Publisher Health

Inflammation is the sign that our body is defending itself against an aggression. But when this response escalates, for example in the brain, it can lead to serious neurological or psychiatric diseases. A team from the University of Geneva (UNIGE), the University Hospitals of Geneva (HUG), Imperial College London and Amsterdam UMC, investigated a marker protein targeted by medical imaging to visualise cerebral inflammation, but whose interpretation was still uncertain. The team reveals that a large quantity of this protein goes hand in hand with a large quantity of inflammatory cells, but its presence is not a sign of their overactivation. These results, published in Nature Communications, pave the way for optimal observation of neuroinflammatory processes and a re-reading of previous studies on the subject.
Inflammation is a natural defensive reaction initiated by the immune system. It enables our cells to fight off aggression, such as injury or infection. But this response can also get out of control and lead to the onset of serious pathologies. When it occurs in the brain — in which case it is known as neuroinflammation — this overactivation can play a part in the mechanisms of neurodegenerative diseases (Alzheimer’s, amyotrophic lateral sclerosis, multiple sclerosis) and psychiatric diseases (schizophrenia, bipolar disorder, depression).
In the brain, microglial cells play an important role in inflammation and its potential overactivation. They can be ”activated” when dysfunction occurs, phagocytize pathological cells or proteins and even produce protective substances. Currently, in medical imaging, only one marker can be used to locate and measure microglia non-invasively and in vivo: the TSPO protein, which is present in these cells. This protein can be observed by Positron Emission Tomography (PET), a common imaging technique.
What does TSPO protein reveal?
”Hundreds of studies have used PET scans of this protein to explore and quantify microglia. However, no study has succeeded in precisely interpreting the significance of its quantity in the context of an inflammatory reaction,” explains Stergios Tsartsalis, senior clinical associate in the Department of Psychiatry at the UNIGE Faculty of Medicine. Does a large quantity of TSPO correspond to a large quantity of inflammatory cells? Is it a sign of their overactivation? Together with researchers from Imperial College London (Dr David Owen) and Amsterdam UMC (Prof Sandra Amor), Stergios Tsartsalis and members of Prof Philippe Millet’s team from the HUG’s Laboratory of translational imaging in psychiatric neuroscience and the UNIGE’s Group of molecular neuroimaging in psychiatry set out to find out.
The international research team worked on the brains of mouse models of Alzheimer’s disease, amyotrophic lateral sclerosis and multiple sclerosis, and on post-mortem brain samples from patients affected by the same diseases. ”We discovered that a high density of TSPO protein is indeed an indicator of a high density of microglia. On the other hand, the observation of TSPO does not allow us to say whether or not the inflammatory cells are overactivated,” explains the UNIGE researcher, co-first author of the study.
Re-reading the past, optimising the future
This discovery highlights the value of medical imaging of TSPO: it makes it possible to identify cases where the neuroinflammatory disease is linked to a deregulation in the number of glial cells. In addition, the scientists have identified two markers of the state of microglia activation in humans — the LCP2 and TFEC proteins — which pave the way for new medical imaging approaches.
”These results represent a further step towards understanding the role of microglia in neuroinflammation. They will help to optimise the focus of future studies and also to review the conclusions of previous research,” enthuses Stergios Tsartsalis. Combined with the significant development of molecular imaging at the UNIGE and the HUG, this study, supported by the Swiss National Science Foundation and the Prof Dr Max Cloëtta Foundation, set the scene for effective observation of the immune mechanisms of neurological and psychiatric diseases, within the two Geneva institutions and beyond.

The genetic code of a rare form of kidney cancer, called reninoma, has been studied for the first time. In the new paper, published today (25th September) in Nature Communications, researchers at the Wellcome Sanger Institute, Great Ormond Street Hospital and The Royal Free Hospital also revealed a new drug target that could serve as an alternative treatment if surgery is not recommended.
There are around 100 cases of reninoma reported to date worldwide (1), and it is amongst the rarest of tumours in humans. Although it can usually be cured with surgery, it can cause severe hypertension or it can spread and develop into metastases. There are no existing medical treatments for reninoma and management involves surgery alone. Until now, it had been unknown what genetic error causes reninoma.
In the new study, a collaboration between the Wellcome Sanger Institute and Great Ormond Street Hospital and The Royal Free Hospital, funded by The Little Princess Trust, researchers found that there is a specific error in the genetic code of a known cancer gene, NOTCH1, that is behind the development of this rare cancer.
The team examined two cancer samples — from a young adult and a child (2) — with advanced genomic techniques, known as whole genome and single nuclear sequencing (3). Their findings suggest that the use of existing drugs targeting this specific gene is a possible solution to treating reninoma for patients where surgery is not a viable option.
Taryn Treger, first author of the study and The Little Princess Trust Fellow at the Wellcome Sanger Institute, said: “Many cancerous tumours have already been deciphered with genomic technologies, however, this is not so true in rare cancers, particularly those affecting children. Our work aims to fill that gap. This is the first time that we have identified the drivers for reninoma and we hope that our work continues to pave the way towards new therapies for childhood cancers.”
Dr Tanzina Chowdhury, co-lead author of the study, at Great Ormond Street Hospital, said: “Rare kidney cancers known as reninomas do not respond to conventional anti-cancer therapies. The only known treatment at the moment is surgery. Our study shows that, actually, there is a specific and well-studied gene that drives this rare cancer. If we use already known drugs that affect this gene, we might be able to treat it without the need for an invasive technique such as surgery.”
Dr Sam Behjati, co-lead author of the study, Wellcome Senior Research Fellow at the Wellcome Sanger Institute and Honorary Consultant Paediatric Oncologist at Addenbrooke’s Hospital, said: “Rare cancers are exceedingly challenging to study, and patients with such tumours may therefore not benefit from cancer research. Here, we have a powerful example of cutting-edge science rewriting our understanding of an ultra rare tumour type, reninoma, whilst delivering a finding that potentially has immediate clinical benefits for patients.”
Phil Brace, Chief Executive of The Little Princess Trust, said: “We are committed to funding research searching for more effective treatments for all childhood cancers and so we are delighted to hear of the discoveries that have been made. We also want to help researchers find kinder solutions for young people and so we are very pleased to hear there may be ways to treat this rare kidney cancer without the need for surgery.”

