with everything,” she said. “It was very up and down, but I did it.”
WATCH | Andreescu to play in Miami Open final:
Bianca Andreescu of Mississauga, Ont., defeats Greece’s Maria Sakkari 7-6 (7), 3-6, 7-6 (4). The Canadian will face world No. 1 Ash Barty in the Miami Open final. 3:11
Andreescu, who will move up three spots to No. 6 in the rankings next week, will face Barty for the first time on Saturday.
The champion at Miami and the French Open in 2019, Barty also is coming off a long break. After the pandemic hit last March, she did not play for the rest of 2020.
Barty won a tournament in Australia before the Grand Slam and now has a shot to win back-to-back titles in Miami (the event wasn’t held last year).
Both Barty, 24, and Andreescu won their first and only Grand Slam to date in 2019.
“It’s going to be great. Definitely have wanted to play her,” Andreescu said. “I have my chance on Saturday. I know it’s going to be really tough. She’s playing great tennis. I hope I can be on my A game.”
Barty says she doesn’t watch a ton of tennis when she’s not playing, but is well aware of what Andreescu brings to the table.
“Bianca has shown in big tournaments that she’s got the ability to beat the very best,” Barty said. “I know from the little that I have seen that she’s got a way of moving around the court that is extremely physical.
“She’s got great hands and got options off both sides. She’s got a chisel off both sides. She has the ability to flip the ball up or hit through the court. That’s what makes her game exceptionally challenging. She’s got so many different assets and so many different things she can go to to ultimately let the competitor in her figure it out.”
One-way ticket to the final 🎟️<a href=”https://twitter.com/Bandreescu_?ref_src=twsrc%5Etfw”>@Bandreescu_</a> survives Sakkari in yet another three-set thriller, 7-6(7), 3-6, 7-6(4).<a href=”https://twitter.com/hashtag/MiamiOpen?src=hash&ref_src=twsrc%5Etfw”>#MiamiOpen</a> <a href=”https://t.co/VP8Mo90C1e”>pic.twitter.com/VP8Mo90C1e</a>
Andreescu is one of many Canadian athletes or teams to be competing in Florida this spring. She has played her best tennis in North America, going 33-1 since the start of 2019.
Andreescu says it helps having familiar faces watching her. Her parents and her dog, Coco, have received plenty of television time in the stands this week.
“My parents are putting her up and making her dance to the music, which is super cute,” Andreescu said. “It’s nice to have that during these tense moments because I’ll throw a little smirk in there and things will be better.”
A Canadian is fighting one of the best boxers in the world
American Claressa Shields rose to stardom at the 2012 Olympics, where she won middleweight gold at the age of 17. She repeated as Olympic champ in 2016 and also won a pair of middleweight titles at the boxing world championships during her stellar amateur career.
Since turning pro in late 2016, Shields has won all 10 of her fights and captured titles in three different weight classes. In addition to being the current undisputed middleweight (160 pounds) champ, the 25-year-old also holds the WBC and WBO women’s light middleweight (154 pounds) belts. ESPN and The Ring magazine both rate her as the second-best pound-for-pound women’s boxer in the world.
On Friday night in her hometown of Flint, Mich., Shields will step into the ring for the first time in 14 months. Her opponent is a Canadian, 34-year-old Marie-Eve Dicaire, who’s 17-0 as a pro and currently holds the IBF light middleweight title. The bout will unify the two fighters’ various light middleweight belts, and the vacant WBA and The Ring titles are up for grabs too.
Shields is also putting herself out there. She and her manager personally put together Friday night’s card, which is being billed as the first-ever all-female pay-per-view boxing event. The Shields-Dicaire main event is the first women’s bout to headline a boxing pay-per-view since Laila Ali (Muhammad Ali’s daughter) fought Jacqui Frazier-Lyde (Joe Frazier’s daughter) in 2001.
