Is there anything good about menopause? Yep, here are 4 things to look forward to

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Menopause is having a bit of a moment, with less stigma and more awareness about the changes it can bring.

A recent senate inquiry recommended public education about perimenopause and menopause, more affordable treatments and flexible work arrangements.

But like many things in life the experiences of menopause are on a continuum. While some women find it challenging and require support, others experience some physical and emotional benefits. These are rarely reported – but we can learn from the research available and, importantly, from people’s lived experiences.

Here are four changes to look forward to once you reach menopause.

Insta_Photos/Shutterstock

1. No more periods or related issues

Menopause is considered “complete” 12 months after the final period of a woman (or person assigned female at birth) who previously menstruated.

Perhaps unsurprisingly, the benefit at the top of the list is no more periods (unless you are taking hormone therapy and still have your womb). This can be particularly beneficial for women who have had to manage erratic, unpredictable and heavy bleeding.

At last, you don’t need to keep sanitary protection in every bag “just in case”. No more planning where the bathroom is or having to take extra clothes. And you’ll save money by not purchasing sanitary products.

There is also good news for women who have had heavy bleeding due to uterine fibroids – common benign gynaecological tumours that affect up to 80% of women. The evidence suggests hormonal changes (for women not taking hormone therapy) can lead to a reduction in the size of fibroids and relieve symptoms.

Women who suffer from menstrual migraine may experience an improvement in migraines post-menopause as their hormonal fluctuations begin to settle – but the timeframe for this remains unclear.

For some women, no more periods also means more participation in social activities from which they may have been excluded due to periods. For example, religious activities or food preparation in some cultures.

2. Getting your body and your groove back

Throughout their reproductive lives, women in heterosexual relationships are usually the ones expected to be proactive about preventing pregnancy.

Some post-menopausal women describe a re-emergence of their sexuality and a sense of sexual freedom that they had not previously experienced (despite contraceptive availability) as there is no longer a risk of pregnancy.

A participant in my research into women’s experiences of menopause described the joy of no longer being child-bearing age:

I’ve got a body back for me, you know, coz I can’t get pregnant, not that I haven’t enjoyed having [children] and things like that and it was a decision to get pregnant but I feel like, ooh my body isn’t for anybody now but me, people, you know?

For women who have chosen to be child-free there may also be a sense of freedom from social expectations. People will likely stop asking them when they are planning to have children.

3. A new chapter and a time to focus on yourself

Another participant described menopause as an unexpected “acceleration point” for change.

Women told us they were more accepting of themselves and their needs rather than being focused on the needs of other people. Researchers have previously tracked this shift from “living for others” to “a life of one’s own”.

Some women find the strength of emotions at this time a challenge, whereas others find their potency can facilitate liberation – enabling them to speak their minds or be more assertive than at any other time in their lives.

4. Increased self-confidence

A new sense of liberation can fuel increased self-confidence at menopause. This has been reported in studies based on in-depth interviews with women.

Confidence boosts can coincide with changes in career and sometimes in relationships as priorities and self-advocacy transform.

Life on the other side

It can be hard to think about what is good about menopause, particularly if you are having challenges during perimenopause – but these can get better with time.

In cultures where women are valued as they become older, women describe themselves as positively contributing to the community. They find they gain power and respect as they age.

We need to work towards more positive societal attitudes on this front. Our bodies change across the lifespan and are remarkable at every stage, including menopause.

Yvonne Middlewick, Nurse, Lecturer & Director of Post-graduate Studies in the School of Nursing and Midwifery, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • 3 Day Juice Fasting? Not So Fast!

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Juice fasts are trending… Again. They have been before, and this will probably not be the last time either.

    The rationale is that by having nothing but fruit and/or vegetable juice for a few days, the body can clear itself of toxins while it’s not being preoccupied by dealing with what you’re eating on a daily basis.

    This is not bad in theory, and in fact is a sort of parallel to the actually good advice to help the liver regenerate—by abstaining from things that the liver has to do hard work about, it has more internal resources to devote to taking care of itself.

    Learn more about this: How To Unfatty A Fatty Liver

    Just one problem

    By having only juice for a few days, you are doing the opposite of what the liver needs.

    In fact, by giving it what’s basically straight sugars in water with no fiber and not even any fats to slow it down, you are making your liver work overtime to deal with the flood of sugars, and it will not cope well.

