CNN
 — 

Rafael Nadal will miss the French Open for the first time since he made his debut in 2005 after the 14-time champion announced on Thursday that he has withdrawn from the tournament due to injury, adding that “next year is my last year” in professional tennis.

The Spaniard suffered a hip injury during his second-round Australian Open defeat to Mackenzie McDonald in January and initially said he hoped to be fit again within six to eight weeks.

However, in an update posted on social media on April 20 and then again on Thursday, the 22-time grand slam champion said his recovery process was taking longer than anticipated.

Nadal also revealed that he will be away from the court for the next “few months” as he continues to recover, meaning the 36-year-old will also likely miss Wimbledon.

“My ambition is to try to stop to give myself an opportunity to enjoy next year, that’s probably going to be my last year on the professional tour,” Nadal told a press conference at his Rafa Nadal Academy in Manacor, Spain.

“That’s my idea, even then I can’t say 100% because you never know what can happen – but my idea and my motivation is to try to enjoy and try to say goodbye to all the tournaments that have been important for me in my tennis career during [next] year, and just try to enjoy that, being competitive and enjoying being on the court, something that today is not possible.

“I really believe, if I keep going now, I will not be able to make that happen. I don’t know if I stop if I will be able to make that happen, but I know the chances are much higher.”

The ‘King of Clay’ said he intended to return for the Davis Cup Finals, which get underway in September.

Roland Garros

Nadal has lost just three times at the French Open since his victorious debut appearance in 2005, undoubtedly one of the most dominant records in all of sport.

In 2009, he suffered one of the biggest upset in tennis history after losing in the round of 16 to Robin Söderling, before being beaten Novak Djokovic in 2015 and 2021.

In 2016, Nadal withdrew ahead of his third-round match against compatriot Marcel Granollers due to a wrist injury.

Nadal has not played since the Australian Open and in March dropped out of the world’s top 10 for the first time since 2005.

“Rafa, we can’t imagine how hard this decision was,” Roland Garros wrote on Twitter.” We’ll definitely miss you at this year’s Roland-Garros. Take care of yourself to come back stronger on courts.

“Hoping to see you next year in Paris.”

CNN
 — 

Australian tennis star Nick Kyrgios is set to miss the French Open after injuring his foot during an incident where his car was stolen, his agent confirmed to CNN Sport on Thursday.

According to Daniel Horsfall, Kyrgios – the runner-up at Wimbledon last year – hurt himself in the “high-adrenaline rush” of the robbery in Canberra earlier this month.

Police said that Kyrgios’ mother was held at gunpoint and that his Tesla was stolen during the incident near his house in the Australian capital, Reuters reported.

“During the incident on May 1, they had the armed robbery at the house. With all the stuff that was going on, Nick lacerated the side of his left foot. We don’t know how,” Horsfall said.

“Basically, it’s just set him back about two-and-a-half weeks in terms of his loading schedule to get back on court for what we thought was going to be the grand slam.”

When contacted by CNN, Canberra police referred to a statement from May 1 which said that a 32-year-old man had been arrested for allegedly stealing a car from a residence in the suburb of Watson.

The statement added that the man had threatened a woman at the residence with a firearm and demanded the keys to a Tesla parked at the residence.

The man was charged with aggravated robbery, driving a stolen motor vehicle, furious driving, and failure to stop for police, police said.

Kyrgios’ last tournament was in Tokyo in October. He underwent knee surgery at the start of the year and had hoped to make a return at the French Open.

However, Horsfall said that the 28-year-old had suffered a laceration to his foot during the robbery, rendering practice difficult.

“He couldn’t slide, couldn’t get on court because every time he put a shoe on it moved and it would re-open,” said Horsfall.

“His knee, as far as we’re concerned, is actually in fantastic shape, the surgery went well.

“His fitness is at a fantastic level. It was just when we got to the last point of that rehab, the on-court loading, this freak accident happened.”

According to Horsfall, Kyrgios is planning to return to the tour in Stuttgart, Germany, at the beginning of June.

“The family has had it rough during the last month,” he told CNN. “Not just Nick and his mother Nill, but also his sister Hali and partner Costeen who was there the morning of the robbery.”

The French Open begins on May 22 and runs until June 11. Tournament organizers confirmed that Kyrgios had withdrawn but declined to give any further information.

CNN
 — 

Monica Puig won more than 300 matches during her tennis career and the feeling afterwards was often the same: relief, excitement, and satisfaction that the weeks and months of sacrifice and preparation had paid off.

Today, exactly a year after shoulder issues forced her to retire aged 28, Puig is still able to revisit some of those winning emotions without picking up a tennis racket or stepping foot on a court.

She’s turned to running marathons – first in New York City, then in Boston and London on back-to-back weekends earlier this year and is already halfway towards her goal of completing all six of the world’s marathon majors by the end of 2024.

“Every time I cross the finish line of a marathon and I get a new personal best time, I get emotional, I’ve cried,” Puig tells CNN Sport.

“I’ve just felt in awe of what I’ve been doing because I could easily just be sitting on the couch crying and feeling sorry for myself. But I tried to channel all of that energy that I have towards whatever I had been feeling about my career into something more productive.”