As this story by ESPN’s Michael Rothstein explains, Shields decided to go the DIY route after growing increasingly frustrated with her broadcast partner Showtime. She felt the cable network wasn’t offering her the same opportunities as some of its big-name male boxers.
At the same time, she noticed that mixed martial arts does a better job of showcasing its women’s stars (case in point: the co-main event on this Saturday’s UFC 259 card is a women’s featherweight title bout between star champion Amanda Nunes and challenger Megan Anderson). So Shields is becoming a two-sport athlete. She recently signed a deal with the Professional Fighters League that will see her do two MMA bouts this year, and she’s also planning to fight twice in the boxing ring. The bout everyone would like to see is Shields vs. Ireland’s Katie Taylor — the reigning undisputed lightweight champion and the consensus No. 1 pound-for-pound women’s boxer in the world. It’s a bit tricky, though, because Shields would have to drop down in weight quite a bit to make the fight.
As for Dicaire’s chances of ruining Shields’ big night with an upset, well, they don’t look great. The Canadian is a good fighter (The Ring rates her No. 2 in the world behind Shields in the light middleweight division) and her 17-0 record looks impressive. But she’s never fought outside of her home province of Quebec, and now she’s going right into the backyard of an opponent who’s nine years younger and more talented.
As CBC Sports’ resident fight expert Cole Shelton (follow him on Twitter here) noted when we talked about this matchup, outpointing Shields over 10 rounds is a tall order for Dicaire. So a surprise knockout is probably the best path to victory for the Canadian. Unfortunately, she doesn’t seem to have that kind of stopping power. All 17 of her pro fights have gone the distance. As a result, the current betting odds imply Dicaire has only about a 13 per cent chance of beating Shields. But, win, lose or draw, simply getting the opportunity to fight in the main event of this historic card — and getting to do so against one of the world’s very best — is a big deal for Dicaire and for Canadian boxing.
The Raptors will be very shorthanded tonight. Five Toronto players — starters Fred VanVleet, Pascal Siakam and OG Anunoby; reserves Patrick McCaw and Malachi Flynn — plus head coach Nick Nurse and five of his assistants will miss tonight’s game vs. Detroit as part of the NBA’s health and safety protocols. This is just the latest of the Raptors’ coronavirus-related issues, which started last week when Siakam, Nurse and five coaching assistants missed Friday’s game against Houston. Sunday’s game against Chicago was postponed, and Tuesday’s game vs. Detroit was postponed until tonight due to what the league said was “positive test results and ongoing contact tracing within the Raptors organization.” Mercifully, tomorrow night’s game in Boston is Toronto’s last before the all-star break, which lasts a full week. Read more about the Raptors’ problems here.
Trivia question: which NHL team holds the record for most goals scored in a game?
Gotta be one of the ’80s Oilers squads, right? Maybe Lemieux’s early-’90s Penguins? Or the legendary ’76-77 Habs?
No, it’s actually the 1919-20 Canadiens, who on this date 101 years ago beat the Quebec Bulldogs 16-3 to set a single-game goals record that has never been matched (hat tip to CBC News’ Morning Brief newsletter for that factoid). Forward Newsy Lalonde and defenceman Harry Cameron each scored four times, and forwards Odie Cleghorn and Didier Pitre also had hat tricks. The legendary Georges Vezina was in net for the Canadiens that night. Quebec star Joe Malone, who about a month earlier had scored seven goals in a game to set an NHL record that still stands, was held to only one goal.
It might surprise you to hear that 1919-20 was the highest-scoring season in NHL history in terms of average goals per game. Montreal also scored 14 and 12 in separate contests that year, and teams averaged 4.79 goals per game (for comparison, last season it was 3.02). It also might surprise you to hear that, to this day, the four highest-scoring seasons in NHL history are still the first four — 1917-18 through 1920-21.
Coming up from CBC Sports
Snowboard cross: Watch the first of two sets of men’s and women’s World Cup races in Georgia on Thursday from 2-3:30 a.m. ET on CBCSports.ca and the CBC Sports app. The second set goes Friday at the same time. Canada’s Eliot Grondin is second in the men’s season standings with only one World Cup stop left after this one.