    Indeed, processed carbs without sufficient fiber are one of the main drivers of non-alcoholic fatty liver disease.

    And yes, that’s what juice is: processed carbs without fiber

    (juicing is a process!)

    You can read more about the science of that, here:

    From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same? ← we get into quite some detail about how, exactly, such a harmless-seeming thing as fruit juice messes up the liver so badly

    Here be (more) science

    A three-day interventional study was performed on juicing and microbiome health, with three groups:

    1. Juice only
    2. Juice with whole foods
    3. Only whole plant-based foods

    The results?

    1. Juice only: biggest growth in bacteria that cause inflammation and gut permeability (that’s bad; very bad)
    2. Juice with whole foods: the same bad effects, but much less pronounced than the juice-only group
    3. Only whole plant-based food: notable improvements in the microbiome

    That’s what the changes were immediately post-intervention; what’s interesting to note is that the bad effects of the juice-only group also lingered longer, whereas the juice+food group enjoyed a relatively quicker recovery in the two weeks after the intervention.

    Here’s the paper itself; be warned, you’ll be reading a lot about feces and saliva alongside eating and drinking:

    Effects of Vegetable and Fruit Juicing on Gut and Oral Microbiome Composition

    Ok, what can I do to detox?

    Well, the advice we gave up top in the linked article about liver health is very sound, and also you might like to check out:

    Detox: What’s Real, What’s Not, What’s Useful, What’s Dangerous?

    Want to learn more?

    Here’s a video explainer from the ever-charming French biochemist Jessie Inchauspé (and our own text overview, for those who prefer reading):

    Fruit Is Healthy; Juice Isn’t (Here’s Why)

    Take care!

    Share This Post

  • The Brain Alarm Signs That Warn Of Dementia

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When it comes to predicting age-related cognitive impairment:

    First there are genetic factors to take into account (such as the APOE4 gene for Alzheimer’s), as well as things such as age and sex.

    When it comes to sex, by the way, what matters here is hormones, which is why [it seems; this as technically as yet unproven with full rigor, but the hypothesis is sound and there is a body of evidence gradually being accumulated to support it] postmenopausal women with untreated menopause get Alzheimer’s at a higher rate and deteriorate more quickly:

    Alzheimer’s Sex Differences May Not Be What They Appear

    Next, there are obviously modifiable lifestyle factors to take into account, things that will reduce your risk such as getting good sleep, good diet, good exercise, and abstaining from alcohol and smoking, as well as oft-forgotten things such as keeping cognitively active and, equally importantly, socially active:

    How To Reduce Your Alzheimer’s Risk

    (the article outlines what matters the most in each of the above areas, by the way, so that you can get the most bang-for-buck in terms of lifestyle adjustments)

    Lastly (in the category of risk factors), there are things to watch out for in the blood such as hypertension and high cholesterol.

    Nipping it in the blood

    In new research (so new it is still ongoing, but being at year 2 of a 4-year prospective study, they have published a paper with their results so far), researchers have:

    1. started with the premise “dementia is preceded by mild cognitive impairment”
    2. then, asked the question “what are the biometric signs of mild cognitive impairment?”

    Using such tools as functional near-infrared spectroscopy (fNIRS) while the participants performed cognitive tasks, they were able to record changes in plasma levels of extracellular vesicles, assessing them with small-particle flow cytometry.

    Translating from sciencese: they gave the participants mental tasks, and while they completed them, the researchers scanned their brains and monitored blood flow and the brain’s ability to compensate for any lack of it.

    What they found:

    • in young adults, blood flow increased, facilitating neurovascular coupling (this is good)
    • in older adults, blood flow did not increase as much, but they engaged other areas of the brain to compensate, by what’s called functional connectivity (this is next best)
    • in those with mild cognitive impairment, blood flow was reduced, and they did not have the ability to compensate by functional connectivity (this is not good)

    They also performed a liquid biopsy, which sounds alarming but it just means they took some blood, and tested this for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which—in more prosaic words—are bits from the cells lining the blood vessels in the brain.

    People with mild cognitive impairment had more of these brain bits in their blood than those without.

    You can read the paper itself here:

    Neurovascular coupling, functional connectivity, and cerebrovascular endothelial extracellular vesicles as biomarkers of mild cognitive impairment

    What this means

    The science here is obviously still young (being as it is still in progress), but this will likely contribute greatly to early warning signs of dementia, by catching mild cognitive impairment in its early stages, by means of a simple blood test, instead of years of wondering before getting a dementia diagnosis.

