Dr. Lucinda A. Halstead is the Vice Chairman for Resident Education in the department of Otolaryngology, Head and Neck Surgery, and the Medical Director of the MUSC Evelyn Trammell Institute for Voice and Swallowing. Dr. Halstead founded the MUSC Voice Center in 1987 to support research and advanced care in laryngology, swallowing, voice, pediatric otolaryngology, and performing arts medicine. In 2000, she became the medical director of the Evelyn Trammell Institute for Voice and Swallowing

She is the laryngologist for the internationally renowned Spoleto Festival USA, and president of the Performing Arts Medicine Association.

Hello, everyone,

and welcome to our last

Medical University

of South Carolina

Science Never Sleeps

Podcast

It has been quite a

year,

and we thought

our December podcast

would begin with a

soothing

and beautiful musical piece

in the spirit

of the holiday season.

You are listening to

"Sing We Now of

Christmas,"

an original composition

by Susan Conant,

performed by

The Robert Taylor

Festival Choir

here in Charleston,

with a CD of the same

name

recorded and released

by Robert LaPorta's

MSR Classics label.

But, it is not

just by chance

that we offer this

lovely vocal rendition.

It is a segue to a very

fitting

and timely podcast

with our guest

Dr. Lucinda A. Halstead,

Vice Chairman

for Resident Education

in the department

of Otolaryngology,

Head and Neck Surgery,

and the Medical Director

of the MUSC

Evelyn Trammell

Institute

for Voice and

Swallowing.

Dr. Halstead founded

the MUSC Voice Center in

1987

to support research

and advanced care

in laryngology,

swallowing, voice,

pediatric

otolaryngology,

and performing arts

medicine.

the medical director

of the Evelyn Trammell

Institute

for Voice and Swallowing

She is the laryngologist

for

the internationally reno

Spoleto Festival USA,

and president

of the Performing Arts

Medicine Association.

Welcome, Dr. Halstead.

Thank you, Loretta,

it is an honor to be

here.

I mentioned that

this is a timely

podcast,

not only because it is

a season of holiday

cheer,

and singing

only sweetens the joy,

but because the research

with which you have been

engaged

has much to say

about how COVID is

spread.

It was and is

a massive undertaking.

Would you share a little

bit

about this study

and how it came about?

Absolutely.

First, I should like

to clarify that my role

in the aerosol study

has been primarily that

of disseminating

information

to performers via webina

sponsored by Performing

Arts

Medicine Association,

the National Association

of Teachers of Singing,

and the British

Association

for Performing Arts Medi

Additionally, I have

communicated this

information

by phone and email to

my patients who are

performers,

and my performing

colleagues

at educational instituti

that range

from elementary schools

to university programs.

Also, to my delight,

I have been fortunate

to exchange ideas

with some of

the study co-chairs

and principal

investigators

during this study.

The exchange of ideas, I

hope,

has benefited all of us.

Dr. Halstead, I'm going

to stop

you for a moment and ask

so this is

an international group

of scientists

looking at

this particular study,

is that correct?

Yes, it is.

It is the most amazing

piece of research

in a long time.

The study

is actually entitled

The Unprecedented

International Coalition

led by

Performing Arts

Organizations

to Commission

the COVID-19 Study.

Before I go into the

details

of who is conducting this

I would like to give you

just a little bit of

background

as to why this study

was important.

As the pandemic started,

it became apparent that

the virus might be

transmitted

by aerosolized

viral particles,

as evidenced by multiple

super spreader events

worldwide

involving choirs.

The first one that we

had

in the United States

was in Washington State,

where no masks were

worn.

Among 61 persons who

attended

that March 10th choir pr

one person was known

to be symptomatic

of some sort of viral

illness,

which later

was identified as COVID.

Subsequently, they had

53 choir members

identified,

including 33 confirmed

and 20 probable cases

of COVID-19.

Three of the people who

became ill were

hospitalized,

-and two of them died.

-That's horrible.

Yeah, it was very, very

tragic.

This two-and-a-half-hour

singing practice,

when they studied it,

provided several

opportunities

for droplet transmission

and fomite transmission,

meaning between

inanimate objects,

such as books, chairs,

music.

These included members

sitting close together

and sharing snacks,

stacking chairs

together,

but most importantly,

they were not wearing

masks

during the rehearsal.

