Daily Archives: July 3, 2022

CLEVELAND, Ohio - A new diagnostic test for the coronavirus could make nose and throat swabs a thing of the past, researchers establish the effectiveness of COVID-19 vaccines for obese people, and super immune molecules from llamas may hold the key to outwitting viral mutations.

Heres a summary of some of the latest coronavirus research findings for Saturday, July 2.

A skin patch that detects COVID-19 infection

Researchers in Japan are developing a new coronavirus test that they hope will take the place of unpleasant nose and throat swabs. Its a patch that detects antibodies through the skin.

Results from nasal and throat swab tests are expensive, take a long time (46 hours), and require specialized equipment and training. Alternatively COVID-19 infection can be detected in as little as 20 minutes by measuring antibody levels in the blood - but that requires a blood draw or painful finger stick.

However, a group of scientists from the University of Tokyo have developed a new test that can quickly and accurately detect COVID-19 infection without using any blood at all.

The test uses a skin patch about the size of a Band-Aid with tiny, biodegradable microneedles on one side. The microneedles painlessly draw small amounts of fluid from the skin, and transfers them to a paper-based immunoassay biosensor designed to detect SARS-CoV-2 antibodies .

Researchers say the test delivers results in three minutes, can be adapted to detect antibodies from other diseases, and can be used safely for on-site, rapid screening in a variety of settings. The research was published in the journal Scientific Reports.

Vaccines have demonstrated benefit for people of all body weights

Obesity was identified early on in the pandemic as a risk factor for severe COVID-19. It was previously shown that people with obesity have a slightly reduced benefit from flu vaccines. However, until now, little was known about the effectiveness of coronavirus vaccines for people with obesity.

A new study published in The Lancet Diabetes & Endocrinology shows that vaccines greatly reduced the number of cases of severe COVID-19 disease for everyone regardless of their body size, to different degrees.

The researchers compared risk of severe disease in vaccinated versus non-vaccinated people at least 14 days after receiving their second dose. Over 9 million people were included in the study.

Individuals with healthy or high BMI who were vaccinated were around 70% less likely to be hospitalized than unvaccinated people. People with a healthy or a higher BMI were also around two-thirds less likely to die than their unvaccinated counterparts.

By comparison, vaccinated people who were underweight were found to be 50% less likely to be hospitalized or die form severe COVID-19 infection..

Super immune molecules derived from llamas may provide protection from future viruses

Tiny immune molecules from a llama could provide protection against a vast array of SARS-like viruses, including COVID-19, researchers say.

In a paper published in the journal Cell Reports, the scientist suggest that super-immunity molecules, known as nanobodies, could be precursors to a fast-acting, inhalable antiviral treatment or spray that could potentially be stockpiled and used globally against the evolving pandemic and future viruses.

Llamas, camels, and alpacas have unique immune systems. They produce antibodies that are roughly one-tenth the size of normal ones, are exceptionally stable, and can firmly bind to disease targets.

Researchers discovered that by immunizing a llama against part of the COVID-19 virus, they could produce and isolate these tiny antibodies, called nanobodies, that recognized not just SARS-CoV-2, the virus that causes COVID-19, but a vast array of other coronaviruses. Because of the unique properties of these molecules, researchers can readily link multiple unique nanobodies in a chain, so if a virus attempts to escape by mutating, another nanobody is ready to keep it in check.

Their superior stability, low production costs, and the ability to protect both the upper and lower respiratory tracts against infection mean they could provide a critical therapeutic to complement vaccines and monoclonal antibody drugs if and when a new COVID-19 variant or SARS-CoV-3 emerges, explained the studys lead author Yi Shi in a press release.

While more research is needed, we believe that the broad protection, ultrapotent nanobodies we were able to isolate in the lab can be harnessed for use in humans.

More here:

Could nasal swabs one day be a thing of the past? Coronavirus research update for July 2, 2022 - cleveland.com

Print a poster version of this comic to hang up on your fridge or give away to friends. Download the poster here. Malaka Gharib/ NPR hide caption

Print a poster version of this comic to hang up on your fridge or give away to friends. Download the poster here.

Outdoor events are way less risky than indoor events when it comes to COVID. They are still, by far, the safest way to gather as the country continues to see high levels of cases and rising hospitalizations.

But "way less risky" is not "zero risk." There's still a chance of catching COVID even at an outdoor event especially as the virus continues evolving to become more transmissible and to break through prior immunity from vaccination or earlier cases.

"With the more transmissible variants, it's likely that shorter periods of close contact will result in transmission," says Dr. Preeti Malani, an infectious diseases physician and a professor of medicine at the University of Michigan.

That means activities that once seemed pretty safe are potentially riskier and that includes outdoor activities.

As Maimuna Majumder, an assistant professor at Harvard Medical School and a computational epidemiologist at Boston Children's Hospital, puts it, "the more transmissible a variant is indoors, the more transmissible it is in outdoor settings, too."

So additional precautions during a surge like the one the U.S. is currently seeing may be in order particularly if you are vulnerable or are in frequent contact with someone who is, say the experts interviewed for this story.

"People are going to make judgments based on [their] own level of risk and comfort," says Donald Milton, a professor of environmental and occupational health at the University of Maryland School of Public Health.

But, Majumder says, "that transmissibility can be drastically reduced by ensuring that an outdoor event doesn't get too crowded." That means having plenty of room for guests to move around and making sure they are vaccinated, recently tested and symptom-free is also a very good idea, she says.

With the July 4 weekend upon us and wedding season in full swing, experts answered frequently asked questions about staying safe while gathering outdoors with family and friends.

When should guests get tested?

Majumder helped her friend plan a wedding with about 100 attendees, and they have not heard of any resulting cases of COVID.

First, they made sure everything was outdoors, including events that happen around the wedding rehearsal dinners, happy hours and so on.

They reminded everyone to be up-to-date on vaccinations and boosters, which can help prevent transmission of the virus.

They also asked guests to stay home if they were feeling any symptoms.

And everyone agreed to take a rapid test right before the event.

Majumder has thrown other events and parties with similar guidelines, and so far, she's not heard of anyone getting sick.

And for those who still think that you aren't contagious if you're not showing symptoms, a required pre-event test could surprise you.