    And of course, forewarned is forearmed, so if this is something that could be done as a matter of routine upon hitting the age of, say, 65 and then periodically thereafter, it would catch a lot of cases while there’s still more time to turn things around.

    As for how to turn things around, well, we imagine you have now read our “How To Reduce Your Alzheimer’s Risk” article linked up top (if not, we recommend checking it out), and there is also…

    Do Try This At Home: The 12-Week Brain Fitness Program To Measurably Boost Your Brain

    Take care!

    When it comes to predicting age-related cognitive impairment:

    First there are genetic factors to take into account (such as the APOE4 gene for Alzheimer’s), as well as things such as age and sex.

    When it comes to sex, by the way, what matters here is hormones, which is why [it seems; this as technically as yet unproven with full rigor, but the hypothesis is sound and there is a body of evidence gradually being accumulated to support it] postmenopausal women with untreated menopause get Alzheimer’s at a higher rate and deteriorate more quickly:

    Alzheimer’s Sex Differences May Not Be What They Appear

    Next, there are obviously modifiable lifestyle factors to take into account, things that will reduce your risk such as getting good sleep, good diet, good exercise, and abstaining from alcohol and smoking, as well as oft-forgotten things such as keeping cognitively active and, equally importantly, socially active:

    How To Reduce Your Alzheimer’s Risk

    (the article outlines what matters the most in each of the above areas, by the way, so that you can get the most bang-for-buck in terms of lifestyle adjustments)

    Lastly (in the category of risk factors), there are things to watch out for in the blood such as hypertension and high cholesterol.

    Nipping it in the blood

    In new research (so new it is still ongoing, but being at year 2 of a 4-year prospective study, they have published a paper with their results so far), researchers have:

    1. started with the premise “dementia is preceded by mild cognitive impairment”
    2. then, asked the question “what are the biometric signs of mild cognitive impairment?”

    Using such tools as functional near-infrared spectroscopy (fNIRS) while the participants performed cognitive tasks, they were able to record changes in plasma levels of extracellular vesicles, assessing them with small-particle flow cytometry.

    Translating from sciencese: they gave the participants mental tasks, and while they completed them, the researchers scanned their brains and monitored blood flow and the brain’s ability to compensate for any lack of it.

    What they found:

    • in young adults, blood flow increased, facilitating neurovascular coupling (this is good)
    • in older adults, blood flow did not increase as much, but they engaged other areas of the brain to compensate, by what’s called functional connectivity (this is next best)
    • in those with mild cognitive impairment, blood flow was reduced, and they did not have the ability to compensate by functional connectivity (this is not good)

    They also performed a liquid biopsy, which sounds alarming but it just means they took some blood, and tested this for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which—in more prosaic words—are bits from the cells lining the blood vessels in the brain.

    People with mild cognitive impairment had more of these brain bits in their blood than those without.

    You can read the paper itself here:

    Neurovascular coupling, functional connectivity, and cerebrovascular endothelial extracellular vesicles as biomarkers of mild cognitive impairment

    What this means

    The science here is obviously still young (being as it is still in progress), but this will likely contribute greatly to early warning signs of dementia, by catching mild cognitive impairment in its early stages, by means of a simple blood test, instead of years of wondering before getting a dementia diagnosis.

    And of course, forewarned is forearmed, so if this is something that could be done as a matter of routine upon hitting the age of, say, 65 and then periodically thereafter, it would catch a lot of cases while there’s still more time to turn things around.

    As for how to turn things around, well, we imagine you have now read our “How To Reduce Your Alzheimer’s Risk” article linked up top (if not, we recommend checking it out), and there is also…

    Do Try This At Home: The 12-Week Brain Fitness Program To Measurably Boost Your Brain

    Take care!

    Share This Post

  • 10 Unexpected Benefits Of Slow Jogging

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Sometimes, less is more:

    Slow and steady wins the race?

