COVID-19 spread during short conversations

 When a person sneezes or coughs, they can potentially transmit droplets carrying viruses like SARS-CoV-2 to others in their vicinity. Does talking to an infected person also carry an increased risk of infection? How do speech droplets or “aerosols” move in the air space between the people interacting?

To answer these questions, a research team has carried out computer simulations to analyse the movement of the speech aerosols. The team includes researchers from the Department of Aerospace Engineering, Indian Institute of Science (IISc), along with collaborators from the Nordic Institute for Theoretical Physics (NORDITA) in Stockholm and the International Centre for Theoretical Sciences (ICTS) in Bengaluru. Their study was published in the journal Flow.

The team visualised scenarios in which two maskless people are standing two, four or six feet apart and talking to each other for about a minute, and then estimated the rate and extent of spread of the speech aerosols from one to another. Their simulations showed that the risk of getting infected was higher when one person acted as a passive listener and didn’t engage in a two-way conversation. Factors like the height difference between the people talking and the quantity of aerosols released from their mouths also appear to play an important role in viral transmission. 

“Speaking is a complex activity … and when people speak, they’re not really conscious of whether this can constitute a means of virus transmission,” says Sourabh Diwan, Assistant Professor in the Department of Aerospace Engineering, and one of the corresponding authors.

In the early days of the COVID-19 pandemic, experts believed that the virus mostly spread symptomatically through coughing or sneezing. Soon, it became clear that asymptomatic transmission also leads to the spread of COVID-19. However, very few studies have looked at aerosol transport by speech as a possible mode of asymptomatic transmission, according to Diwan.

To analyse speech flows, he and his team modified a computer code they had originally developed to study the movement and behaviour of cumulus clouds – the puffy cotton-like clouds that are usually seen on a sunny day. The code (called Megha-5) was written by S Ravichandran from NORDITA, the other corresponding author on the paper, and was used recently for studying particle-flow interaction in Rama Govindarajan’s group at ICTS. The analysis carried out by the team on speech flows incorporated the possibility of viral entry through the eyes and mouth in determining the risk of infection – most previous studies had only considered the nose as the point of entry. 

“The computational part was intensive, and it took a lot of time to perform these simulations,” explains Rohit Singhal, first author and PhD student at the Department of Aerospace Engineering. Diwan adds that it is hard to numerically simulate the flow of speech aerosols because of the highly-fluctuating (“turbulent”) nature of the flow; factors like the flow rate at the mouth and the duration of speech also play a role in shaping its evolution. 

In the simulations, when the speakers were either of the same height, or of drastically different heights (one tall and another short), the risk of infection was found to be much lower than when the height difference was moderate – the variation looked like a bell curve. Based on their results, the team suggests that just turning their heads away by about nine degrees from each other while still maintaining eye contact can reduce the risk for the speakers considerably. 

Moving forward, the team plans to focus on simulating differences in the loudness of the speakers’ voices and the presence of ventilation sources in their vicinity to see what effect they can have on viral transmission. They also plan to engage in discussions with public health policymakers and epidemiologists to develop suitable guidelines. “Whatever precautions we can take while we come back to normalcy in our daily interactions with other people, would go a long way in minimising the spread of infection,” Diwan says. 

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JOURNAL

Flow

DOI

10.1017/flo.2022.7 

ARTICLE TITLE

Virus transmission by aerosol transport during short conversations

ARTICLE PUBLICATION DATE

2-Jun-2022

https://www.eurekalert.org/news-releases/956332

Welcome To The Post-Digital Era, As Technology Drives A ‘Great Dispersion’

 We’ve seen the en masse “Great Resignation,” with employees reassessing their careers and making bolder-then-usual moves to new jobs. They are not alone — their employers are also re-assessing their goals and purpose. Call it the “great dispersion,” that’s prompting leaders in every industry to question and reassess their business paths.

That’s the word from Scott Galloway, author and professor of marketing at New York University, speaking at Infosys' recent Cobalt event, where he provided his predictions on going forward into the digital — or post-digital — 2020s.

