As unprecedented as the outbreak of COVID-19 felt, it was far from the first time a deadly disease has swept the globe. dating as far back as 430 B.C. Records tell us how these diseases spread and how many people died, but not people鈥檚 personal experiences of the crises.听听

COVID-19 presented a rare opportunity to document in real-time how people processed the tumult of a pandemic, and how necessary public health measures affected their lives. Starting in the earliest days of the 2020 outbreak, a team of researchers at the 91爆料 conducted real-time surveys of King County residents, asking what measures people had taken to protect themselves, how their daily lives had been affected and what worried them most. 听

The results, , provide a glimpse into the subtle effects that public health measures like social distancing and stay-at-home orders had on the community.听听

91爆料 News spoke with , research scientist at the 91爆料 Collaborative on Extreme Event Resilience, and a 91爆料 assistant professor of environmental and occupational health sciences and director of the new , to discuss the study, how people experienced those early months and what public health practitioners can learn for future pandemics.听听

It鈥檚 been four years since COVID-19 changed all our lives, and more than two years since we started to emerge into this new normal. Why is it important to share this research now, to understand people鈥檚 experiences of the pandemic and collective efforts to limit COVID鈥檚 spread?听听

Kathleen Moloney: Unfortunately, COVID-19 is unlikely to be the last pandemic we face. To fully understand this pandemic鈥檚 impacts and better prepare for the next, we need research studies like ours 鈥� where data was collected in real time, from March to May of 2020 鈥� that document the lived experiences of communities during the pandemic. For example, by documenting how people in King County experienced the social distancing measures in real-time, our study provides valuable insights into which negative impacts were most acute during the early stages of the pandemic. Our results, combined with evidence from other research studies, can provide direction for researchers and policymakers to explore effective interventions for future pandemics.听

Nicole Errett: It is really important to start collecting data in the immediate aftermath of a disaster to understand effects on health and well-being, but researchers face a variety of administrative, logistical and ethical challenges when designing rapid-response research studies. By sharing our approach in this paper, we can provide ideas and guidance for other investigators while designing studies for future disasters, whether those are caused by an infectious disease or natural hazard.听听

The COVID-19 pandemic has been unprecedented in a lot of ways, and was for most Americans the most significant disruption to our daily lives ever. How unusual are events like this in human history? What do we know about how past pandemics and epidemics have affected the people who lived through them?听听

KM: During the height of the COVID-19 pandemic, we often heard comparisons to the 1918 influenza pandemic, as closures of schools, businesses and other community gathering spaces were implemented in response to both. However, it isn鈥檛 really possible to compare the experiences of those who lived through COVID-19 with those who lived through the 1918 Flu and other pandemics throughout history, because there weren鈥檛 any research studies conducted at the time to document those experiences. That鈥檚 why rapid-response disaster research, like our study, is so important.听听

In the paper you evaluate the unintended impacts of efforts to slow the pandemic, like people losing their jobs and students falling behind in school. How do you think about that delicate balance between public health and individual well-being?听听

KM: I don鈥檛 think of protecting public health and individual well-being as opposing priorities that need to be balanced. Public health, as a field, is dedicated to protecting and improving the health and well-being of the individuals that make up communities. Disruptions to employment and schooling can negatively impact long-term health outcomes, and ideally, these potential consequences should be considered when thinking through the type and duration of social distancing measures. Unfortunately, all the empirical research needed to inform those decisions was limited prior to this pandemic.听听

You asked participants about steps they took to protect themselves at the height of the pandemic. Some steps had pretty low rates of participation 鈥� for example, only 63% of people said they stopped going to the gym, and 82% of people avoided large gatherings. What does that say about the effectiveness of our collective response to the pandemic?听听

KM: I want to give the caveat that our survey only captured participants鈥� self-reported behavior at a single point in time. For example, someone who responded to the survey on March 19th, 2020, that they had not stopped going to the gym might have stopped the next week, when the statewide Stay Home, Stay Safe order was issued. Our survey was also a convenience sample, and therefore shouldn鈥檛 be considered representative of the compliance of King County residents as a whole with various social distancing recommendations.听听

With that said, those numbers were still slightly surprising. The narrative we often hear of public acceptance of COVID-19 social distancing measures is that compliance was initially high, and then decreased over time due to factors such as message fatigue 鈥� there鈥檚 research documenting this phenomenon. We need additional research to confirm this, but our results might indicate that there was also an initial lag in compliance with the social distancing recommendations implemented in response to COVID-19.听听

Overall, these measures still appear to have been effective, despite imperfect or slightly delayed compliance among certain residents.听

NE: At the time of our survey, our understanding of disease transmission was still evolving. It鈥檚 possible that people took measures they thought were protective (like hand washing) while attending these gatherings, based on their understanding of transmission at the time. It would have been interesting to re-survey folks at various time points throughout the pandemic to see how their behavior evolved as the pandemic, and our understanding of the disease, progressed.听

You evaluated participants鈥� well-being as described in their written stories about their experience. What trends appeared there, and were they what you expected to find?听听

KM: Two findings surprised me in particular. First, less than half of our participants described impacts to their social life 鈥� I expected the percentage to be much higher. It would be interesting to know how that result might change if we surveyed the same participants at a later point in the pandemic, when social distancing measures had been in place for longer. I was also surprised to see the poorest average well-being reported by those over the age 65, and the highest average well-being reported by 18-to-34 year olds. This is in contrast to several other national-scale studies in the US and Europe, which found worse mental health impacts in young adults.听听

