How historical precedents impeded recognition of airborne COVID-19 transmission

Millions of people have died of coronavirus infection since 2020 because influential institutions took too long to recognize that it is primarily airborne, and a new University of Colorado Boulder-led historical analysis sheds light on the delay. The authors trace this deadly resistance one hundred years back in history, to the rejection of sickly air called “miasma,” the rise of germ theory and our own stubborn tendency to retain beliefs in spite of accumulating evidence to the contrary.

While the SARS-CoV-2 virus was invisibly infecting people in 2020 through the air in hospitals, churches, workplaces and restaurants, people across the world were focused on disinfecting surfaces and washing their hands. Many governments and businesses installed plexiglass barriers that actually increased coronavirus spread, said Jose-Luis Jimenez, lead author of a new comprehensive historical assessment of major medical mistakes involving disease transmission, now published in the journal Indoor Air.

“History set us up for a poor response to the pandemic,” said Jimenez, fellow at the Cooperative Institute for Research in Environmental Sciences (CIRES) and distinguished professor of chemistry at CU Boulder. “We might have had millions of fewer deaths, hundreds of millions fewer cases, if we’d taken appropriate, effective action from the start.”

The overview, written with colleagues from 10 countries, illuminates the often deadly impact of “belief perseverance,” in which it can take years or decades to challenge a set of beliefs — especially when the consequence of changing a set of beliefs is costly. It’s less expensive to ask people to wash hands or disinfect surfaces than it is to update a ventilation system, for example, or to re-engineer school classrooms, city buses and corporate boardrooms.

The authors, who include physicians, virologists, public health specialists, aerosol scientists, engineers, historians, a sociologist and an architect, spin through numerous examples of fatal mistakes in the history of research on infectious diseases. In 1847, for example, a scientist working in Austria showed that handwashing by medical doctors reduced deadly puerperal fever in a clinic. His work was dismissed because at the time, established medical and scientific beliefs blamed “a miasma in the air.” Handwashing made no sense to the establishment, and the suggestion that physicians, themselves, might be spreading disease, offended many.

Half a century later, another prominent researcher, Charles Chapin, ridiculed the idea of spooky miasmas or infected air. Chapin’s own work on infection had suggested to him that “contact infection” was the predominant way most infections spread. But he also knew how difficult it was to persuade people to wash their hands and disinfect surfaces if they thought some diseases might spread through the air, and how difficult it would be to figure out how to clean the air itself. So he argued his “contact infection” theory without evidence and managed to effectively label airborne disease transmission as superstition.

Jimenez and his co-authors trace disease transmission history from Chapin to 2020, when the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and other institutions expressed deep skepticism or outright denial that SARS-CoV-2 might spread through the air, despite increasing evidence it was doing just that.

Jimenez said he thinks that most people at WHO and CDC were honest in their skepticism in early 2020, just struggling to get their minds around the fact that the conventional way of thinking about respiratory infection transmission — spreading through heavy droplets falling on surfaces — might be inadequate to explain the pandemic.

“They were stuck on the theory, distorting the interpretation of the observations to match their pre-existing beliefs,” said Jimenez.

Others have suggested that economics have also been at play, much as with climate change.

It’s convenient to ask individuals to take small, individual actions like handwashing and driving less, Jimenez noted. It’s more expensive for institutions to make structural changes, such as increasing ventilation everywhere, or replacing fossil fuel infrastructure with renewable energy.

So in preparation for facing the next pandemic intelligently, Jimenez and his colleagues are first working to find allies, especially in the hardworking medical and public health professions where many people have been too busy saving lives to enter the discussion about disease transmission, but have direct experience.

“And confrontation is also needed when major institutions refuse to accept the science and to communicate it clearly,” Jimenez added. “Maybe we have to badger the establishment a little, like Florence Nightingale did.”

Nightingale “lobbied” the British government for decades to support her reforms at hospitals, increasing hygiene, ventilation and distance between beds at a time when it was still seen as unnecessary.