Boosting virtual screening with machine learning allowed for a 10-fold time reductionin the processing of 1.56 billion drug-like molecules. Researchers from the University of Eastern Finland teamed up with industry and supercomputers to carry out one of the world’s largest virtual drug screens.
In their efforts to find novel drug molecules, researchers often rely on fast computer-aided screening of large compound libraries to identify agents that can block a drug target. Such a target can, for instance, be an enzyme that enables a bacterium to withstand antibiotics or a virus to infect its host. The size of these collections of small organic molecules has seen a massive surge over the past years. With libraries growing faster than the speed of the computers needed to process them, the screening of a modern billion-scale compound library against only a single drug target can take several months or years — even when using state-of-the-art supercomputers. Therefore, quite evidently, faster approaches are desperately needed.
In a recent study published in the Journal of Chemical Information and Modeling, Dr Ina Pöhner and colleagues from the University of Eastern Finland’s School of Pharmacy teamed up with the host organisation of Finland’s powerful supercomputers, CSC — IT Center for Science Ltd. — and industrial collaborators from Orion Pharma to study the prospect of machine learning in the speed-up of giga-scale virtual screens.
Before applying artificial intelligence to accelerate the screening, the researchers first established a baseline: In a virtual screening campaign of unprecedented size, 1.56 billion drug-like molecules were evaluated against two pharmacologically relevant targets over almost six months with the help of the supercomputers Mahti and Puhti, and molecular docking. Docking is a computational technique that fits the small molecules into a binding region of the target and computes a “docking score” to express how well they fit. This way, docking scores were first determined for all 1.56 billion molecules.
Next, the results were compared to a machine learning-boosted screen using HASTEN, a tool developed by Dr TuomoKalliokoski from Orion Pharma, a co-author of the study. “HASTEN uses machine learning to learn the properties of molecules and how those properties affect how well the compounds score. When presented with enough examples drawn from conventional docking, the machine learning model can predict docking scores for other compounds in the library much faster than the brute-force docking approach,” Kalliokoski explains.
Indeed, with only 1% of the whole library docked and used as training data, the tool correctly identified 90% of the best-scoring compounds within less than ten days.
The study represented the first rigorous comparison of a machine learning-boosted docking tool with a conventional docking baseline on the giga-scale. “We found the machine learning-boosted tool to reliably and repeatedly reproduce the majority of the top-scoring compounds identified by conventional docking in a significantly shortened time frame,” Pöhner says.
“This project is an excellent example of collaboration between academia and industry, and how CSC can offer one of the best computational resources in the world. By combining our ideas, resources and technology, it was possible to reach our ambitious goals,” continues Professor Antti Poso, who leads the computational drug discovery group within the University of Eastern Finland’s DrugTech Research Community.
Studies on a comparable scale remain elusive in most settings. Thus, the authors released large datasets generated as part of the study into the public domain: Their ready-to-use screening library for docking that enables others to speed up their respective screening efforts, and their entire 1.56 billion compound-docking results for two targets as benchmarking data. This data will encourage the future development of tools to save time and resources and will ultimately advance the field of computational drug discovery.

With the ability to map dozens of biomarkers at once, a new method could transform testing for conditions including heart disease and cancer.
Currently, many diseases are diagnosed from blood tests that look for one biomarker (such as a protein or other small molecule) or, at most, a couple of biomarkers of the same type.
The new method, developed by scientists at Imperial College London in a research collaboration with Oxford Nanopore Technologies (Oxford Nanopore), can analyse dozens of biomarkers of different types at the same time. This would potentially allow clinicians to gather more information about a patient’s disease.
For example, current tests for heart failure look for a couple of common proteins to tell whether the condition is present. The new method was able to additionally detect 40 different types of miRNA molecules, which have the potential to be used as a new class of biomarkers. It can simultaneously examine proteins, small molecules like neurotransmitters, and miRNA from the same clinical sample, providing comprehensive data for a more precise diagnosis.
The results of using the new test in this way with the blood of healthy participants, for a proof-of-concept study, are published today in Nature Nanotechnology.
Co-first author Caroline Koch, from the Department of Chemistry at Imperial, said: “There are many different ways you can arrive at heart failure, but our test will hopefully provide a low-cost and rapid way to find this out and help guide treatment options. This kind of result is possible with less than a millilitre of blood. It’s also a very adaptable method so that by changing the target biomarkers it could be used to detect the characteristics of diseases including cancer and neurodegenerative conditions.”
Co-first author Ben Reilly-O’Donnell, from the National Heart and Lung Institute at Imperial, added: “The ability to monitor different types of molecules at the same time, in the same sample, offers a distinct advantage over traditional analysis methods.”