"There have been multiple instances where folks without symptoms have tested positive, so they've stayed home," says Majumder, who asks everyone to get rapid tested within an hour of her events. She also keeps rapid tests on hand in case someone isn't able to test before they arrive.

Getting tested right before the event is key. Rapid tests are pretty good at telling someone whether they are positive and very contagious at that moment. But their status can change within hours, so if you take a rapid test in the morning, you could be contagious by night.

Rapid tests aren't always foolproof sometimes you have a false negative but they can be a very helpful layer of protection in addition to other precautions.

There have also been times when people felt a bit off and stayed home from one of Majumder's events, only to test positive a day or two later which meant they would have been contagious during the party.

And in addition to monitoring symptoms, Malani says, "if you add testing and vaccination to a low risk outdoor setting, the risk of COVID becomes manageable."

Do the old rules of staying safe still apply once the event gets going?

Keeping a distance still helps enormously. Whether you're having a wedding or BBQ, that might mean putting families together at the same table, rather than mixing them in with other guests, and spacing each table a few feet apart.

The "15-minute rule" was developed for contact tracers to reach out to people who may have been exposed to COVID. If you're in close contact with someone for more than 15 minutes, you're likelier to get sick. But it is also possible to catch the virus in passing, especially indoors.

Australian authorities reported a case last summer where someone got sick after walking by an infected person for a few seconds at a shopping mall, according to video footage.

Whether you get sick all depends on several factors: how much virus a person is emitting, what your immunity level is from vaccination or prior infection and, importantly, how much fresh air is between you.

Where do masks fit in?

When it comes to COVID, the outdoors are great for two main reasons: there's plenty of fresh air outside, and you have more space to keep a distance, Milton says.

But if you're not able to keep a distance in a crowd at a concert, sporting event or protest, for instance masking up greatly reduces the risks of getting sick.

That's especially true if people are shouting and yelling, if you're near them for a long period of time and if you don't know their vaccination, test and symptom status.

"If you're close together, you're likely to share air with other people," says Milton.

Two of his colleagues believe they caught COVID outdoors early in the pandemic one at an outside brunch, and one who was waiting in line to pick up groceries in spring 2020.

"There's always been a risk outdoors," Milton says. "It's much lower [than indoors], but it's not nothing."

The closer you are physically to someone, the higher the risk. If you're close enough, say, to smell on their breath what they chose for dinner, you're close enough to inhale the viral particles on their breath.

There is also the off-chance of air blowing the wrong way.

Just like plumes of smoke, virus-laden exhalations can "travel the distance outdoors," Milton says. That means it's possible to get infected even if you're not right next to someone.

But the chances of getting COVID at a distance outdoors are significantly lower than pretty much any other form of interaction, such as talking closer together or meeting indoors.

"I think the most important thing to remember about the outdoors is that while it's safer, it's not 100% safe," Majumder says. "The more crowded an outdoor space is, the more it begins to mimic an indoor space in terms of our exposure to shared air."

But, she says, "I don't think masks are necessary while outdoors as long as the event isn't too crowded, everyone tested negative, no one is experiencing symptoms and everyone is up-to-date on their vaccinations."

What if we need to go inside during an outdoor event?

Even if your event is outside, people may need to go indoors briefly to use the bathroom or wash their hands "something I think many folks forget when planning an event," Majumder says.

Guests should wear a high-quality mask, like an N95 or KF94, anytime they need to dash inside. Hosts can keep masks "stocked and accessible" for any of these indoor forays, Majumder says.

"Masks remain very important and very effective," Malani says. Especially if you or a member of your household is high risk, "keep masks handy not so much for outdoor use, but when you go in and out."

(You can also improve ventilation and filtration indoors by opening doors and windows and running air purifiers in bathrooms or hallways.)

Outdoor tents that don't have side flaps enclosing the space can help protect from the sun or rain while allowing air to pass through. But "if the tent is enclosed, it's not that different than being indoors," Milton says.

And "sometimes, social gatherings end up moving indoors," Malani points out, because of bad weather, high or low temperatures, or annoying mosquitoes and "that's when transmission risk can go from low to high."

Should I invite people from out of town?

The nature of a big event with lots of out-of-town guests is a recipe for transmission when cases are high. Guests are likely to fly in, stay in hotels that may not have good ventilation, eat inside restaurants and meet up with family and friends. Even if the event that you're hosting is itself low-risk, these other activities may not be.

And "the larger the group, the higher the risk," Malani says, because there are more chances of someone having the virus and passing it on.

"Prevention means using a layered approach," she says. Try to take as many precautions as possible distancing, staying home if you're sick, testing and masks when needed.

When those measures are taken, she says, "being outdoors is a wonderful way to spend time together."

Melody Schreiber (@m_scribe) is a journalist and the editor of What We Didn't Expect: Personal Stories About Premature Birth.

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Could I catch COVID at an outdoor wedding or picnic? : Goats and Soda - NPR

On a cold, damp Monday just over a year into the pandemic, Jacob Hopkins tilted his head back in a London hospital and did something no other human had ever done before: He allowed five doctors in full hazmat garb to dribble into his nostrils a precisely calibrated suspension of the coronavirus that causes COVID-19.

Hopkins would go on to become one of the more than 546 million people across the globe to be infected with the virus known to scientists as SARS-CoV-2.

He did it for science.

Hopkins was the first of 36 healthy young Britons to participate in a human challenge study of the most consequential virus on the planet. The experiment was widely accepted in the United Kingdom as an efficient way to gain insights into how, where and for how long the virus establishes itself in people.

Knowing the minute details of a coronavirus infection is critical to vaccine and drug designers, to public health officials, and to those caring for patients. Many of those details remained elusive until the studys findings were published this spring.

Jacob Hopkins rests his arm near vials of blood that were drawn to study what the coronavirus does inside the body.

(Jacob Hopkins)

Hopkins had only a fuzzy sense of how his act might help others. As a teenager, he had responded to a cousins leukemia by signing up with a stem cell registry, and ended up donating bone marrow. This time, he hoped his participation might speed the development or testing of vaccines for low-income countries.

I would have been devastated if I couldnt take part, he said.

In the United States, deliberately infecting humans with the coronavirus was so controversial that American officials declared it a last resort. They argued that scientists could find ways to unlock the virus secrets without exposing volunteers to even a tiny risk of death.

