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Musical Chairs? Why Swapping Seats May Cut back Orchestra Aerosols.

If musical instruments were people, trumpets would be super spreaders. When a trumpeter blows into the mouthpiece, tiny droplets of breath, so-called aerosols, come out of the musician’s mouth, whiz through the brass tube and spray into the air.

During a deadly pandemic, when a musician unknowingly exhales an infectious virus, it presents a potential problem for orchestras. And the trumpet isn’t the only musical health hazard.

“Wind instruments are like machines for aerosolizing breath droplets,” says Tony Saad, chemical engineer and expert in computational fluid dynamics at the University of Utah.

A simple but radical change – reorganizing the musicians – could significantly reduce aerosol formation on stage, reported Dr. Saad and his colleagues in a new study published in Science Advances on Wednesday.

Work began last summer when the Utah Symphony began to wonder if and how they could safely perform again.

“They were looking for people who could provide insights into mitigation strategies that people would believe in.” said James Sutherland, a chemical engineer at the University of Utah and co-author of the study.

Researchers created a detailed computer model of the symphony’s concert hall and noted the location of each vent and the rate of air flow through the HVAC system.

Then they mapped the typical position of every musician. The Utah Symphony, like most modern orchestras, positioned its musicians in a standard pattern, with the stringed instruments at the front of the stage, followed by several rows of wood and brass instruments – the flutes and oboes, then the bassoons and clarinets, and then the trumpets and French horns. The trombones and drums were positioned at the very back of the stage.

To model the spread of aerosols during a concert, they incorporated the latest research led by Jiarong Hong, a mechanical engineer at the University of Minnesota. Working with the Minnesota Orchestra, Dr. Hong and his colleagues measured the concentration and size of aerosol particles emitted by various wind instruments. (Among their findings, trumpet, bass trombone, and oboe posed the greatest risk.)

With these parameters, Dr. Saad and Dr. Sutherland ran computational fluid dynamics simulations to model how the air and aerosols would flow through the Utah concert hall if all the musicians were playing.

The simulation revealed complex air flow patterns. In general, the air flowed down from the air vents in the ceiling to the air return vents in the floor at the back of the stage. But two different eddies also formed, in front and in the back of the stage, they found. “You see these big regions circulating like a big tornado,” said Dr. Saad.

Aerosols can get caught in these eddies, swirl around the stage, and build up over time.

Updated

June 24, 2021, 4:02 p.m. ET

The trumpets, which emitted large, concentrated clouds of aerosol, posed a particular problem. When the aerosol plumes from the instruments wandered to the ventilation slots in the back of the stage, they passed directly through the drummers’ breathing zone.

“We saw that and said, ‘Okay, this is a big problem, we have to fix it,'” said Dr. Sutherland. “And given the insight we had about how the river was moving, we said, ‘Well, let’s move some of these instruments.'”

They knew the idea could be controversial; For decades, orchestras have generally been arranged in the same way, for both acoustic and traditional reasons. “We asked them at the beginning of the project: ‘What restrictions do we have to work with? Can we move people? ‘”Said Dr. Sutherland. “And they said, ‘You are doing everything you think possible to reduce the risk.'”

They moved the trumpets all the way back to the stage, right next to the air return ducts. Then they relocated the other wind instruments from the center of the stage and moved them either closer to the rear vents or to the stage doors they suggested opening.

These movements, the team hoped, would allow the aerosols to flow straight out of the concert hall without passing through other musicians’ breathing zones or getting caught in a vortex on the stage. “You want the smoker to sit close to the window,” said Dr. Saad. “That’s exactly what we did here.”

Finally, they moved the instruments that don’t create aerosols at all – the piano and percussion section – into the center of the stage. Together, these optimizations reduced the average aerosol concentration in the musicians’ breathing zones by a factor of 100, the researchers calculated.