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Transgender parents bring child-centered perspective to parenthood, research finds

Many transgender parents with children between one-and-a-half and six years of age hesitate to label their child’s gender identity, according to new research from a team at Penn State and Guilford College. In addition, the results suggest that many children with transgender parents play in ways that conform to gendered societal expectations, while others play in more gender-expansive ways.

“Previous research has shown that misgendering, or incorrectly labeling someone’s gender identity, often harms a person’s mental and physical health,” said Samantha L. Tornello, assistant professor of human development and family studies at Penn State and principal investigator of the Gender Diverse Parents Study, who noted that gender identity is a person’s internal sense of their own gender — for example, woman, man, nonbinary, or another gender identity. “This new research suggests that transgender parents may offer their children supportive environments to explore their own gender identity and expression.”

Tornello and lead co-author Rachel G. Riskind, the Christina B. Gidynski Associate Professor of Psychology at Guilford College, also found a strong link between child age and the likelihood of labeling — the older the child, the more likely parents were to label their child’s gender identity. Transgender parents of elementary-school-aged children may be more likely than transgender parents of toddlers to label their child’s gender identity.

“This study can’t speak to whether transgender parents assign their children gendered names or pronouns, or otherwise socialize them in gendered ways,” Riskind said. “But it does suggest that transgender parents hesitate to label their child’s gender identity before their child can communicate it themselves.”

The study utilized web-based surveys of 64 nonbinary and binary transgender parents from across the United States. Binary transgender people are those who identify primarily as women, girls, men, or boys; nonbinary people are those whose gender identity is not captured by these labels.

The study measured children’s gender expression: their interest in masculinized and feminized toys (e.g., toolsets and jewelry), activities (e.g., climbing and playing house), and personality characteristics (e.g., enjoying tumble play and liking pretty things). Participants rated how often their child engaged with and enjoyed each item or activity.

The surveys also asked parents about the sex their child was assigned at birth and about their child’s current gender identity.

The team found that 41% of the participants did not report their child’s current gender identity, choosing either “unknown,” “choose not to label,” or “self-describe,” with a text field to write in their response. For “self-describe,” parents often described a gender-fluid child or a child who had not verbalized their gender identity. Several parents wrote, “I think it’s too early to know.” Although the surveys revealed that, on average, children’s play was conventionally gendered, there was a great deal of diversity within the sample. Older children of nonbinary parents, for example, may be more likely to engage in gender-expansive play.

The study published on Aug. 17 in the journal Frontiers in Psychology.

According to Tornello, “Some believe that parent gender identity has either everything, or nothing, to do with child gender expression. But this study suggests that the truth is somewhere in between.”

“This is one of the largest studies to focus on the gender of young children with transgender parents. It will further inform our understanding of gender development, parenting, and child development more broadly.”

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Materials provided by Penn State. Original written by Mary Campbell. Note: Content may be edited for style and length.

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From wound healing to regeneration

The phenomenon of regeneration was discovered over 200 years ago in the freshwater polyp Hydra. Until now, however, it was largely unclear how the orderly regeneration of lost tissues or organs is activated after injury. In its investigations of Hydra, an interdisciplinary research team at Heidelberg University was able to show how wound healing signals released upon injury are converted into specific signals of pattern formation and cell differentiation. Essential components are the mitogen-activated protein kinases (MAPK) and the Wnt signalling pathway — molecular mechanisms that have remained relatively unchanged throughout evolution.

The ability to regenerate varies widely in animals. Most mammals and vertebrates have only limited regeneration capacity, while basal and simple animals that emerged early in evolution, like cnidarians and planarians, can regenerate their whole body. In all cases, the process of regeneration begins with wound healing. The cells at the site of injury proliferate and form an undifferentiated mass — a blastema — from which the missing structures are re-patterned. This activates genetic processes that also control embryonic development. To determine the molecular mechanisms involved, the research team led by Prof. Dr Thomas W. Holstein studied the freshwater polyp Hydra to understand the basic features of this activation of regeneration.

