The English National Opera is becalmed in a windless pandemic sea (and beset by overcooked metaphors), but it’s putting its expertise to use by teaching breathing exercises to people struggling with long Covid. On Zoom, of course. Because nothing happens in person anymore. 

Jenny Mollica, who runs the opera company’s outreach program, started hearing about long Covid–the chest pains, the exhaustion, but above all the breathlessness– and thought, “Opera is rooted in breath. That’s our expertise.” Maybe, she thought, the company had something to offer.

She got hold of Dr. Sarah Elkin, a respiratory therapist in the National Health Service, who thought, Why not? 

Yes, I know. I’m claiming to know an awful lot about what people who aren’t me thought. But I’m stealing the information straight from what they said, so we’re on relatively safe ground.

Irrelevant photo: Primroses.

Elkin and her team had some drug treatments they could try patients on, but beyond that they didn’t have a lot to offer. And Elkin used to sing jazz, so she understood first hand what vocal training could do.

They recruited a dozen participants, and one of them said in an interview that in everything he’d done since recovering from Covid, “I was struggling for air.” Even a few of the simple breathing exercises made a huge difference. “The program really does help. Physically, mentally, in terms of anxiety.”

In addition to exercises, they sing, working with lullabies from around the world. They’re easy to learn and they’re soothing, since anxiety is as much an issue for the participants as breath.

Just reading about it, I feel better. If you’ll excuse me, I’m going to go hum a lullaby to the cat. 

Ultraviolet light and Covid

A reader and frequent comment-leaver, Peter Wetherill, has been telling me about UV-C light as a way to battle Covid, and I got intrigued enough to see what I could learn about it. The internet isn’t exactly awash in information on the subject, but it does have a bit, so here’s what I’ve been able to sort out. 

Ultraviolet radiation–let’s call it UV, since we’re friends–comes in three flavors: A, B, and C. They’re not the most exciting flavors nature ever created,and that’s probably why you don’t hear about them on cooking shows and why no one’s given them more exciting names. But they’re what we’ve got to work with, so will you pipe down so we can get some work done?

We’re used to A and B, even if we don’t know it. If you use sunscreen, they’re what you’re blocking. Give them enough time and opportunity and they’ll damage the skin, no matter how dark skinned you are, and they don’t do the eyes any favors either. But it takes them a good long while to do their damage. Basically, our bodies have learned to live with them.

C, though, gets blocked by the earth’s ozone layer, so we and our many germs have all evolved without protection to it. It kills germs. It’ll also damage the hell out of people. So that’s the promise and that’s the problem, all neatly wrapped around each other. Can you separate one from the other to clear our public spaces of Covid?

Answer, yes-but.

Robots have been armed with UV-C so they can disinfect the surfaces of empty planes and subway cars. That’s useful but only up to a point. Problem one, Covid doesn’t spread primarily through surface deposits. As far as they’ve been able to trace the beast, airborne transmission’s the main culprit. And problem two, the minute you let people back into the space, it’s no longer clean. Because you know what we’re like. 

UV-C can also be adapted to clean N-95 masks, but its ability to sanitize depends on (problem three) the light hitting the virus directly. If some of the viruses are covered by a fiber or by dirt, the virus wins a round. If some bit of the mask is shadowed, any virus living there wins a round. In an experiment with Staphylococcus aureus, the kill rate varied as much as 500-fold depending on the angle of the light. So it generally takes three UV systems to disinfect a hospital room, and they won’t get everything. The surfaces still need to be cleaned the old-fashioned way.

Why bother? Because they’ll kill viruses and bacteria that the old-fashioned cleaning would have missed.

All of this, remember, has to be done away from human skin and eyes, because we never evolved any protection against it. So you have to clear people out before you can do it. 

What about cleaning the air? It can do that. 

One approach is to install UV-C units in the air ducts of ventilation systems, where no one goes unless they’re in some movie, there’s tense music in the background, and everyone watching suspends what little they know about reality. Using it this way could prevent, for example, what may have happened in a quarantine hotel in New Zealand where the ventilation system (may have; it’s not certain) helpfully moved the virus from one room to another. 