Given that older adults are more likely to reside alone in the U.S. than in most other countries and report high rates of social isolation and loneliness even during non-pandemic times, interventions to mitigate the mental health impacts of future pandemics on older adults probably deserve special attention.听听

In their written responses, participants most frequently described a negative financial or employment-related impact, even more than social impacts. How might that change how we prepare to help people through future crises?听听

KM: Knowing which negative impacts are most prevalent at various points in the pandemic, and how these impacts differ between groups, can help us develop more specific, more effective interventions to prevent these unintended consequences in the future. We saw that employment and financial impacts were the top concern for every age group except those 65 and older 鈥� this group expressed higher concern about physical health and social impacts. So while an early intervention to mitigate the financial impacts of a future crisis on younger adults could be effective, we would likely want to prioritize different resources for older adults.听听

What鈥檚 also interesting is that many of the concerns our participants reported, both in written narratives and the close-ended survey questions, were about impacts to others, rather than themselves. Concern and empathy for fellow community members鈥� well-being is something that we should want to cultivate for many reasons, but specifically in a pandemic context, there鈥檚 evidence that decreased concern for others鈥� well-being is correlated with decreased compliance with non-pharmaceutical interventions. Something we should also think about while preparing for future crises is how we can foster the concern for others and the sense of community that were clearly present during the early stages of the pandemic to make sure they endure.听听

NE: The pandemic influenced the development 鈥� or at least accelerated the uptake 鈥� of systems that allowed many folks to work safely from the comfort of their own home without financial or employment impacts. However, folks with jobs in 鈥渆ssential鈥� services and sectors often had to physically report to work, and often interface with the public. My colleague, Marissa Baker, found that . Accordingly, I鈥檇 suspect that employment and financial concerns would be disproportionately borne among lower wage workers, who would have to choose between their health and safety and their income. In advance of the next pandemic, we need to figure out ways to keep these folks safe and at work.听听

For more information, contact Errett at nerrett@uw.edu or Moloney at kmoloney@uw.edu.听

Early in the COVID-19 pandemic, as it became clear that people with suppressed immune systems were particularly vulnerable to the worst of the virus, public health officials prioritized their protection. Leaders presented stay-at-home orders and masking requirements as measures to prevent the virus from spreading to high-risk individuals. And when vaccines became available, many governments placed immunocompromised 听people near the front of the line. 听

All the while, public health officials believed only about 3% of the American population was immunocompromised.听听

New research from the 91爆料 suggests that number may have been a drastic undercount. The study, p, places the prevalence of immunosuppression at around 6.6% of American adults 鈥� more than twice as high as previously understood. That rise could have broad implications for how we navigate the late stages of COVID-19 and prepare for future pandemics. 听

91爆料 News spoke with co-author , a 91爆料 associate professor of social work, about the reasons behind the rise and how public health officials can better serve this growing population.听

Immunosuppression and the experiences of immunocompromised people have become more visible in recent years, with the COVID-19 pandemic and our collective attempts to slow its spread. How has that added visibility affected people鈥檚 experiences?听听

Melissa Martinson: The COVID-19 pandemic really brought the experiences of immunosuppressed (more commonly called immunocompromised) people to the public attention, and the voices of this population and other medically vulnerable people were important to how people interacted in their communities in the early days of the pandemic. Early in the pandemic, public health guidance was focused on protecting medically vulnerable people. Four years on, that guidance has changed, and most folks are engaging in activities similarly to before the pandemic.听听

However, for some immunocompromised people, the lack of community protections today despite their continued risk of contracting COVID-19, can be an isolating experience. 听

You set out to find a better estimate of the prevalence of immunosuppression nationwide. Why is a more accurate number important? 听

MM: We were surprised by reports in the popular media that said about 3% of American adults were immunocompromised. Much of my research focuses on framing U.S. health in an international context, and we had seen estimates of immunocompromise prevalence in countries like the United Kingdom and Canada that were much higher than the widely reported American estimate. 听

Getting an updated and accurate estimate is important because immunosuppressed people are more likely to experience viral and bacterial infections, and these infections are more likely to be severe. We also now know that this population is still advised to take precautions against COVID-19 due to the higher risk of serious outcomes like hospitalization, death, and long COVID. This is a group who also has access to public health tools like additional vaccine doses and antiviral treatment (such as Paxlovid) regardless of age, so it is important that these tools are readily available to this population.Having an accurate estimate of the prevalence of immunosuppression can ensure that we have adequate supply of these tools.听

You estimate that about 6.6% of American adults have immunosuppression, which is more than twice as high as the figure in 2013 (2.7%). That鈥檚 quite the jump. What鈥檚 behind it? 听

MM: Unfortunately, we can鈥檛 answer this question definitively with the available data. However, we know that since prevalence was last estimated, immunosuppressive therapies for autoimmune diseases have been prescribed much more frequently and more of these medications are available. It might also be that more people have a better understanding of their immunocompromised health status due to conversations with their healthcare providers during the COVID-19 pandemic, along with awareness from public health guidance.