DNA barcoding

Changes to the vagina can mess with your sex life. But there are solutions that work.In a 2022 study that asked a few dozen postmenopausal women who experienced pain during penetrative sex to describe their experiences of intercourse, the most common response was “burning.” Other terms were “raw,” “dry,” “sharp,” “ripping,” “sandpaper” and “knives.”What they were describing is known as dyspareunia, which is one of the more overlooked and under-treated symptoms of menopause, said Dr. Martha Goetsch, an emeritus assistant professor in the obstetrics and gynecology department at Oregon Health & Science University and a co-author of the paper.Dyspareunia can occur at any life stage but it spikes after the menopausal transition, though signs can emerge during perimenopause too, said Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Northwestern University and author of “Slip Sliding Away: Turning Back the Clock On Your Vagina.” Estimates about the prevalence of dyspareunia range between 13 and 84 percent of postmenopausal women — a highly inexact figure in large part because many women and doctors don’t broach the subject.As a result, women often don’t receive the care they need for dyspareunia despite the fact that it is easily treatable, Dr. Streicher said. If left untreated, the condition can worsen to a point that it leads to a loss of self-esteem, reduced quality of life, depression and a significant shift in the relationship dynamic with a partner.“They just think ‘OK, well, I guess my sex life is over,’” Dr. Streicher said.Why does sex become painful in menopause?The drastic drop in estrogen during and after menopause is the main reason sex can become a painful affair. Among its many functions, estrogen is responsible for keeping the vaginal walls elastic and lubricated, Dr. Streicher said. The accordionlike folds in the vaginal wall that enable them to stretch, called rugae, are plumped up by estrogen.Without it, the vaginal walls thin out, the rugae all but disappear and lubrication becomes “history,” Dr. Streicher said. “When we look inside the vagina with the speculum, we can see it — we can see that these little folds in the skin are no longer there” and the lining is dry.The loss of estrogen also alters the vestibule — the small, highly sensitive entryway to the vagina that is packed with nerve endings or, as Dr. Goetsch described it, “the two square inches that could wreck your life.” In fact, in her research and among her patients, she has found that a majority of women who complained about painful sex suffered from pain in the vestibule rather than inside the vagina. After menopause, those two square inches can become extremely tender. In her research, Dr. Goetsch has found that it might be because the drop in estrogen may stimulate a proliferation of new nerve endings in the area, which can signal pain.“Quite a few animal studies show that when estrogen levels go low, the various nerves sprout new nerve endings,” she said, “and then when the estrogen levels go back up, those extra nerve endings are pruned back.”Not all postmenopausal women will experience severe changes associated with the drop in estrogen, but even mild shifts in the vagina can make pain-free, pleasurable sex elusive, leading to irritation and possibly even cuts and tears of the brittle vaginal tissues, Dr. Goetsch said.There are several other factors that can also contribute to dyspareunia among menopausal women. The hormonal changes alter acidity levels of the vagina, Dr. Streicher said, which can lead to recurrent urinary tract infections among menopausal women, creating discomfort in the area whether or not they are having sex. And some common health conditions among older people, like diabetes or cardiovascular disease, can also dry out the vagina, she added.So what is the solution?It all depends on the degree of changes to the vaginal area, Dr. Streicher said, and the safest way to determine what treatment you need is by seeking out an expert who will do a thorough exam. “There’s a big difference between ‘Oh, you know, I’m not as wet as I usually am’ versus it is so dry, so tight and so thin that the tissue literally splits.”Here are a few of the treatment options:Lubricants: This is a quick and easy solution for women who suffer only from dryness. Dr. Streicher recommends warming the lubricant because “cold is a vasoconstrictor, which will make you have even less natural lubrication, whereas heat is a vasodilator and will help the muscles relax,” she said. One option is placing a bottle of lubricant in a bowl of hot water for a few minutes before use.Vaginal moisturizers: These creams and gels can be found over the counter. “What they actually do is increase water content in vaginal mucosal cells — the ones that are lining the wall,” Dr. Streicher said, helping restore their elasticity and lubrication, though they can also be helpful for those who have pain in the vestibule. Some moisturizers can also help lower vaginal pH levels, she said. Beware that many lubricants market themselves as moisturizers; the difference is that a moisturizer will have instructions to apply it inside the vagina, Dr. Streicher said, whereas a lubricant should only be used on the outside.Estrogen creams: Studies have repeatedly found that this prescription option is highly effective at reducing pain, including in the vestibule area. They are generally low-dose, localized and come in different formulations that your doctor can help you choose among.Lidocaine: This is an unconventional prescription option that Dr. Goetsch has recommended for many of her patients, particularly those who can’t use hormones, like breast cancer survivors. Liquid lidocaine is an anesthetic that numbs the nerve endings of the vestibule. In a small randomized trial in women with dyspareunia, lidocaine reduced pain substantially during intimacy for most participants, Dr. Goetsch said, and women who had sex while using lidocaine rarely reported residual pain after the anesthetic wore off. And, Dr. Goetsch added, application of liquid lidocaine didn’t numb the partner.

Group running has exploded in New York City. As friendships, marriages and even rivalries emerge, the benefits are proving as social as they are physical.On a Thursday evening in early September, the Upper West Side Run Club met on the steps of the American Museum of Natural History in Manhattan. It was 6:30 p.m., and temperatures were hovering in the low 90s. But despite the extreme heat, over 25 people, ranging in age from teens to late 60s, showed up to run a four-mile loop around Central Park.They made frequent stops at the water fountains. They also played a game called “Liars” to keep their minds off the brutal conditions.Usually the group heads somewhere after to wind down with a coffee or beer. It was the women’s semifinals of the U.S. Open, so about three-fourths of them went to Gin Mill, a gastro pub on Amsterdam Avenue, to cheer on the American players Coco Gauff and Madison Keys. Still in their running clothes, the crew, high on endorphins, drank beers and ate burgers, some staying until the matches ended after midnight.“Every running club is different, but ours is very social,” said Maddy Nguyen, 25, a tech recruiter who started the club in February. “It’s very loose and very easy to hang with us.”Running clubs — in which people meet to run and often do something social after — have exploded in New York City, offering runners of all boroughs, skill sets and goals the opportunity to be part of a community.Members of the Upper West Side Run Club cooling off in an açai bowl shop this month. The club frequently winds down with coffee or beers after a run.Ben Rayner for The New York TimesThose who join are finding not only health benefits — it’s easier to stick to a running regimen when you have people holding you accountable and helping the miles pass faster — but social ones. They are meeting best friends, neighbors, activity partners, even future spouses through the clubs.