Widespread media coverage of antibody testing for SARS-CoV-2, the virus that causes COVID-19, has generated high hopes that we will be able to readily identify individuals who are immune to this virus.
There has also been coverage about developing immunity passports, which employers can use to let people return to work. While these are all tantalizing thoughts, the idea of using antibody testing as a true measure of protection is something that requires much more research.
As immunologists, our interest is in understanding how the immune system responds to viruses, especially zoonotic viruses that can be transmitted from animals to humans, like SARS-CoV-2. Here, we share our insights into different aspects of antibody testing, including its promises as well as caveats.
Immune response to a new pathogen
An emerging zoonotic pathogen — such as SARS-CoV-2 — is unique in the sense that humans have never been exposed to it, so our immune system has never mounted a response to this specific virus. When we are exposed to an emerging pathogen, our immune system mounts different types of responses within seven to 14 days.
Antibodies are one type of response: they are secreted into the blood and, more importantly, are present at sites of infection. In the case of SARS-CoV-2, antiviral antibodies can be found in the blood after infection, but they are also presumably present in the respiratory system, where the virus resides and propagates.
Although the presence of antibodies in an individual confirms that an infection has occurred, antibodies alone cannot differentiate between a historical versus current infection.
Several companies have begun producing antibody testing kits, some of which have received regulatory approval. Currently, Health Canada has approved only one antibody test. The U.S. Food and Drug Administration has issued emergency use authorization for 12 tests, including a combination of lab-based and point-of-care tests, while 200 other devices are awaiting approval.
Large-scale antibody testing has already been performed in parts of the U.S. and Europe. For example, in Chelsea, Mass., 64 out of 200 people in the downtown area tested positive for COVID-19 exposure using antibody testing. Other areas have also reported high prevalence of antibody response to SARS-CoV-2, including 25 per cent in New York City, approximately 2.8 per cent in Santa Clara County, Calif., and 14 per cent in Gangelt, Germany.
While these data imply that significantly more people have been exposed to or infected with SARS-CoV-2 than have been diagnosed using nucleic acid-based tests, these antibody-positive people may not be immune to SARS-CoV-2.
Are people who have had COVID-19 immune?
Depending on the type of virus, antibodies in the blood may or may not confer protection against the virus. We can only hope that the antibodies circulating in the blood of patients infected with SARS-CoV-2 are good indicators of protection.
However, there is a chance that there is only a weak connection, or no connection at all, between antibody presence in the blood and protection against SARS-CoV-2. This is because antibodies in the blood will have to find their way to the respiratory system — where the virus resides — to exert their protective functions. Sometimes they do not end up in the lungs where they are most needed for protection. Also, these antibodies may not be of the right type to protect against infection or there may not be enough of them present to establish protection.
It is speculated that protective antibodies bind to the molecular structures on the surface of SARS-CoV-2, especially its spike protein. The spike proteins are the points that cover the surface of the virus, forming the “crown” that gives coronaviruses their name. The virus uses these spikes to attach to cells of the respiratory system. The antibodies that bind to SARS-CoV-2’s spike protein may prevent the virus from attaching to cells. Viruses that are not able to attach and enter a cell cannot propagate and will eventually die out.
It is safe to say that antibody testing is an excellent way to determine whether there has been exposure to the virus, but not necessarily whether protection has been established. That presents a potential danger in rushing the concept of immunity passports into use: people with positive antibody tests may behave as though they are protected against COVID-19 when, in fact, they may not be.
How can we test for immunity?
Given what we now know, can we conceivably use antibody testing as a measure of immunity? The answer is maybe! If one looks at other more familiar respiratory viruses, like influenza viruses, there is usually good correlation between antibodies in the blood and protection against influenza virus.
What needs to happen now is a series of epidemiological studies looking at people with high and low concentrations of antibodies to determine whether the presence of antibodies is associated with protection against re-infection with SARS-CoV-2 and if so, what is the minimum quantity of antibodies for conferring protection.
