Currently available data are consistent with increased severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) replication at temperatures encountered in the upper airways (25–33°C when breathing room temperature air, 25°C) compared to those in the lower airways (37°C). One factor that may contribute to more rapid viral growth in the upper airways is the exponential increase in SARS‐CoV‐2 stability that occurs with reductions in temperature, as measured in vitro. Because SARS‐CoV‐2 frequently initiates infection in the upper airways before spreading through the body, increased upper airway viral growth early in the disease course may result in more rapid progression of disease and potentially contribute to more severe outcomes. Similarly, higher SARS‐CoV‐2 viral titer in the upper airways likely supports more efficient transmission. Conversely, the possible significance of air temperature to upper airway viral growth suggests that prolonged delivery of heated air might represent a preventative measure and prophylactic treatment for coronavirus disease 2019.

Air temperature and body temperature may influence COVID-19 disease severity and transmission rates. In vitro data indicate that SARS-CoV-2 loses infectivity at normal core body temperature (37°C); however, small reductions in temperature proximate to 37°C may result in substantially increased viral stability. If these results are representative of viral decay rates in vivo, then cooler temperatures in the body may enable more rapid viral growth. Breathing cool air—even as warm as 25°C—cools upper respiratory tract (URT) surfaces to several degrees below body temperature, and these lower temperatures may make the URT exceptionally conducive to SARS-CoV-2 replication. Increased URT viral load may enable more effective transmission. Additionally, because SARS-CoV-2 infection may frequently begin in the URT before spreading through the body, an increased rate of viral replication in the URT early in the disease course may result in more rapid progression of disease, potentially causing more severe adverse outcomes. Core body temperature may also be a factor in disease severity, as lower core body temperatures may enable more rapid viral growth. The significance of air temperature and body temperature to disease severity and transmission rates may inform preventative measures and post-exposure prophylaxis treatments for COVID-19.

Innovation in basic research is vital to scientific progress and technological development; however, such research finds insufficient support in the current research environment. To stimulate high-risk, high-reward basic research, this paper proposes a “research equity” funding model in which funders—such as government agencies and philanthropies—would pay researchers and institutions for completed research: The more valuable the research, the greater the reward. The valuation of completed research could be done with a novel “chess rating” method: A peer reviewer would be presented with a pair of research papers and would decide which of the two is of greater value, and a large number of comparisons would produce a numerical rating to inform payment. Payment based on research value would enable many of the qualities found in healthy markets. Initial capital for basic research would be provided by research institutions, which would be financially incentivized to invest in a diverse body of basic research that includes both low-risk, conservative research and high-risk, innovative research. Institutions would be motivated to demonstrate the value of completed research in their portfolios, which may accelerate recognition of important results. By motivating researchers and institutions to produce and promote valuable research, the research equity model could stimulate more rapid scientific discovery and progress. Notably, the research equity model could coexist with grant funding.

Currently available data are consistent with increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication at temperatures encountered in the upper airways (25–33°C when breathing room temperature air, 25°C) compared to those in the lower airways (37°C). One factor that may contribute to more rapid viral growth in the upper airways is the exponential increase in SARS-CoV-2 stability that occurs with reductions in temperature, as measured in vitro. Because SARS-CoV-2 frequently initiates infection in the upper airways before spreading through the body, increased upper airway viral growth early in the disease course may result in more rapid progression of disease and potentially contribute to more severe outcomes. Similarly, higher SARS-CoV-2 viral titer in the upper airways likely supports more efficient transmission. Conversely, the possible significance of air temperature to upper airway viral growth suggests that prolonged delivery of heated air might represent a preventative measure and prophylactic treatment for coronavirus disease 2019.