The core of their investigations is the doctoral thesis of Anja Tursch. She repeated the key experiment of Geneva naturalist Abraham Trembley (1710 to 1784) which led him to discover the regeneration phenomenon. The Hydra polyp is bisected, prompting the upper half to regenerate a new “head” and the lower half a new “foot” — hence totally different body parts can grow from the exact same tissue at the cut surface in the middle. Building on their previous work on Hydra regeneration, the researchers at the Centre for Organismal Studies (COS) of Heidelberg University have now shown how this is possible.

Regardless of where it occurs, any damage triggers nonspecific signals for an injury response, i.e. wound healing, via calcium ions and the production of reactive oxygen species. The signals are transmitted intracellularly by three mitogen-activated protein kinases — p38, JNKs, and ERK. Activation of these three molecules is required for both head and foot regeneration. Wnt signalling pathways are then activated that are important during embryonic development for the formation of rudimentary organs and the body axis. The generic signals of wound healing are thus transferred into position-specific signals of patterning and cell differentiation for regeneration.

“Our experiments show that the Wnt signalling pathway is a main component of the initially general injury response and, depending on signal strength, directs the tissue toward head or foot development,” explains Prof. Holstein. This is why, in the case of MAPK inhibition, the otherwise absent regeneration can be induced by artificially generated, recombinant Wnt proteins. “It was also surprising that in middle body parts that had both head and foot removed, heads can be induced at both ends in this way,” adds Dr Suat Özbek, a member of Prof. Holstein’s “Molecular Evolution and Genomics” research group at the COS.

Wnt/β-catenin, one piece of the Wnt signalling pathway, was already known to encode positional information for new head structure formation. In collaboration with mathematicians led by Prof. Dr Anna Marciniak-Czochra, the research team of Prof. Holstein and Dr Özbek developed a model that shows how basal positional information in the tissue transforms the initially undifferentiated injury response into a differential patterning process via the Wnt signalling pathway. “Because MAPKs and Wnts are highly evolutionarily conserved, this mechanism is likely deeply embedded in our genome, which is important for regenerative processes in vertebrates and mammals as well,” stresses Thomas Holstein.

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

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Quantum materials: Entanglement of many atoms discovered

Be it magnets or superconductors: materials are known for their various properties. However, these properties may change spontaneously under extreme conditions. Researchers at the Technische Universität Dresden (TUD) and the Technische Universität München (TUM) have discovered an entirely new type of such phase transitions. They display the phenomenon of quantum entanglement involving many atoms, which previously has only been observed in the realm of few atoms. The results were recently published in the scientific journal Nature.

In physics, Schroedinger’s cat is an allegory for two of the most awe-inspiring effects of quantum mechanics: entanglement and superposition. Researchers from Dresden and Munich have now observed these behaviors on a much larger scale than that of the smallest of particles. Until now, materials that display properties like, e.g., magnetism have been known to have so-called domains — islands in which the materials properties are homogeneously either of one or a different kind (imagine them being either black or white, for example). Looking at lithium holmium fluoride (LiHoF4), the physicists have now discovered a completely new phase transition, at which the domains surprisingly exhibit quantum mechanical features, resulting in their properties becoming entangled (being black and white at the same time). “Our quantum cat now has a new fur because we’ve discovered a new quantum phase transition in LiHoF4 which has not previously been known to exist,” comments Matthias Vojta, Chair of Theoretical Solid State Physics at TUD.

Phase transitions and entanglement

We can easily observe the spontaneously changing properties of a substance if we look at water: at 100 degrees Celsius it evaporates into a gas, at zero degrees Celsius it freezes into ice. In both cases, these new states of matter form as a consequence of a phase transition where the water molecules rearrange themselves, thus changing the characteristics of the matter. Properties like magnetism or superconductivity emerge as a result of electrons undergoing phase transitions in crystals. For phase transitions at temperatures approaching the absolute zero at -273.15 degrees Celsius, quantum mechanical effects such as entanglement come into play, and one speaks of quantum phase transitions. “Even though there are more than 30 years of extensive research dedicated to phase transitions in quantum materials, we had previously assumed that the phenomenon of entanglement played a role only on a microscopic scale, where it involves only a few atoms at a time,” explains Christian Pfleiderer, Professor of Topology of Correlated Systems at the TUM.