Completing a marathon, Puig says, feels “very similar and very different” to winning a tennis match. With tennis, the stakes felt higher when rankings points, global recognition, and prize money were on the line.

But the sense of personal satisfaction she gets from running has endured, helping to ease the lingering pain of her retirement from tennis.

“It’s more about showing myself that I didn’t let myself fall into this big black hole of depression and sadness when I had to finish my career so early,” Puig adds.

“I was able to pick myself back up and find something else that motivates me to get out of bed every day, that motivates me to continue to be strong, fit, and have fun at the same time.”

Puig reached a career-high ranking of No. 27 in the world and won one WTA Tour title in 2014. Her crowning moment arrived two years later when she won Olympic gold in Rio – Puerto Rico’s first-ever gold medal at the Games.

As a tennis player, Puig always saw running as a form of punishment – never enjoyment. It became a means to clear her head when she was rehabbing from injuries and, over time, she started to increase the distance of her runs – three miles became five, five became eight, then eight became half and full marathons.

Now, Puig has also set her sights on competing in triathlons, as well as running the remaining marathon majors in Chicago, Berlin, and Tokyo. Her first half Ironman – a 1.2-mile swim, 56-mile bike, and 13.1-mile run – is in Augusta, Georgia, in September, and she plans to race another back home in Puerto Rico next year.

An amateur runner and triathlete, it’s a sharp transition from her life as one of the best tennis players in the world, though Puig thinks her experience of the latter has benefited the former.

“You are competing against yourself,” she says of all three disciplines, “you are your biggest enemy or supporter out there. What you think can either push you or it can limit you.

“In tennis, I’m not going to say my mental fortitude was my strength because a lot of the time I didn’t know how to deal with negative thoughts, but I feel like everybody matures at their own time mentally.

“Doing the marathons and triathlon has really helped my mentality to grow and to develop this can-do attitude towards everything that I do. It’s also thanks to tennis that I have a certain discipline … All of that discipline has really helped me to stay in shape and stay true to my goals.”

Elbow surgery in 2019 followed by three shoulder surgeries in three years ultimately signaled the end to Puig’s tennis career. She played her first match since 2020 at the Madrid Open last year, but the shoulder problems persisted.

There were times, Puig says, that she couldn’t sleep on the affected side, such was the pain in her shoulder. Moreover, the mental toll of constant rehab and almost four years away from regularly competing on the tour was starting to mount.

“It felt like I was pushing a stone up a mountain and the stone kept squashing me as I kept getting further and further,” says Puig.

“I obviously believed that I could come back, I believed in myself enough. Last year, I had full intention of playing again competitively.

“But when I saw my surgeon after the last time I was on the court, he said, ‘Look, I have to be honest with you, your shoulder – it’s not doing well. And we can’t just keep opening up your shoulder to fix it every single time it goes wrong.”

Not ready to walk away from tennis entirely, Puig still hopes to play exhibition matches in the future. She returned to the practice court recently and had to temper expectations from fans, who interpreted footage posted on social media as the start of a competitive comeback.

But Puig has remained involved with the sport as a broadcaster, enabling her to engage with the game in a different way compared to her playing days.

“When I commentate or I’m watching matches, I’ve noticed that my understanding of the game has gotten a lot better,” she says. “I feel like I’m smarter and I can see things, I can notice things. I study the game a lot better than when I was playing.

“My understanding for tennis has grown and I wish that I was still playing so I could implement some of the things that I see and have that knowledge translate onto what I do on the court.”

Puig adds that she still misses tennis, particularly when she watches her contemporaries thrive at grand slams.

With her shoulder never going to be as it was prior to the surgeries, she’s come to accept her body’s limitations and is honing her swimming technique to withstand the rigors of Ironman-distance triathlons.

“I’ve learned to handle my shoulder in a different way and knowing that, if there is pain, then it’s okay to stop, it’s okay to take a break, it’s okay to say that you’re not feeling 100%,” says Puig.

“Usually, when I was trying to come back last year, I would play through pain and that wasn’t necessarily something that felt very good. It was very challenging and involved a lot of tears.”

What she has instead developed over the past year is “a new life” and “a new way of doing things.”

“I want to continue to do this for my whole life; I see people well into their fifties, sixties, still doing triathlon and doing Ironman,” says Puig.

“That’s something that I want to continue to do … I don’t know how far I’ll get or anything like that, but the sky’s the limit.”

CNN
 — 

ESPN’s lead tennis analyst John McEnroe said he tested positive for the virus that causes Covid-19 and will miss some time covering the US Open tennis championships.

“Unfortunately, after feeling a bit under the weather, I tested positive for Covid,” McEnroe said in a statement Tuesday. “I’m watching the US Open from home & can’t wait to get back to work soon.”

ESPN said it wishes the tennis Hall of Famer well and looks “forward to welcoming him back when he’s ready.”

According to the US Centers for Disease Control and Prevention, people who have a positive Covid test should stay home for at least five days and isolate from others. People who have moderate or severe cases need to isolate for at least 10 days.