Although the exact airflow patterns will be different at each venue, the general principles should apply everywhere, the team said. Orchestras can reduce the risk of aerosol spread by placing the most risky instruments near open doors and air return ports. (Orchestras that can’t do their own computer modeling could put a fog machine on stage and watch the fog flow, the researchers suggested.)

Dr. Hong, who was not involved in the Utah study, praised the modeling work. “It’s not easy to simulate the flow in an orchestra hall,” he said. “You did a great job when it comes to characterizing the river.”

But he wondered if moving musicians was really a viable solution. “We work closely with musicians and they don’t like being rearranged,” he said. (He noted, however, that “I think that’s perfectly fine for a student band.”)

Instead, he suggested a different, albeit equally unconventional, solution: masks for the instruments. In a recent study, he found that covering the bell of a trumpet with a single layer of acoustic fabric can reduce particulate emissions by around 60 percent without compromising sound quality.

The Utah Symphony, on the other hand, was open to rethinking the seating. And when it took the stage last fall, it did so with the stage doors open and the wind instruments in the stern.

“That was a big challenge for the musicians,” said Steven Brosvik, President and CEO of the Utah Symphony and the Utah Opera. “But they all got into it and said, ‘Come on, let’s try.'”

It took the musicians a few weeks to familiarize themselves with the new arrangement, and they plan to revert to their traditional seating configuration in the fall, Brosvik said. But the simulations gave the musicians security and enabled them to get back on stage, he said: “For us it changed our lives.”

The researchers were pleased with the willingness of the musicians to embrace an unusual solution, although their findings may have hit some instrumentalists harder than others. Like Dr. Sutherland said, “We had to apologize to the trumpets in advance.”

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Open center seats might cut back Covid publicity of maskless passengers

View of the cabin of a Delta flight between Minneapolis and Baltimore on April 25, 2020.

Sebastien Duval | AFP | Getty Images

Passenger exposure to the virus that causes Covid-19 could be reduced by more than half if the center seats on airplanes were left open, according to a new study published Wednesday.

Researchers from the Centers for Disease Control and Prevention and Kansas State University used laboratory models to find that passenger exposure to SARS-CoV-2, which causes Covid-19, could be reduced by between 23% in large and narrow-body aircraft and 57% when airlines leave middle seats open – Even if they don’t wear masks.

The study comes after airlines have spent much of the last year promoting increased on-board cleaning procedures and filtration to reassure travelers worried about flying during the pandemic. The demand for travel has recovered somewhat since then, as more people are vaccinated against Covid-19.

U.S. airlines, including JetBlue Airways and Southwest Airlines, limited the capacity on board their aircraft at the start of the pandemic, but have since abolished the policy, citing hospital-grade filtration and other safety measures to limit the risk of exposure on board. Delta Air Lines plans to end the lockdown of the center seats next month, the last U.S. carrier to make the change. However, capacity caps were halted over the Easter weekend as staff shortages resulted in dozens of flight cancellations.

The researchers’ study did not look at wearing masks on flights, which became an airline and federal government policy during the pandemic.

However, they cited a New Zealand case study which stated that “some of the virus aerosol is given off by an infectious masked passenger, so distancing might still be useful.”

They used a surrogate virus to stand up for SARS-CoV-2 in the air.

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How Sporting a Masks Can Scale back Allergy Signs

As we head towards our second pandemic, many of us may itch when we give up our masks. But for the 19.2 million American adults who suffer from seasonal allergies, there’s another reason to keep wearing your mask.

While cloth and medical masks protect us well from virus particles, studies show that masks can also be effective at filtering common allergens that are usually floating around in much larger sizes, making them easier to block. Pine pollen, for example, is about 800 times larger than the coronavirus, said Dr. David Lang, an allergist at the Cleveland Clinic. Even before the pandemic, he advised patients with severe allergies to wear a mask outside, especially during prolonged activities such as gardening or gardening.