We also found that the proportional increase in prevalence was almost 2.5 times between 2013 and 2021, and this increase was even higher for some subpopulations including males, people with Hispanic ethnicity, adults under 50, and older adults ages 70 to 79. 听

You write that the COVID-19 pandemic may have contributed to the increase of immunosuppression prevalence. One obvious possibility is that the virus itself weakened people鈥檚 immune systems, but do you see any other ways in which the pandemic might have contributed to that rise?听

MM: New evidence does suggest that COVID-19 leads to an increased risk of autoimmune conditions that may result in immunosuppression either through the condition itself or medication to treat the condition. We also looked at the data available for the second half of 2020, and the rates were similar to 2021. To us, this suggests that more people may have been informed about their immunosuppressed status in light of the COVID-19 pandemic and conversations they may have had with their healthcare providers due to their increased risk of serious outcomes from infection.听听

From a public health perspective, what changes might we need to consider making in the face of these findings? How do we help to protect a population that might be twice as large as previously thought?听听

MM: It is important to note that almost 1 in 15 adults is immunosuppressed and that this population may need additional precautions in workplaces, schools and universities, and especially medical settings. Making sure that our gatherings and built environment are accessible to people who are at greater risk is something that we can all do. Measures such as ventilation, air filtration, and mask use can protect immunocompromised people in public settings.听听

The pandemic has been a difficult time for everyone, but this is a medically vulnerable group who is still advised to follow precautions that many people have given up at the end of the public health emergency in 2023. Given the recent changes in COVID-19 isolation guidelines from the CDC, it is important for the public 鈥� and policymakers 鈥� to consider that between older adults and this immunosuppressed population at high risk, it is worthwhile to use and promote tools like testing, vaccines, sick leave and staying home when ill, and use of masks or respirators to reduce virus spread to vulnerable people.听

For more information, contact Martinson at melmart@uw.edu. 听

Infants whose mothers test positive for COVID-19 tend to develop less-severe symptoms than their parents, if they become infected with the virus at all.

In one of the first studies to explore how COVID-19 specifically affects older infants, researchers from the 91爆料 and at institutions at four other locations in the Western and Southern U.S. found that the number of infected people in a household was the factor most closely linked with the infant鈥檚 likelihood of being infected.

鈥淭he focus on infants early in the pandemic was about possible transmission risks during pregnancy, birth or through breastfeeding, but there were other questions about the risks in the household to infants and other children when caregivers are sick,鈥� said , assistant professor of anthropology at the 91爆料 and the first author of the , which published Oct. 12 in Frontiers in Immunology. 鈥淚nfants are in the most contact, and very close contact, with their caregiver than with any other family members. And so we asked, how much are infants at risk, and how do you protect children when they are sick?鈥�

The study analyzed surveys and antibody results (taken from pin-prick blood samples) of 46 pairs of COVID-positive mothers and their infants for two months following maternal infection. Infants were at least 1 month old, and COVID-positive mothers were enrolled in the study within days, sometimes hours, of receiving their positive PCR test results. The researchers also recruited a comparative group of 11 COVID-negative mothers, who tested negative after exposure or symptoms, and a control group of 26 mothers with no known COVID exposures or symptoms.

In all, about half of the infants of COVID-positive mothers developed symptoms or antibodies indicative of COVID-19 infection. The rates of infection and symptoms in those infants were similar to those of other household children, but lower than for fathers and other household adults. None of the COVID-negative mothers or their infants tested positive for SARS-CoV-2 antibodies, including one infant who tested PCR positive. While nearly half of the mothers in the control group had antibodies targeting SARS-CoV-2, likely signaling a previous infection they were unaware of, none of their infants did.

Infant age and maternal symptoms were not associated with risk of infection among infants of COVID-positive mothers, but families with greater numbers of infected family members were more likely to have infants who had tested positive.

鈥淚nfant infection was mostly related to household infection. The risks to infants were not stemming solely from their mothers; there was just transmission in the household,鈥� Martin said.

Researchers noted that the study was limited by its overall sample size, and that data relied on participants鈥� own reports and collection of blood samples. With some COVID symptoms nearly impossible to assess among infants 鈥� headache, loss of smell or taste 鈥� and others, such as a runny nose, common outside of COVID, researchers noted that parental perception of symptoms could vary.

The study was conducted from June 2020 to March 2021, before vaccines were widely available, though one COVID-positive mother and some of the mothers in the control group had received a first dose during the study. The researchers removed the samples taken after vaccination from their analyses, but observed antibody responses following vaccination in those mothers.

Nearly all infants in the study were breastfeeding. While the researchers weren鈥檛 able to directly test for protective effects of breastfeeding against infection, the breastfed infants who had been exposed to COVID did not appear to be at higher risk of infection than other children and adults in the household. In , the researchers found that none of the milk collected from the infected mothers contained SARS-CoV-2 virus. Most milk samples contained antibodies to the virus for up to two months following infection.

鈥淥verall, the risks to COVID-19 exposed infants in this study were minimal. The findings support recommendations for infected mothers and other caregivers to continue infant care and feeding as usual, including breastfeeding,鈥� Martin said.

The study was funded by the National Science Foundation, the Bill & Melinda Gates Foundation, the National Institutes of Health, the USDA National Institute of Food and Agriculture, the 91爆料 Center for Studies in Demography and Ecology, the 91爆料 Department of Anthropology, and the Washington State University Health Equity Research Center.

For the full list of co-authors from institutions in Washington, Idaho and Louisiana, see the paper in .

For more information, contact Martin at martin7@uw.edu.

First, pause and take a deep breath.