Nordic ski world championships: Watch the women’s cross-country 4×5-km relay Thursday at 7:15 a.m. ET on CBCSports.ca and the CBC Sports app.
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At 7 a.m. Christmas morning, Dr. Lisa Richardson will start her day helping COVID-19 patients at Toronto General Hospital in what could become a 12-hour shift.
“I was actually thinking … OK, I need to find one of those ugly Christmas sweaters or holiday sweaters … so that I can try and add some cheer in some way,” said Richardson, a general internal medicine specialist at the downtown Toronto hospital.
She and her team will be looking after 25 in-patients all day, until the next shift arrives at 5 p.m. But if a patient isn’t doing well, Richardson said she’ll often stay later, which might mean that she won’t make it home in time to eat with her family on Friday.
“None of us like to leave one of our patients if they’re unwell and clinically deteriorating,” she told The Current.
“You don’t want to sort of say, ‘Sorry, I’ve got to go for my Christmas dinner.’ So it’s just unpredictable in that way.”
With COVID-19 visitor restrictions in place, Richardson is worried about hospital patients who won’t get to see their families at all.
Being a witness to that loneliness has been one of the hardest parts of the pandemic.
“When you’re hospitalized, you’re acutely unwell, and to be alone is very, very hard,” she said.
The CBC’s Coronavirus Tracker has recorded 189,667 new confirmed cases in the past month (from Nov. 23 to Dec. 22), accounting for 36 per cent of the 521,509 known cases in Canada throughout the pandemic.
While several provinces have introduced new lockdown measures to try to bring the numbers down, tallies of new daily cases continue to overtake previous records.
WATCH | Second COVID-19 wave hitting some of Canada’s most vulnerable:
Canada’s second COVID-19 wave is taking a toll on some of the country’s most vulnerable. 4:06
The spike in cases has taken its toll on front-line health-care workers. Richardson said it’s exhausting “that this has been going on for so long, and that we’re continuing to see the numbers rise.”
“We don’t have that energy that we had initially,” she said.
Mounting stress fuels staff shortages: paramedic
The holiday period is one of the busiest times for health-care workers in “a normal year,” said Vancouver paramedic David Leary. Now, that pressure has been exacerbated by the pandemic and is fuelling other issues, including the opioid crisis.
“The strain and stress, it’s compounding the mental health issues with our paramedics and dispatchers — at levels we’ve never seen before,” said Leary, a spokesperson for the Ambulance Paramedics of BC (APBC).
He said the stress is leading to a staffing crisis, as APBC members “have to take time off work to recover and recuperate.”
Leary said he worked through half his vacation earlier this year to help cover that staffing crisis. He’ll take Christmas Day off but otherwise will be working through most of the holidays this year.
“Time off is important, but I feel it is important that we do step up,” he said. “And most of my co-workers feel the same way.”
Richardson agreed that it’s been very difficult to get time away. On a recent free weekend, she received a page telling her a patient’s condition had worsened and went back to the hospital to help.
“There are so many crises all the time, so for those of us who are on the front line and also have leadership roles, you cannot disconnect,” she said.
An ongoing study at the University of Alberta in Edmonton is assessing the toll of the pandemic on 5,000 health-care workers in Alberta, British Columbia, Ontario and Quebec. Initial data suggests high levels of anxiety among the workers, with the highest numbers among physicians.
Amid the stress, Richardson said the pandemic has “also taught us a lot around our resilience, around how we can support one another.”
Just had a moment that made my heart melt when I asked one of my admitted patients who is quite frail and has numerous things going on how they are feeling and they respond with: “I’m ok. How are you doing, doctor?”
Recently, she was moved when a patient took the time to ask her how she was doing.
“I literally almost cried,” she said.
“The idea that our patients are thinking about the toll that this is taking on us as well was really moving for me.”