This process will take some time, but it is very doable. One way to speed up the process is to develop tests to assess antibodies for their potential to prevent SARS-CoV-2 infection. Using antibodies taken from the respiratory systems of individuals who have been infected, these tests would see if those antibodies could prevent the virus from infecting susceptible cells in a culture dish.
Simultaneously studying antibodies in the blood of these same individuals would then tell us how well the current “quick and easy” antibody tests correlate with the antiviral functions of the antibodies in the respiratory system.
On April 23, 2020, Prime Minister Justin Trudeau announced the formation of the COVID-19 Immunity Task Force to “… oversee the co-ordination of a series of country-wide blood test surveys that will tell us how widely the virus has spread in Canada and provide reliable estimates of potential immunity and vulnerabilities in the Canadian population.”
What T cells can tell us
If it turns out that antibody tests can confirm exposure but do not indicate immunity, there are alternative approaches to immunity testing. One of the main players in immunity against viruses is a subset of cells called T-cells. These cells have an enormous capacity to recognize and respond to viruses by killing the virus-infected cells.
We have limited understanding of the involvement of T-cells in immunity against SARS-CoV-2, but it is possible that these cells play a pivotal role in protection. The question is whether we can use T-cell responses as indicators of immunity. The answer is both yes and no.
While it is feasible to measure T-cell responses in laboratory settings, it is time-consuming and requires a level of technical sophistication that is not available in most diagnostic labs. Also, T-cell testing will have to be done as a high-throughput procedure, meaning that a large number of samples is tested at once. Although high-throughput testing has not been fully developed for diagnostic purposes, the technology is there, so T-cell testing may play a role in assessing immunity to SARS-CoV-2.
This pandemic has been a true test for science and scientists. Studying our immune response to SARS-CoV-2 may not only be the key to identifying who is protected from the virus, but also to developing potential vaccines and treatments.
Shayan Sharif receives funding from Canada's First Research Excellence Funds.
Byram Bridle received funding from the Canadian Institutes of Health Research, the Natural Sciences and Engineering Research Council of Canada and the Canada Foundation for Innovation.
Despite one of the US military’s greatest fiascoes, American troops are still in Somalia fighting an endless war
Thirty years after the Battle of Mogadishu, the US continues waging war in Somalia, with little public knowledge, scrutiny or constructive results.
Nearly 30 years after the infamous Battle of Mogadishu, the U.S. military is still conducting operations in Somalia.
Popularized in the U.S. by the 2001 film “Black Hawk Down,” the Battle of Mogadishu occurred on Oct. 3, 1993, and saw the downing of two U.S. helicopters and the deaths of 18 American soldiers. Some of their bodies were dragged along city streets by Somali militants.
The battle was considered one of the worst fiascoes in U.S. military history.
Since then, the U.S has waged economic and military warfare in Somalia to first eliminate the Union of Islamic Courts, a grassroots legal and political group, and most recently to attack the militant group al-Shabaab. There have been at least 282 U.S. counterterrorism operations in Somalia, including drone strikes and other aerial bombardments.
But its my belief as a scholar of contemporary U.S.-Somali relations that the U.S. efforts to develop political stability and eliminate terrorism has achieved the very opposite and not brought an end to political violence in the war-torn country.
In fact, al-Shabaab is still waging one of the largest and deadliest insurgencies in the world.
To meet the latest threat, President Joe Biden has increased military assaults in Somalia that target al-Shabaab insurgents, conducting dozens of airstrikes so far in 2023. In May 2022, Biden also agreed to send about 500 U.S. troops to Somalia.
But the question remains: Why are U.S. forces still intervening in Somalia?
The cost of US involvement in Somalia
Between 2007 and 2020, the U.S. spent at least US$2.5 billion on counterterrorism operations in Somalia, according to Costs of War, a 2023 Brown University study. This amount was largely spent by the U.S. Department of State and does not include the unknown expenditures of the U.S. Central Intelligence Agency and U.S. Defense Department.