Human challenge studies were Plan D, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who contemplated them only as a way to put a new vaccine through its paces.

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Experiments that intentionally expose healthy volunteers to serious harm pose deep quandaries. Thats especially true when too little is known about a virus to predict its impact, and when effective treatments arent available.

But in the next pandemic, or even later in this one, some U.S. scientists say they may rethink their resistance.

We can learn things more quickly by doing challenge studies, said Dr. Stanley Plotkin, a University of Pennsylvania vaccinologist who was a leading voice in calling for such research.

When an infectious disease is spreading out of control, saving time may be worth the risk, said Arthur L. Caplan, a bioethicist at New York University.

If volunteers were willing to be infected, you could prevent potentially millions of deaths, he said.

::

Jacob Hopkins took this selfie while he was participating in a human challenge trial to help scientists learn more about SARS-CoV-2.

(Jacob Hopkins)

Jacob Hopkins path to becoming a human guinea pig wasnt particularly fraught. He had always been fit, he said, and volunteering felt like something I could do.

Hopkins was a 22-year-old history student at Newcastle University when Britain imposed the first of several strict lockdowns. He went home to live with his parents in Birmingham after his school closed.

In the final months of 2020, Hopkins was working in a grocery store and scrolling through his social media feed when he saw an ad with pictures showing attractive people masked and socially distanced, but otherwise equipped with the usual accoutrements of young adulthood backpacks, schoolbooks and earbuds.

Help us fight COVID-19, said the advertisement. Stripped across the bottom, in fine print, was a disclaimer: You may suffer COVID-19 symptoms if you take part.

It seemed like a way to help the world get back to normal faster. Hopkins first love, backpacking abroad, was not an option. Nor was socializing at home. His studies in Cold War history had been put on hold. But the prospect of playing some small role in this historical moment gave him a sense of mission.

In fact, hands shot up across the world. Hopkins was one of nearly 37,000 people who expressed initial interest in participating in the study. Researchers screened 6,135 by phone, winnowing the unresponsive, the unsure and those who were too old or too sick. With 187 potential candidates left, they pruned people whod become infected, lost interest or had gained access to vaccine. Thirty-six, including Hopkins, were deemed healthy, stable, ready to go.

His parents were definitely not happy, Hopkins said. But he was determined to see it through. While his countrymen were letting down their guard after a third round of lockdowns, Hopkins double- and triple-masked when in public. If he got infected before the study began, hed be disqualified.

I never wanted to get COVID, Hopkins said, and then quickly corrected himself. Well, I did want COVID, but I wanted it at the right time.

::

In the U.S., scientists at the National Institutes of Health took a step toward launching a human challenge trial early in the pandemic. The government ordered up SARS-CoV-2 viral samples that could be used to deliver precise, genetically identical doses to human subjects.

But that, Fauci told CNN at the time, was an absolutely far-out contingency.

He stands by that decision nearly two years later. Even if researchers had an urgent need to test a new vaccine, they could do so without infecting volunteers because the coronavirus is readily available in the world at large, he said in an interview.

Plotkin was among the scientists who lobbied the NIH to conduct a human challenge trial. He said officials were concerned that a volunteer would be harmed and that if that happened, the reputation of the NIH would be harmed.

The British, by contrast, were interested right from the beginning, he said.

A daytime view of London from Jacob Hopkins hospital room.

(Jacob Hopkins)

The United Kingdom was uniquely positioned to move ahead quickly with a human challenge study. The National Health Service provides care for all Britons, so participants medical and mental health histories are readily available. Its universal healthcare system also means that research subjects would never be refused follow-up care if something went awry. (Neither is the case in the U.S.)

British researchers had a long tradition of studying infectious diseases including influenza, common cold viruses and malaria using controlled human infection models. The practice came of age in 1946, when Britain repurposed a wartime hospital in Salisbury as a Common Cold Research Unit.

Compensation was the principal inducement for participation, and it remained that way for decades. Healthy people with time on their hands could spend a couple of weeks in what was sometimes billed as Flu Camp. Theyd depart well-fed and rested, with some cash in their pockets.

With the COVID-19 study, it was clear that volunteers motives were overwhelmingly altruistic, said Carol Dalton, a spokeswoman for hVIVO, the clinical research company that carried out the COVID-19 study with scientists from Imperial College London. Participants earned 4,565 British pounds (about $5,500) for a 17-day hospital stay and several follow-up visits, though the pay was not a prominent feature of the hVIVO advertisements.

Separately, more than 38,000 people reached out to 1DaySooner, an online clearinghouse for people willing to participate in human challenge studies. Hopkins signed up on that website, as well as on the studys official enrollment site.

There was no precedent for so many volunteers asking scientists to put their own health at risk in such a trial, said Abie Rohrig, a student of bioethics at Swarthmore College who helped set up 1DaySooner.

::

One of Jacob Hopkins meals during his hospital stay.

(Jacob Hopkins)

Hopkins took that risk in stride. He said he understood he was taking a chance, but he was more concerned about developing long COVID, an array of lingering post-infective symptoms, than he was about catching COVID-19 itself.

As he anticipated spending weeks holed up in St. Marys Hospital in Londons Paddington quarter, he had high hopes for using his time well. He thought he might learn British sign language online and stream some movies for fun.

But the schedule didnt leave much time. Participants started each day in front of a laptop, churning through a battery of odious cognitive tests. There was also a daily scratch-and-sniff smell test and the hour he spent with his face buried in a plastic mask that measured his respiratory output. Research staff, often unrecognizable under layers of protection, were in and out of his room all day taking vital signs and drawing blood.

Meals were tasty but spartan. A bag of crisps showed up on his tray once or twice, prompting great excitement.

Strictly isolated in his hospital room, he gazed out the window at the London Eye, the citys famous Ferris wheel, and lost himself in the reassuring nostalgia of classic video games like The Sims and Ratchet & Clank.

On two occasions, Hopkins was bundled into his own hazmat suit and wheeled to a CT scanner. Those days were rare treats, when we were seeing something other than the four walls of a very sterile room, he said.