She now has some time off booked over New Year’s and hopes to see extended family via video call.
Missing family at Christmas
Like Richardson and many Canadians, Leary will be having a smaller Christmas this year, forgoing time with grandparents and extended family.
“We’ll just be keeping within our bubble, and we feel it’s important to protect ourselves — but not only ourselves, the rest of the public,” he said.
Even so, he is worried about the stress of isolation at “a time of year where it can already be lonely for people.”
As a nurse working in COVID-19 units, Naveed Hussain has chosen to limit interactions with his family not just during the holiday season but since the pandemic began.
“My father’s over 70; my mother is over 60. My father does have medical ailments and I prioritize their health,” said Hussain, a registered nurse at McGill University Health Centre in Montreal.
Hussain will also work through the holidays and hasn’t “had time off in a long time.”
“It’s been tough emotionally and mentally, you know, being away from family and friends,” he said.
“But it’s also a sacrifice we chose to take, right? It’s just like a firefighter running into a fire in a building.”
Risk of catching virus
Hussain contracted COVID-19 at work in April, suffering the common symptoms of malaise, body aches and fever, as well as difficulties with his liver. He also inadvertently passed the illness on to his girlfriend.
Despite lingering symptoms that took six months to shake, he said it’s given him “the ability to care more closely.”
“You understand symptoms and how to manage those symptoms better,” he said.
“It gives you a different perspective on how to care for patients and how to have empathy for those who are affected.”
The University of Alberta study is also looking at how many front-line health workers have contracted COVID-19, with a view to improving safety measures.
“If a health-care worker is sick and not able to go to work … that’s going to very much affect all of us in the community,” Cherry, an occupational epidemiologist at the university, told CBC News.
WATCH | Approval of vaccines will be life-changing for many vulnerable Canadians:
The approval of the Pfizer-BioNTech COVID-19 vaccine will be life-changing for many vulnerable Canadians who have been anxiously awaiting the rollout. 2:02
Light at the end of the tunnel
As case numbers have climbed over the fall, Hussain said he struggles when he sees misinformation about the vaccines or people who refuse to wear masks to help limit the spread of the virus.
“It’s discouraging because we end up seeing more and more patients coming in, and then we hear the rhetoric coming from the other side,” he said.
Dr. Alexander Wong, an infectious diseases physician at Regina General Hospital, said he’s seeing the virus affect the most vulnerable more and more in the second wave.
They include “those in long-term care settings, as well as our inner-city vulnerable populations as well, so it’s been exhausting, it’s been tiring,” he said.
Wong said he hasn’t taken “any meaningful stretch of vacation basically since the beginning of March.”
When his daughter was born in August, he took a few days off but then resumed work while technically on leave. He expects to take half of Christmas Eve and Christmas Day off, and then “be back to my usual sort of craziness.”
Armed with ration packs, personal protective equipment and tents, members of the Canadian Armed Forces are preparing to spend Christmas deployed in isolated and remote northern communities.
“If you’d asked me a couple years ago, I would not have in my wildest dreams imagined that this was the situation we’d find ourselves in,” Brig.-Gen. William Fletcher said in an interview from Edmonton.
Brig.-Gen. Fletcher, who is in charge of all army troops from Thunder Bay to Vancouver Island and domestic operations on the Prairies, said military pandemic response plans made prior to the arrival of COVID-19 in Canada have put the Armed Forces in good shape.
“We’ve got a saying in the military that a plan never survives contact with the enemy, but it’s a good baseline” to start from, he says.
The military is currently deployed in at least six remote Indigenous communities in Ontario, Manitoba, Saskatchewan and Alberta.
Brig.-Gen. Fletcher said the military is working with provinces to figure out where troops might be needed next, but couldn’t say how many more communities are expected to receive support on the ground.
“If nothing else, we will be very busy monitoring the situation.”
He said troops have been given different tiers of pandemic training depending on their duties.
Indigenous awareness training is also provided and tailored to cultural realities, but not every solider will necessarily have that before going to a First Nation.