“I think it was the merging of two things,” said Kristopher Imperati, 36, who works in a luxury hotel and lives in West Harlem. He heads Front Runners New York, a running club for L.G.B.T.Q. people and their allies, that currently has almost 1,200 members.“I think a lot of people took up running during the pandemic because it was one of the few things you could get up and do,” he added. “But the pandemic also spurred this desire to be part of groups, to do social things.”Indeed, according to a report by Nielsen Sports released in the spring of 2021, 13 percent of all surveyed runners began during the pandemic. Twenty-two percent of respondents who were already running before the pandemic said they started running more once it started.As they experience growth spurts, New York’s running clubs are struggling with how to keep their communities intact and deal with breakoff factions. Some clubs have chosen to organize with an elected board, sponsors and membership dues, while others criticize those steps as alienating or acts of selling out.Then there are the turf wars and rivalries that naturally arise with so many runners trying to operate in the same parks and spaces — sometimes annoyingly, as when other run clubs take up an entire path — and sometimes with civility.In recent years, more and more New Yorkers have discovered the health and social benefits of group running.Ben Rayner for The New York Times“There is kind of this unspoken code among run clubs,” said Ryo Yamamoto, 47, a creative director and a co-founder of the Old Man Run Club, which meets on the Lower East Side. “It’s understood that the Brooklyn Track Club does track workouts on Tuesday, so we wouldn’t take that space because it’s their thing.”The turf issues have even extended to the all-important social media handle. Ms. Nguyen started the Upper West Side Run Club in February because she was looking for people with whom to train for a marathon. “I made an Instagram page and posted a bunch on Upper West Side Facebook groups,” she said.The exact same week, coincidentally, Oliver Barrett, 33, a classical musician who also lives on the Upper West Side, was trying to start a club for the exact same reasons. “I actually was going to call mine the Upper West Side Run Club, and I saw it was available on Instagram, but I thought about it for too long and when I went back to grab it a week later, it was taken,” he said, laughing. He named his club the Upper West Side Runners instead.‘You See People at Their Lowest’Felipe Toribio, 35, who works in accounting and lives in Brooklyn, met his wife, Ting Li, 31, through a club named NYC Bridgerunners that runs on Wednesday evenings out of the Lower East Side.“We met there once, and then she messaged me through Instagram a few days later and asked if I wanted to go on a run together,” he said, explaining they were both training for the New York City Marathon. “Then we would see each other at least once a week at the club. I definitely tried to impress her.”“It is very easy to get to know someone through running because it’s easy to get emotional,” he added.Members of the Village Run Club, billed as “New York’s Slowest Run Club,” in Hudson River Park. The club does a regular three-mile run up the West Side Highway.Ben Rayner for The New York TimesFor Sarah Sibert, 24, a film writer who moved from Indiana to Manhattan three years ago, in the early months of the pandemic, her run club, the Dashing Whippets Running Team, which has chapters in Manhattan and Brooklyn, is her main community.“I literally had no one in New York City — my roommate was even someone I found online,” said Ms. Sibert, who ran track in college. “Now everything I’ve experienced in New York City has been with someone from the Whippets. We go to Broadway, we go to birthday parties, we go to bars.”She said running was particularly conducive to bonding. “You see each other without makeup; you see each other exhausted,” she said. “Running is such a challenging sport mentally, so you see people at their lowest. I think it creates this sense of security even more than you have with other friends. It’s like family.”Too Big to Bond?In May, Will Truettner, 32, a creative producer who lives in the West Village, started the Village Run Club because he wanted a sober activity. “In New York City, it can feel like the only way to socialize with people is to go drinking or go to a restaurant,” he said.He came up with the tagline “New York’s Slowest Run Club.” “I wanted it to feel like the average person can come and meet new people and have fun,” he said. The club does a three-mile run up the West Side Highway and keeps a slow pace.The run club now has eight to 10 people show up each week, which, to Mr. Truettner, feels like an ideal size. “When we have seven or eight people running, everyone has a group chat,” he said. “But when it gets more than 15, everyone starts breaking off into groups, and it becomes harder to meet people,” he said.Better living through sweating.Ben Rayner for The New York TimesIndeed, other run clubs are seeing the repercussions of getting too big.Mr. Yamamoto, from the Old Man Run Club, used to pride himself on creating such a close-knit community. “We had one member going through health stuff, and the whole running community rallied behind her,” he said. “They did a GoFundMe.”Now that the club attracts over a hundred people for each run, he has noticed smaller groups breaking away after the run to do their own activities. “I hate saying cliques, but there are cliques,” he said. “There are six people who always go off to do something after, and it kind of bothers me, because I love the idea of family.”To Charge, or Not to Charge“It’s an operation, for sure,” said Mr. Imperati, the Front Runners president. The club has an elected board of directors and several committees (among them, social and coaching), and members pay $30 in annual dues. The Dashing Whippets also charge $30 a year.Mr. Yamamoto of the Old Man Run Club feels strongly that runners in his club shouldn’t have to pay to join. “It’s a free club, a come-as-you-are kind of thing,” he said. The club, however, is supported by Nike and Oakley, so members get glasses and merchandise throughout the year, though there is no requirement to wear them.When Stephen McGowan, 37, who works in graduate admissions at Fordham University, started the BX Pints and Pavement running club in the Bronx in 2019, he swore off dues. “The membership fee is that you show up with an open mind,” he said.“I think it’s really important in the Bronx to have no barrier to entry,” he added. “If you have a fee, even a small one, you are holding someone back from participating, and then there is no point.”After mulling other clubs, Shahin Behnamian, far left, took a chance on the Village Run Club. “I started with this one, and it ended up being a good one,” he said.Ben Rayner for The New York Times‘I Just Found My People’While some clubs are trying to make a name for themselves by offering free merchandise, social benefits or “owning” a day of the week, others are content just to be one of many clubs in the city.“I think that for me personally, a rising tide lifts all ships,” Mr. Imperati said. “The more people are out there running, whether they are with our club or another club or not at all, it creates more resources for others. There are more stores that cater to runners. Some of the clubs are putting on races.”“I know people who are like ‘Upper West Side or die, I’m never going to another run club,’ but also people who attend more than one club because it’s a great way to meet new people,” Ms. Nguyen of the Upper West Side Run Club said.But some people just find the right fit. “The first one you try is usually the one you stick with,” she said.That’s what happened to Shahin Behnamian, 34, who works in cybersecurity, when he joined the Village Run Club. He had been looking at other clubs, he said, but “I started with this one, and it ended up being a good one. I just found my people.”