Getting the study underway took a year of debate and preparation. By the time British scientists deliberately infected Hopkins on March 2, 2021, several COVID-19 vaccines were beginning to go into arms across the United Kingdom. It was a milestone but it threatened to derail the human challenge study, which had been intended to help with vaccine development.

We had to completely rethink what this study was for, said Dr. Christopher Chiu, an immunologist and infectious disease specialist who led the team from Imperial College London. With so much still unknown about the virus, there was still a public health need, Chiu said. And researchers testing antiviral medications would still need to know how much virus it took to seed an infection.

So the aim was recast. The trial would identify the exact dose at which an exposure to SARS-CoV-2 virus would infect half of healthy young people. And it would track the coronavirus behavior and its interaction with its hosts across the length of infection.

The studys findings were reported this spring in the journal Nature Medicine.

Among its insights:

Even at the lowest concentration measurable in a lab, SARS-CoV-2 virus established a beachhead in the throats of just over half of the young, healthy subjects within two days.

The viral loads in their noses reached peak concentration an average of five days after exposure.

Whether or not subjects developed COVID-19 symptoms, they were capable of infecting others for an average of five more days.

None of the infected became seriously ill, but 83% lost their sense of taste or smell; in most cases, it returned slowly over three months. None experienced lung damage.

The findings made powerfully clear that young people have been potent drivers of pandemic spread. Further analysis of the findings is expected to yield insights into how the immune system resists infection, and why some people become infected while others do not.

So were these insights worth the risk taken by Hopkins and his fellow volunteers?

Chiu, the senior author of the paper detailing the studys findings, thinks so.

Theres unique strength to the findings from this kind of study, Chiu said. You capture every part of infection from the point of exposure to the end.

In the U.S., Caplan said he was frustrated that so much of the medical establishment was wary of allowing healthy Americans to be deliberately infected, when doing so could have yielded lifesaving insights.

People who sign up for such experiments must never be compelled to do so, Caplan said, nor induced with extravagant rewards. But people in many walks of life from test pilots and deep-sea divers to virologists who collect bat guano from caves take risks for science, he said. Every day, regular folks volunteer for early clinical trials of experimental drugs, where the correct dose is unknown and its safety is still very much in question.

Its a noble thing to do, he said, adding that many Americans wanted to do it: We knew because wed been asked.

::

This hospital room was Jacob Hopkins home for 17 days while he weathered a case of COVID-19 for the sake of science.

(Jacob Hopkins)

Hopkins said hed do it again, in a heartbeat.

Though the virus plunged him into a two-day ordeal of feeling rubbish, it was an enormous relief to realize he had become infected. After the tests he endured to get into the study, and after fending off so many COVID-19 surges, he finally had something to offer. He high-fived one of the doctors who dribbled virus down his nose.

During his entire bout, researchers tracked hour by hour the rise and fall of his vital signs, his viral loads, his altered cognitive state and his immune systems strenuous effort to clear the virus.

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When at last it did after 17 days, Hopkins received a check for 1,535 British pounds (nearly $1,900); the remainder was held in reserve pending follow-up visits.

All I did was sat in a room, said Hopkins, who now counsels low-income Britons on how to secure access to nutritious food. But I was so proud and happy to be a part of this. I was really part of something special.

On his last day at the hospital, as Hopkins slung his rucksack over his shoulder and marched toward the exit, the men and women who had taken his vital signs, delivered his meals and monitored his progress showed up to applaud him.

It was a heros farewell.

Read the rest here:

What it's like to catch the coronavirus for the sake of science - Los Angeles Times

Cracking a window can help reduce the risk of indoor COVID transmission. Tanishka R./NPR hide caption

Cracking a window can help reduce the risk of indoor COVID transmission.

We regularly answer frequently asked questions about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions." See an archive of our FAQs here.

Over the past two years, we've all had a crash course in understanding how to prevent respiratory infections.

And we've learned that clean air via ventilation (i.e. fresh air flow via open windows and doors) and filtration (removing particles from the air with a filtering device) is really important for preventing COVID and other respiratory illnesses. It's something many experts knew all along. Now the public is catching on.

"Most of the air that we breathe in our lifetimes, we breathe indoors," says Richard Corsi, dean of the University of California Davis College of Engineering. And virus particles can linger in the air of unventilated places, increasing chances of getting sick.

Of course, those particles are not visible. "If people could see COVID in the air, it would make a lot more sense that what you need to do is clean the air in your house, exchange the air out, get fresh air in, improve ventilation so that you don't have a lot of air hanging around where other people can breathe it in and get infected," says Abraar Karan, an infectious disease physician at Stanford University.

So what can you do, as an individual at home, work, school, the gym to make the air cleaner and safer?

That's what we asked three experts.

What's the most basic way I can improve ventilation?

"Just getting more air flow into the house itself" helps, Karan says.

Open windows if you can, says Linsey Marr, professor of civil and environmental engineering at Virginia Tech. "Especially if you can open them on opposite sides of the room, so you get some cross-ventilation air coming in one and going out the other."

Even if you can't open all of the windows or can't open them all of the way, cracking windows a little bit is still very helpful. "They don't have to be wide open," Marr says.

Opening doors in shops and gyms also helps.

Marr worked with the owner of her local gym to improve ventilation early in the pandemic. The gym didn't have central air conditioning, so it couldn't rely on filtration. The easiest option was to open the doors. "I estimated how much benefit we would get from opening the doors and it was a ton, so we kept them open all winter," Marr says.

And there was no known transmission in the gym, says Marr, who advised the facility and kept track of COVID developments. Even when staff picked up the virus from other places, they don't seem to have passed it on at work, she says.

How can I improve my home filtration system?

If you have an HVAC system forced air heating/cooling/ventilation you can do two main things: run the fan more and upgrade the filter in order to catch more viral particles. Every HVAC system has replaceable filters that trap allergens and dust in the air and viral particles, too.

HVAC systems typically don't circulate air 24/7, only running part of the time when indoor temperatures drop or rise.

To make sure the air is getting filtered through the HVAC system, "if you can, run the fan continuously," Corsi says.

When the windows are open, you can also turn on other fans, like the bathroom and kitchen exhaust fans, to "help pull in that clean air from the outside and flush out the virus," Marr says. True, they can be noisy, but they can create some air flow by pulling the air up toward the ceiling and out of the room.