Using masks to relieve allergy symptoms can take a bit of “trial and error,” said Dr. Purvi Parikh, an allergist and immunologist at NYU Langone Health. But overall: “If less pollen gets into the nose and mouth, the likelihood of an allergy attack is less,” she said.

Israeli researchers recently examined how much of a difference wearing a mask can make for allergy sufferers with mild, moderate, and severe symptoms. Using data from 215 nurses who used surgical masks or N95 masks over a two-week period, they found that nearly 40 percent of 44 nurses with severe allergy symptoms had fewer sneezes, runny noses, and nasal congestion when they had surgery wore or N95 mask. Among the 91 nurses with moderate symptoms, 30 percent improved when they wore a surgical mask; that rose to 40 percent when they wore an N95. Among the 80 nurses who started the study with mild symptoms, 43 nurses, or about 54 percent, felt their symptoms improved when they wore a surgical or N95 mask, said Dr. Amiel Dror, a physician-scientist at Galilee Medical Center and Bar-Ilan Medical School, Azrieli University and lead author of the study.

The use of masks was also more effective in nurses with seasonal allergies than in nurses with year-round symptoms. Wearing a mask didn’t solve the problem of itchy eyes, according to the September report published in the Journal of Allergy and Clinical Immunology.

Although the results suggest that wearing a mask may relieve allergy symptoms in some people, the researchers noted that more study is needed. It could be that the nurses had fewer symptoms because when they were not working they stayed at home avoiding the crowds during lockdown and therefore had less exposure to allergens in the environment. The fact that wearing a mask covering the nose and mouth was associated with improvement in nasal symptoms but not eye irritation suggests that masking likely helped reduce many allergy symptoms.

Wearing a mask not only filters out allergens, but also makes the air in our nasal cavities warmer and more humid, said Dr. Dror. “We know that dry and cold air sometimes have the ability to trigger a reaction in the nose,” he said. “This is an added benefit of wearing a mask. With all the bad, you can find something good. “

The protection varies from mask to mask, depending on the fit and, in the case of fabric masks, on the weave of the fabric. And if you don’t always wear a mask, you may still be affected by indoor allergens like dust mites or pollen, which are carried through open windows in spring breezes.

“It can help, but it won’t necessarily eliminate all of your symptoms,” said Dr. Sandra Lin, professor of ear, nose and throat medicine at the Johns Hopkins School of Medicine. “Pretty much everyone wears masks most of the time now, and people are still getting allergy symptoms.”

Here are some more tips to help reduce your symptoms during allergy season.

  • Protect your eyes. Dr. Lang recommends allergy sufferers to wear glasses or sunglasses outdoors to prevent allergens such as tree pollen from making direct contact with the eyes.

  • Wash and change your mask frequently. “The last thing you want is for allergen to get trapped in it,” said Dr. Parikh. She recommends that patients change when they come home and shower before bed to make sure pollen doesn’t stick to their skin and wash reusable masks frequently. The Centers for Disease Control and Prevention recommend washing a cloth mask after each use.

  • Find a mask that won’t irritate your skin. Choosing the right mask for an allergy-prone wearer can also be important. People with sensitive skin may react to dyes in some cloth masks and should use fragrance-free detergents. Or choose a surgical or medical mask that is less irritating to the skin. “My allergy sufferers have very sensitive skin because the same animals that make them sneeze or cough can also irritate their skin,” said Dr. Parikh.

  • Talk to a doctor if your allergy symptoms are severe. “If people continue to have symptoms that interfere with normal activity – if they are absent from work, absent from school, sleep is disturbed at night – see a doctor,” said Dr. Long. “There are other ways we can help. You shouldn’t suffer unnecessarily. “

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FDA approves new gadget worn in the course of the day to cut back loud night breathing and sleep apnea

The U.S. Food and Drug Administration on Friday approved a new device that can help prevent sleep apnea and snoring – and that doesn’t have to be worn at night.

People who snore – and their partners – have very few options in the market right now to alleviate their suffering. And a lot of what is available involves uncomfortable mouthguards or noisy C-Pap machines.