Published24 SeptemberShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Jim ReedHealth reporterThe number of people in hospital has gone up. Google searches have doubled in a month and booster vaccines have been brought forward because of a new variant. It might all feel a bit 2021. But – these days – how much do we really need to worry about Covid?Marjorie from Pembrokeshire had gone through the whole pandemic without catching the virus – until this month. “I thought I had natural immunity,” she says. “But I caught it from my granddaughter who had the same symptoms as mine.”In her case, that meant a headache, muscle pain and a loss of smell and taste.”I just didn’t realise I would feel so weak and lethargic,” she adds.How many people – like Marjorie – are catching Covid this autumn is impossible to know for sure. All those drive-in testing sites are long closed and those free boxes of lateral flow tests probably dried up months ago. The Office for National Statistics infection survey, which used to test a random sample of the population, was scrapped back in March.But we do still record the number of people who test positive in hospital across the whole UK, and that figure has been creeping up since the summer.”What does it tell me about the virus? It tells me it’s spreading and it tells me it still has the ability to make people very unwell,” says Stuart McDonald, an actuary at the consultants LCP, who has studied the data closely since the start of the pandemic. On 17 September, 3,019 hospital beds in England were taken up by someone with Covid. That number has tripled since July, but dipped last week, and is just a fraction of the 33,000 seen at the peak of the second wave in 2021.About a third of those patients were being treated mainly for the disease, with most testing positive after they were admitted for another reason.Covid boosters for over-65s as hospital cases riseWho can get another Covid jab this autumn?Why do some people get infected?Hospital trends give us a very rough idea of how much virus is around and whether infection levels are rising or falling. How likely we are to catch it, and how sick we get, then depends on a mix of complex factors – from genetics and age, to lifestyle and the environment in which we live.Research published in the journal Nature this year suggests about 10% of the population carry a gene which allows them to identify and eliminate the virus before they even start to develop tell-tale symptoms like a cough, sore throat or fever. GettyCovid immunity in the UK93%aged 12+ have received at least one vaccine82%infected at least once by Nov 2022Source: NHS Digital, ONSWe have all built up different levels of immunity over the last four years depending on our vaccine record and contact with the disease. “There’s probably no two people in the country whose history of vaccinations and Covid exposure are alike,” says Mr McDonald. “So I think it’s more difficult to predict what will come next than it has been at any previous point.”Image source, Getty ImagesThat immunity starts to fall soon after an infection or a vaccine. This is where the virus differs from measles or polio, for example, where jabs in childhood can protect you for life.Protection against catching Covid is likely to last just a few months – at best – although data shows protection against severe disease is more long-lasting.In part that is because the virus itself is constantly changing.Previous waves have been driven by different forms – or variants – which have undergone multiple genetic changes. Those mutations can alter the virus’s behaviour – making it spread faster, for example.But crucially they might also make it harder for our immune systems, which have been primed to respond to those older versions, to recognise and fight off. In late 2021, the Omicron variant did just that and infected millions, although that wave did not lead to a huge spike in hospitalisations and deaths. “Being exposed to the virus, either through vaccination, infection or a combination of both, is undoubtedly reducing the severity of disease when we get it,” says Alex Richter, a professor of clinical immunology at the University of Birmingham. More recently we have seen a series of smaller waves driven by close relatives – or subvariants – of Omicron.GettyBA.2.86 Covid variant18countries with confirmed cases54cases detected in the UK28infections at Norfolk case home0residents needed hospital treatment for CovidSource: GISAID, UKHSA, PHSIn August 2023, scientists around the world started tracking the spread of yet another version with a large number of mutations. Just 54 cases of BA.2.86, as it is now called, have been confirmed in the UK, including a large outbreak at a care home in Norfolk. Early lab tests appear to be reassuring – with signs it may be less contagious and immunity dodging than some originally feared.How well protected are we?The emergence of BA.2.86 meant a decision was made to bring forward the autumn Covid booster to better protect the most vulnerable this winter.But the new jabs are only available to people over 65 years old – it was the over-50s last year – and those with certain health conditions. That is a tactical decision, says Dr Adam Finn, professor of paediatrics at the University of Bristol.He explained: “When younger people who’ve already had infections and vaccines get Covid [again], they get a cold and a cough and might be off work for a few days.”There’s no real value in investing a lot of time and effort immunising them again when there are so many other things for the health service to be doing.”The reality is then that most under-65s will now end up boosting their immunity not through vaccination, but through catching Covid many times. How worried should we be?Prof Richter says it is now time to start thinking of Covid more like flu, where new forms of the disease, some worse than others, appear every year and new vaccines are rolled out for the latest winter strain.Covid will still be a problem for the most vulnerable, she adds, and hospitals, which will still need to deal with new infection waves.”We have bad flu years and good flu years,” she says.”There’s a good chance that once every four or five years, we’re going to have a bad dose [of Covid] and we are going to need to go to bed for a few days, otherwise most of the time, for most of us, I think it will be OK.”Every dose of the virus is not completely without danger, even for the healthy, with some research suggesting an increased risk of long-Covid symptoms like fatigue, shortness of breath and brain fog.But – in general – Prof Finn says each new infection should feel milder with the length of time you are sick reduced.”Each time you catch it, your immunity gets stronger and broader,” he adds.Sam, an IT worker from north London, managed to pick up infection number three on a trip to Turkey with her family this month.”The first time was really horrible, the second time it felt like flu, but by the third time I didn’t really think about it,” she says. “I just had a stinker of a cold and was all bunged up.”This is maybe what scientists meant when, at the very start of the pandemic, we were told that, one day, we would have to learn to live with Covid. The virus is not going away.But perhaps it is starting to become part of the background to our everyday lives.More on this storyCovid boosters for over-65s as hospital cases risePublished18 SeptemberWho can get another Covid jab this autumn?Published19 September