But when the windows are closed, most home HVAC systems simply recirculate the same indoor air, and the standard filters you use may not be effective at catching the tiny virus particles. So you can also look into replacing those filters with higher-quality options, like a filter with a minimum efficiency reporting value (MERV) of 13.

"If you can put a MERV-13 filter in your HVAC system and if the fan is recirculating continuously, then you're going to remove a lot of the aerosol particles," Corsi says.

The majority of school ventilation systems can also be upgraded to MERV-13 filters, he says.

But, he cautions, not all systems can handle the more effective filters, so it's a good idea to have an HVAC specialist inspect yours. You don't want your whole system to break down because it is too strained trying to pull air through incompatible filters.

HEPA is another kind of filter that is even more effective at removing viruses from the air, but most home HVACs don't work with HEPA filters. However, you can get a portable HEPA air purifier.

Can portable purifiers help?

"If it says HEPA, then it's going to filter out over 99% of the air that passes through it," Marr says. "In general, price goes with size in terms of how much air it moves through it." That means the bigger the unit, the more it costs.

It's important to find the right-sized unit to purify the air of a room in an hour or two. "There's a big difference between like a $50 one that can clean the air in a closet in a reasonable amount of time and a much bigger one that probably costs $200 or $300 and can clean the air in a bedroom in a reasonable amount of time," Marr says.

But, she says, there are cheaper options: for example, a do-it-yourself system involving a simple box fan a portable model that is typically square, has a propeller blade and can often fit in a window and MERV-13 filters. That "is actually more effective in many cases" than expensive HEPA units, says Marr.

Known as the Corsi-Rosenthal box after its creators, this DIY filter is easy and inexpensive to make: you create a square shape with four filters making up four sides and the fan, pointing up toward the ceiling, duct-taped on top. A piece of cardboard is taped to the bottom, and the homemade air purifier can be put anywhere a more expensive purifier might go.

Karan agreed. "The Corsi-Rosenthal box is basically a very low-cost way to get better ventilation."

Corsi also agreed and only partly because he was one of the inventors. When he first sketched out the idea early in the pandemic, he thought it might be a more cost-effective way to offer some air filtration. And it is the materials cost between $80 and $100.

"But I also didn't realize how incredibly effective it would be," Corsi says.

The boxes can be up to 2.5 times more effective than a $300 HEPA filtration unit, according to a study by other researchers.

No matter what portable filtration system you go with, make sure you position it carefully. Don't put the device in a corner, where it might just recirculate the same air. Keep your purifier a foot or so away from the wall for the same reason.

For larger rooms, two or more units can be a good idea, says Corsi, and you can put them across the room from each other so all the air in the room gets filtered well.

What about those little travel-size air filters? Any benefit?

You might have seen little HEPA purifiers about the size of a water bottle that you can stash in a purse or backpack. But do these small devices actually help?

"They should, and you'd want to direct the airflow," Marr says. "That can clean a small area of a small amount of air."

Just make sure you position the stream of clean air as close to your face as possible, setting it on the table or desk in front of you.

"If you're using them so that the air is right in front of you working at your desk and it's blowing the air up toward your face, it can reduce the concentrations of aerosols as you're breathing," Corsi says. "I wouldn't overemphasize their benefit, but there can be some benefit."

Such purifiers, which cost $30 to $50, can add another layer of protection while you're traveling, eating at restaurants or going to work or school.

Should I buy a CO2 monitor to check how good the ventilation is in different places I go?

"If you are a very cautious person, then that can be a good tool to help you gauge the risk in different spaces," Marr says.

CO2 monitors measure how much carbon dioxide is in the air. They can't tell how much COVID is in the air, but if there is a lot of CO2 in a space, then it's not well-ventilated.

"If the CO2 readout is under 1,000, that's pretty good. Anything over that is a warning sign that a space is poorly ventilated. At high rates, you're breathing in a lot of "other people's exhaled breath like drinking backwash," Marr says a nice way of saying drinking other people's spit while sharing a drink.

But these are loose rules that depend on how big the space is, how many people are there, whether they are masked, and how many cases are circulating in the community.

"I'm not a big fan of using CO2 monitors for very specific analysis," Corsi says. "They're not exact." But, he says, they are very useful for telling you when air quality is very good or very poor.

Does improving ventilation mean I can skip wearing a mask?

Improving air quality means you're less likely to get sick, because there's less virus in the air. But it's not 100% effective.

The experts all agreed that wearing a mask is one of the most effective ways to reduce your chances of getting sick even further, or if you're sick passing the virus on.

That means you should continue to mask up in indoor public places when cases are high, as they are in the U.S. right now.

And if you're sick or someone in your household is, wearing a mask can keep the virus from transmitting even at home.

"If you have someone who is sick, then you want to try, if it's reasonable, to have them wear a mask because that will reduce the amount [of virus] that gets into the air in the first place," Marr says. And it's a good idea to mask up when you are around them to protect yourself.

If a family member gets sick, will good ventilation keep me from catching COVID?

Yes! It may take a little work, but it is possible to stop transmission in the home.

As an infectious disease doctor, Karan has seen many patients who got sick at home from other family members. "That's the one thing that we have a really hard time with right now," he said.

But "I know that there are ways you can make the home safer I've done it myself," Karan says.

All of the advice the experts offer here is especially important to keep cases from spreading at home: open windows, have a fan blowing air out the windows, wear masks as source control, improve air filtration.

In the sick person's room, try to keep the door closed and face a fan to blow out the window, so "what they're emitting into their room doesn't get back into the rest of the house underneath the door and that kind of thing," Corsi says. "That'll actually go a long way to helping others in the house not get infected."

Should I press for better air quality in public spaces?

Sometimes you will be in places where you can't control air quality, like at work, school, restaurants or businesses.

But it doesn't hurt to ask what improvements such places have made to air quality. If you're worried about your kid returning to school in the fall, for instance, you can talk to the teacher about opening windows or using a portable air filter.

"We need to be holding businesses and then the government responsible," Karan says, to make sure they upgrade ventilation and establish new indoor air quality standards.

"It's not just about COVID," he says. Cleaning the air can reduce other respiratory viruses, like the flu and RSV, as well as mold and allergens.