Indigenous soldiers have been instrumental in preparing their colleagues to go to reserves, he added.
“They are tremendous even for informally being able to provide some realities to folks who’ve not experienced interactions with a First Nations community.”
‘Big step forward’ for reconciliation: chief
In recent days, 55 Armed Forces members on the Shamattawa First Nation in northern Manitoba have built a temporary wall in the community’s school to separate COVID-positive patients by gender.
They’ve also gone door to door in the community, which has seen a severe COVID-19 outbreak, to test residents for the coronavirus that causes the illness and do wellness checks.
“I’ve never seen military up close, so [it’s] exciting at the same time,” said Rusty Redhead, a Shamattawa resident who got tested for COVID-19 in recent days by a military medic, accompanied by soldiers.
Redhead is still waiting for the result of his test.
“I’m just, like, shaking,” he said. “I’m just worried now.”
Military personnel are expected to be in the fly-in community, located 745 kilometres northeast of Winnipeg, until the situation stabilizes.
In Shamattawa, they’re staying in classrooms in the community’s school, but Brig.-Gen. Fletcher said digs may not be so comfy for personnel in other communities.
WATCH | Troops prepare to spend Christmas deployed in remote Canada:
Military troops are preparing to spend Christmas away from their families, helping remote communities fight COVID-19. The CBC’s Austin Grabish has this inside look at the Canadian mission. 2:11
“We are absolutely prepared to go and live in tents, be completely austere, because what we don’t want to do is become a burden on the local economy or local infrastructure.”
While the soldiers are prepared to live in tents if needed, Brig.-Gen. Fletcher said he doesn’t expect the military to set up field hospitals in isolated communities this winter.
“I think if we did it would be very much an extremely dire situation, where we exhausted all other resources at the federal and provincial levels,” he said.
“Never say never, I guess, but I don’t think it’s likely.”
Shamattawa Chief Eric Redhead, who first asked for military support at the end of November, said the help from the Armed Forces is about more than handling the rapid spread of COVID-19.
“In the past, the military was used against First Nations people. And right now, today, they’re used to help First Nations people,” he said.
“I think it’s a big step forward in terms of reconciliation between Canada and the First Nations people, so I’m really, really proud of that.”
With COVID-19 cases rising in parts of the country, tightened restrictions are causing some Canadians to abandon the safety precautions they’ve been obeying for months.
While it’s not ideal timing to surrender to COVID fatigue — British Columbia and Ontario both reported record-high case numbers this week — experts aren’t surprised to see attitudes ranging from apathetic to angry as people respond to restrictions.
In Vancouver’s entertainment district for example, nightlife revellers were criticized by police for openly flouting rules last weekend, while business owners in hot-spots have recently been pushing back on COVID-related closures, with gym owners in Quebec even threatening to disregard public-health directives.
“It’s human nature, right?” said Dr. Zain Chagla, an infectious disease expert with McMaster University in Hamilton. “At the beginning of [the pandemic], we had our own personal fears that were motivating us.
“And now, cases are rising and it’s discouraging and there’s a breaking point for some people where they want to get out and they want to be normal again.”
The longer the pandemic lasts, the likelier that constraints aimed at slowing the spread of the virus will be cast aside by those who believe they’ve already sacrificed so much, Chagla says. And having even just a small minority of Canadians skirting the rules due to COVID fatigue could be detrimental.
“It’s a hard message … and one that we really haven’t [dealt with]” Chagla said. “It’s just been this open-and-close, open-and-close mentality and we’re not actually giving people the opportunity to still have some social connection without exposing them to a high level of risk.”
Dr. Vincent Agyapong, a clinical professor and director of community psychiatry at the University of Alberta, says that as cases rise, some may be feeling their efforts to curb the disease were futile.
So they may have decided to gather for a group dinner or attend a wedding reception despite public health warnings, or they may start questioning safety directives like mask-wearing if they don’t perceive them to be working.