    Here’s the rundown… Slowly:

    1. You burn more body fat: running at 50-60% of max heart rate primarily burns fat without having the usual compensatory metabolic slump afterwards, unless you go for a very long time.
    2. You can build more muscle: lower-intensity workouts improve muscle recovery, which is essential too.
    3. You can reduce muscle soreness: light jogging helps clear lactic acid faster (10almonds note: muscle soreness after exercise isn’t about lactic acid)
    4. You avoid injuries: less impact on joints reduces injury risk.
    5. You learn the proper form: running slowly allows better focus on technique.
    6. You can enjoy it more: slower pace lets you take in surroundings and boosts mood.
    7. You still improve your cardiorespiratory fitness: strengthens heart and lungs over time.
    8. You’ll burn more calories than you think: can burn 200–400 calories per 30 minutes.
    9. You’ll improve your mobility: gentle movement supports joint health and collagen production.
    10. You can improve your performance: builds endurance and strength for faster running

    For more on each of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    How To Rebuild Your Cartilage

    Take care!

    Share This Post

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  • Twice-Baked Stuffed Potatoes

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Packed with protein and fiber and dosed with healthy spices, these tasty treats can be enjoyed hot as they are, or cold as part of a salad dinner.

    You will need

    • 4 large baking potatoes
    • 2 cans chickpeas, drained
    • 1 can coconut milk
    • ½ cup shredded mozzarella cheese, or plant-based alternative
    • 1 bulb garlic (sounds like a lot, but this is about three cloves per potato; adjust if you want, though)
    • 3 tbsp chopped pickled jalapeños
    • 1 tbsp black pepper
    • 2 tsp ground cumin
    • 2 tsp dried thyme
    • 1 tsp onion powder
    • Toppings: smoked paprika, finely chopped parsley

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 400℉ / 200℃.

    2) Wash, prick, and bake the potatoes—the latter being for an hour, or until tender.

    3) Remove them from the oven and lower the temperature to 350℉ / 175℃.

    4) Cut the potatoes lengthways and scoop out the insides into a food processor, leaving enough in the potato that it can hold its shape.

    5) Add the remaining ingredients (except the toppings, and half the chickpeas) to the food processor, and blend until smooth.

    6) Stuff the filling back into the potato shells (by simple physics of volume, you’ll have a little more than you need, but make it heaped mounds rather than a flat fill-in, and you can probably use most of it, if not all), add the other half of the chickpeas on top and then finally the paprika dusting, and bake for a further 20 minutes.

    7) Serve, adding the chopped parsley garnish.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Bromelain vs Inflammation & Much More

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    Let’s Get Fruity

    Bromelain is an enzyme* found in pineapple (and only in pineapple), that has many very healthful properties, some of them unique to bromelain.

    *actually a combination of enzymes, but most often referred to collectively in the singular. But when you do see it referred to as “they”, that’s what that means.

    What does it do?

    It does a lot of things, for starters:

    ❝Various in vivo and in vitro studies have shown that they are anti-edematous, anti-inflammatory, anti-cancerous, anti-thrombotic, fibrinolytic, and facilitate the death of apoptotic cells. The pharmacological properties of bromelain are, in part, related to its arachidonate cascade modulation, inhibition of platelet aggregation, such as interference with malignant cell growth; anti-inflammatory action; fibrinolytic activity; skin debridement properties, and reduction of the severe effects of SARS-Cov-2

    ~ Dr. Carolina Varilla et al.

    Some quick notes:

    • “facilitate the death of apoptotic cells” may sound alarming, but it’s actually good; those cells need to be killed quickly; see for example: Fisetin: The Anti-Aging Assassin
    • If you’re wondering what arachidonate cascade modulation means, that’s the modulation of the cascade reaction of arachidonic acid, which plays a part in providing energy for body functions, and has a role in cell structure formation, and is the precursor of assorted inflammatory mediators and cell-signalling chemicals.
    • Its skin debridement properties (getting rid of dead skin) are most clearly seen when using bromelain topically (one can literally just make a pineapple poultice), but do occur from ingestion also (because of what it can do from the inside).
    • As for being anti-thrombotic and fibrinolytic, let’s touch on that before we get to the main item, its anti-inflammatory properties.