McEnroe’s younger brother, Patrick, who is also an ESPN broadcaster, tested positive for coronavirus in March 2020.

John McEnroe joined the network for its first US Open coverage in 2009. As a player, McEnroe won four of his seven Grand Slam singles titles at the US Open.

The final tennis major of the year started Monday and concludes September 10.

CNN
 — 

Former world No. 1 Naomi Osaka intends to return to professional tennis in 2024, the 25-year-old said in an interview with ESPN on Wednesday.

The four-time major champion – who welcomed a baby girl in July with her boyfriend, rapper Cordae – said she plans to play a busy schedule next year.

“It’s definitely way more tournaments than I used to play,” Osaka told ESPN. “So, I think some people will be happy with that.”

“I think it’s because I realized that I don’t know how the beginning of the year is going to go for me. I don’t know the level of play and I think I have to ease into it. So at the very least, I’m going to set myself up for a very good end of the year,” Osaka said.

Osaka, who has not played since the Toray Pan Pacific Open in Tokyo in September 2022, has previously said she planned to return to tennis in 2024 for the Australian Open, a tournament she has won on two previous occasions.

Osaka was asked if her break from tennis made her miss it, to which she responded “definitely.”

“I’ve been watching matches and I’m like, ‘I wish I was playing too,’” Osaka said. “But I’m in this position now and I’m very grateful. I really love my daughter a lot, but I think it really fueled a fire in me.”

Osaka took some time away from competitive tennis and made several highly publicized disclosures about her struggles with mental health following an incident in 2021, where she was visibly stressed and emotional while addressing the media during a mandatory news conference at Roland Garros.

She subsequently pulled out of the French Open that year and revealed she had “suffered long bouts of depression” since winning her first major championship in 2018.

Osaka was in attendance at the US Open in New York on Wednesday. She also participated the same day in a forum on mental health at the USTA Billie Jean King National Tennis Center, joined by USA Olympic swimming legend Michael Phelps, US Surgeon General Dr. Vivek Murthy, and Dr. Brian Hainline, chairman of the US Tennis Association’s board and NCAA chief medical officer.

Osaka said she learned a lot from talking about her experiences with mental health and becoming an advocate for mental health awareness.

“I feel like I am someone that’s learning all the time. Obviously, I learned a lot from the talk as I was talking,” Osaka said. “I would say my role is just raising awareness and letting people know that they’re not alone.

“Physical pain and mental pain are sort of the same to me. We have doctors for physical health but when we talk about mental health it’s not as well received, so just raising awareness on that.”

She was also asked about her comments previously that she felt “lonely” while she was pregnant.

“I definitely only know this world, the tennis world,” Osaka said. “Just being away from that for a long time, it was new for me. I think it was just the new situation and not being able to train like I wanted to, it made me feel like I would just stay at home. … It felt like a lot of restrictions.”

CNN
 — 

Now that the Fall-Winter 2023 catwalks have been disassembled, it’s clear one trend was more pervasive than any collective penchant for ruffles, pleated skirts or tailored coats.

Across runways in New York, London, Milan and Paris, there was a notable scarcity of plus-size models. This comes at a time when there are five injectable medications which can be used as appetite suppressants currently available by prescription in the US, stirring much conversation; a sixth medication, Rybelsus, is taken as an oral pill. Two are officially approved in the UK — the largest influx of weight loss medication seen in the country in almost a decade.

In recent months, injectables such as Wegovy and Ozempic — which share the same active ingredient, semaglutide — have been widely reported as Hollywood’s worst-kept weight loss secret. (Ozempic is intended for use primarily to treat Type 2 diabetes.) Comedian Chelsea Handler claimed her “anti-aging doctor just hands (Ozempic) out to anybody” while appearing on a podcast in January. Even Elon Musk tweeted last year about being on Wegovy.

For many fashion commentators and diversity advocates, the Fall-Winter 2023 runways were in sharp contrast to the (albeit limited) progress and heady promise of recent seasons. This rollback has been widely criticized in the style media as such. And its potential impact is being assessed more broadly: With the rise of these weight loss panaceas, the pursuit of size zero is now just a prescription away.

In 2020, Jill Kortleve and Paloma Elsesser became the first models outside of a sample size to walk for the Italian fashion house Fendi. (Traditionally, a sample size falls between a US 0-4.) British label Erdem entered the plus-size market in 2021, extending its offering to a UK size 22 (or US size 18). And in January 2022, Valentino made headlines after its haute couture show featured a broad spectrum of body types. But this season, there was a visible lack of curve bodies on their runways — or many others.

Fendi and Valentino did not respond when contacted by CNN, while Erdem declined to comment.

According to fashion search engine Tagwalk, the number of mid and plus-size models dropped by 24% in comparison to Spring-Summer 2023. Similarly, a size inclusivity report conducted by Vogue Business found that 95.6% of all looks presented for Fall-Winter 2023 were in a size US 0-4. For context, industry market firm Plunkett Research estimated in 2015 that 68% of American women wear a size US 14 or above.

“It was a definitive backslide,” said IMG model agent Mina White, who represents plus-size and curve supermodels including Elsesser and Ashley Graham. “It was frustrating to see some of these designers not using curved bodies where they had in the past.” Fendi and Valentino did not respond when contacted by CNN, while Erdem declined to comment.