When we breathe in, our lungs fill with oxygen, which is distributed to our red blood cells for transportation throughout our bodies. Our bodies need a lot of oxygen to function, and healthy people have at least 95% oxygen saturation all the time.

Conditions like asthma or COVID-19 make it harder for bodies to absorb oxygen from the lungs. This leads to oxygen saturation percentages that drop to 90% or below, an indication that medical attention is needed.

In a clinic, doctors monitor oxygen saturation using pulse oximeters 鈥� those clips you put over your fingertip or ear. But monitoring oxygen saturation at home multiple times a day could , for example.

In a proof-of-principle study, 91爆料 and University of California San Diego researchers have shown that smartphones are capable of detecting blood oxygen saturation levels down to 70%. This is the lowest value that pulse oximeters should be able to measure, as recommended by the U.S. Food and Drug Administration.

The technique involves participants placing their finger over the camera and flash of a smartphone, which uses a deep-learning algorithm to decipher the blood oxygen levels. When the team delivered a controlled mixture of nitrogen and oxygen to six subjects to artificially bring their blood oxygen levels down, the smartphone correctly predicted whether the subject had low blood oxygen levels 80% of the time.

The team Sept. 19 in npj Digital Medicine.

“Other smartphone apps that do this were developed by asking people to hold their breath. But people get very uncomfortable and have to breathe after a minute or so, and that’s before their blood-oxygen levels have gone down far enough to represent the full range of clinically relevant data,” said co-lead author , a 91爆料 doctoral student in the Paul G. Allen School of Computer Science & Engineering. “With our test, we’re able to gather 15 minutes of data from each subject. Our data shows that smartphones could work well right in the critical threshold range.”

Another benefit of measuring blood oxygen levels on a smartphone is that almost everyone has one.

“This way you could have multiple measurements with your own device at either no cost or low cost,” said co-author , professor of family medicine in the 91爆料 School of Medicine. “In an ideal world, this information could be seamlessly transmitted to a doctor’s office. This would be really beneficial for telemedicine appointments or for triage nurses to be able to quickly determine whether patients need to go to the emergency department or if they can continue to rest at home and make an appointment with their primary care provider later.”

The team recruited six participants ranging in age from 20 to 34. Three identified as female, three identified as male. One participant identified as being African American, while the rest identified as being Caucasian.

To gather data to train and test the algorithm, the researchers had each participant wear a standard pulse oximeter on one finger and then place another finger on the same hand over a smartphone’s camera and flash. Each participant had this same set up on both hands simultaneously.

“The camera is recording a video: Every time your heart beats, fresh blood flows through the part illuminated by the flash,” said senior author , who started this project as a 91爆料 doctoral student studying electrical and computer engineering and is now an assistant professor at UC San Diego’s and the Department of Electrical and Computer Engineering.

“The camera records how much that blood absorbs the light from the flash in each of the three color channels it measures: red, green and blue,” said Wang, who also directs the . “Then we can feed those intensity measurements into our deep-learning model.”

Each participant breathed in a controlled mixture of oxygen and nitrogen to slowly reduce oxygen levels. The process took about 15 minutes. For all six participants, the team acquired more than 10,000 blood oxygen level readings between 61% and 100%.

The researchers used data from four of the participants to train a deep learning algorithm to pull out the blood oxygen levels. The remainder of the data was used to validate the method and then test it to see how well it performed on new subjects.

“Smartphone light can get scattered by all these other components in your finger, which means there’s a lot of noise in the data that we’re looking at,” said co-lead author , a 91爆料 alumnus who is now a doctoral student advised by Wang at UC San Diego. “Deep learning is a really helpful technique here because it can see these really complex and nuanced features and helps you find patterns that you wouldn’t otherwise be able to see.”

The team hopes to continue this research by testing the algorithm on more people.

“One of our subjects had thick calluses on their fingers, which made it harder for our algorithm to accurately determine their blood oxygen levels,” Hoffman said. “If we were to expand this study to more subjects, we would likely see more people with calluses and more people with different skin tones. Then we could potentially have an algorithm with enough complexity to be able to better model all these differences.”

But, the researchers said, this is a good first step toward developing biomedical devices that are aided by machine learning.

“It’s so important to do a study like this,” Wang said. “Traditional medical devices go through rigorous testing. But computer science research is still just starting to dig its teeth into using machine learning for biomedical device development and we’re all still learning. By forcing ourselves to be rigorous, we’re forcing ourselves to learn how to do things right.”

Additional co-authors are , a doctoral student at Southern Methodist University; , associate professor of computer science at Southern Methodist University; , who completed this research as a 91爆料 undergraduate student; and , 91爆料 professor in both the Allen School and the electrical and computer engineering department. This research was funded by the 91爆料. The researchers have applied for a patent that covers systems and methods for SpO2 classification using smartphones (application number: 17/164,745).

For more information, contact Hoffman at jasonhof@cs.washington.edu, Wang at ejaywang@eng.ucsd.edu and Viswanath at varunv9@eng.ucsd.edu. For questions specifically for Matthew Thompson, please contact Leila Gray at leilag@uw.edu.

But new research, using cellphone location data, shows that visits to restaurants that identify as Black-owned, compared to those without a label, dropped off after some initial spikes and were inconsistent across 20 U.S cities.

Authors of the study, led by the 91爆料, say the findings raise questions about the effectiveness of such a labelling campaign, and how tech companies and even local governments could better support communities of color, whether through such programs or other means.