Desensitized to daily news
Agyapong says the recovery rate of COVID-19 may also be desensitizing people to the actual dangers of the disease.
“They don’t particularly see it as a serious condition compared to how they viewed it initially when there were so many unknowns,” he said. “There were images of people dying in Italy, and in the U.K., and in Brazil, but they’re not seeing the same kind of alarming death rates here in Canada.
“So they may not attach that level of seriousness when they judge restrictions against how it impacts their own quality of life.”
In other instances, some may be getting desensitized to daily COVID-19 news altogether and tuning out new directives as they come.
Still others may be turned off by the negative language surrounding restrictions.
‘Restrictions’ or ‘safety measures’?
Danielle Gaucher, an associate professor of psychology at the University of Manitoba, says she’s noticed a shift in how people discuss shutdowns, focusing on the word ‘restrictions’ rather than presenting them as safety measures.
And that could be triggering what’s referred to as “reactance.”
“It’s that unpleasant arousal that happens when people experience a threat to their free behaviours,” Gaucher said. “This unpleasant motivational state can result in behavioural and cognitive efforts to re-establish one’s freedom and it’s usually accompanied by the experience of strong emotions.”
Business owners feeling hardships from forced closures may be experiencing reactance — like the gym proprietors in Quebec who last week threatened to reopen their facilities amid extended lockdown measures in the province.
Reactance can also be seen in anti-mask protests. One such rally planned for this weekend in Aylmer, Ont., led the town to declare a state of emergency on Tuesday.
Judith Versloot, a behavioural psychologist in Mississauga, Ont., says some people will engage in their own risk-assessment before committing to safety measures like mask-wearing, for example.
First, she says people need to believe that masks work. But they also need to see the virus as serious enough to cause harm — even if that’s not what they’re experiencing in their own community.
“If you don’t see anybody with COVID, or if you do and they get better, you might think ‘I can handle that. Why should I wear that mask?”‘ Versloot said. “So authorities need to make very clear [the reasons] for wearing masks. … And people should feel that it’s important to them.”
WATCH | Anti-mask protests in history and now:
To wear a mask, or not to wear a mask? It’s a uniquely “2020” question, and as fraught with politics as with public health implications. 6:52
Versloot says messaging needs to be consistent and include positives when possible to motivate people to continue with restrictive measures.
“Somehow, [safety precautions] need to feel good to you,” she added. “You need to feel your actions are helping.”
Chagla agrees that inconsistent messaging from public health and government officials may be fuelling COVID fatigue in some.
He used Thanksgiving as an example, saying when people are told they can eat dinner in a restaurant with 100 people but not host 10 of their family members at home, they become aware of that contradiction. And the longer the pandemic goes on, the less patience people have for fluctuating messages.
“Those inconsistencies stick out; they cause more distress and people harp on it, especially as new restrictions come down,” Chagla said. “People will look back and say: ‘Well, I could do this before. What’s different today?”‘
One solution, Chagla says, is making sure leaders offer safe alternatives to risky behaviour rather than cancelling them outright. Asking people to modify the way they socialize is better than telling them to stay home altogether.
While he acknowledges that harsh Canadian winters will make it harder to take social situations outdoors, Chagla says we need to embrace that this year.
“I’m not saying go out in a blizzard, but get a warm winter jacket, get gloves, get all that stuff,” he said. “A walk in the park with some coffee is not a terrible thing.”
This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
There’s a lot of confusion — and speculation — about immunity to COVID-19 at the moment.
You may have seen the headlines this week implying that antibodies the immune system creates to fight off the coronavirus decline rapidly after infection, jeopardizing the hope for long-term immunity from the virus.
But the issue is both more complicated than it may seem and more hopeful.
The preprint study, which has not undergone peer review, found the number of people with detectable antibodies in their blood in England fell from six per cent of the population at the end of June to just 4.4 per cent by mid-September.