Amid an uptick in Covid infections, administrators, staff and patients are divided over the need for masks in health care settings.Liv Grace came down with respiratory infections three times over the course of four months. Each occurred after a visit to a medical provider in the Bay Area.Mx. Grace, 36, a writer who uses they/them pronouns, was infected with respiratory syncytial virus, which led to pneumonia, in December, after they were treated by a nurse wearing a surgical mask who complained about her children being ill with the virus.Mx. Grace got Covid after a visit to a cancer center for an infusion in February. And there was the pale, coughing phlebotomist who treated them in April, just before they came down with Covid again.Mx. Grace was born with a rare immune deficiency related to lupus and takes a medication that depletes the cells that produce antibodies. The combination renders the body unable to fend off pathogens or to recover quickly from infections.Since the pandemic began, Mx. Grace has rarely ventured anywhere other than health care facilities. But hospitals, by their nature, tend to be hotbeds of illnesses, including Covid, even when community rates are relatively low.“People like me who are very high risk and very susceptible will still get sick when we’re sitting in, like, virus soup,” Mx. Grace said.Facing a potential wave of coronavirus infections this fall and winter, relatively few hospitals — mostly in New York, Massachusetts and California — have restored mask mandates for patients and staff members. The vast majority have not, and almost none require them for visitors.By Thursday, several Bay Area counties had announced mask mandates for staff members of health care facilities that treat high-risk patients, including infusion centers, effective Nov. 1.The order does not apply to Berkeley, including Alta Bates Summit Center — a part of the Sutter Health network — where Mx. Grace was treated.“We continue to monitor the impact of Covid-19 in our communities, and work with state and local health departments to ensure any additional masking and public health requirements are incorporated into our policies,” a spokeswoman for Sutter Health said in a statement.Among patients, health care workers and public health experts, opinions are sharply divided over whether and when to institute masking mandates in hospitals.Brigham and Women’s Hospital, which is part of the Mass General Brigham system, currently requires masks only in inpatient settings. Yet some of its own experts disagree with the policy.Hospitals have an ethical obligation to prevent patients from becoming infected on site, regardless of what they might choose to do elsewhere, said Dr. Michael Klompas, a hospital epidemiologist at Brigham and Women’s.“That’s their prerogative,” he said of patients taking risks outside the health care setting. “But in our hospital, we should protect them.”In August, Dr. Klompas and his colleagues published a paper showing that masking and screening for Covid at Brigham and Women’s also decreased flu and R.S.V. infections by about 50 percent.The Centers for Disease Control and Prevention recommends that hospitals consider putting masking in place when levels of respiratory infections rise, especially in urgent care and emergency rooms, or when treating high-risk patients.But the guidelines do not specify what the benchmarks should be, leaving each hospital to choose its own criteria.Ideally, every patient would be given a mask on arrival at an emergency room or urgent care, and asked to wear it regardless of symptoms, said Saskia Popescu, an infection control expert at the University of Maryland.A recent study found that more cancer patients died of Covid during the Omicron surge than in the winter surge of the original virus, in part because people around them had stopped taking precautions.Rory Doyle for The New York TimesBut hospitals also must reckon with the backlash against masking in large swaths of the population. “Now that we’re not in this emergent state with Covid, I think that’s going to be the most challenging, especially since masks have been so politicized,” she said.As a result, in emergency rooms at many hospitals — like Banner-University Medical Center Tucson, in Arizona, and Kaiser Permanente Sunnyside Medical Center, outside Portland, Ore. — patients with Covid sit alongside older adults, pregnant women and those with conditions like diabetes that put them at high risk should they become infected.A very few hospitals that predominantly treat immunocompromised patients, such as City of Hope, a cancer-treatment center in Los Angeles, have maintained universal masking. But some of the nation’s most prestigious hospital systems don’t require masks even in their cancer centers, where severely immunocompromised patients like Mx. Grace receive infusions.“Just do whatever you want — that’s essentially what the C.D.C. guidance says, at this point, in terms of universal masking,” said Jane Thomason, lead industrial hygienist for National Nurses United, which represents nearly 225,000 registered nurses.The guidelines give hospitals “permission to prioritize profits over protecting nurses and patients,” Ms. Thomason said. The union has called for stronger protections, including the use of N95 respirators, to protect health care workers, patients and visitors.A recent study found that more cancer patients died of Covid during the Omicron surge than in the first winter wave, in part because people around them had stopped taking precautions.But partial masking — say, only in units with high-risk patients — may still endanger patients, said Dr. Eric Chow, head of communicable diseases at Public Health — Seattle & King County, in Washington State. People at high risk “are scattered throughout the hospital,” he said. “They are not necessarily confined to one specific space.”Until Thursday, hospitals in the Emory Healthcare system required staff members to mask only when interacting with inpatients. It now also requires masks for staff members working in high-risk settings, such as cancer centers.Emory’s Winship Cancer Center in Atlanta changed its policy “based upon the currently increasing prevalence of and hospitalizations from Covid-19 and other respiratory illnesses in the community,” Andrea Clement, associate director of public relations for the institute, said in a statement.Staff members are now required to mask anywhere they might encounter patients, including lobbies, elevators and stairwells. Masking for patients and visitors is “encouraged,” but not required.Mass General Brigham is evaluating new criteria for reintroducing masking, such as the proportion of people in its emergency rooms with respiratory illness, admissions for such illnesses and wastewater data, said Dr. Erica Shenoy, the hospital system’s chief of infection control.In June, Dr. Shenoy and her colleagues argued in the journal Annals of Internal Medicine that the time for universal masking had passed, partly because most interactions between patients and health care personnel are brief.In response to criticism from scientists, they later cited results from an unpublished study showing that only 9 percent of people without symptoms carried infectious coronavirus.“The fact is that the conditions for Covid have changed dramatically,” Dr. Shenoy said in an interview. “It’s important from a policy perspective to have an open mind and to be able to reflect and revise our policies as we go along.”Masks available outside Mx. Grace’s home. Since the pandemic began, they have rarely ventured anywhere other than health care facilities.Rachel Wisniewski for The New York TimesBut several experts, including Dr. Klompas, said that stance underestimated the long-term effects of other respiratory infections, like influenza and R.S.V.Respiratory viruses can unmask or exacerbate chronic conditions of the heart, lung or kidneys and trigger autoimmune conditions. “It’s much bigger than simply the actual infection,” Dr. Klompas said.The C.D.C.’s infection-control guidelines date to 2007 and are being revised by an advisory committee. The process has been fraught with controversy: Critics fear that the recommendations will be too modest to protect patients and staff members. (Dr. Shenoy is one of eight committee members, and a co-author of the June editorial, Dr. Sharon Wright, is its co-chair.)In July, National Nurses United delivered a petition to Dr. Mandy Cohen, the C.D.C. director, that was signed by hundreds of experts in health care, virology and infection control, and dozens of unions and public health organizations.The petition criticized the infection-control committee as lacking in diversity of expertise and its decision-making as opaque. The committee did not seem to recognize how the coronavirus spreads indoors, and the need for N95 or similar respirators that block virus particles effectively, the petition said.The advisers were scheduled to vote on the changes at a meeting in August, but deferred the vote to November. During a public comment period at an August meeting, several people, including Mx. Grace, expressed dismay at the draft guidelines, which they said were inadequate and endangered their lives.The repeated infections have taken a toll on Mx. Grace, triggering more frequent migraines and brain seizures and leaving them afraid to seek care even when they need it.Before the pandemic, hospitals were less dangerous because staff members often wore masks, and people in waiting rooms and elevators were likely to be sick only in the late fall or winter, Mx. Grace said.“It was still scary,” Mx. Grace said. But there wasn’t a “negative attitude around asking for more precautions.”