For comparison, between 2001 and 2022 the U.S. spent approximately $2.3 trillion, or nearly 1,000 times more, on “counterterrorism” wars in Afghanistan.
The U.S. spends time and money training the Somali National Army, assisting in surveillance and drone strike operations. Many of their activities are not publicly traceable. According to one U.S. congressional staffer who wished to remain anonymous, “even the U.S. government’s own officials do not know the total amount that has, and continues to be, spent on counterterrorism in Somalia.”
Understanding the crisis in Somalia
Located in East Africa on the coast of the Indian Ocean, Somalia is one of the poorest countries in the world.
Decades of civil war coupled with extreme droughts have caused the roughly 17 million people to exist in dire living conditions.
In 2022, about 43,000 people died from drought, while more than one million have been displaced so far just in 2023 by drought, famine and ongoing violent attacks. The nexus of climate chaos and political violence poses significant challenges for the Somali government. And yet, the counterterrorism and climate policies enacted by the Somali government continually exacerbate these problems.
In 2005, under the Bush administration, the CIA backed an unpopular and violent attempt to overthrow the Union of Islamic Courts. The group comprised about a dozen local Islamic courts in southern Somalia that solved social disputes, reopened schools and ended roadblocks erected by violent warlords.
The Union of Islamic Courts was generally popular among the Somali people living within their jurisdiction and seen by many residents as a welcomed alternative to the prior decade of civil war that decimated the region.
The US global war on terrorism
In the post-9/11 era, U.S. government officials were wary of an Islamic government coming to power in Somalia and were fearful of the Union of Islamic Courts. When the CIA’s effort failed to topple the group, the U.S. government then backed an Ethiopian military invasion of Somalia in late 2006.
During this brutal two-year invasion, many members of the Union of Islamic Courts were killed or chased out of Mogadishu, and a small group of youth began a recruitment campaign using the slogan “al-Shabaab,” or “the youth” in Arabic.
In my view, this U.S.-supported Ethiopian invasion was largely responsible for creating the conditions of political uncertainty and violence that prevail today.
Al-Shabaab portrayed the U.S.-backed Ethiopian invasion in religious and nationalist terms and painted the U.S. and Ethiopia as Christian invaders of a Muslim country.
After two years of war, Ethiopia withdrew its troops, claiming their mission to rid the extremist threat was accomplished.
This assertion proved to be false, as al-Shabaab insurgents recaptured nearly all territory lost by the UIC.
Time for a US reckoning on Somalia?
The economic harm and social devastation caused by the U.S. government is extensive, and there is little reason to believe the U.S. approach to Somalia will change in the near future.
On Sept. 6, 2023, for instance, the U.S. military reportedly provided “remote assistance” to an aerial strike operation conducted by the Somali government that killed five civilians.
Besides devastating the families left behind in the wake of violence, the lack of transparency and accountability has created an enduring tragedy for the Somali victims of the U.S.’s covert activities.
The U.S. role in Somalia does not absolve al-Shabaab of its crimes, as the militant group continues to recruit from socially and economically disenfranchised communities in Somalia. Among those crimes are bombings of civilian targets throughout Africa and the Middle East, resulting in hundreds of deaths.
But in my view, a demand for reparations from the Somali government before an international tribunal may force a U.S. reckoning on its global war against terrorism that nevertheless still rages on in Somalia.
Jason C. Mueller does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.army extremist africa
Why are some Chinese women still looking to the West for love?
Their desire to pursue marriage abroad not only reveals their longing for a better life but also reveals the pervasive gender, age and class inequalities…
Robert, an American truck driver in his 50s, lived in a trailer park in the Deep South. After divorcing his wife, who had cheated on him, he joined an online dating agency that connected Western men with Chinese women through translator-assisted email exchanges.