The researchers concluded there was “decreasing population immunity” and “increasing risk of reinfection” and that the community study of 365,000 patients clearly showed detectable antibodies were in decline.
But while the study and its discouraging conclusion made headlines around the world, experts say there’s a lot more to consider before we can definitively say coronavirus antibodies don’t last long enough to protect us.
Drop in antibodies after infection is expected
One key factor to keep in mind is that it’s not uncommon for immunity to drop after an infection, said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon.
“Simply showing that antibodies decline after an infection does not simply mean we are no longer protected,” she said. “Our immune system is more complicated than that — which is a good thing.”
A drop in detectable antibodies is actually expected after an infection and that high levels of antibodies remaining after an illness has passed could actually be a bad thing, Kelvin said.
“Typically, we would associate high levels of an activated immune response when there is no threat with more of an autoimmune disease,” she said.
“So we do want to see somewhat of a decline to know that our bodies are in check after we’ve cleared the virus.”
The other important factor is that the immune system can actually remember how to make new antibodies when needed to fight off future infections, by storing types of protective white blood cells in the body called B cells.
Kelvin said just because there aren’t detectable antibodies in the blood doesn’t mean we don’t have reservoirs of these immune memory cells stored in other parts of our body like in our bone marrow.
“That’s usually where your memory B cells would kind of hide out, waiting for another exposure,” Kelvin said. “Because you’re not going to have these circulating antibodies when you’re not being exposed, you kind of need to put them away for when you need them.”
It looked at antibody responses in the plasma samples of more than 30,000 COVID-19 patients in New York City’s Mount Sinai Health System between March and October.
It came to a much different conclusion than the preprint study: that more than 90 per cent of patients produced moderate to high levels of antibodies that were both powerful enough to neutralize the virus and lasted for many months after infection.
WATCH | COVID-19 antibodies may disappear quickly, study finds:
A new study out of the U.K. has found COVID-19 antibodies can disappear quickly from people who’ve had the virus, which experts say makes herd immunity unlikely without a vaccine. 3:33
One difference in the two studies is that the preprint looked at patients ranging from asymptomatic to severe, while the published study focused on hospitalized patients who were primarily symptomatic.
“There seems to be some type of split where milder cases after infection don’t have this notable increase in antibody responses for long periods of time,” Kelvin said. “That might be more evident in people who have more severe infection.”
Researchers in the New York study concluded that the antibodies they found were likely produced by “long-lived plasma cells in the bone marrow,” something that backs up the idea that dormant immune memory B cells could be hiding there.
“This study suggests that the majority of those people infected with SARS-CoV-2 [the coronavirus that causes COVID-19] will produce protective antibodies, which will likely protect from reinfection,” Kelvin said.
“This would support the notion that we will be able to produce a vaccine that is safe and leads to a protective immune response.”
How our immune system responds to the coronavirus
After an exposure to a virus from either an infection or a vaccination, the body goes through what’s called an “expansion phase” where these memory immune cells produce antibodies in response to it — something Kelvin likens to climbing a mountain.
Once the body believes it has cleared the infection and reached the top of the mountain, those antibodies then start to decline during what is known as the “contraction phase,” the start of the descent down the mountain.
As you get to the bottom of the mountain, the body moves into a “memory phase,” where the most effective antibodies get stored until the next exposure — like the experience you might have to better climb the mountain next time.
At that point, B cells are not thought to be detectable in the bloodstream, instead going into immune reservoirs in the body such as bone marrow, which means they could be missed by researchers only focusing on antibodies in the blood.
“We don’t yet know what level of these antibodies is actually needed to prevent infection,” said Dr. Lynora Saxinger, an infectious disease specialist and associate professor of microbiology and immunology at the University of Alberta.
“But there are lots of examples of low antibody levels getting boosted up quickly when you are re-exposed to an infectious agent due to B cell memory pumping out antibodies on re-exposure.”
Another tool our body uses to help fight infection are T cells, a different type of white blood cell stored in the body that can also attack the virus the next time they encounter it but are a separate arm of the immune system.