“Watching somebody like Ashley Graham attend the front row for so many of these major houses in full looks (provided by the designer), it was frustrating,” White continued. “They wanted to utilize her image and her social following to command a certain space in the market, but they didn’t want to be reflective on their runways.”

For others, even the term “backslide” was too generous. “Slipping back from… what? A glorious time when the average American woman (size 16) was as present on the runways as she is in everyday life? A time when fashion ads cast as many ‘plus-size’ and ‘mid-size’ women as ‘straight-size’ women?” fashion journalist Amy Odell wrote in her Substack newsletter of this past season’s runways. “No one needed any data to understand that representing a wide array of body shapes and sizes in runway shows or in fashion imagery is not a priority for the industry.”

That said, a handful of — mostly smaller — brands pushed ahead this season. In London, emerging labels Di Petsa, Karoline Vitto and Sinead O’Dwyer showcased lineups of size-diverse models. Inclusivity at Christian Siriano, Coach, Kim Shui, Collina Strada and Bach Mai stood out in New York; while in Paris, Belgian brand Esther Manas — a consistent flag-bearer for size diversity — staged one of the city’s most refreshing runways with an assortment of fun, sensual, feminine looks that complimented a range of bodies.

There was also a smattering of mid- and plus-size castings to be seen elsewhere: Off-White and Michael Kors, for example, featured a few such models. At Harris Reed’s debut for Nina Ricci, Precious Lee opened the show — which also featured three more plus- and mid-size models.

Fashion samples and sample size pieces are one-off garments made before an item is mass-produced, typically to be worn during runway shows. Prioritizing the same body type in sample sizes means runway models are more easily interchangeable, saving fashion houses time and money if someone were to drop out or get sick during or after the casting process for a show.

It’s also partly why, according to White, casting curve models is still an uphill battle. She says she introduces brands to new faces months in advance of runway season, with their specific measurements up-top and easy to read in all correspondence. “I want to be ahead of that,” White said. “So I’m never told ‘Oh, we wanted to make it work, but we didn’t have her size’ or whatever that conversation might look like.”

But despite her efforts, she says she’s frequently told it’s too much of a “financial lift” to make larger samples — even by legacy brands. “I get very upset when brands say that,” White said. “I don’t believe that it is, I believe that it’s people not being properly educated on how to do this right.”

Beyond the lack of representation, White notes it’s painful for plus-size consumers to watch brands leverage resources to create custom, made-to-fit pieces for celebrities — all the while claiming the pot is empty for more inclusive runway samples.

London-based stylist and editor Francesca Burns agrees sample sizes are part of the problem. In 2020, Burns went viral after she posted on Instagram about a fashion job gone wrong. She says she was sent five looks to style from Celine, none of which fit the size UK 8 (US 4) model booked for the shoot— an 18-year-old on her first job in the business. The experience left her “horrified,” Burns told CNN, recalling what she saw as the model’s shame and embarrassment. “Looking into this girl’s eyes,” Burns said, “she shouldn’t have felt like that.”

Burns’ post, which called the current system “unacceptable,” was picked up widely in the fashion media. (When reached by CNN, Celine declined to comment on the incident.) “Ultimately, the desire to see change has to be there,” Burns said. “And I wonder whether luxury has that desire?”

Progress has been slow, but not entirely inexistent. Across fashion campaigns, magazine covers and editorial shoots, there is a growing enthusiasm for inclusivity. “I see the options rolling in for the plus-sized talent, and they’re great offerings,” said White. “Great, strong editorials and covers and campaigns. But I do feel like without the clothes, we are going to go back to see more naked curve stories, or lingerie curve stories or a curve girl in a trench coat. That’s what I don’t want.”

For British Vogue’s April issue, unveiled March 16, Elsesser, Lee and Jill Kortleve were dubbed “The New Supers.” Preceding the cover story is a letter written by editor-in-chief, Edward Enninful commending the models for “leading the way” and holding “powerful space” in the industry.

“Catwalks are once again under scrutiny for a stark lack of body diversity,” read the magazine’s Instagram caption, unveiling the cover. “But this cover was not conceived as a statement. It is a crowning of an all-powerful trio, the supermodels for a new generation.”

But many online were quick to point out the disconnect: Two of the Saint Laurent Spring-Summer 2023 dresses were modeled by plus-size women, though they are not available to buy in most plus sizes.

In his own social media post, Enninful wrote about his disappointment at the Fall-Winter 2023 runways. “I thought I had gotten into a time machine. Show after show dominated by one body type, so many limited visions of womanhood… one prescribed notion of beauty prevailed again, and it felt like the reality of so many women around the world were being ignored.”

But for White, the power rests within the entire industry — not just at the feet of brands. “I really do believe there should be an industry standard between the (Council of Fashion Designers of America), the British Fashion Council and key editors at some of these major mass market magazines,” she continued. “If there was a call-to-action from these figureheads saying, moving forward samples need to be readily available for a few different body types, we would see significant and impactful change.”

