The researchers determined the particle emissions and the associated maximum risk of transmission when playing many different wind instruments. The results provide clues as to how cultural events can be organized with the lowest possible risk of infection even during the pandemic.

The fact that wind music is not harmless for musicians and the audience in terms of infection control is due to the fact that particles with a size of less than five micrometres largely penetrate from the instrument to the outside. They remain in the air for longer and spread further, so that they can reach high concentrations, especially in unventilated rooms. How many of these small particles are released by the wind music also depends on the instrument.

A relatively large number of viruses can come from the clarinet. It releases significantly more aerosol, which can contain pathogens such as Sars-CoV-2, than the flute, for example. The risk of infection from a clarinet and a trombone at a distance of one and a half meters is already 50 percent after four minutes. At the same distance from a flute, this risk of infection is only reached after three hours. All other instruments measured were in between. In general, however, the risk of transmission from an infected person on a wind instrument is significantly lower than with singing or speaking people if they are in their vicinity for the same amount of time.

In the study, the team also investigated how well the risk of infection could be reduced by using custom-made particle filters, similar to the fleece of FFP2 masks. They placed the prototypes of the masks on the ends of the brass instruments; wooden wind instruments were almost completely covered with the filter material. According to Oliver Schlenczek, first author of the study, masks work reliably on the bell of brass instruments to reduce the emission of infectious particles. If the listeners also wear an FFP2 mask, the risk of infection is a maximum of 0.2 percent even after an hour.

Simone Scheithauer, Director of the Institute for Hospital Hygiene and Infectiology at the University Medical Center Göttingen, is very positive about these results. On this basis, much more targeted protective measures could be recommended in future and musical cultural activities could be maintained with only minor restrictions, even in critical situations. With sufficient ventilation and the wearing of FFP2 masks, lessons, rehearsals and concerts with wind instruments can be held safely, concludes aerosol researcher Eberhard Bodenschatz from the MPI-DS.

www.ds.mpg.de/3959178/220922_aerosols_instruments

SMM -- The Swiss Society for Music Medicine (SMM) brings together under one roof specialists from the fields of medicine and a wide range of therapeutic approaches, as well as scientists and professional musicians. A central concern of the SMM is to encourage constructive dialog between these groups. However, it also wants to help musicians who are struggling with specific health restrictions or are simply interested in putting their music-making on a sustainably healthy footing.

We are proud to have doctors in our circle who can offer medical solutions for music-related illnesses at the highest level. The SMM also points those seeking help from the world of music in the direction of low-threshold therapy services. The variety of methods, schools and techniques in the therapy jungle can be confusing. The decision in favor of a technique is often a matter of chance - usually based on personal encounters or recommendations. The prerequisite for therapy should always be a medical diagnosis. The right choice then determines whether success is achieved, but also whether damage can be avoided due to the wrong choice

With the 18th symposium, the SMM would like to offer those seeking help the opportunity to get to know some of the most important body-oriented approaches in music in one place and at the same time take the opportunity to talk to their representatives without obligation. The therapists should also be able to approach each other on this day. The following forms of body-oriented approaches to music are expected to be discussed: Feldenkrais, Alexander Technique, Dispokinesis, Functional Kinetics FBL, Klein-Vogelbach, Yoga, Pilates, Spiral Dynamics and Schlaffhorst Andersen breathing therapy.

The symposium will open with an unusual world premiere. It is a work by saxophonist Fabio da Silva, who was awarded an Ober-Gerwern Master's Prize for his outstanding Master's thesis at Bern University of the Arts (HKB). "Rugueux 10" for baritone saxophone, alto flute and pre-produced sounds is a low-frequency performance in which the baritone saxophone and alto flute approach very specific frequencies microtonally. Together with the soundtrack, a play between tension and relaxation, concentration and distraction is created. The use of different multiphonics creates stronger and weaker frictions.

Various recognized and proven forms of body-oriented approaches in music will be presented on stage and at tables at the 18th SMM symposium. Keynote speakers will be Klaus Scherer (music psychologist and founder of the Geneva Center Interfacultaire en Sciences Affectives) and Eberhard Seifert (medical director of the Department of Phoniatrics at the University Clinic and Polyclinic for Ear, Nose and Throat Diseases, Head and Neck Surgery at the Inselspital Bern).