A recent paper published in the journal Cell found that a balance of both T cells and B cells produced in the body could lead to a better outcome after infection from the coronavirus, and Kelvin said understanding more about T cell immunity could be helpful for vaccine development.
One positive note is that memory B cells, which have the capacity to protect against future infections, have already been detected in both symptomatic and asymptomatic COVID-19 patients, as pointed out in another study published in the journal Nature this week.
Kelvin said COVID-19 patients who develop severe disease or die after being infected with the virus may have a lower ability to generate antibodies because it is possibly targeting and destroying those B cells.
“These results would support the idea that ‘herd immunity’ through natural infection will not lead to long-lasting immunity,” she said. “Which will instead keep our vulnerable populations at risk of death.”
Other coronaviruses, such as SARS and MERS, can also provide hints as to how long the dormant antibodies might stick around waiting to protect us from infection down the road.
“In both SARS and MERS, for years after antibodies were no longer detectable, immune memory cells geared for specific responses to both viruses could still be found in recovered patients,” said Dr. David Naylor, co-chair of the federal government’s Immunity Task Force.
“Bottom line: It seems really likely based on millions of people infected, the duration of the epidemic and the still very small percentage of reinfections that there is pretty durable immunity to SARS-CoV-2 after an initial infection.”
Vaccines safest way of achieving immunity
It’s important to keep in mind that research showing declining antibodies over time does not necessarily mean there is somehow less of a chance that we’ll be able to develop safe and effective vaccines in the coming months.
“There’s still lots to learn about durability of immunity,” Naylor said.
No one expects any of the vaccine candidates to grant “indefinite immunity,” and they may work more like an annual flu shot, he said.
“The immediate issue is whether vaccines will achieve and maintain enough overall immunity to keep spread under control so we can get on with our lives.”
Regardless, Kelvin says that immunity gained from vaccines is safer than achieving it through rampant infections, a concept also known as herd immunity.
“More work is needed to understand how long immunity lasts,” she said, adding that while a vaccine might not offer long-lasting protection either, it doesn’t come with the same risk of death faced by patients with COVID-19.
“So having a safe and effective vaccine would be the best way of controlling outbreaks.”
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Distance runner Hilary Stellingwerff competed for Canada in the 1,500 metres at the 2012 London Olympics. Two years later, at 34, she had a son and continued to receive her funding, as one of six “senior injury” cases listed by Athletics Canada. But in June 2015, after resuming training, she got injured and lost her funding.
“I felt that this was a human rights issue that my male counterparts weren’t going to be dealing with the same situation,” she said. “Any female would have to choose from injury or pregnancy – and, of course, you don’t choose to get injured. I thought this is discriminatory against women because it isn’t the same case for males.” Stellingwerf believes there need to be changes at Sport Canada to secure women’s rights. She took her case to arbitration.
In the 2016 final ruling, arbitrator Carol Roberts wrote: “The AAP [Sport Canada’s Athlete Assistance Program] policy of preventing female athletes who have been pregnant from subsequently obtaining a medical card is discriminatory.” Although Stellingwerf won her dispute, her carding did not resume immediately because Athletics Canada was not convinced she could compete at the Olympic level following her pregnancy. But Stellingwerff made the Olympic standard, and got her funding reinstated in time for the 2016 Rio Olympics. Eight months after giving birth, Stellingwerf ran a career personal best in a five-kilometre road event.
Following the ruling, Caroline Sharp, communications manager at Athletics Canada, said the organization stopped using the term “injury card,” replacing it with “health card,” which encompasses more than just physical injuries, and updated provision 8.14.5 of its policy: “Athletes may be nominated for Health Card status due to pregnancy more than once.”
The language matters, because it can obscure even the best-intended policies. Aside from pregnancy, any number of health carding cases may not involve injury: mental health, and personal matters among them. By the same token “retirement” is now called “transition” because it’s a better descriptor for young athletes whose competitive careers are ending.