It's easy to want to give up on COVID precautions, thinking this is the best we can do. But "people need to hear that there is a way to solve this problem," Karan says.

"We're not going to eliminate COVID. But what we can do is we can reduce COVID transmission significantly."

His verdict: "Ventilation is the way forward."

Melody Schreiber (@m_scribe) is a journalist and the editor of What We Didn't Expect: Personal Stories About Premature Birth.

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Tips to improve indoor air flow to reduce the risk of catching COVID : Goats and Soda - NPR

Health authorities need to act urgently to prepare for an autumn that could see further waves of Covid-19 cases spreading across the UK.

That is the clear warning from scientists and doctors after last weeks figures revealed another dramatic jump in cases. More than 2 million people across Britain were found to be infected for the week ending 24 June, a rise of more than 30% on the preceding week.

And while most experts said they expected the current wave driven by the Omicron BA4 and BA5 variants of the virus to peak in a few weeks, they also warned that it will inevitably be followed by another wave this autumn. Our current planning assumptions are that we will see at least one wave [of Covid] in the autumn-winter period once we have got through the current wave that were in right now, said Susan Hopkins, chief medical adviser at the UK Health Security Agency.

This view was backed by virologist Prof Lawrence Young of Warwick University. We need to prepare now for the autumn and winter months, when colder weather will drive people indoors, increasing the risk of infection, not only with new Covid variants but also with other respiratory virus infections.

A key component of these preparations will be the selection of those vaccines that will be best suited to counter the next big wave of the disease. Moderna, Pfizer and other drug companies are all working on vaccines that target different Omicron variants in different ways.

However, it will be up to the government to decides which of these versions will be best for country, said Prof Adam Finn of Bristol University. Officials are likely to be influenced not so much by data which shows which formulation looks the most promising in tackling the new variants as by the company which looks the most able to deliver the right number of vaccines on time.

This point was backed by Prof Francois Balloux, director of University College Londons Genetics Institute. Obviously, if you wait until the last moment, you will have the best chance of designing a vaccine that is best able to tackle the variant that is most widespread but you do not want to risk production failing to deliver sufficient doses in time.

Covid-19 is not the only health threat looming on the horizon, however. Scientists have warned that pandemic measures in particular the imposition of lockdown that were used to control Covid-19 are likely to have left the public vulnerable to other illnesses such as flu.

Finn said: Basically, we have not been infecting each other with flu for two years now and so we have not been building up immunity to it.

He added: As a result, we are now more vulnerable to flu and we are likely to see winter peaks, possibly big ones, this year. Indeed, flu may turn out to be a much bigger problem this winter than Covid-19. For this reason, I think it is crucial that we give the autumn Covid booster vaccine at the same time as we give the yearly flu vaccine for the over-65s.

Other factors that could affect the nations wellbeing this winter will include the cost of living crisis. It could inadvertently help to reduce the spread of the Covid-19 virus if people are less able to spend time in indoor crowded leisure spaces such as shopping centres and cinemas, said virologist Julian Tang of Leicester University. On the other hand, an inability to heat homes, together with an increased circulation of viruses will exacerbate hospitalisation rates from the disease.

Stephen Griffin of Leeds University also urged that a comprehensive plan for continued vaccination was needed for the UK, one that was aimed particularly at younger age groups.

While far less common than in adults, we can expect based on the previous wave that the very high prevalence of Omicron will sadly cause a considerable number of juvenile hospitalisations and long Covid, whose impact on a young life is soul-destroying.

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UK scientists warn of urgent need for action on vaccines to head off autumn Covid wave - The Guardian

To understand how Japan has fared better than most of the world in containing the dire consequences of the coronavirus pandemic, consider Mika Yanagihara, who went shopping for flowers this past week in central Tokyo. Even when walking outside in temperatures in the mid-90s, she kept the lower half of her face fully covered.

People will stare at you, Yanagihara, 33, said, explaining why she did not dare take off her mask. There is that pressure.

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Japan's secret to taming the coronavirus: peer pressure - The Japan Times

In yet another reflection of Oregons tentative transition out of the acute phase of the COVID-19 pandemic, health officials as of Friday will release coronavirus hospitalization totals only once a week, down from one update for every workday.

Considered a key metric throughout the pandemic, the Oregon Health Authoritys decision to provide fresh numbers only on Wednesdays reflects the states confidence that current trends dont augur a severe wave, as well as the agencys apparent desire to wind down work it believes is no longer necessary.

Oregons understanding of the pandemic has long been hitched to hospitalization counts. Predictions of surge peaks numbering in multiple thousands of occupied beds triggered anxious press events where officials begged Oregonians to save the health care system by masking up. Updates showing steady declines were served up as evidence that citizens efforts to protect each other had paid off.

But even as Oregons seventh COVID-19 wave continues with, as of Thursday, sharply rising hospitalizations, state officials and experts tracking pandemic trends dont believe hospitalizations are the vital data point they once were. Nor do they believe trends indicate the current surge will morph into a wave that could threaten the states health care system.

The Oregon Health Authority will continue to receive and track hospitalization statistics internally, a spokesperson for the agency said, and will resume more frequent publishing of the data if it deems it necessary.

As the pandemic changes, we are constantly balancing the response, information, and resource needs, spokesman Rudy Owens said in an emailed statement. The daily data release was necessary during the COVID-19 pandemic when information was quickly evolving and changing, and when the number of COVID-19 and other patients stretched the capacity of Oregons hospitals.

University of Washington Professor Ali Mokdad, who has been tracking and modeling cases and hospitalizations throughout the pandemic, said the health authoritys decision to reduce reporting is in line with what he has seen elsewhere.

Nationally and in Oregon, cases are leveling off or declining. Hospitalizations are still climbing because they always lag behind cases, but should soon start falling, too, Mokdad said.

Thats a lot of work on a daily basis, Mokdad said of the effort necessary to prepare and publish data.

The number of Oregonians hospitalized with positive coronavirus tests has climbed 26% in the past week but remains far below the nearly 1,200-person record during last years delta wave. Patients requiring intensive care remain comparatively low.

Coronavirus hospitalizations stood at nearly 420 as of Thursday, more than 90 occupied beds higher than what Oregons chief pandemic forecaster believed would be the current waves peak. Even now, that forecaster, Oregon Health & Science Universitys Peter Graven, has delayed release of new projections by a week in part because of difficulty incorporating new omicron subvariants into the model.