A popular taxidermy exhibit in Sioux Falls, S.D., was closed after the toxin was discovered laced throughout the specimens. Many lament the loss of the “works of art.”Usually, you go to the zoo to look at live animals. But at the Great Plains Zoo in Sioux Falls, South Dakota, people also went to see the dead ones.The attraction, called the Delbridge Museum of Natural History, hosted one of the most impressive taxidermy collections in the country, with some 150 animals from six continents, each meticulously positioned in a diorama depicting their natural habitat. There, visitors could encounter — up close — a (stationary) mob of kangaroos, a pouncing lion, a panda eating bamboo and more.On Aug. 18, Sioux Falls and Great Plains Zoo officials announced that the Delbridge Museum had closed after nearly 40 years, citing an increased risk of chemical exposure to staff and visitors as the animal specimens age. At a news conference, streamed live on Facebook on Aug. 29, they specified that a majority of the taxidermy mounts contained arsenic, a toxin that can cause pregnancy complications, cancer and even death.“When we have a known carcinogen in one of our public displays, we can’t take risk,” Paul TenHaken, the mayor of Sioux Falls, said at the conference. Dave Pfeifle, city attorney for Sioux Falls, added that “there are no acceptable levels of risk regarding arsenic.”But the museum’s closing has drawn a backlash from Sioux Falls residents, many of whom have fond memories of visiting the taxidermy collection and worry that the decision represents the first step toward its disposal. Some feel the city is not being transparent about the risk, while others suspect that the zoo wants to get rid of the museum to make room for newer attractions.Greg Neitzert, a member of the Sioux Falls City Council, described the closing as an “out of the blue” decision that had come as a shock to him and other council members. He said the reasoning “just isn’t passing the smell test” — that the risk alone should not lead to the museum’s decommissioning.Conservators at large worry that the museum’s closing could raise undue concern over how safe antique collections truly are. “This is already something that bubbles along the surface for natural history museums,” said Fran Ritchie, chair of the Society for the Preservation of Natural History Collections’ conservation committee. “And then to have something boil over like this — it’s difficult.” Since the closing, she said, her colleagues have been contacted by other museums anxious to know if they should remove taxidermy pieces from display, or get rid of them entirely.A panda display.Great Plains ZooDamage on a taxidermy bongo, a forest-dwelling antelope native to West and Central Africa.Great Plains ZooThe closing of the Delbridge Museum has raised concerns about antique collections in museums elsewhere across the country.Great Plains ZooThe presence of arsenic is not uncommon in antique artifacts. The element is prevalently found in green pigments that were once used to dye clothing, book covers and even artificial flowers, according to Ms. Ritchie. (In the Victorian era, she said, people even ate small amounts of the toxin, hoping to make their skin appear pale.)Arsenic can exist organically in animals and plants, but it is the inorganic kind, found in soil and groundwater, that can be harmful. Before the 1980s, inorganic arsenic “soap” was used in taxidermy as an embalming agent, applied to the inside of an animal skin to prevent harmful pests. The skin was then pasted over a mannequin shaped in the animal’s likeness, and sewn together to create a realistic mount.“These aren’t stuffed animals, these are model sculptures,” said John Janelli, former president of the National Taxidermy Association. Most of the specimens at the Delbridge Museum were procured between the 1940s and 1970s by Henry Brockhouse, a Sioux Falls businessman and hunter, and the skins were mounted by the Jonas family, renowned taxidermists in the conservation world, Mr. Janelli said.Mr. Brockhouse displayed the animals behind glass, in the back of West Sioux Hardware, a store he owned, until his death in 1978. In 1981, his attorney, C.J. Delbridge, purchased the collection at a public auction and donated it to the city of Sioux Falls. Three years later, the Delbridge Museum opened, one of only a few natural history collections in the state.Wear and tear above the eye of a female nyala, an antelope found in southern Africa. Arsenic was applied to the inside seams of most specimens, so that as they age the arsenic is exposed where the skin separates from the mannequin.Great Plains ZooThe value of the exhibit extends beyond Sioux Falls, Ms. Ritchie said, in part because many of the species it includes are now protected, so a collection like this could never be replicated. Taxidermy is an invaluable educational tool, offering “a chance to get up close to an animal in a way that you cannot do safely in the wild,” she said. “It creates an experience that’s unlike anything else.”According to Becky Dewitz, chief executive of the Great Plains Zoo, who spoke at the Aug. 29 news conference, an appraisal had concluded that at least 45 percent of the collection showed wear and tear. In a chemical analysis, 79.5 percent of the mounts tested positive for arsenic.Conservators generally assume that all taxidermy mounts dating from before the 1980s were probably made using arsenical soap, Ms. Ritchie said. That the substance was applied to the inside means that, as the mounts age, arsenic is exposed around the seams, where the skin separates from the mannequin.At a city council meeting on Aug. 29, Ms. Dewitz showed photos of the deterioration on many of the larger animals in the museum, including a zebra, an elephant and a giraffe. “Gravity and age are not kind, even when you’re 15 feet tall,” she said. Reported levels of arsenic ranged from 0.5 to 54.6 milligrams per kilogram.But Kerith Schrager, an objects conservator at the National September 11 Memorial & Museum who specializes in hazardous collections, said that such data generally reveal little about the risk of exposure. “I can have a bottle of alcohol sitting on my desk, but if I don’t ever open it or touch it or drink it, I’m not exposed to it,” Ms. Schrager said.With arsenic, the route of exposure matters. Ingestion is the most harmful, followed by inhalation, then skin contact. Milligrams per kilogram is a common dose measurement for arsenic levels in food, Ms. Schrager said, but it is not useful for assessing surface or air contamination, which are the primary ways that museum staff or visitors might be exposed to the chemical.A hyena.Great Plains ZooGiraffe.Great Plains ZooThe Delbridge space currently functions as a warehouse, while officials wait for the recommendations of a work group commissioned by the mayor to determine the specimens’ future.Great Plains ZooTo accurately determine that risk requires an in-depth exposure assessment, Ms. Schrager said. This includes monitoring the breathing of a visitor as they “go about their business,” and taking wipe samples of anything touched, to test for cross contamination. Museums can then make adjustments where needed, such as enclosing the mounts in airtight glass cases or working with taxidermists to redo the mounts without arsenical pesticides.But that comes with a hefty price tag, Ms. Dewitz said. Installing glass and updating the museum’s ventilation system for better climate control could reach up to $4.2 million; a new building for the collection could cost up to $14 million.Sioux Falls residents at the city council meeting responded emotionally. “My soul is just broken,” said Beverly Bosch, the youngest daughter of Mr. Brockhouse. “This was my dad’s life.”On Sept. 15, Mr. TenHaken, the Sioux Falls mayor, announced the assembly of a new work group to develop a plan to make the taxidermy collection surplus, which marks the property as no longer useful to the city. But even if that occurs, navigating federal and state laws and figuring out what to do with the collection will prove tricky, as many of the animals are considered protected species.