    If you want to read more of the above before moving on, though, here’s the full text:

    Bromelain, a Group of Pineapple Proteolytic Complex Enzymes (Ananas comosus) and Their Possible Therapeutic and Clinical Effects. A Summary

    Anti-thrombotic and fibrinolytic

    While it does have anti-thrombotic effects, largely by its fibrinolytic action (i.e., it dissolves the fibrin mesh holding clots together), it can have a paradoxically beneficial effect on wound healing, too:

    Stem Bromelain Proteolytic Machinery: Study of the Effects of its Components on Fibrin (ogen) and Blood Coagulation

    For more specifically on its wound-healing benefits:

    In Vitro Effect of Bromelain on the Regenerative Properties of Mesenchymal Stem Cells

    Anti-inflammatory

    Bromelain is perhaps most well-known for its anti-inflammatory powers, which are so diverse that it can be a challenge to pin them all down, as it has many mechanisms of action, and there’s a large heterogeneity of studies because it’s often studied in the context of specific diseases. But, for example:

    ❝Bromelain reduced IL-1β, IL-6 and TNF-α secretion when immune cells were already stimulated in an overproduction condition by proinflammatory cytokines, generating a modulation in the inflammatory response through prostaglandins reduction and activation of cascade reactions that trigger neutrophils and macrophages, in addition to accelerating the healing process

    ~ Dr. Taline Alves Nobre et al.

    Read in full:

    Bromelain as a natural anti-inflammatory drug: a systematic review

    Or if you want a more specific example, here’s how it stacks up against arthritis:

    ❝The results demonstrated the chondroprotective effects of bromelain on cartilage degradation and the downregulation of inflammatory cytokine (tumor necrosis factor (TNF)-α, IL-1β, IL-6, IL-8) expression in TNF-α–induced synovial fibroblasts by suppressing NF-κB and MAPK signaling❞

    ~ Dr. Perephan Pothacharoen et al.

    Read in full:

    Bromelain Extract Exerts Antiarthritic Effects via Chondroprotection and the Suppression of TNF-α–Induced NF-κB and MAPK Signaling

    More?

    Yes more! You’ll remember from the first paper we quoted today, that it has a long laundry list of benefits. However, there’s only so much we can cover in one edition, so that’s it for today

    Is it safe?

    It is generally recognized as safe. However, its blood-thinning effect means it should be avoided if you’re already on blood-thinners, have some sort of bleeding disorder, or are about to have a surgery.

    Additionally, if you have a pineapple allergy, this one may not be for you.

    Aside from that, anything can have drug interactions, so do check with your doctor/pharmacist to be sure (with the pharmacist usually being the more knowledgeable of the two, when it comes to drug interactions).

    Want to try some?

    You can just eat pineapples, but if you don’t enjoy that and/or wouldn’t want it every day, bromelain is available in supplement form too.

    We don’t sell it, but here for your convenience is an example product on Amazon

    Enjoy!

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  • WHO Overturns Dogma on Airborne Disease Spread. The CDC Might Not Act on It.

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The World Health Organization has issued a report that transforms how the world understands respiratory infections like covid-19, influenza, and measles.

    Motivated by grave missteps in the pandemic, the WHO convened about 50 experts in virology, epidemiology, aerosol science, and bioengineering, among other specialties, who spent two years poring through the evidence on how airborne viruses and bacteria spread.

    However, the WHO report stops short of prescribing actions that governments, hospitals, and the public should take in response. It remains to be seen how the Centers for Disease Control and Prevention will act on this information in its own guidance for infection control in health care settings.

    The WHO concluded that airborne transmission occurs as sick people exhale pathogens that remain suspended in the air, contained in tiny particles of saliva and mucus that are inhaled by others.

    While it may seem obvious, and some researchers have pushed for this acknowledgment for more than a decade, an alternative dogma persisted — which kept health authorities from saying that covid was airborne for many months into the pandemic.

    Specifically, they relied on a traditional notion that respiratory viruses spread mainly through droplets spewed out of an infected person’s nose or mouth. These droplets infect others by landing directly in their mouth, nose, or eyes — or they get carried into these orifices on droplet-contaminated fingers. Although these routes of transmission still happen, particularly among young children, experts have concluded that many respiratory infections spread as people simply breathe in virus-laden air.

    “This is a complete U-turn,” said Julian Tang, a clinical virologist at the University of Leicester in the United Kingdom, who advised the WHO on the report. He also helped the agency create an online tool to assess the risk of airborne transmission indoors.

    Peg Seminario, an occupational health and safety specialist in Bethesda, Maryland, welcomed the shift after years of resistance from health authorities. “The dogma that droplets are a major mode of transmission is the ‘flat Earth’ position now,” she said. “Hurray! We are finally recognizing that the world is round.”

    The change puts fresh emphasis on the need to improve ventilation indoors and stockpile quality face masks before the next airborne disease explodes. Far from a remote possibility, measles is on the rise this year and the H5N1 bird flu is spreading among cattle in several states. Scientists worry that as the H5N1 virus spends more time in mammals, it could evolve to more easily infect people and spread among them through the air.