Burns agrees there must be a trickle-down effect. “I think a lot of responsibility is put on young designers to solve all these issues around sustainability or issues around body inclusivity,” she said. “It’s important that the big powerhouses, which have the capacity to action change, really take some responsibility.”

On March 8, Wegovy — developed primarily as a treatment for those living with obesity and weight-related conditions — was approved in the UK. It’s the second injectable weight management medication to be made available with a prescription via the country’s National Health Service (NHS) in about 3 years, after almost a decade of quiet. Before 2020, the last weight loss medication was approved in the UK was in 2010.

Similarly, the US has now approved three weight management injections: Wegovy, Saxenda and IMCIVREE. Medications for type-2 diabetes like Mounjaro and Ozempic are not FDA-approved for weight loss, though some doctors are issuing them at their own discretion.

While these medicines are a revolutionary tool for those who struggle to lose weight for genetic or medical reasons, they are at risk of being abused.

Semaglutide, the active ingredient in Wegovy and Ozempic, was originally developed for treating type-2 diabetes. It quells hunger signals to the brain by mimicking the hormone glucagon-like peptide-1 (GLP-1). “It can slow how quickly your stomach empties out and may give you a little more feeling of feeling full,” said Dr. Robert Lash, an endocrinologist and Chief Medical Officer of the Endocrine Society in Washington, D.C. In clinical trials, over a period of 68 weeks, participants who used the medication in conjunction with eating fewer calories and increasing their physical activity on average lost around 15% of their body weight compared to 2.4% of those using a placebo, according to the manufacturer Novo Nordisk.

On March 13, the European Medicines Agency issued a statement warning of an Ozempic shortage that could continue through the year, urging doctors to prioritize prescriptions to diabetics. “Any other use, including for weight management, represents off-label use and currently places the availability of Ozempic for the indicated population at risk,” read the release.

Patients typically need a BMI of 27 or higher (along with another weight-related condition like high blood pressure or diabetes) or have a genetic predisposition towards obesity to be prescribed such appetite suppressant medication by their doctor. But talk of these injectables has been sweeping the West. In January, the New York Times reported on the term “Ozempic Face,” coined by a New York-based dermatologist who reported treating several patients with a hollowed-out appearance that can come with rapid weight loss. By the end of February, the medication had made it to the cover of New York Magazine in a feature titled “Life After Food?” Adverts for GLP-1 injections are even blanketing New York City subway stations.

And across social media, online forums and private group chats, some people looking to lose weight for primarily aesthetic purposes are searching for a way to skirt the requirements.

“I was just looking for a way to lose a few pounds, like 10 to 15 at most,” said one 30-year-old American woman, who wished to remain anonymous, in a phone interview. She scoured social media and forums for guidance on securing a weight loss drug. “I’m certainly a normal BMI, I just have a trip to Mexico coming up and I want to look really good,” she said.

Although she says she found a way to access Wegovy, she decided against the medication after considering the cost (which can reach more than $1,000 a month without insurance). “I’ve always very much fit the societal standard but lately I was just like f*ck it, I want to be skinny,” she told CNN.

Dr. Lash emphasized the importance of taking weight loss drugs only with medical supervision and a valid prescription. “If somebody was a normal weight and they took this drug because they thought they could be even thinner than they are now, that could lead to complications,” he told CNN, warning of nausea, vomiting, diarrhea and even gallbladder problems. “These drugs are not benign, they do have side effects involving the GI tract. There’s no such thing as a free lunch.”

Every body is invited

Fashion has long promoted size 0 as the ultimate virtue — regardless of its viability for many people, or any health risks. And now with the accessibility of accelerated weight loss medication, the stakes are even higher. For Burns and White, the industry is responsible for amplifying a new, more inclusive vision of beauty.

“There’s a very archaic way of looking at women over a size 16 and just assuming that they’re unhealthy or uneducated or unstylish. Or don’t have the resources to buy into luxury,” said White. “The reality is the same women these brands are alienating in their fashion space are the same women running out to buy their handbags, shoes, perfumes, cosmetics and skincare.”

Not only do designers need to create clothes with this consumer in mind, according to White, but they need to be seen on the runway, too.

“It shouldn’t be a conversation. It should just be normalized that we’re not just looking at a single view of beauty,” echoed Burns.

Ester Manas and Balthazar Delepierre, whose bridal-inspired Fall-Winter 2023 collection was one of this season’s most size-diverse runways, summarized it best in their accompanying show notes: “The body is not the subject. Because, obviously, at a wedding, everybody is invited. And all to the party. That is where the designer duo Ester and Balthazar take their stand.”

CNN
 — 

Scientists in Germany say they’ve been able to make a nasal vaccine that can shut down a Covid-19 infection in the nose and throat, where the virus gets its first foothold in the body.

In experiments in hamsters, two doses of the vaccine – which is made with a live but weakened form of the coronavirus that causes Covid-19 – blocked the virus from copying itself in the animals’ upper airways, achieving “sterilizing immunity” and preventing illness, a long-sought goal of the pandemic.

Although this vaccine has several more hurdles to clear before it gets to a doctor’s office or drug store, other nasal vaccines are in use or are nearing the finish line in clinical trials.