SMM - Cultural scientist Hannah Bregler points out that professional music careers involve numerous physiological, social and psychological demands. In her work for the Hamburg Institute for Culture and Media Management, she confirms that everyday life is characterized by permanent peak performance under stressful conditions, which affects both fine motor skills and cognitive abilities. As in professional sport, the limits of performance and physical resilience are reached in everyday musical life. This is associated with considerable health risks. In both sectors, it takes years of training or practice to achieve peak performance. Everyday life in both is therefore also characterized by irregular working hours, frequent travel and constant self-criticism.

According to the author, numerous studies show how precarious the health situation in orchestras is after many years of professional activity. It has been observed that orchestra members develop chronic poor posture even at a young age. However, the importance of and responsibility for health in the musical profession is increasing, not least in order to achieve a reduction in days of absence due to illness, which, among other things, improves the economic efficiency of cultural institutions. The fact that this professional group is not a small, negligible group of people is reflected in the number of employees.

According to the German Orchestra Association, there are currently 9766 positions in German cultural orchestras. In contrast to other areas, especially sports, the topic of pain and complaints is still often taboo. There is a lack of knowledge and education on how to avoid poor posture, how to recognize symptoms early on and what treatment options are available. Awareness of this has been raised in recent years, but there is still a need for action in view of the current situation, and it is worth taking a look at competitive sport.

According to Bregler, sports psychology began early on to investigate the influence of emotions on competitive performance and how they can be used optimally before, during and after a competition or training session. Sport and emotions are inseparable, as can be seen on and off the pitch after competitions or football matches. Like performance anxiety, competition anxiety is also a phenomenon that can inhibit performance and is widespread.

An important component in avoiding complaints is the relationship between recovery and stress and its effect on performance. A balance between stress and recovery is essential in order to continuously deliver peak performance. Michael Kellmann, one of the leading sports psychologists, differentiates between passive (e.g. massage), active (e.g. a relaxed run after a competition) and proactive (e.g. social activities) approaches to recovery.

An increase in performance entails a certain degree of exhaustion and can be compensated for by extensive recovery methods, as functional exhaustion only produces a brief reduction in performance. If a systematic and individualized recovery phase is not observed after training or exhaustion, a persistent imbalance between recovery and overreaching can lead to a harmful condition that manifests itself in persistent underrecovery and non-functional overreaching (NFO).

Awareness and structural change in orchestral operations requires interaction at many different levels, from musical education at music schools and conservatoires to the working atmosphere in professional orchestras. The practices of competitive sport offer an opportunity to copy, adapt or vary successful methods according to the needs of the orchestra.

Literature:

Hannah Bregler, 2021, Prevention

for professional musicians as a management task. What the orchestra business

can learn from professional sport, Munich, GRIN Verlag,

> www.grin.com/document/1152272

SMM - Are you a musician looking for support with health issues? For advice, you can contact the advice center of the Swiss Society for Music Medicine (SMM) by e-mail (see box) and leave a telephone number or e-mail address. You will be contacted within one to two working days. SMM consultations are free, confidential and non-binding. They can be used by people of all styles, be it classical, jazz, pop, folk music or other styles. Above all, the first steps in the counseling process are the same. Anatomical, physiological and emotional circumstances are ultimately the same for everyone.

If you wish, you can already explain in the email why you are contacting the SMM. It helps our medical advisor to prepare for the conversation. However, you can also simply let us know that you wish to be contacted without providing any further details. We would be happy to offer a permanently staffed and accessible hotline. However, this would far exceed the company's resources. Our first advisor, an extremely experienced ENT specialist, is a doctor in everyday practice and is therefore unable to take telephone calls at all times.

If, for whatever reason, an initial telephone contact is the only option for you, you can first contact our secretariat. Our secretary Pascal Widmer will be happy to inform you about further steps, but is not a medical specialist. You can also find the secretary's telephone number in the box at the bottom of this page. For reasons of medical confidentiality, you should limit your contact with our secretary to questions about the formal procedure.