“These are like works of art,” Mr. Neitzert said. “You don’t throw works of art away — not lightly.”Mr. TenHaken affirmed that the city would not simply dispose of the collection in a landfill. “We wouldn’t just take artifacts like this and treat them like a Papa John’s pizza box,” he said at the Aug. 29 news conference.But some Sioux Falls residents want to keep the animals on display. A Facebook page for the effort has amassed over 15,000 followers. Mr. Neitzert plans to propose that the city hire a conservator to independently assess the situation.John Sweets, owner of the building that used to be West Sioux Hardware, said he felt a personal obligation to help save the collection, because he is so frequently stopped by older residents reminiscing about the magic of the building’s former contents.The space currently functions as a warehouse, but Mr. Sweets dreams of turning it into an artists’ bazaar, perhaps with taxidermy mounts arrayed throughout: the elephant here, the giraffe and hippo there. If the zoo can no longer house the animals, “let’s get them to a place where they can go,” he said. “And it just so happens that I own a place.”

No talking. No podcasts. No music. Just some time alone with your thoughts.In a TikTok video that has now amassed nearly half a million views, the influencer Mady Maio describes taking a walk. But not just any walk: a silent one.Listen To This ArticleListen to this story in the New York Times Audio app on iOS.For her, the 30-minute stroll was revelatory. No podcasts, no music. Just “me, myself and I.”She was resistant at first. (It was her boyfriend’s idea.) “My anxiety could never,” she said in the video.Ms. Maio described the first two minutes as mental “mayhem” that eventually gave way to a “flow state.” Her brain fog lifted. Ideas started popping into her head because she was “giving them space to enter.”The silent walk is TikTok’s latest wellness obsession, a blend of meditation and exercise that aims to improve mental health. Unlike the similarly trendy “hot girl walk,” a four-mile odyssey that requires goal-setting and giving thanks, the silent walk does not involve multitasking. There is no agenda other than to set one foot in front of the other and take note of the world around you.Walking in silence is an ancient tradition rooted in mindfulness, a form of meditation that helps people focus on the physical sensations, thoughts and emotions of the present moment, without any judgment.The fact that the silent walk is nothing new has attracted a chorus of critics; “Gen Z thinks it just invented walking,” they say.To that, Arielle Lorre, 38, a content creator in Los Angeles, had to laugh.“Fifteen or 20 years ago, this would not have even been a conversation,” said Ms. Lorre, who has often discussed the benefits of silent walks, most recently on her podcast and on TikTok. But silent walking feels relevant right now because many of us have become tethered to our devices, she added.The question then becomes: “How do we counteract that?” Ms. Lorre said.Walking is a well-established balm for the mind and body. Research has shown that walking for as little as 10 extra minutes a day may lead to a longer life. And a 2020 study in The Journal of Environmental Psychology found that a 30-minute walk in an urban park reduced the amount of time that people dwelled on negative thoughts. Walking has also been shown to improve creativity and help fend off depression.Ms. Lorre, who walks in silence for at least 45 minutes roughly four times a week, said that since she started this practice about a year ago, she now sleeps better, feels calmer and has more consistent energy throughout the day.But for some people, the idea of a silent walk might seem torturous. One 2014 study found that, if left with no other option, people would shock themselves rather than sit alone with their thoughts.“Most people seem to prefer to be doing something rather than nothing, even if that something is negative,” the study authors wrote.Walking, however, can make it more pleasant to spend time with ourselves, experts say.Erin C. Westgate, an assistant professor of psychology at the University of Florida in Gainesville who studies boredom, found in her research that being in transit, which included walking or riding public transportation, was one of the times when people most often reported having enjoyable thoughts.Walking “isn’t so demanding that it’s actually taking up a lot of your mental bandwidth,” Dr. Westgate said, which “gives us permission and license to daydream.”If the idea of daydreaming seems luxurious, it may be because our attention spans have shriveled over the last two decades.We now spend an average of about 47 seconds on a piece of screen content before switching to another piece of content, according to research led by Gloria Mark, a professor of informatics at the University of California, Irvine, and the author of “Attention Span.” Back in 2004, however, Dr. Mark found that people could spend an average of two and a half minutes on email before turning to another work task.Continually flipping our attention from one task to another is draining, Dr. Mark said. But a silent walk can help replenish our “tank” so that we have a greater reserve of mental energy, she added. In other words, disconnecting for a while can actually help us perform better.Dr. Mark suggested taking digital breaks at other times, not just when we’re walking, and that we think about an emotional goal for the day, not just a list of tasks.For example, if your goal is to feel calm, you can write that on a Post-it note and refer back to it when thinking about how you’ll spend your fleeting free time that day.“So many of us feel like we’re always behind and running to catch up,” said David M. Levy, a professor at the Information School at the University of Washington in Seattle, and the author of “Mindful Tech.” This can lead to a state of being “so distracted that we aren’t present at all.”But in a future-oriented society we need opportunities to be satisfied with the here and now, Dr. Levy said, and drop the pressure to be productive.“There is great beauty and aliveness in the world outside of whatever it is we’re doing on our devices,” Dr. Levy said.Audio produced by