China and India both rolled out vaccines given through the nasal tissues last fall, though it’s not clear how well they may be working. Studies on the effectiveness of these vaccines have yet to be published, leaving much of the world to wonder whether this approach to protection really works in people.

The US has reached something of a stalemate with Covid-19. Even with the darkest days of the pandemic behind us, hundreds of Americans are still dying daily as the infection continues to simmer in the background of our return to normal life.

As long as the virus continues to spread among people and animals, there’s always the potential for it mutate into a more contagious or more damaging version of itself. And while Covid infections have become manageable for most healthy people, they may still pose a danger to vulnerable groups such as the elderly and immunocompromised.

Researchers hope next-generation Covid-19 vaccines, which aim to shut down the virus before it ever gets a chance to make us sick and ultimately prevent the spread of infection, could make our newest resident respiratory infection less of a threat.

One way scientists are trying to do that is by boosting mucosal immunity, beefing up immune defenses in the tissues that line the upper airways, right where the virus would land and begin to infect our cells.

It’s a bit like stationing firefighters underneath the smoke alarm in your house, says study author Emanuel Wyler, a scientist at the Max Delbruck Center for Molecular Medicine in the Helmholtz Association in Berlin.

The immunity that’s created by shots works throughout the body, but it resides primarily in the blood. That means it may take longer to mount a response.

“If they are already on site, they can immediately eliminate the fire, but if they’re like 2 miles away, they first need to drive there, and by that time, one-third of the house is already in full flames,” Wyler said.

Mucosal vaccines are also better at priming a different kind of first responder than injections do. They do a better job of summoning IgA antibodies, which have four arms to grab onto invaders instead of the two arms that the y-shaped IgG antibodies have. Some scientists think IgA antibodies may be less picky about their targets than IgG antibodies, which makes them better equipped to deal with new variants.

The new nasal vaccine takes a new approach to a very old idea: weakening a virus so it’s no longer a threat and then giving it to people so their immune systems can learn to recognize and fight it off. The first vaccines using this approach date to the 1870s, against anthrax and rabies. Back then, scientists weakened the agents they were using with heat and chemicals.

The researchers manipulated the genetic material in the virus to make it harder for cells to translate. This technique, called codon pair deoptimization, hobbles the virus so it can be shown to the immune system without making the body sick.

“You could imagine reading a text … and every letter is a different font, or every letter is a different size, then the text is much harder to read. And this is basically what we do in codon pair deoptimization,” Wyler said.

In the hamster studies, which were published Monday in the journal Nature Microbiology, two doses of the live but weakened nasal vaccine created a much stronger immune response than either two doses of an mRNA-based vaccine or one that uses an adenovirus to ferry the vaccine instructions into cells.

The researchers think the live weakened vaccine probably worked better because it closely mimics the process of a natural infection.

The nasal vaccine also previews the entire coronavirus for the body, not just its spike proteins like current Covid-19 vaccines do, so the hamsters were able to make immune weapons against a wider range of targets.

As promising as all this sounds, vaccine experts say caution is warranted. This vaccine still has to pass more tests before it’s ready for use, but they say the results look encouraging.

“They did a very nice job. This is obviously a competent and thoughtful team that did this work, and impressive in the scope of what they did. Now it just needs to be repeated,” perhaps in primates and certainly in humans before it can be widely used, said Dr. Greg Poland, who designs vaccines at the Mayo Clinic. He was not involved in the new research.

The study began in 2021, before the Omicron variant was around, so the vaccine tested in these experiments was made with the original strain of the coronavirus. In the experiments, when they infected animals with Omicron, the live but weakened nasal vaccine still performed better than the others, but its ability to neutralize the virus was diminished. Researchers think it will need an update.

It also needs to be tested in humans, and Wyler says they’re working on that. The scientists have partnered with a Swiss company called RocketVax to start phase I clinical trials.

Other vaccines are further along, but the progress has been “slow and halting,” Poland said. Groups working on these vaccines are struggling to raise the steep costs of getting a new vaccine to market, and they’re doing it in a setting where people tend to think the vaccine race has been won and done.

In reality, Poland said, we’re far from that. All it would take is another Omicron-level shift in the evolution of the virus, and we could be back at square one, with no effective tools against the coronavirus.

“That’s foolish. We should be developing a pan-coronavirus vaccine that does induce mucosal immunity and that is long-lived,” he said.

At least four nasal vaccines for Covid-19 have reached late-stage testing in people, according to the World Health Organization’s vaccine tracker.

The nasal vaccines in use in China and India rely on harmless adenoviruses to ferry their instructions into cells, although effectiveness data for these has not been published.

Two other nasal vaccines are finishing human studies.

One, a recombinant vaccine that can be produced cheaply in chicken eggs, the same way many flu vaccines are, is being put through its paces by researchers at Mount Sinai in New York City.

Another, like the German vaccine, uses a live but weakened version of the virus. It’s being developed by a company called Codagenix. Results of those studies, which were carried out in South America and Africa, may come later this year.

The German team says it’s eagerly watching for the Codagenix data.