Quantum entanglement is one of the most astonishing phenomena of physics, where the entangled quantum particles exist in a shared superposition state that allows for usually mutually exclusive properties (e.g., black and white) to occur simultaneously. As a rule, the laws of quantum mechanics only apply to microscopic particles. The research teams from Munich and Dresden have now succeeded in observing effects of quantum entanglement on a much larger scale, that of thousands of atoms. For this, they have chosen to work with the well-known compound LiHoF4.

Spherical samples enable precision measurements

At very low temperatures, LiHoF4 acts as a ferromagnet where all magnetic moments spontaneously point in the same direction. If you then apply a magnetic field exactly vertically to the preferred magnetic direction, the magnetic moments will change direction, which is known as fluctuations. The higher the magnetic field strength, the stronger these fluctuations become, until, eventually, the ferromagnetism disappears completely at a quantum phase transition. This leads to the entanglement of neighboring magnetic moments. “If you hold up a LiHoF4 sample to a very strong magnet, it suddenly ceases to be spontaneously magnetic. This has been known for 25 years,” summarizes Vojta.

What is new is what happens when you change the direction of the magnetic field. “We discovered that the quantum phase transition continues to occur, whereas it had previously been believed that even the smallest tilt of the magnetic field would immediately suppress it,” explains Pfleiderer. Under these conditions, however, it is not individual magnetic moments but rather extensive magnetic areas, so-called ferromagnetic domains, that undergo these quantum phase transitions. The domains constitute entire islands of magnetic moments pointing in the same direction. “We have used spherical samples for our precision measurements. That is what enabled us to precisely study the behavior upon small changes in the direction of the magnetic field,” adds Andreas Wendl, who conducted the experiments as part of his doctoral dissertation.

From fundamental physics to applications

“We have discovered an entirely new type of quantum phase transitions where entanglement takes place on the scale of many thousands of atoms instead of just in the microcosm of only a few,” explains Vojta. “If you imagine the magnetic domains as a black-and-white pattern, the new phase transition leads to either the white or the black areas becoming infinitesimally small, i.e., creating a quantum pattern, bevor dissolving completely.” A newly developed theoretical model successfully explains the data obtained from the experiments. “For our analysis, we generalized existing microscopic models and also took into account the feedback of the large ferromagnetic domains to the microscopic properties,” elaborates Heike Eisenlohr, who performed the calculations as part of her PhD thesis.

The discovery of the new quantum phase transitions is important as a foundation and general frame of reference for the research of quantum phenomena in materials, as well as for new applications. “Quantum entanglement is applied and used in technologies like quantum sensors and quantum computers, amongst other things,” says Vojta. Pfleiderer adds: “Our work is in the area of fundamental research, which, however, can have a direct impact on the development of practical applications, if you use the materials properties in a controlled way.”

The research has been financially supported by the Excellence Strategy of the German Federal and State Governments within the Würzburg-Dresden Cluster of Excellence Complexity and Topology in Quantum Matter (ct.qmat) and the Cluster of Excellence Munich Center for Quantum Science and Technology (MCQST). In addition, the work has been supported by the European Research Council (ERC) via the Advanced Grant ExQuiSid and by the Deutsche Forschungsgemeinschaft (DFG) within the Collaborative Research Centers (SFB) 1143 und TRR80.

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Mystery pneumonia: Argentina investigates three deaths

Three of nine people struck with the unexplained respiratory illness in recent days have died.

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Long Covid: 11-year-old on Leeds long Covid clinic help

The clinic is one of 15 regional hubs established to help children with long Covid symptoms.

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‘My mesh horror story is now on public display’

Lisa Megginson had her transvaginal mesh tape surgically removed after years of health problems.

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Prostate cancer symptoms and treatment: What to check for

One in eight men will be diagnosed with prostate cancer in their lifetime.

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Bill Turnbull: Former BBC Breakfast presenter dies aged 66

The presenter hosted BBC Breakfast for 15 years and more recently hosted programmes on Classic FM.

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Review into Nottingham NHS maternity failings launches

Families are urged to take part in the review being conducted by influential midwife Donna Ockenden.

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