The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in an unprecedented shutdown in social and economic activity, with the cultural sector particularly severely affected. Restrictions on musical performances have arisen from a perception that there is a significantly higher risk of aerosol production from singing than speaking, based upon high-profile A c c e p t e d M a n u s c r i p texamples of clusters of COVID-19 following choral rehearsals. However, comparing aerosol generation from different types of vocalization, including singing, across a range of volumes is a rapidly evolving area of research. Here, we measured aerosols from singing, speaking and breathing from a large cohort of 25 professional singers in a range of musical genres in a zero-background environment, allowing unequivocal attribution of aerosol production to specific vocalizations. We do not assess the relative volumes at which people speak and sing. However, both showed steep increases in mass concentration with increase in loudness (spanning a factor of 20-30 across the dynamic range measured, p<0.001). At the quietest volume (50 to 60 dBA), neither singing (p=0.19) nor speaking (p=0.20) were significantly different to breathing. At the loudest volume (90 to 100 dBA), a statistically significant difference (p<0.001) was observed between singing and speaking, but with singing only generating a factor of between 1.5 and 3.4 more aerosol mass. Guidelines for musical performances should be based on the loudness and duration of the vocalization, the number of participants and the environment in which the activity occurs, rather than the type of vocalization.Mitigations such as the use of amplification and increased attention to ventilation should be employed where practicable.

The performing arts have been significantly restricted due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We report measurements of aerosol and droplet concentrations generated when playing woodwind and brass instruments and comparisons with breathing, speaking, and singing. These measurements were conducted in a room with zero number concentration aerosol background in the 0.5-20 μm diameter size range, allowing clear attribution of detected particles to specific activities. A total of 13 instruments were examined across 9 participants. Respirable particle number concentrations and size distributions for playing instruments are consistent with those from the participant when breathing, based on measurements with multiple participants playing the flute and piccolo as well as measurements across the entire cohort. Due to substantial interparticipant variability, we do not provide a comparative assessment of the aerosol generated by playing different instruments, instead considering only the variation in aerosol yield across all instruments studied. Both particle number and mass concentrations from playing instruments are lower than those from speaking and singing at high volume, and no large droplets >20 μm diameter are detected. Combined, these observations suggest that playing instruments generates less aerosol than speaking or singing at high volumes. Moreover, there is no difference between the aerosol concentrations generated by professional and amateur performers while breathing, speaking, or singing, suggesting conclusions for professional singers may also apply to amateurs.

The results show a measured significant improvement in olfaction following functional Septorhinoplasty but not a subjective improvement in the patients perception of their sense of smell and hence not a clinically significant difference. The reasons for the measured improvement are not clear and are likely to be multifactorial.

Aerosol particles of respirable size are exhaled when individuals breathe, speak and sing and can transmit respiratory pathogens between infected and susceptible individuals. The COVID-19 pandemic has brought into focus the need to improve the quantification of the particle number and mass exhalation rates as one route to provide estimates of viral shedding and the potential risk of transmission of viruses. Most previous studies have reported the number and mass concentrations of aerosol particles in an exhaled plume. We provide a robust assessment of the absolute particle number and mass exhalation rates from measurements of minute ventilation using a non-invasive Vyntus Hans Rudolf mask kit with straps housing a rotating vane spirometer along with measurements of the exhaled particle number concentrations and size distributions. Specifically, we report comparisons of the number and mass exhalation rates for children (12–14 years old) and adults (19–72 years old) when breathing, speaking and singing, which indicate that child and adult cohorts generate similar amounts of aerosol when performing the same activity. Mass exhalation rates are typically 0.002–0.02 ng s −1 from breathing, 0.07–0.2 ng s −1 from speaking (at 70–80 dBA) and 0.1–0.7 ng s −1 from singing (at 70–80 dBA). The aerosol exhalation rate increases with increasing sound volume for both children and adults when both speaking and singing.

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