“They will be very important in order to know where whether this kind of attempt is basically promising or not,” Wyler said.

They have reason to worry. Respiratory infections have proved to be tough targets for inhaled vaccines.

FluMist, a live but weakened form of the flu virus, works reasonably well in children but doesn’t help adults as much. The reason is thought to be that adults already have immune memory for the flu, and when the virus is injected into the nose, the vaccine mostly boosts what’s already there.

Still, some of the most potent vaccines such as the vaccine against measles, mumps and rubella use live attenuated viruses, so it’s a promising approach.

Another consideration is that live vaccines can’t be taken by everyone. People with very compromised immunity are often cautioned against using live vaccines because even these very weakened viruses may be risky for them.

“Although it’s strongly attenuated, it’s still a real virus,” Wyler said, so it would have to be used carefully.

CNN
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A new study found a moderately higher risk of autism spectrum disorder in children born to pregnant people exposed to tap water with higher levels of lithium, but experts caution that this association does not show a direct link between the two.

About 1 in 36 children in the US is diagnosed with autism spectrum disorder (ASD) each year, according to data from the US Centers for Disease Control and Prevention.

Scientists still don’t know the exact cause of autism, a developmental disorder. Genetics may be a factor, but some have been looking at potential environmental causes, too.

Cases may be on the rise, but that is also unclear. One study published this year on cases in the New York-New Jersey area found that autism diagnosis rates tripled among certain age groups between 2000 and 2016. A 2021 report found similar increases in cases, but the CDC says the increased number of cases is most likely linked to more doctors screening for the condition.

Lithium is an alkali metal that can be found naturally in some food and ground water. It’s used in batteries, grease and air conditioners, as well as in the treatment of bipolar disorder and some blood disorders. Its levels in US drinking water are not regulated, according to the US Geological Survey.

A new study, published Monday in the journal JAMA Pediatrics, found a small association between lithium and autism diagnosis in Denmark, where the researchers say the level of lithium in drinking water is similar to that in American water systems.

The researchers checked a database of people with psychiatric disorders for children born between 2000 and 2013 to find information on 8,842 cases of ASD and 43,864 participants who did not have ASD. They then measured the concentration of lithium in 151 public waterworks that served more than half of the Danish population and mapped out where pregnant people lived in relation.

As lithium levels in water increased, there was a modest increased risk of an ASD diagnosis. Specifically, compared with people at the lowest exposure level, those who had the second and third highest exposure during pregnancy had a 24% to 26% higher risk of ASD diagnosed in children. The group with the highest exposure had a 46% higher risk than those at the lowest level of exposure.

The researchers could not tell how much water the pregnant people drank, but they picked Denmark in part because residents there consume some of the lowest amounts of bottled water in Europe.

Experts say it’s important to note that the research can’t show that lithium exposure leads directly to an autism diagnosis.

Further study is required, said study co-author Dr. Beate Ritz, a professor of neurology in the David Geffen School of Medicine at UCLA, and a professor of epidemiology and environmental health at the UCLA Fielding School of Public Health.

“Any drinking water contaminants that may affect the developing human brain deserve intense scrutiny,” Ritz said in a news release. She added that the research would need to be replicated in other countries to look for a similar connection.

The implications of the findings are complex as far as public health policy is concerned, according to an editorial published alongside the study. Lithium levels in water, at concentrations that the study associated with a potential ASD risk, have also been linked with health benefits such as lower rates of hospitalization for psychiatric disorders and suicide.

“If all these of associations are valid, the wisdom of Solomon will be required to develop guidelines for lithium in drinking water that are maximally protective of the entire population,” wrote Dr. David C. Bellinger, a professor of neurology and psychology at Harvard Medical School. “Until the basic biology of ASD is better understood, it will be difficult to distinguish causal from spurious associations.”

Dr. Max Wiznitzer, director of the Rainbow Autism Center at University Hospitals Rainbow Babies and Children’s Hospital in Cleveland, points to other research on the effects of lithium on pregnant people who take it for mental health disorders. Those studies – which look at people exposed to much higher levels than are found in drinking water – do not show a connection with autism spectrum disorder.

“It’s an interesting association, but causation is definitely not proven,” said Wiznitzer, who was not involved in the new research. “We have to see if there’s a viable and biologically plausible mechanism by which a small amount of lithium in the water supply can somehow do this, yet pharmacologic dosing of lithium in women with bipolar disorder has not been reported to be causing increased risk of ASD.”

Other studies have also suggested connections between ASD and environmental exposures to things like pesticides, air pollution and phthalates. But none of them points to any of these factors as a direct cause of the disorder.

A link between environmental exposure and ASD is hard to prove, Wiznitzer said. With research showing that increased exposure to air pollution raises the risk of giving birth to a child with ASD, for example, he often wonders whether pollution is the determining factor or if it’s just the populations who live in more polluted areas.

“There’s a lot of speculation about about environmental factors, but how many of them are truly causally associated?” Wiznitzer said. “We are bombarded with a variety of environmental stressors in our everyday lives. We have to figure out how to basically safely navigate them, and this is probably not one that’s high on our list.”