Setting the stage, Ravi Kumar, president of Infosys, joined Galloway to discuss the acceleration into the digital realm. “CXOs now have a lot of confidence on the digital platform, thanks to the pandemic,” he says. “They have a trusted brand, they have a consumer base, they think they should straddle industries like Amazon did. We have an oil company wants to get into autonomous retail because they can change their gas stations into EV charging, then there is wait time for them to do retail. One of them has already said they want to do financial services and healthcare.”

With accelerated digital engagements, “it’s time to re-evaluate where the value is coming from supply chains,” Galloway says, because the locus of business value is shifting. “We’re on the cusp of a third big tectonic shift in our economy. The first was globalization, the second was digitization. The third is dispersion.”

With dispersion, the challenge is to find the sources of value — “whether it’s an admissions department, or a campus,” says Galloway. “Whether it’s a doctor’s office, or a hospital office, whether it’s a store and shelves. We’re dispersing it out to our porches, our smart speakers, to micro-campuses.”

For example, he says, “pre-pandemic less than 1% of doctors office visits were virtual, now its 30%,” he says. “Think about Covid — 98% or 99% of the people who have contracted Covid never set foot in a hospital, much less a doctor’s office,” he says. “Healthcare is being dispersed away from the traditional sources of value add. You can’t get an appendectomy over the phone, but you can get the consultation, the physical therapy, the drugs.”

Industry leaders will need to “go through their entire supply chains, to see where they traditionally add value. Is that being dispersed out to something else, to technology? If so, how do we take advantage of it?”

Galloway then took aim at his own industry — higher education. “My industry has benefitted off of the concentration of value in the admissions department,” he relates. “Me and my colleagues are drunk off of a rejectionist luxury strategy, where we think we are no longer public servants but we are a Chanel bag. Where my dean will stand up and brag that we turned away 92% of the applicants this year, which, in my view, is tantamount to the head of a homeless shelter bragging that he or she turned away 92% people last night. That’s not what we’re there for.”

The great dispersal here, delivered through technology, would “disperse education away from these concentrated rejectionist cultures. The fastest way to double capacity at NYU or UCLA is to take a third or a half of our sessions online. You can take a half of these professors’ sessions online with no loss in quality. And overnight, you double the capacity.”

With digital transformation dispersing and accelerating, Galloway urges business leaders to look at the trends and take stock of where they want to be in 10 years — both business-wise and personally. “It’s a useful exercise to take the two or three biggest trends in your sector and your business and take them out 10 years and are we here right now,” he says. “What would it mean in terms of our capital allocation, our operating and hiring strategy?”

There are personal implications as well, Galloway says. “What are your relationships with your spouse, your relationships with work, or your mental well-being? Look at trends and take that trend out 10 years and say, do you like where it is?”

Ten years isn’t that long of a time, he adds. “Anyone over the age of 40 knows 10 years is like a season now. It just happens so damn fast it’s just crazy.”

https://www.forbes.com/sites/joemckendrick/2022/05/26/welcome-to-the-post-digital-era-as-technology-drives-a-great-dispersion/

Oldest adults can benefit from game-like intervention targeting cognitive, physical function

 As human lifespans increase, new societal challenges arise. In a "superaging society," in which young people are few and older people are many, caring for the older adult population adequately with limited resources is a difficult balancing act to perform. However, the hope is that by implementing new knowledge of how to keep aging adults healthy, caring responsibilities may be lightened.

In an article that was recently published in Alzheimer's & Dementia, a research team from the University of Tsukuba puts their findings that a game-like intervention called Synapsology helps to improve cognitive function and physical capabilities in older adults and its implications into perspective.

In areas of research such as pathological changes to the brain during aging (for example, mild cognitive impairment and dementia), a lot remains unknown. Although drug therapies to treat dementia are available and more are continually being developed, prevention is arguably the most important area of focus in working toward humankind's goal of healthy long life. Convincing evidence exists that dual-task exercises, which are performed by the brain and body simultaneously, have the potential to be beneficial for the physical and mental health of older adults. However, as highlighted by the World Health Organization, the weak link in this area of research was the lack of translation of dual-task exercises into practice to yield concrete evidence on efficacy.