Like Mokdad, Graven was mostly unconcerned that OHA will now publish the data weekly as opposed to daily. In theory, he said, delayed data release could result in delayed behavior change, if people dont know about changes in hospitalization trends. But those potential issues could be dealt with if people know where else to find analogous data, including on Centers for Disease Control and Prevention and Oregon Association of Hospitals and Health Systems webpages, which dont precisely match previous state tallies but do indicate general trajectories.

That would require communication, Graven said of alternative sources needing to be more widely known.

And hospitalizations simply arent the statistic they once were. Graven said well over half of the COVID-19 patients at OHSU are incidental cases where the person is seeking care for something other than COVID-19 but tests positive upon admission, a pattern likely seen across hospital systems. He believes emergency department visits for COVID-like symptoms are becoming a more reliable indicator.

Along with the daily hospitalization count, the health authority will also stop daily releases of how many COVID-19 patients are in intensive care units and how many are on ventilators. The same applies to its hospitalization and hospital capacity statistics broken down by Oregon region and each facilitys seven-day hospitalization average.

OHA will continue to monitor these data, Owens said. If circumstances warrant it, OHA would resume more frequent public reporting of hospitalization data.

Fedor Zarkhin

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Oregon COVID-19 hospitalizations are rising; why did the state decide to stop disclosing daily patient number - OregonLive

Scrapping special Covid leave for NHS staff is completely unacceptable and will put patients and healthcare workers at significant risk, the British Medical Association has warned.

From 7 July the government plans to withdraw the special paid leave for Covid-related sickness and isolation for NHS staff in England, meaning they will revert to normal contractual sick pay arrangements.

Periods of absence due to Covid are fully paid for all NHS workers at the moment, regardless of their length of service.

Prof Raymond Agius, co-chair of the BMAs occupational medicine committee, said the decision to end it is completely unacceptable and will put patients and healthcare workers at significant risk.

NHS staff rely on this special Covid leave so that they can effectively recuperate and return to work safely, he said.

Removing this support is unsafe for patient care and pressuring people to return to work, which ultimately this will do, is appalling and demonstrates once again that the government doesnt care about the health and wellbeing of NHS staff.

He added that it will not only force many staff to continue working if symptomatic but may have a significant impact on their livelihoods if they develop long Covid.

At a time when we are seeing rapidly rising infection rates across the country, the risk to staff remains very high, Agius said. Yet the government has removed many of the routine protections within healthcare environments and are not offering adequate protection and support to doctors.

The Royal College of Nursing (RCN) also criticised the move.

Patricia Marquis, RCN England director, said: We know many of our members are suffering from long Covid, with their lives adversely affected, making them unable to work.

Facing the threat of losing full sick pay should they remain off sick from a condition some could argue is an occupational hazard, is neglectful and unfair. Its another indication of how little the UK government values its nursing staff.

Agius has called for a long-term strategy for dealing with Covid that is underpinned by adequate research, data collection and long-term investment which must include improved financial and wider support for those unable to work due to long Covid.

The BMA said it supports calls by the all-party parliamentary group for coronavirus for a compensation scheme for frontline workers.

The latest figures from the Office for National Statistics show an estimated 2.3 million people in the UK or one in 30 have the virus, a rise of 32% on the week before.

This increase is being driven by two new fast-spreading subvariants of Omicron called BA.4 and BA.5.

A spokesperson for the Department of Health and Social Care said: As we learn to live with Covid, we are withdrawing the temporary NHS staff sickness guidance that was put in place at the height of the pandemic, as part of plans to move back to the normal arrangements set out in the NHS terms and conditions.

This provides generous support for NHS staff with up to six months full pay and six months half-pay, depending on length of service.

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End of special Covid leave for NHS staff in England branded unacceptable - The Guardian

Whether heading for a scorching Mallorca beach or dancing beneath neon flags at a music festival, millions of people will be hoping for a Covid-free summer. But it isnt working out like that. With infections soaring once more, how can people make sure they stay safe and keep holiday plans on track?

Crowded spaces are ideal for spreading infection, and the dominant Omicron strains BA.4 and BA.5 are reported to evade antibody immunity effectively and are spreading about a third faster than previous variants. So you may feel dismayed at having to squeeze into your seat on the plane next to a stranger who keeps clearing their throat.

But planes have an unfair reputation as reservoirs of infection, experts say, and the actual risk is lower than in many indoor environments. For trains and other transport it depends on how busy they are and whether they have modern ventilation systems. Definitely consider wearing a mask in crowded areas, on public transport, and in the airport where theres a crowd, said Prof Ben Cowling, an epidemiologist at the University of Hong Kong. On the plane itself, ventilation is excellent so the risk is actually lower in your seat.

Masks may feel like a thing of the past to some in the UK, but this isnt the case in all countries, so check the rules before you set off. Italy, for instance, has retained a requirement to wear an FFP2 mask on public transport, with the exception of planes. Some airlines have also maintained a mandate.

You may also be motivated by wanting to be a responsible citizen, or by self-preservation. In this case, an FFP2 mask, which filters out potentially infectious particles in the air, is better than a cloth or disposable paper mask. If youre concerned, Id strongly advise a mask, said Dr Stephen Griffin, an associate professor at the University of Leeds. Its been turned into this token of freedom but its sensible and not much of a hassle. Its a no-brainer. Why spoil your holiday feeling rubbish?

This summer festivals are back, from Primavera in Spain to Tomorrowland, the worlds largest dance music festival, in the Belgium town of Boom. Do these huge gatherings lead to outbreaks? Anecdotally a lot of people reported testing positive for Covid after Glastonbury, but then 200,000 people attended and about one in 30 people in England had Covid last week. Its hard to pinpoint whether events like this make much difference to overall numbers at this stage.

If youre trying to assess your own risk, common sense applies: indoor, crowded places make transmission more likely. This scenario may be relevant at a festival or in a nightclub, but equally to highbrow holiday pursuits such as an afternoon in a stuffy museum or crowded art gallery, or exploring the vaults of a medieval church.

The one time Ive been abroad recently was a microbiology conference in Northern Ireland, where I got Covid, said Griffin. Id put all the provisions in place for the conference to be Covid safe, but came back with Covid. Im pretty sure I caught it in a restaurant.