Robert told me he had become frustrated with American women, whom he felt were overly materialistic and had lost their “traditional family values.” (To protect the identities of my interviewees, I’ve used pseudonyms.) Yet Robert could barely afford to travel to China to meet the women with whom he exchanged emails. To save up, he often ate just a few dumplings for dinner, sometimes skipping the meal altogether.
Across the ocean, several Chinese women had gathered at their local dating agency, waiting to speak with their translator. Among them was Ruby, a former businesswoman in her mid-40s who had received a generous divorce settlement from her wealthy Chinese ex-husband and had retired in leisure. Next to Ruby stood another divorcee in her 40s, Daisy, who struggled to make ends meet as a department store sales clerk.
Despite their immense class differences, both women shared the same hope of marrying a Western man and moving abroad.
Commercial dating agencies like the one described here facilitate email exchanges and marriages between women from developing countries, such as Russia, Ukraine, China or Colombia, and men from economically advanced Western countries, such as the U.S., U.K., Canada or Australia. It’s a US$2 billion global business. From 2008 to 2019, I conducted research for my book “Seeking Western Men: Email-Order Brides under China’s Global Rise” at three international dating agencies in China, interviewing 61 Chinese female clients.
I wanted to know why, despite China’s meteoric economic and cultural rise, so many women – especially those who were financially well-off – were still looking to the West for love and companionship.
Options narrow with age
Despite China’s staggering male-female gender imbalance – where single men outnumber women by more than 30 million – middle-aged divorced women still face significant struggles.
There’s the stereotypical Western media representation of “mail-order brides” – young women who marry older Western men to escape poverty. This dynamic persists. But contrary to this stereotype, the majority of women enrolled at the dating agencies where I conducted research were middle-aged and divorced.
None of them felt coerced, and they cited age discrimination in China as their No. 1 reason for seeking Western men.
As Ruby confided, “Here, rich men want a young girl who is 20 to show off.”
Although it’s no secret that divorced or widowed men in many countries remarry younger women, the pressure to do so is particularly acute in China, where women as young as 27 years old are stigmatized as “leftover.”
Adding to the complexity, women with children from previous marriages – especially those with sons instead of daughters – face even more challenges in the local marriage market. Chinese women attribute this to societal norms that expect young men to own a home or have made a down payment before tying the knot. This means that parents are expected to financially assist their sons with mortgages, and many single men don’t want to assume this financial responsibility when marrying a woman with a son.
Infidelity also ranks among the top concerns for women, in large part due to the country’s post-1978 economic reforms, which spawned a new capitalist upper class. Many newly wealthy men – even those who were already married – started seeking younger, more sexualized women.
Ruby told me that her affluent ex-husband, who had a number of extramarital affairs, once quipped that “men are like teapots, each teapot should be matched with multiple teacups.”
It wasn’t just China’s newly wealthy class of men who started seeking romance outside of their marriages. Women told me of husbands who had lost their jobs and then turned to drinking, gambling and infidelity to cope with their newfound financial struggles.
While many female clients sought Western men as a tonic against Chinese men’s infidelity, this was hardly a concern for women who were mistresses to wealthy businessmen.
One former mistress, Jennifer, said, “I believe in patriarchy.” She preferred the company of rich men with multiple partners over faithful but less prosperous men.
As these mistresses aged, however, their wealthy paramours abandoned them for younger women. But they were unwilling to settle for lower-status, less successful men in China. After years of being out of the workforce, their lavish consumption habits were at odds with their weakened labor market prospects.
As a result, they turned to marriage migration as an option for escape.
Spurned by the service sector
Meanwhile, my interviews with sales clerks and nannies shed light on the challenges faced by middle-aged women without college degrees. Many of them had been laid off from state-owned factories in the 1990s, when over 30 million workers lost their jobs.
These women struggled to find new work in China’s service sector, which prioritizes hiring young, good-looking women. Daisy, a 43-year-old, felt fortunate to have secured a job at a luxury department store, but she feared for her future job prospects.