"We conducted a study to assess the effects of 60-minute sessions of Synapsology twice per week," says Professor Jieun Yoon. "The exercises combined body movement with tasks that stimulate frontal, temporal, and occipital brain activity. We found that, in comparison with older adults aged 85 to 97 who did not take part, those who did maintained or improved their cognitive and physical abilities over a period of 24 weeks."

Synapsology is also a cost-effective intervention, because it doesn't require special tools or facilities. This means that the findings of the study were likely to be useful because Synapsology can be scaled and adapted.

"Furthermore, we used well-known measures to quantify the changes to cognitive and physical function," adds Professor Yoon, "which means that both the intervention and the assessment can be extended to different populations of older adults to yield sufficient evidence to support the use of this dual-task intervention at a scale that can have a societal impact."

Some questions remain -- such as, can an intervention help prevent or delay the onset of Alzheimer disease? The team has already begun research that will address this question by simultaneously monitoring biological changes in the brain from the disease and those that may represent cognitive and physical improvements from Synapsology.

Story Source:

Materials provided by University of Tsukuba. Note: Content may be edited for style and length.

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Journal Reference:

1. Jieun Yoon, Hiroko Isoda, Tetsuya Ueda, Tomohiro Okura. Cognitive and physical benefits of a game‐like dual‐task exercise among the oldest nursing home residents in Japan. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 2022; 8 (1) DOI: 10.1002/trc2.12276

https://www.sciencedaily.com/releases/2022/06/220616101938.htm

Iowa Supreme Court: Abortion not fundamental right in state

 The Iowa Supreme Court on Friday cleared the way for lawmakers to severely limit or ban abortion in the state, reversing a decision by the court just four years ago that guaranteed the right to abortion under the Iowa Constitution.

The court, now composed almost entirely of Republican appointees, concluded that a less conservative court wrongly decided abortion is among the fundamental privacy rights guaranteed by the Iowa Constitution and federal law.

Friday’s ruling comes amid expectations that the U.S. Supreme Court will overturn the landmark Roe v. Wade decision that legalized abortion nationwide. If that happens, Iowa lawmakers could ban abortion without completing the lengthy process of amending the state constitution.

The Iowa decision stemmed from a lawsuit filed by abortion providers who challenged a 2020 law that required a 24-hour waiting period before a woman can get an abortion. A judge who struck down the law cited the state high court’s 2018 ruling. The judge also concluded that the law violated rules prohibiting passage of bills with more than one subject.

The state Supreme Court action means those seeking an abortion in Iowa must abide by the 24-hour waiting period which means returning to the clinic for a second time, an obstacle that opponents said could place abortion out of reach for some.

“The court’s decision today is a devastating and shocking reversal. But abortion remains legal in Iowa and we will continue to fight to challenge the two-appointment, minimum 24-hour mandatory delay law under the undue burden standard that the court declined to overrule today,” said ACLU of Iowa Legal Director Rita Bettis Austen.

The court returned the legal battle over the 24-hour wait to district court for further proceedings.

“We definitely have a long fight ahead of us. It’s important now more than ever that Iowans engage, and step up, stand up, have their voices heard that they want to retain the fundamental right to abortion care,” said Sheena Dooley, spokeswoman for Planned Parenthood North Central States

In its 2018 ruling, decided by a 5-2 vote, the court said “autonomy and dominion over one’s body go to the very heart of what it means to be free.”

The opinion released Friday and written by Justice Edward Mansfield said the court isn’t obligated to abide by precedent, especially in cases evaluating constitutional rights or in cases decided recently.

The reversal reflects a dramatic change in the court’s makeup. Gov. Kim Reynolds has named four justices since 2017, and six of the seven people on the court were appointed by Republican governors.

But Mansfield rejected the argument by legal scholars and law professors that said shifting opinions on such important matters within a short period of time feeds into the idea that courts are politicized.

“We do not agree that every state supreme court decision is entitled to some minimum try-out period before it can be challenged,” he said.

He said “courts must be free to correct their own mistakes when no one else can.”

Reynolds said in a statement that the ruling is a “significant victory in our fight to protect the unborn.” She and legislative leaders have not said whether they will call a special session this summer to take up a new abortion law.