    Traditional beliefs on droplet transmission help explain why the WHO and the CDC focused so acutely on hand-washing and surface-cleaning at the beginning of the pandemic. Such advice overwhelmed recommendations for N95 masks that filter out most virus-laden particles suspended in the air. Employers denied many health care workers access to N95s, insisting that only those routinely working within feet of covid patients needed them. More than 3,600 health care workers died in the first year of the pandemic, many due to a lack of protection.

    However, a committee advising the CDC appears poised to brush aside the updated science when it comes to its pending guidance on health care facilities.

    Lisa Brosseau, an aerosol expert and a consultant at the Center for Infectious Disease Research and Policy in Minnesota, warns of a repeat of 2020 if that happens.

    “The rubber hits the road when you make decisions on how to protect people,” Brosseau said. “Aerosol scientists may see this report as a big win because they think everything will now follow from the science. But that’s not how this works and there are still major barriers.”

    Money is one. If a respiratory disease spreads through inhalation, it means that people can lower their risk of infection indoors through sometimes costly methods to clean the air, such as mechanical ventilation and using air purifiers, and wearing an N95 mask. The CDC has so far been reluctant to press for such measures, as it updates foundational guidelines on curbing airborne infections in hospitals, nursing homes, prisons, and other facilities that provide health care. This year, a committee advising the CDC released a draft guidance that differs significantly from the WHO report.

    Whereas the WHO report doesn’t characterize airborne viruses and bacteria as traveling short distances or long, the CDC draft maintains those traditional categories. It prescribes looser-fitting surgical masks rather than N95s for pathogens that “spread predominantly over short distances.” Surgical masks block far fewer airborne virus particles than N95s, which cost roughly 10 times as much.

    Researchers and health care workers have been outraged about the committee’s draft, filing letters and petitions to the CDC. They say it gets the science wrong and endangers health. “A separation between short- and long-range distance is totally artificial,” Tang said.

    Airborne viruses travel much like cigarette smoke, he explained. The scent will be strongest beside a smoker, but those farther away will inhale more and more smoke if they remain in the room, especially when there’s no ventilation.

    Likewise, people open windows when they burn toast so that smoke dissipates before filling the kitchen and setting off an alarm. “You think viruses stop after 3 feet and drop to the ground?” Tang said of the classical notion of distance. “That is absurd.”

    The CDC’s advisory committee is comprised primarily of infection control researchers at large hospital systems, while the WHO consulted a diverse group of scientists looking at many different types of studies. For example, one analysis examined the puff clouds expelled by singers, and musicians playing clarinets, French horns, saxophones, and trumpets. Another reviewed 16 investigations into covid outbreaks at restaurants, a gym, a food processing factory, and other venues, finding that insufficient ventilation probably made them worse than they would otherwise be.

    In response to the outcry, the CDC returned the draft to its committee for review, asking it to reconsider its advice. Meetings from an expanded working group have since been held privately. But the National Nurses United union obtained notes of the conversations through a public records request to the agency. The records suggest a push for more lax protection. “It may be difficult as far as compliance is concerned to not have surgical masks as an option,” said one unidentified member, according to notes from the committee’s March 14 discussion. Another warned that “supply and compliance would be difficult.”

    The nurses’ union, far from echoing such concerns, wrote on its website, “The Work Group has prioritized employer costs and profits (often under the umbrella of ‘feasibility’ and ‘flexibility’) over robust protections.” Jane Thomason, the union’s lead industrial hygienist, said the meeting records suggest the CDC group is working backward, molding its definitions of airborne transmission to fit the outcome it prefers.

    Tang expects resistance to the WHO report. “Infection control people who have built their careers on this will object,” he said. “It takes a long time to change people’s way of thinking.”

    The CDC declined to comment on how the WHO’s shift might influence its final policies on infection control in health facilities, which might not be completed this year. Creating policies to protect people from inhaling airborne viruses is complicated by the number of factors that influence how they spread indoors, such as ventilation, temperature, and the size of the space.

    Adding to the complexity, policymakers must weigh the toll of various ailments, ranging from covid to colds to tuberculosis, against the burden of protection. And tolls often depend on context, such as whether an outbreak happens in a school or a cancer ward.

    “What is the level of mortality that people will accept without precautions?” Tang said. “That’s another question.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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