鈥淏ig tech plays an increasingly influential role in almost every aspect of our everyday life, especially in today鈥檚 economic recovery, and the Black-owned labelling campaign appears to be well-intended,鈥� said , an associate professor of geography at the 91爆料 who led the study through his . 鈥淏ut what have been the consequences? As allyship to minorities has become a core value of our time,听how can big tech become a better and more inclusive ally? This research provides a timely case study.鈥�

and have documented how the pandemic has exacerbated social and health disparities. And while the city- and statewide lockdowns of the pandemic鈥檚 early months had significant economic impacts, , less is known about specific businesses, in specific communities, over time.

The , published online Aug. 25 in the Annals of the American Association of Geographers, is among the first to use cellphone location data to estimate restaurant visits, and to use that data to compare impacts.

Several companies initiated a 鈥淏lack-owned鈥� labelling campaign in spring 2020. The program generally allows an owner to identify their business as 鈥淏lack-owned,鈥� and, through online reviews, customers can comment on ownership or other aspects of the business.

With Yelp鈥檚 鈥淏lack-owned鈥� label as a guide, researchers then turned to visitation records from SafeGraph, which collects points-of-interest data from the GPS systems of 45 million mobile devices in the U.S. Researchers selected 20 major cities as their sample, to represent a geographic and demographic range, including Chicago, Detroit, New York and Seattle.

Overall, the researchers found there were statistically significant differences between Black-owned and 鈥渙wnership-unreported鈥� restaurants throughout the 20 cities, primarily measured by relative declines in visits. New Orleans and Detroit showed the greatest disparities, while New York showed the least. Looking at just the first few months after the labelling began, cities such as Baltimore, Denver, and Charlotte, North Carolina, were among those that showed higher spikes in visits to Black-owned restaurants than those whose ownership was unreported.

Due to the number of cities involved, and the fluctuations in the number of visitors at various stages of the pandemic, broader explanations are harder to draw. Early in the pandemic, visits to Black-owned businesses outpaced those to ownership-unreported businesses, peaking in June and July, but eventually declines led to larger disparities between businesses with and without the label.

Further research could explore the different outcomes within and among cities, Zhao said, and, through ethnographic fieldwork and interviews, how the labelling program affected individual businesses. The study cites reports of fake reviews at a Black-owned antique store in Brooklyn to underscore the possibility of harassment and other negative impacts from an online label.

First author , an assistant professor of geosciences at the University of Arkansas, said the study鈥檚 findings illuminate another example of how communities of color have suffered more negative impacts over the past two years.

鈥淭he voices of the听minority, the vulnerable, and others who have been disproportionately affected by the COVID-19 pandemic need to be heard,鈥� Huang said.

The results reveal how a label alone doesn鈥檛 necessarily generate sustained positive results, Zhao said. Tech companies have a responsibility, in launching such a program, to think through consequences, listen to business owners and provide supports, including a way for businesses to opt out. But currently, a complete opt-out appears impossible. While a restaurant can terminate the use of the label on a particular platform, previous online reviews, for example, could turn it up.

鈥淚t is easy for tech companies to set up an opt-out mechanism, but it is extremely difficult to stop the proliferation of the ownership information if it has been reposted to other outlets or platforms. So, the tech company should inform the business owner of the risk of that information remaining available even after the opt-out,鈥� Zhao said.

Local government agencies, too, can learn from how Black-owned restaurants experienced the pandemic differently, and use the cellphone location data to inform place-based relief strategies in the future, Zhao said.

The study was funded by the Department of Geography Research Fund at the 91爆料. Additional co-authors were , a graduate student in the 91爆料 Department of Geography; Shaozeng Zhang of Oregon State University; and at the University of South Carolina.

For more information, contact Zhao at zhaobo@uw.edu.

This release includes material from the University of Arkansas.听

Your immune system鈥檚 ability to combat COVID-19, like any infection, largely depends on its ability to replicate the immune cells effective at destroying the SARS-CoV-2 virus that causes the disease. These cloned immune cells cannot be infinitely created, and a key hypothesis of a new 91爆料 study is that the body鈥檚 ability to create these cloned cells falls off significantly in old age.

According to a model created by 91爆料 research professor , this genetically predetermined limit on your immune system may be the key to why COVID-19 has such a devastating effect on the elderly. Anderson is the lead author of a paper detailing this modeled link between aging, COVID-19 and mortality.

鈥淲hen DNA split in cell division, the end cap 鈥� called a telomere 鈥� gets a little shorter with each division,鈥� explains Anderson, who is a modeler of biological systems in the School of Aquatic and Fishery Sciences. 鈥淎fter a series of replications of a cell, it gets too short and stops further division. Not all cells or all animals have this limit, but immune cells in humans have this cell life.鈥�

The average person鈥檚 immune system coasts along pretty good despite this limit until about 50 years old. That鈥檚 when enough core immune cells, called T cells, have shortened telomeres and cannot quickly clone themselves through cellular division in big enough numbers to attack and clear the COVID-19 virus, which has the trait of sharply reducing immune cell numbers, Anderson said. Importantly, he added, telomere lengths are inherited from your parents. Consequently, there are some differences in these lengths between people at every age as well as how old a person becomes before these lengths are mostly used up.

Anderson said the key difference between this understanding of aging, which has a threshold for when your immune system has run out of collective telomere length, and the idea that we all age consistently over time is the 鈥渕ost exciting鈥� discovery of his research.