Justice Brent Appel, the only Democratic appointee to the court, wrote a dissenting opinion saying “the right to reproductive autonomy should not be eviscerated by narrow textualism.”

Chief Justice Susan Christensen also disagreed with overturning the 2018 decision, saying little has changed and that since the Iowa Legislature has begun the process of amending the Iowa Constitution to say abortion is not a fundamental right, the people should decide the issue.

“If the majority truly wants to leave this issue to the will of the people, it should let the people have their say through the ongoing constitutional amendment process,” she said.

If lawmakers approve the amendment next year, a vote could come as soon as 2024.

Reynolds, an outspoken opponent of abortion rights, and Republicans in the Legislature have repeatedly said they hoped the court would overturn the 2018 ruling, and GOP lawmakers gave the governor more control over the panel that chooses nominations for court positions.

The 2018 decision made Iowa the sixth state — with Alaska, Florida, Kansas, Montana and Minnesota — where abortion rights were recognized by the state’s high court.

As in Iowa, Republicans control the Legislatures and governorships in Florida and Montana, where GOP leaders have been stymied from enacting abortion bans that could take effect if the U.S. Supreme Court overturns its 1973 landmark decision and puts decision-making power in state government hands.

In Montana, a challenge to abortion restrictions that could test its high court opinion is before the Supreme Court.

In Iowa, Reynolds has demurred on questions of what exceptions she would accept. She said last month she is “proud of the legislation she signed in 2018,” including the ban on abortions once cardiac activity is detected, as early as six weeks and often before many women know they are pregnant. The measure included exceptions to protect the life of the mother and in pregnancies that result from incest or rape.

Yet more recently, she stopped short of specifying similar exceptions. “I’m not going to set any parameters,” she told reporters.

Iowa Department of Public Health data shows there were 4,058 abortions in Iowa in 2020 — 835 surgical abortions and 3,222 by medication. That was an increase over the previous year when 3,566 abortions were reported. Iowa averaged just under 3,500 abortions a year from 2015 to 2019.

Court documents show Planned Parenthood performs about 95% of Iowa abortions. Surgical and medical abortions may be obtained in clinics in Des Moines and Iowa City. Medication abortions are provided in other clinic locations including Ames, Council Bluffs and Sioux City.

https://apnews.com/article/abortion-health-iowa-supreme-court-government-and-politics-0074e14defa4a6699e65d921f0edbc58

White House clams up on Biden COVID-19 testing regimen

 In an abrupt change of course, the White House is now declining to comment on the frequency of President Joe Biden’s COVID-19 testing regimen, even as it maintains that it would inform the public if he were to ever test positive for the coronavirus.

Since Inauguration Day, the White House had frequently answered questions from reporters about when Biden, 79, last tested negative for the virus. Now, the White House says its policy is not to answer those questions.

“I’m telling you he has a regular cadence,” White House press secretary Karine Jean-Pierre said Thursday, refusing to say what day he last tested negative. “I just don’t have a date to share with you, but he does have a regular weekly cadence.”

Following Jean-Pierre’s comments, deputy press secretary Chris Meagher tweeted Thursday that “Our policy is not to readout every test POTUS has taken.”

Biden has often been tested more frequently, either because of close calls with people who have subsequently tested positive for COVID-19 or because of his travel schedule. And the White House had previously been more transparent about Biden’s testing.

“To remain transparent with you and the American people, we wanted to share that the President tested negative for COVID-19 on Monday,” then-White House press secretary Jen Psaki said last February. “We will venture to provide this update the following day in the future.”

As recently as May 4, Psaki told reporters that Biden tested negative the previous day.

The new, more opaque approach comes as top White House officials have been matter-of-fact about the chances of the president getting COVID, a measure of how ingrained the virus has become in society — and of its diminished threat for those who are up to date on their vaccinations and with access to treatments.

Jean-Pierre said Thursday that the White House would inform the public if Biden were to test positive or if he were to be deemed a “close contact” of someone who tested positive. The White House uses the Centers for Disease Control and Prevention definition of a “close contact,” which is being in the presence of someone with known or suspected COVID-19 for more than 15 minutes, or within six feet of someone with the virus up to two days before they tested positive.