Meanwhile, less attractive women often had to work in less desirable positions: as nannies helping mothers take care of newborns, or street vendors who earned less than $5 per day. Without access to health insurance, retirement benefits or other social safety net programs, many of these women were desperate to leave China.
Finally, many struggling single mothers marry Western men so their children can study overseas.
Some of them want their children to escape China’s exam-driven education system that can burden students with excessive schoolwork and no playtime. Others feel that the Chinese job market favors social connections over qualification.
Joanne, a retail manager with dreams of sending her teenage son to the U.S. for college, pointed out, “Unlike in the U.S., a lot of good jobs in China depend on ‘hou tai’” – the Chinese term for “social background” or “lineage.”
“Having a degree is not enough,” she added.
Mixed marriage experiences
Interestingly, of the 30 women in my study who were financially secure, only 12 ended up marrying Western men. By comparison, 26 of the 31 financially struggling women married and moved abroad.
This is because many financially secure women were used to dating wealthy Chinese businessmen and politicians, so they often rejected their working-class Western suitors. After meeting these men face to face, they realized that they lacked the refined taste, lifestyle and sexual experience of their Chinese lovers.
By contrast, the financially struggling women held a different perspective. Daisy, who married a French mechanic, eventually grew to appreciate her husband for being kind and caring to her, even though she was not initially attracted to him and called him “foolish and clumsy, like someone from the peasant class.”
Moreover, Daisy valued the opportunity to work as a waitress and earn $1,500 per month, which enabled her to send some money home to her daughter in China.
Likewise, Robert, the truck driver, eventually found love with a Chinese woman. She moved into his trailer and worked as a masseuse on the side to send money back to her sons in China.
While some brides felt content in their new marriages, others suffered. For example, Joanne found herself in a toxic relationship with a controlling American man. Yet she stayed with her husband because her older age, limited English skills and her son’s need for financial support as a college student in the U.S. left her with few other options.
As Joanne’s experience shows, given the gender, age and class inequalities that continue to plague modern-day China, single Chinese women can find themselves choosing between a rock and a hard place.
Monica Liu does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.canada russia ukraine china
The Nobel Peace Prize offers no guarantee its winners actually create peace, or make it last
The Nobel Peace Prize has recognized some legendary leaders and peace activists, but it has a mixed track record of recognizing people who actually deserve…
The Norwegian Nobel Committee is set to announce the recipient of the annual Nobel Peace Prize on Oct. 6, 2023, drawing from a pool of 351 nominees.
Environmental activist Greta Thunberg and Ukrainian Prime Minister Volodymyr Zelenskyy are reportedly two of the nominees, among political dissidents, leaders and human rights activists who are up for the prize. The winner will receive a medal, US$994,000 and global recognition.
I have worked in the peace-building field for over 20 years to support societies as they work to prevent violence and end wars. Each year, I think I should look forward to this moment, when a champion of peace is celebrated on the world stage. But given the track record of the Norwegian Nobel Committee, I always feel some dread before the peace prize announcement. Will the award celebrate a true peace builder, or a politician that just happened to sign a peace agreement? Will it celebrate a true and historic achievement, or what happens to be in the newspaper right now?
A mixed history
Admittedly, the Norwegian Nobel Committee – made up of five Norwegians, mostly former politicians, whom the Norwegian parliament appoints for a six-year term – has made some great peace prize selections over the years.
South African politician Nelson Mandela, for example, won the prize in 1993 for his work to help end apartheid.
And Leymah Gbowee, an activist who helped bring peace to Liberia, won the award in 2011, alongside former Liberian President Ellen Johnson Sirleaf and Yemeni women’s rights activist Tawakkul Karman.
Gbowee brought Christian and Muslim women together to end Liberia’s devastating 14-year civil war by using creative tactics – including a sex strike, in which Liberian women promised to withhold sex from their husbands until a peace agreement was signed.