鈥淒epending on your parents and very little on how you live, your longevity or, as our paper claims, your response to COVID-19 is a function of who you were when you were born,鈥� he said, 鈥渨hich is kind of a big deal.鈥�

To build this model the researchers used publicly available data on COVID-19 mortality from the Center for Disease Control and US Census Bureau and studies on telomeres, many of which were published by the co-authors over the past two decades.

Assembling telomere length information about a person or specific demographic, he said, could help doctors know who was less susceptible. And then they could allocate resources, such as booster shots, according to which populations and individuals may be more susceptible to COVID-19.

鈥淚鈥檓 a modeler and see things through mathematical equations that I am interpreting by working with biologists, but the biologists need to look at the information through the model to guide their research questions,鈥� Anderson said, admitting that 鈥渢he dream of a modeler is to be able to actually influence the great biologists into thinking like modelers. That鈥檚 more difficult.鈥�

One caution Anderson has about this model is that it might explain too much.

鈥淭here鈥檚 a lot of data supporting every parameter of the model and there is a nice logical train of thought for how you get from the data to the model,鈥� he said of the model鈥檚 power. 鈥淏ut it is so simple and so intuitively appealing that we should be suspicious of it too. As a scientist, my hope is that we begin to understand further the immune system and population responses as a part of natural selection.鈥�

Co-authors include Ezra Susser, Mailman School of Public Health, Columbia University; Konstantin Arbeev and Anatoliy Yashin, Social Science Research Institute, Duke University; Daniel Levy, National Heart, Lung, and Blood Institute, National Institutes of Health; Simon Verhulst, University of Groningen, Netherlands; Abraham Aviv, New Jersey Medical School, Rutgers University.

###

For more information, contact Anderson at jjand@uw.edu.

With the start of spring quarter on March 28, face masks became optional 鈥� but still recommended 鈥� inside most 91爆料 facilities. Wearing a face covering for the first two weeks of the quarter is strongly recommended, and anyone who wishes to wear a mask throughout the quarter is encouraged and welcome to do so.

You may be asked by other people, or may ask other people, to wear a mask while around each other. While you are not required to wear a mask, please remember that other people may need to or choose to wear 鈥� or not wear 鈥� masks for a wide range of reasons. It is important to be clear, in any request, that masks are optional and that wearing a mask or not will have no impact on professional or academic evaluations, including grades.

In light of the policy change, 91爆料 News spoke with several 91爆料 experts about what to expect on campus, how the current science and transmission rates inform our policy, and emotions and feelings we may experience as a result of removing our face coverings.

Learn more in these university FAQs that address various situations that students,听instructors听and听staff听may encounter.听

Read a recent message from the 91爆料’s Advisory Committee on Communicable Diseases听and a letter from 91爆料 President Ana Mari Cauce to students about changes for spring quarter.

Elvi Olano had been working for only a month as a custodian when she had an experience she鈥檚 never forgotten. While she was cleaning a bathroom, a professor walked in and yelled at her for keeping him, and the students around him, from using it. When she apologized, he said, 鈥淵ou鈥檙e ridiculous.鈥�

Olano, an immigrant from the Philippines, didn鈥檛 have strong English skills at the time, so she didn鈥檛 know what 鈥渞idiculous鈥� meant 鈥� although she could tell he was angry from the tone of his voice. As the students stared at her, she started to cry.

A friend helped her report the incident, and news of it made its way to the department chair. The chair called a meeting the next morning to make it clear behavior like that wasn鈥檛 acceptable. But for Olano, remembering the humiliation still hurts, 16 years later.

鈥淭hey should respect us,鈥� she said, referring to professors, students and all those who benefit from her work.

The is calling on the 91爆料 community to do just that. The volunteer-led effort, which is not affiliated with 91爆料, is advocating for custodians, lifting their voices and raising awareness about their important roles on campus. As part of the project, an art exhibit called 鈥�(in)Visibility鈥� is hanging in 91爆料 Tower through March. It features photos taken by 16 custodians, paired with their testimonials.

The 91爆料 Custodian Project was started in March 2020 by Evalynn Fae Taganna Romano, the daughter of two 91爆料 custodians who earned her bachelor鈥檚 degree, and master鈥檚 degrees in social work and in public health, from the 91爆料. Custodians were continuing to report to work while the COVID-19 pandemic shut down much of campus life.

Inspired by her parents 鈥� who dedicated a total of nearly six decades to cleaning 91爆料 buildings 鈥� Romano brought food, coffee, hand-sewn masks and thank-you cards to custodians once a week, with support from friends, businesses and community organizations.

From there, the project grew from a way to show appreciation to include direct services and a larger advocacy effort. Many campus custodians are immigrants, refugees and people of color, groups that often are more vulnerable due to health and social inequities.

鈥淐ustodians might not feel comfortable telling leadership to their face what they need, and I think it’s really important to think about how to create intentional spaces for them to do that,鈥� Romano said. 鈥�91爆料 has a responsibility to take actions and structure policies that recognize the value and ensure the safety of their essential workers.鈥�

Romano based 鈥�(in)Visibility鈥� on a method she learned about while pursuing her master鈥檚 in public health and later used for her thesis. Called , it incorporates voices of community members in research. She started recruiting participants for photography-based storytelling sessions in August 2020 to learn more about the health impacts of their workplace and home. She then asked custodians to take photos and conducted group sessions with the custodians to collect their testimonials.