The White House said Biden has never tested positive for COVID-19.

https://apnews.com/article/biden-covid-health-karine-jean-pierre-government-and-politics-7ce9109f7be5127b3b1e0483127425d8

Some clinics halting abortions while bracing for Roe’s fall

 Abortion providers in some places where the procedure could be banned if the U.S. Supreme Court overturns Roe v. Wade are bracing for a ruling by halting scheduling for the procedure, transitioning staff to help patients travel to other states and creating networks of clinics that will span across regions of the country.

Planned Parenthood of Wisconsin, which operates three clinics that provide abortions in the state, is not scheduling the procedure beyond June 25 as it anticipates a late June decision reversing the landmark 1973 decision that guaranteed abortion rights nationwide. The organization in recent weeks has dedicated two staff members to help patients book appointments and figure out how to get to clinics.

Whether clinics in Wisconsin will be able to provide abortions, though, has turned into a day-to-day question.

“One of the hardest aspects of this is not knowing what day this decision will come down and what it will be,” said Michelle Velasquez, the director of legal advocacy and services at Planned Parenthood Wisconsin. “The unknown has been difficult.”

It’s a window into what abortion providers and access funds are planning in more than a dozen other states across the South and Midwest. In South Dakota this week, the state’s only abortion clinic, also operated by Planned Parenthood, announced it had “paused” scheduling abortions beyond the end of the month. In Oklahoma, providers already stopped the procedure after a law was enacted to ban it.

In Wisconsin, a law banning abortion has been on the books since 1849, but Roe v. Wade overrode it. While Roe’s fall would likely spark a legal tussle over whether it is valid, Planned Parenthood does not want to put its staff at risk of prosecution.

Velasquez said clinic staff wanted to provide abortions in Wisconsin up until the last minute it was legal, but also had to consider that scheduling appointments for dates when it could become illegal could create uncertainty and be “distressing” for patients.

Velasquez acknowledged that the Supreme Court could release its decision as soon as next week, even while Planned Parenthood has appointments on the books. She said if that happened, Planned Parenthood would help those patients book appointments for abortions in nearby states, such as Minnesota and Illinois. Patients could still get counseling, lab work and ultrasounds in Wisconsin in the meantime.

“We wouldn’t leave patients, like, ‘You’re on your own,’” Velasquez said.

“Even if we can’t provide the medications or we can’t do a procedure, we are absolutely able to help people find the care they need,” she added.

The strategy will inevitably put more pressure on providers in states in the region where abortion will still be legal, said Caitlyn Myers, an economic professor at Middlebury College who studies abortion access.

“As hundreds of thousands of women flood out of these states, it is going to enormously tax the resources of these providers,” she said. “I don’t think they are prepared for this huge influx.”

It comes as the number and rates of U.S. abortions is on the rise after a long decline. Abortions increased from 2017 to 2020, according to figures from the Guttmacher Institute, a research group that supports abortion rights. It counted more than 930,000 abortions in the U.S. in 2020.

Clinics shuttering, like one did in Idaho recently, or halting scheduling show that a post-Roe reality has already arrived in many places. Myers said getting an appointment for an abortion may soon become “critical” across the country.

https://apnews.com/article/abortion-us-supreme-court-politics-planned-parenthood-wisconsin-7a385f2a957b9a19c4f0f8b292ad66af

US opens COVID vaccine to little kids, shots begin next week

 The U.S. on Saturday opened COVID-19 vaccines to infants, toddlers and preschoolers.

The shots will become available next week, expanding the nation’s vaccination campaign to children as young as 6 months.

Advisers to the Centers for Disease Control and Prevention recommended the vaccines for the littlest children, and the final signoff came hours later from Dr. Rochelle Walensky, the agency’s director.

“We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can,” Walensky said in a statement.

While the Food and Drug Administration approves vaccines, it’s the CDC that decides who should get them.

The shots offer young children protection from hospitalization, death and possible long-term complications that are still not clearly understood, the CDC’s advisory panel said.

The government has already been gearing up for the vaccine expansion, with millions of doses ordered for distribution to doctors, hospitals and community health clinics around the country.