CNN
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Buffalo Bills player Damar Hamlin has been discharged from a Buffalo medical center, his club said Wednesday, after more than a week of hospitalization due to a cardiac arrest he suffered during a “Monday Night Football” game this month.

The 24-year-old Bills safety had been showing signs of accelerated improvement in the days leading up to his release from Buffalo General Medical Center in New York, hospital officials had said.

“We have completed a series of tests and evaluations, and in consultation with the team physicians, we are confident that Damar can be safely discharged to continue his rehabilitation at home and with the Bills,” a physician leading Hamlin’s care in Buffalo, Dr. Jamie Nadler, said in a statement the Bills released Wednesday on Twitter.

Hamlin initially was hospitalized in Cincinnati when his heart suddenly stopped after a tackle during a game against the host Cincinnati Bengals on January 2, but was transferred to the Buffalo facility Monday after doctors determined his critical condition had improved enough for the move.

Doctors at the Buffalo hospital were trying to determine why Hamlin suffered the cardiac arrest, Kaleida Health, the group of hospitals that includes the Buffalo medical center, said before his discharge. That included whether pre-existing conditions played a role in the event, which shocked many around the country and prompted a huge outpouring of support for the second-year NFL player.

On Tuesday, Hamlin went through “a comprehensive medical evaluation as well as a series of cardiac, neurological and vascular testing,” the Bills said on Twitter.

No cause of Hamlin’s cardiac arrest has been publicly announced.

“Special thank-you to Buffalo General it’s been nothing but love since arrival! Keep me in y’all prayers please!” Hamlin tweeted Tuesday.

It will be up to Hamlin to decide when he will be around the team again while recovering, Bills coach Sean McDermott said Wednesday.

“Grateful first and foremost that he is home with his parents and his brother, which is great,” McDermott told reporters Wednesday, as the Bills prepared to host the Miami Dolphins for a playoff game Sunday. No timetable for Hamlin’s return to professional football has been announced.

“We’ll leave (when he’ll be around the team) up to him. His health is first and foremost in our mind as far as his situation goes and when he feels ready, we will welcome him back,” McDermott said.

While in critical condition in Cincinnati, Hamlin was sedated and on a ventilator for days. On Friday morning the breathing tube was removed, and Hamlin began walking with some help by that afternoon, his doctors said Monday.

The health care team focused on stabilizing Hamlin and upgraded his condition Monday because his organ systems were stable and he no longer needed intensive nursing or respiratory therapy, doctors said.

“He’s certainly on what we consider a very normal to even accelerated trajectory from the life-threatening event that he underwent,” Dr. Timothy Pritts, chief of surgery at the University of Cincinnati Medical Center, said earlier this week. “He’s making great progress.”

Normal recovery from a cardiac arrest can be measured in weeks to months, Pritts said Monday. Hamlin had been beating that timeline at each stage and is neurologically intact.

When Hamlin collapsed seconds after an open-field tackle against a Bengals wide receiver, medical personnel rushed onto the field and administered CPR quickly – which helped save his life.

Hamlin’s heart had stopped, and medical responders revived it twice before putting him into an ambulance and taking him to the hospital. The immediate actions of medical personnel were vital to “not just saving his life, but his neurological function,” said Pritts.

The horrifying scene of Hamlin suddenly falling on his back after standing up following the tackle unsettled his teammates, the other players and millions of watching fans.

The game was initially postponed and later cancelled by the NFL – a decision several former football players said was a sign of a shift in prioritizing players’ mental and physical health.

Now, the Bills organization is encouraging people to learn the critical, life-saving skill of administering CPR.

The team has pledged support for resources including CPR certifications, automated external defibrillator units and guidance for developing cardiac emergency response plans within the Buffalo community, according to the statement. “We encourage all our fans to continue showing your support and take the next step by obtaining CPR certification,” the Bills said.

CNN
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Tennis star Naomi Osaka announced her pregnancy on Wednesday, posting a photo of an ultrasound scan on her social media accounts.

“The past few years have been interesting to say the least, but I find that it’s the most challenging times in life that may be the most fun,” the four-time major champion wrote alongside the photo.

“These few months away from the sport [have] really given me a new love and appreciation for the game I’ve dedicated my life to.”

Osaka said she plans to return to tennis in 2024 for next year’s Australian Open, a tournament she has won on two previous occasions.

“I know that I have so much to look forward to in the future,” she added. “One thing I’m looking forward to is for my kid to watch one of my matches and tell someone, ‘that’s my mom.’”

The 25-year-old’s withdrawal from the upcoming Australian Open was announced by the competition’s organizers on Sunday.

Osaka has not played since the Toray Pan Pacific Open in Tokyo in September last year.

She took some time away from competitive tennis and made several highly publicized disclosures about her struggles with mental health following an incident in August 2021, where she was visibly stressed and emotional while addressing the media during a mandatory news conference at Roland Garros.

Osaka subsequently pulled out of the French Open that year and revealed she had “suffered long bouts of depression” since winning her first major championship in 2018.

“I don’t think there’s a perfectly correct path to take in life but I always felt that if you move forward with good intentions you’ll find your way eventually,” Osaka added in her statement on Wednesday.