Approved on Friday, the eXciteOSA device is the first of its kind to be approved to treat sleep apnea and snoring by improving tongue muscle function by electrically stimulating the tongue through a mouthpiece worn for 20 minutes a day. It helps retrain the tongue to prevent it from collapsing backwards and blocking airflow while you sleep.

Obstructive sleep apnea is widespread and occurs when the upper airway becomes repeatedly blocked during sleep, reducing or completely blocking airflow. If left untreated, OSA can lead to serious complications such as glaucoma, heart attack, diabetes, cancer, and cognitive and behavioral disorders.

“Obstructive sleep apnea not only affects the quality of sleep, it can also have other serious health effects if left untreated. Today’s approval provides a new option for thousands of people with snoring or mild sleep apnea,” said Dr. Malvina Eydelman, director of the Ophthalmic, Anesthetic, Respiratory, ENT, and Dental Devices Bureau at the FDA’s Center for Equipment and Radiological Health.

The eXciteOSA mouthpiece has four electrodes, two above the tongue and two under the tongue. It provides electrical muscle stimulation in sessions that consist of a series of electrical impulses with periods of rest in between. It is used once a day for 20 minutes while you are awake, for 6 weeks, and then once a week thereafter.

The agency said the device reduced loud snoring by 20% in 87 of the 115 patients studied. Of the patients who all snored, 48 also had mild sleep apnea.

The most common side effects observed were excessive salivation, tongue or tooth discomfort, tongue tingling, tenderness to filling, metallic taste, gagging, and tight jaw.

The FDA has granted Signifier Medical Technologies marketing authorization.

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Pfizer to briefly scale back Covid vaccine deliveries to Europe

A picture taken on January 15, 2021 shows a pharmacist holding a vial of undiluted Pfizer BioNTech vaccine for Covid-19 with gloved hands, which is stored at -70 ° in a super freezer at Le Mans hospital in northwestern France became country runs a vaccination campaign to fight the spread of the novel coronavirus.

Jean-Francois Monier | AFP | Getty Images

LONDON – Pfizer will temporarily reduce the number of doses of its coronavirus vaccine shipped to Europe.

The Norwegian Public Health Institute received a message from Pfizer “shortly before 10 a.m.” on Friday, according to a statement by the agency published shortly thereafter. The NIPH statement said supplies of the Pfizer BioNTech vaccine would be reduced from next week “and for an upcoming period”.

“In week 3, Pfizer predicted 43,875 doses of vaccine. Now we appear to be receiving 36,075 doses,” the statement said.

NIPH said the temporary reduction in shipments was “related to an upgrade in production capacity”. “The temporary reduction will affect all European countries,” he added.

Pfizer later confirmed the interruption in supplies in a statement. “As part of normal productivity improvements to increase capacity, we need to make changes to the process and facility that require additional regulatory approvals,” he said.

Pfizer added that while this would “temporarily affect shipments from late January to early February, it will significantly increase the doses available to patients in late February and March”.

Meanwhile, Pfizer said there could be fluctuations in orders and shipping schedules at its facility in Puurs, Belgium, “in the near future”.

Albert Bourla, CEO of Pfizer, told CNBC’s “Squawk Box” on Tuesday that he was confident of “dramatically increasing” production of the vaccine this year, with the goal of producing up to 2 billion doses.

Bourla also said that Pfizer currently has more doses of its vaccine available than are being used.

The European Union announced last week that it was doubling its inventory of Pfizer BioNTech vaccines.

Ursula von der Leyen, President of the European Commission, said the deal would allow the EU to buy an additional 300 million cans on top of its existing inventory. The EU executive has already been criticized for not buying more of the vaccine.

Rollouts have been slow in many EU countries including France, Germany and the Netherlands, and this latest news is likely to weigh on vaccination programs in those countries. Canada has also confirmed that its deliveries will be delayed, but said it was hoped that this would not affect its vaccination program.