Despite the prize’s mixed track record – and despite calls by some to stop giving the award – I think the Nobel Peace Prize should continue. War remains one of humankind’s greatest problems, and peace is still a human achievement worth celebrating.
The prize can be off-mark
The Nobel Committee, in my view, does not always give the peace prize to people who actually deserve the recognition. And the prize is not a precursor to peace actually happening, or lasting.
Some previous awardees are head-scratchers, for peace experts and casual observers and recipients alike. For example, former President Barack Obama said that he was even surprised by the award when he won it in 2009.
The committee gave him the award “based on his extraordinary efforts to strengthen international diplomacy and cooperation between peoples.” However, Obama had been in office for less than a year when he got the prize, which is likely not enough time to do either of these things.
Geir Lundestad, a former secretary of the Nobel Peace Prize Committee, wrote in his 2019 memoir that he had hoped the award “would strengthen Mr. Obama” to pursue nuclear disarmament, but in the end he said that he regretted giving Obama the award.
Others selections, such as Ethiopian Prime Minister Abiy Ahmed, have proved embarrassing in hindsight.
Just one year after winning the award in 2019, Abiy ordered a large-scale military offensive against the Tigray People’s Liberation Front, a controversial political party that represents the northern Tigray region of Ethiopia.
The war between the Ethiopian military and the Tigray People’s Liberation Front resulted in tens of thousands of civilian deaths before it ended in November 2022. A United Nations investigation found in 2022 that all sides in the conflict have committed war crimes against civilians.
Berit Reiss-Andersen, the chair of the Nobel award committee, later said in 2022 that Ahmed “has a special responsibility to end the conflict and contribute to peace.”
Unsurprisingly, such statements encouraging peace – alongside the Nobel Prize itself – have had little effect on how prize winners act. The factors that drive war or peace are complex and are unlikely to be significantly influenced by an annual award given in Norway.
Peace is long term
Other Nobel awarding committees seem to understand that it takes a significant amount of time to judge whether an achievement truly merits the prize.
Both physicists and economists wait an average of 23 years to receive an award after they achieve their award-winning work.
In contrast, American diplomat Henry Kissinger won a Nobel Peace Prize in 1973 for negotiating a cease-fire in Vietnam that same year. The cease-fire began to falter almost immediately, and Saigon, the capital of South Vietnam, fell to the North Vietnamese army in May 1975. Kissinger then unsuccessfully tried to return the prize, noting that “peace we sought through negotiations has been overturned by force”.
Similarly, the Palestinian leader Yasser Arafat and Israeli political leaders Shimon Peres and Yitzhak Rabin won the peace prize in 1994, one year after they signed the Oslo Accords, a series of agreements that set up Palestinian self-governance for the West Bank and Gaza. But by 2000, Palestinians had launched the second intifada, and widespread violence returned to the region.
The Nobel committee tends to award prizes to those involved in current events and doesn’t award prizes long after those events have happened. But some awards have stood the test of time, in part because they were given to individuals following long struggles.
Mandela, for instance, won the prize 53 years after his expulsion from university for joining a protest. This sparked a 53-yearlong career in activism and politics that included 27 years of incarceration as a political prisoner by the government he had fought against – and later led as president.
It’s about peace
Swedish scientist Alfred Nobel – the founder of the Nobel awards – said the Nobel Peace Prize should go to the person “who has done the most or best to advance fellowship among nations, the abolition or reduction of standing armies, and the establishment and promotion of peace congresses.”
The language is somewhat archaic, but the message is clear – the peace prize was designed to be about stopping war and promoting peace.
All of these are important issues that require more support and recognition – but it is not the case that freedom of expression or climate change adaptation directly leads to peace.
In my view, there are more than enough problems and deadly conflicts in the world whose solutions merit the award of the Nobel Peace Prize as a reflection of its original intent – to acknowledge attempts aimed at ending the scourge of war and building a sustainable peace.
Andrew Blum does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.army
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