The exhibit made its debut in the Art Building in September 2021 鈥� the building Romano鈥檚 mother has been caring for since 1997 鈥� with the idea that it would rotate to a different building on campus each quarter.

The photos, documenting custodians鈥� lives on and off campus, reflect the time we live in. One picture entitled 鈥淢y Yellow Shield鈥� shows a custodian鈥檚 cart. In the accompanying quote, the custodian talks about how the cleaning materials in the cart shield us from COVID-19.

Gina Tabasan took a picture of one of the surgical masks she receives at work each day. “I was thinking, will this help us for preventing COVID?鈥� Tabasan said in an interview. 鈥淥r how will it help if we don’t have the shot yet? How will it help if it鈥檚 wet?”

Olano took a picture of her squash plant. She eats squash every day because 鈥渋t’s one of the fruits that can be a vitamin for health” 鈥� something that has been particularly important to her as she looks for protection from COVID-19.

These photos capture the anxiety custodians experienced during the height of the pandemic.

“It was horrible, it really was,鈥� said a custodian, who wishes to be identified by her initials, K.P. Although 91爆料 provided some protective equipment, K.P. said it was unnerving going into an uncertain environment. 鈥淲e didn’t know what we were going to be exposed to. We had to do all this extra deep cleaning.鈥�

Another theme of the exhibit is the pride the custodians have in their work. Photos show clean floors, custodians on the job or the machines they use.

鈥淏eing a custodian is not as easy as people think,鈥� Tabasan said. 鈥淎 nurse or a doctor, they save lives. We save them, too, because without us, buildings are dirty. Students and staff can get sick. We are the army protecting you from the garbage.鈥�

Photos also show things or practices that bring comfort, like birds on campus or a walk during break time. K.P.鈥檚 photo is of artwork with lines from a Native American proverb, reflecting her heritage: 鈥淟ive strong as the mountains. Walk tall as the trees. Be known by the tracks that you leave.鈥�

Romano said her childhood was filled with memories of going to other custodians鈥� homes with her parents. When she was a student, she鈥檇 drop in at lunchtime potlucks. Tabasan and Olano get relief from their jobs by taking breaks together, an activity that has been restricted during the pandemic. Many extend this feeling of camaraderie to the 91爆料 community.

鈥淚 can’t speak for all custodians, but I know that there are a lot of them who see people on campus like family, especially the people they interact with,鈥� Romano said. 鈥淢uch like you would with your family, they see it as their job to protect them and make sure that they’re safe and healthy.鈥�

And sometimes people show that the feeling is mutual. Olano remembers a professor who offered to help her with the U.S. citizenship test. Olano was scared that she wouldn鈥檛 be able to pass, but the professor took time to get to know her, which made Olano comfortable enough to try. The professor then tutored her every day for three weeks.

“It was the happiest moment I had here. I passed the citizenship test,鈥� Olano said. 鈥淚 cannot forget her.”

The custodians interviewed for this story say that they don鈥檛 always feel the care they give is returned 鈥� for example, when people throw garbage on the floor. But there are also many who say hello and express thanks, a gesture the custodians all said they appreciate.

“I love to be here. I love to see all the faces. I love to talk. I love to say 鈥榟i鈥� and 鈥榖ye,鈥欌�� said Elsa Tesfai. 鈥淪ome people will talk to you about their lives, and they come to me like a human being. I feel so happy when they tell me their story, because they don’t just say, ‘She’s a custodian. Why do I have to speak with her?’鈥�

Tesfai arrived in the U.S. in 1991 as a refugee from East Africa with two children. She went to community college but for only two quarters. It was hard to get childcare, and she had to take a bus across town. Now, she watches students pursue a dream that wasn鈥檛 available to her. Missing the connection with the people on campus, along with the fear of COVID-19, is what made the height of the pandemic so hard for her.

“It was ugly because no one was here. Even though we got paid, I didn鈥檛 have peace in my heart,鈥� Tesfai said. 鈥淚 have to see them getting their education. For me, if I don’t see them, I’m suffering.”

鈥�(in)Visibility鈥� is on display in 91爆料 Tower on the lobby level past the elevators through March 31.

Researchers at the 91爆料 have developed a new test for COVID-19 that combines the speed of over-the-counter antigen tests with the accuracy of PCR tests that are processed in medical labs and hospitals.

The Harmony COVID-19 test is a diagnostic test that, like PCR tests for COVID-19, detects genetic material from the SARS-CoV-2 virus. But whereas conventional PCR tests can take several hours, the Harmony kit can provide results in less than 20 minutes for some samples and with similar accuracy.

鈥淲e designed the test to be low-cost and simple enough that it could be used anywhere,鈥� said , a 91爆料 associate professor of bioengineering and investigator with the Brotman Baty Institute for Precision Medicine. 鈥淲e hope that the low cost will make high-performance testing more accessible locally and around the world.鈥�

Lutz is senior author on a published Dec. 15 in Science Advances that describes the Harmony COVID-19 test kit. The researchers developed Harmony to be simple and easy-to-use, employing ready-to-use reagents. The test uses a 鈥淧CR-like鈥� method to detect the presence of the SARS-CoV-2 RNA genome in a nasal swab sample with the aid of a small, low-cost detector, which was also designed by Lutz鈥檚 group. A smartphone is used to operate the detector and read the results. The detector can handle up to four samples at a time and would fit into a standard car鈥檚 glove compartment.