Roughly 18 million kids will be eligible, but it remains to be seen how many will ultimately get the vaccines. Less than a third of children ages 5 to 11 have done so since vaccination opened up to them last November.

Here are some things to know:

WHAT KINDS ARE AVAILABLE?

Two brands — Pfizer and Moderna — got the green light Friday from the FDA and Saturday from the CDC. The vaccines use the same technology but are being offered at different dose sizes and number of shots for the youngest kids.

Pfizer’s vaccine is for children 6 months to 4 years old. The dose is one-tenth of the adult dose, and three shots are needed. The first two are given three weeks apart, and the last at least two months later.

Moderna’s is two shots, each a quarter of its adult dose, given about four weeks apart for kids 6 months through 5 years old. The FDA also approved a third dose, at least a month after the second shot, for children with immune conditions that make them more vulnerable to serious illness.

HOW WELL DO THEY WORK?

In studies, vaccinated youngsters developed levels of virus-fighting antibodies as strong as young adults, suggesting that the kid-size doses protect against coronavirus infections.

However, exactly how well they work is hard to pin down, especially when it comes to the Pfizer vaccine.

Two doses of Moderna appeared to be only about 40% effective at preventing milder infections at a time when the omicron variant was causing most COVID-19 illnesses. Pfizer presented study information suggesting the company saw 80% with its three shots. But the Pfizer data was so limited — and based on such a small number of cases — that experts and federal officials say they don’t feel there is a reliable estimate yet.

SHOULD MY LITTLE ONE BE VACCINATED?

Yes, according to the CDC. While COVID-19 has been the most dangerous for older adults, younger people, including children, can also get very sick.

Hospitalizations surged during the omicron wave. Since the start of the pandemic, about 480 children under age 5 are counted among the nation’s more than 1 million COVID-19 deaths, according to federal data.

“It is worth vaccinating even though the number of deaths are relatively rare, because these deaths are preventable through vaccination,” said Dr. Matthew Daley, a Kaiser Permanente Colorado researcher who sits on the CDC’s advisory committee.

In a statement Saturday, President Joe Biden urged parents to get them for their young children as soon as possible.

WHICH VACCINE SHOULD MY CHILD GET?

Either one, said Dr. Peter Marks, the FDA’s vaccine chief.

“Whatever vaccine your health care provider, pediatrician has, that’s what I would give my child,” Marks said Friday.

The doses haven’t been tested against each other, so experts say there’s no way to tell if one is better.

One consideration: It takes roughly three months to complete the Pfizer three-shot series, but just one month for Moderna’s two shots. So families eager to get children protected quickly might want Moderna.

WHO’S GIVING THE SHOTS?

Pediatricians, other primary care physicians and children’s hospitals are planning to provide the vaccines. Limited drugstores will offer them for at least some of the under-5 group.

U.S. officials expect most shots to take place at pediatricians’ offices. Many parents may be more comfortable getting the vaccine for their kids at their regular doctor, White House COVID-19 coordinator Dr. Ashish Jha said. He predicted the pace of vaccination will be far slower than it was for older populations.

“We’re going see vaccinations ramp up over weeks and even potentially over a couple of months,” Jha said.

CAN CHILDREN GET OTHER VACCINES AT THE SAME TIME?

It’s common for little kids to get more than one vaccine during a doctor’s visit.

In studies of the Moderna and Pfizer shots in infants and toddlers, other vaccinations were not given at the same time so there is no data on potential side effects when that happens.

But problems have not been identified in older children or adults when COVID-19 shots and other vaccinations were given together, and the CDC is advising that it’s safe for younger children as well.

WHAT IF MY CHILD RECENTLY HAD COVID-19?

About three-quarters of children of all ages are estimated to have been infected at some point. For older ages, the CDC has recommended vaccination anyway to lower the chances of reinfection.

Experts have noted re-infections among previously infected people and say the highest levels of protection occur in those who were both vaccinated and previously infected.

The CDC has said people may consider waiting about three months after an infection to be vaccinated.

https://apnews.com/article/covid-science-health-centers-for-disease-control-and-prevention-rochelle-walensky-222bc528985a897c2a2d6173cd3659a9