Another way to use UV-C is to install the units close to the ceiling, carefully calculating what it’ll take to miss even the tallest people and being careful not to let the light scatter downwards. Fixtures of that sort cost a couple of thousand dollars each and can be used in waiting rooms, in corridors, and in other badly ventilated places where people gather or pass through and breathe. It sounds like they’ll reliably kill off any germs in their line of sight–but only in their line of sigh. So they clear the upper reaches of the room but not the lower ones.

We’re almost done here. Stay with me, because there’s another possibility, called far UV-C, which is on a different wavelength and don’t ask me about that, please. For reasons best known to itself and to people who actually understand this stuff, it hardly penetrates the outer layer of human skin and, at least in albino rats, doesn’t cause eye damage. If you’re an albino rat, this is good news. But it does still kill viruses and bacteria. So you could use it in a room full of people without worrying about how tall people are or how much of the aerosols they breasted out hang in the lower air. 

David Sliney, retired manager of the U.S. Army’s Laser and Optical Radiation Program said, “There is some evidence that it may even be more effective against airborne viruses” than other UV light. 

This is still in the range of may and some evidence, remember. And again, it only cleans what it can directly hit. The virus underneath your book? It’s safe. The virus hiding in your shadow? It’s safe until you move your shadow. But since most aerosols (and as it happens, the ones we need to worry about) will be floating around somewhere in the room’s air, it can reasonably be expected to unleash a wholesale viral slaughter.

If you’re planning to try this, you need a krypton-chlorine excimer lamp, but they have built-in problems, because they also generate light on a different wavelength–a damaging wavelength.

Back to the drawing board. 

You could filter the lamp–we’ll come back to that–or you could use a far UV-C LED lamp, which is a great idea except that they don’t exist yet, and that’s a problem. It all has to do with wavelengths and efficiency. Get the wavelength right and the efficiency falls off a cliff. Get the efficiency right and the wavelength’s wrong.

That drives us back to excimer lamps. The article I’m linking to expects them to be on the market by early 2021.

Hang on. This is early 2021. You could even argue that it’s late-early 2021. So–as my brother used to ask on car trips–are we there yet? 

Sort of. I asked Lord Google about filtered excimer lamps, and after leading me through some odd corners of the internet, including one involving fishpond sterilizers, I did find some. I think. But first I found some box-like gizmos that draw air in, sterilize it, and breathe it back out so that humans aren’t exposed to UV-C but the virus is.  

I also found a “far UV-C excimer lamp module for microbial reduction applications.” It cleans surfaces and air, it can be used in occupied and unoccupied rooms, and I’m sure the website says how much it costs somewhere but believe me, they’re not leading with that information. Let’s assume it’s expensive, but then so’s death.

In spite of the limited offerings on the internet, the article I’ve drawn most of my information from (it’s published by the IEEE Spectrum) says that “the current pandemic may yet come and go before the world has rolled out germicidal UV broadly enough to make a big impact. And so experts are already planning for the next dangerous pathogen, and when it comes, they hope to greet it with a phalanx of UV air purifiers and surface sterilizers in hospitals, airports, public transit, offices, schools, nursing homes, stores, restaurants, elevators, and elsewhere. The ubiquity of UV technology should make it much harder for an outbreak to spread, perhaps preventing a lethal contagion from ever becoming a pandemic.”

If–like me–you’re wondering what IEEE stands for, it stands for IEEE. You may have to join before they’ll tell you anything more than name, rank, and serial number. It’s a technical professional organization that’s interested in technology. And professionalism. And sounds like the scream of someone falling off a cliff: I-EEEEEEEEEEEEEeeee.

Oh, hell, I don’t know what it does, but it’s big. At least compared to other technical professional organizations. 

By way of a second source, you can find a fairly small bit about it from the FDA–the U.S. Food and Drug Administration.