The accuracy of COVID-19 tests has been a pressing matter throughout the pandemic. Many at-home antigen kits for COVID-19, which detect pieces of the proteins the virus creates instead of its genetic material, are 80-85% accurate, though accuracy may drop with the omicron variant, which harbors a relatively high number of mutations not found in other strains. PCR tests are generally 95% accurate or better 鈥� a key FDA benchmark 鈥� but require expensive equipment and a long wait for results.

Initial results reported in the paper show that the Harmony kit is 97% accurate for nasal swabs. The Harmony kit detects three different regions of the virus鈥� genome. If a new variant has many mutations in one region, the new test can still detect the other two. It can, for example, detect the omicron variant, which has dozens of mutations in the region of the genome that encodes the so-called spike protein.

Though tests based on PCR 鈥� or polymerase chain reaction 鈥� are highly accurate, a key limitation is that PCR tests require dozens of cycles of heating and cooling to detect genetic material in a sample. The test developed by the 91爆料 team sidesteps this issue by relying on a PCR-like method known as RT-LAMP, which doesn鈥檛 have the same stringent temperature-cycling requirements.

鈥淭his test operates at a constant temperature, so it eliminates the time to heat and cool and gives results in about 30 minutes,鈥� said Lutz.

Lutz and two colleagues spun out a new company from the 91爆料, Anavasi Diagnostics, which last year was supported by $300,000 from WE-REACH and received $14.9 million in grants from the National Institutes of Health to develop the Harmony prototype kit into a product and scale up manufacturing to help address the ongoing shortage of COVID-19 diagnostic tests.

Initially, Lutz and his team hope the kits could be made available first for use in clinics, as well as other settings with medical oversight, such as workplaces and schools. Later, they would like to adapt the test for home use.

鈥淔or a long time, the options have been either a PCR test that is expensive and typically takes a day or more to get a result, or a rapid antigen test that gives fast results and is low cost, but typically has lower accuracy than a lab PCR test,鈥� said Lutz. 鈥淔rom the first day, we designed our test to be manufacturable at low cost and high volume, while delivering fast results with PCR-like performance.鈥�

The NIH funding will support high-volume manufacturing at a new Anavasi facility near Seattle.

鈥淲e plan to make our test accessible and affordable throughout the world,鈥� said Lutz.

Lead author on the paper is Nuttada Panpradist, a recent 91爆料 doctoral alum in bioengineering. Second author is Enos Kline, a 91爆料 research scientist in bioengineering, who initiated the project in early 2020. Co-authors in the Department of Bioengineering are doctoral students Robert Atkinson, Ian Hull, Qin Wang, and Shane Gilligan-Steinberg; research scientists Michael Roller, Jack Henry Kotnik, Crissa Bennett and Daniel Leon; and doctoral alum Amy Oreskovic. Other co-authors, all at the 91爆料, are Victoria Lyon in the Department of Family Medicine; Matthew Thompson, a professor of global health and the Helen D. Cohen Endowed Professor in Family Medicine; Peter Han in the Department of Genome Sciences; Lea Starita, an assistant professor of genome sciences; and Paul Drain, an associate professor of global health, of medicine and of epidemiology. The research was funded by the Seattle Flu Study and the National Institutes of Health.

For more information, contact Lutz at blutz@uw.edu.

Now that the rainy season is here, culverts across the city are giving stormwater and streams a clear path away from streets and roads.

Before the rains come, the Washington Department of Transportation inspects these concrete or metal tunnels for any damage that . But there are a lot of spaces to inspect, and these spaces are often small and inaccessible for people.

So 91爆料 students created a rover, called the HydroCUB, that can enter sewer pipes, culverts or other tiny areas and send live video status reports back.

The team worked on the rover throughout the pandemic.

“The pandemic was challenging because I was separated from my family and my friends,” said lead researcher , a 91爆料 master’s student in the electrical and computer engineering department. “It was also challenging because I was in Minnesota and my teammate was in Seattle, so we had to ship things back and forth. In addition, issues with the supply chain meant that many of the parts were unavailable and we had to do extensive searching to find them. But knowing this project would solve a real-world issue made me feel uplifted.”

The goal is for WSDOT, which proposed the idea, to use the tool to look for vegetation, cracks, debris and other potential “fish-barriers” in culverts. HydroCUB is designed to operate from a distance through a 300-foot-long cable that supplies power to the rover and transmits video back to the operator.

This rover was designed as part of a two-quarter 91爆料 industry capstone program where students work with clients to design solutions to real-world problems. In this case, WSDOT asked the 91爆料 team to build a cheap but robust device to monitor culverts. The organization has been working with the 91爆料 team throughout the process to review its design and make suggestions. This capstone program is sponsored by the 91爆料 departments of civil and environmental engineering and of electrical and computer engineering.

“It is a thrill to work on something that is going to solve many issues,” Zhou said. “HydroCUB is one-of-a-kind that is both reliable and low-cost. It also provides a platform for future students to do more improvement or testing.”

For more information, contact Zhou at qishiz@uw.edu and lead 91爆料 faculty , professor of civil and environmental engineering, at fhossain@uw.edu.

To talk to someone at WSDOT about this project, contact , who has been working with the team, at KukesC@wsdot.wa.gov.