Our advisor will listen to you in an initial consultation, assess your situation and symptoms and, if necessary, recommend further investigations or treatment, if possible in your region of residence. You decide on further steps independently and on your own. Your data will not be stored by SMM and will certainly not be passed on.

The SMM was originally founded 25 years ago as a grassroots organization for people seeking help, at a time when health challenges in everyday music-making were even more taboo than they are today and there were no specialized musicians' medical professionals in Switzerland. In the quarter of a century since then, it has built up a network of specialists in medicine and numerous forms of therapy in Switzerland. In this way, it aims to prevent specific musician-medical phenomena from being overlooked or incorrectly treated.

The SMM pursues exclusively and directly charitable purposes. It works closely with international specialist societies in the field of musicians' medicine. The members are musicians, doctors, psychologists, therapists, institutions as well as supporting members and patrons. The experts at our advice center are independent of all institutions (orchestras, music academies, associations, etc.). They have no financial interests and do not favor any form of therapy.

We also welcome a general interest in the medical aspects of music-making. Membership of the SMM benefits musicians and the music and helps people to stay healthy even in this highly competitive professional world and to maintain music as a source of joy.

SMM - The Institute offers regularly updated risk assessments and recommendations. The political assessments of the situation in Germany and Switzerland differ. However, the analysis of the Fribourg team led by Claudia Spahn and Bernhard Richter is also helpful in this country. In the latest update from mid-March, it emphasizes that vaccination remains an important and central point in the fight against the coronavirus, as infection rates remain high. It also continues to recommend the established test methods for culture. They significantly minimize the risk of infection in samples if all participants (regardless of the date of their last vaccination or recovery) are tested on a daily basis.

The World Health Organization (WHO) emphasized the importance of the 3G Plus rule and the AHA rules in a statement on 11 January. 3G-Plus means that access is only permitted for fully vaccinated or recovered persons or persons with a negative PCR test. A negative rapid antigen test is not sufficient. The German AHA rule reminds people to keep their distance, take hygiene measures and wear face masks. If these are adhered to, the current state of knowledge suggests that active singing and making music is still possible despite the more contagious Omikron variant. To reduce the risk, the Fribourg Institute recommends a daily test for all participants in a rehearsal or concert event in addition to the 3-G rule until further notice, i.e. it suggests significantly more restrictive measures than Switzerland.

Since the end of February, amateur choirs in Germany have been allowed to perform without masks again. Nevertheless, the Institute recommends that all participants be tested before the start of the rehearsal/event, even when singing together (especially if the mask can be dispensed with), until further notice.

The team writes that many people are finding it difficult to reconnect with life before coronavirus, although numerous activities are once again permitted for vaccinated people despite high infection rates. Singing in particular has the label of being dangerous. This barrier must first be overcome. The fact that singing and making music are extremely positive and important for mental health must be re-established as the risk of coronavirus decreases. Encouraging children and young people to sing and make music is a particularly important task and an ethical responsibility.

According to the institute, the main transmission of viruses that cause respiratory infections generally occurs via aerosols that are produced when coughing and sneezing and are absorbed by the other person via the mucous membranes of the nose, mouth and deep respiratory tract when inhaled and possibly via the conjunctiva of the eye. According to simulations, if an infected person coughs up viruses, it can be assumed that the viruses will still be detectable in the air after several minutes and possibly hours, even if the infected person has already moved away. It is therefore still important to observe the social distancing rule when making music to protect against droplet infection.

However, contact transmission continues to play a role: Viruses can be transmitted from surfaces if they reach the hands by touching these contaminated surfaces and the hands then touch the face without being cleaned - provided the viruses have retained their infectious properties up to this point.

Musicians of all musical genres should "take strict care to avoid any contact with others in the event of non-specific symptoms such as fever plus respiratory symptoms (dry cough, catarrh) or more typical symptoms such as acute loss of olfactory and gustatory function until the infection has been ruled out by SARS-CoV-2 PCR testing of a swab". The newer omicron variant can manifest itself with milder symptoms, but is more contagious than the previously prevalent delta variant.

Link to the mentioned paper:

> www.mh-freiburg.de/service/covid-19/risikoeinschaetzung