Outdoor spaces are generally low risk and if anything people tend to have fewer social contacts while on holiday. Often people are with their families and theyre not usually making huge numbers of contacts outside their household, being off work and off school, said Prof John Edmunds, of the London School of Hygiene & Tropical Medicine. Actually being on holiday is not particularly high risk. Theres exceptions going clubbing and in bars but I dont want to stop people from having fun.

Again, check the rules for your destination. Many places in Europe no longer require you to arrive at the check-in anxiously clutching a bundle of paperwork, but testing requirements have not evaporated across the board. UK travellers to France need to show a vaccine certificate or show a negative result from a PCR test taken within 72 hours or an antigen test taken within 48 hours pre-departure. Spain and Portugal have similar requirements. Outside Europe there is a spectrum of strictness.

Beyond the rules, should travellers feel a moral duty to take a test? Edmunds says he does not want to tell people what to do, but notes that a well-established rule of medical screening is that theres no point in taking a test if youre not going to act on a positive result.

If someone tests themselves, finds out that theyre positive and goes anyway, whats the point of that? he said. Ideally if youre positive you shouldnt be getting on an aeroplane or public transport, you are putting other people at risk.

At a time when many are struggling financially, cancelling a flight is painful. But some airlines still have specific refund rules if a flight has to be changed due to Covid and offer more flexibility about changing flights than pre-pandemic.

In some places, including the US, vaccination is an absolute requirement. For other destinations, no vaccine means taking tests. For anyone eligible for a booster or children who havent had their first dose, it may be a particularly good time to get up to date. We know that booster doses give that top-up of protection against severe disease, but for a couple of months the dose also gives relatively good protection against infection, said Cowling. Its the time to get the jab if youre due for one.

Some countries, such as the UK, now have minimal legal isolation requirements. But France and Italy, for instance, still mandate seven days isolation after a positive test. At the extreme end, some countries require hotel or hospital-based quarantine. One of my PhD students ended up spending 18 days in an isolation room in hospital in Shanghai while travelling to visit family, said Cowling. It could be a different kind of holiday from what youd planned if you spend it in an isolation room.

Coronavirus cases have increased steeply in recent weeks, with the latest figures showing about 2.3m across the UK last week. But at this stage, with high overall prevalence and many countries scaling back surveillance, its hard to pinpoint with much certainty which countries are going to be the hotspots two months from now. Its difficult enough to predict whats going to happen in the UK, and weve got better data than everywhere else, said Edmunds. I dont think its possible to do that with any accuracy.

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Coronavirus and summer travel: how to stay safe on holiday - The Guardian

How likely is it for people to catch COVID from someone who is asymptomatic? Its not impossible and may be more common than people realize, health experts say.

With coronavirus cases currently stuck at a high level across California as fast-spreading offshoots of the omicron variant crowd out their competitors, that means the chances of getting COVID from an asymptomatic person are heightened.

An estimated 5%, or about 1 in 20, asymptomatic patients coming to UCSF for procedures unrelated to COVID are testing positive for the virus, said Dr. Bob Wachter, one of the universitys leading infectious disease experts.

UCSF asks patients who show symptoms of COVID to postpone their visits. Patients are routinely screened upon arrival, meaning that those who test positive are asymptomatic or pre-symptomatic.

Though its not a perfect sample pre-op patients are more likely to be older, have an illness and be vaccinated because theyre seeking other medical care its a convenient way to measure how many people in the community may be infected and go about their day-to-day lives, Wachter said.

Its been a very useful measure of something that otherwise is very hard to get your arms around, which is the probability that somebody standing next to you in line at a Safeway in the Bay Area would test positive for COVID if I could test them now, he said.

The math is sobering: At the current 5.5% rate of asymptomatic test positivity, In a group of 50 people, I think its a 95% chance that at least one person will be positive, Wachter said. On an airplane of 150 people, theres over 99% chance theres somebody on the plane who has it.

Asymptomatic infections are not uncommon. Many people who routinely test themselves for COVID have received positive test results, including Vice President Kamala Harris.

But guidance from the Centers for Disease Control and Prevention does not advise vaccinated people who have been exposed to COVID-19 to quarantine unless they develop symptoms.

So although many people may have come in close contact with someone diagnosed with the coronavirus, they may not take the same stringent measures for mitigating transmission that they would have two years ago.

We can get a sense there are probably more people asymptomatically infected with SARS-CoV-2 with omicron and its subvariants than there were with delta, said Dr. John Swartzberg, a UC Berkeley infectious disease expert.

A 2021 study in the JAMA Network Open medical journal found that as many as 60% of COVID infections were transmitted by an asymptomatic person.

From the public health standpoint, the public needs to understand you can feel perfectly well and be infected and transmit this virus, Swartzberg said.

Obviously, infected people who show signs of sickness may generate more aerosols by sneezing or coughing. But while asymptomatic people shed less virus, they can still spread the virus without knowing theyve got it.

Fortunately, someone who is vaccinated has less viral load in nasal and throat secretions and vaccination rates for most Bay Area counties are among the highest in the nation, according to state and federal data.

But its still possible to have high viral load without showing signs of sickness, said Dr. Abraar Karan, an infectious diseases expert at Stanford.

So what is responsible for driving the current surge? The recent variants of the coronavirus are many times more infectious than the original one back in 2020 and even more contagious than the omicron version last winter. Combine that with a relaxation of public health mandates on local, state and federal levels, and the opportunities to spread the virus, whether by symptomatic or asymptomatic people, are many times higher.

People who have very mild symptoms, such as a cough or sniffles, and who dont know that they have COVID may also be going out under the assumption that they have a cold or allergies, Wachter said.

How can people protect themselves? The high asymptomatic test rate combined with the plateau in infections in recent weeks has public health experts recommending outdoor dining, voluntary indoor masking and opting for a road trip versus a flight.

I prefer not to take those risks, Wachter said.

Gwendolyn Wu (she/her) is a San Francisco Chronicle staff writer. Email: gwendolyn.wu@sfchronicle.com

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What are the odds you'll get COVID from someone who's asymptomatic? Here's how to measure the risk now - San Francisco Chronicle