Thus, it was postulated

that the act

(unintelligible)

might have contributed

to the emission of

aerosols

and the infection

of the choir members.

Other outbreaks had

already

occurred worldwide,

including choral

rehearsals

in South Korea,

and in retrospect, one

in London

where one of the choir

members

had recently visited Chi

and came back and then

attended a choir

rehearsal.

So, looking back

in the scientific

community

as to what evidence

there was

that viral transmission

could occur through

aerosolized particles.

To our shock, there

really

was only one article

that was published in

1998

pertaining to the spread

of tuberculosis

in a church choir

where loud singing, of

course,

was being performed

but that the

transmission

of tuberculosis occurred

in a population that

historically is not at

risk

to contract

tuberculosis.

That's really

interesting.

So, there was not--of

course,

no one knew at the time,

in late December

what exactly

we were dealing with,

and no clue

that singing

would be a transmission

for the virus.

It's interesting,

I guess they were doing

a literature study

or something,

and that's how they

found out

about the TB,

or how did

that come about

that they looked at that

and said,

"Oh, there might

be a connection here"?

So, that was a case

report

of this outbreak

of tuberculosis

in a choir,

and that was the first

time

that aerosols actually

had been mentioned

in association with

singing.

Again, there have been

other studies later on

that associated

the possibility of loud

talking,

but not singing,

as increasing

aerosol generation

from a person.

-Okay.

-So,

the reason that it

became

paramount at this time,

of course, is that,

if we think about

viral transmission by

singing

and through the bells

of wind and brass

instruments,

it becomes a tremendous

public health issue.

It affects

religious gatherings,

theater and performance

venues,

but most importantly,

it affects

the musical education

of our children,

who are our future

artists.

So, that leads us

to the development

The Unprecedented

International Coalition

led by

Performing Arts

Organizations

to Commission COVID-19

Studies.

This was just

a phenomenal event.

It was organized by

the College Band

Director

National Association

and the National

Federation

of High School Bands,

which are headed by

Doctors

Mark Spede and James Wea

And they commissioned

aerosol experts

to develop a study

to look at instruments,

specifically

the wind and brass

instruments,

singing, acting,

and dancing,

and, most importantly,

what kinds of

mitigations

you could put in place

to prevent these

aerosols

from infecting

other people

and other performers.

The study was really

a giant GoFundMe,

in that they reached

out,

they did not go through

a federal grant request.

They said,

"This needs to happen

now,"

and they reached out

to art organizations

and had over 100

organizations

contribute.

The first $125,000 was

raised

within three weeks,

and the total of

$325,000

was raised within

about eight weeks.

I think that's

phenomenal,

and that really does spe

the desire

of the performing arts

community

to want to continue to

do

the important work they

especially, as you

noted,

for children,

and that

they took the

initiative.

They didn't wait around,

they said,

"Let's figure this out

now,

so we can continue

the great work that we

do,"

so I applaud them for th

That really is

wonderful.

It was just so, so

amazing,

the outreach

and enthusiasm

of the performing arts

community.

I think,

most importantly,

that reflects

the passion

and the personal desire

of these artists

to perform.

I will tell you that,

time and again,

my patients say

when they can't perform

that they feel like

that their soul is dead.

That their sense of self

is completely destroyed,

they have no identity.

So, for performers,

singers,

instrumentalists,

without this

artistic expression,

they feel that

they've really lost

a good portion

of their identity.

So, they were very

lucky,

because they were able

to reach out

to two aerosol experts,

Dr. Shelly Miller

at the University

of Colorado Boulder,

and Dr. Jelena Srebric

at the University of

Maryland.

And these two ladies

should be commended

because they were able

to bring

their labs out of lockdo

complete an IRB

approval,

and design parallel

studies

to verify the findings

of each of their

laboratories

within about

four weeks.

That is incredible.

For those who don't

understand

how the research process

and indeed because of

the COVID-19 lockdown

of research

laboratories,

that is tremendous speed

on their part

to do everything

correctly

to be able

to get up and running,

and make sure they have

approved research study.

So, again, it just

speaks

to the passion

of everyone engaged

in this project.

What were the findings

that came out of this

study,

or at least

the findings to date?

So, the finding to date

is that aerosol

emissions

do occur

and are increased

by loud singing

and through the bells of

most

wind and brass instrumen

So, they then looked at

what kind of mitigations

could be effective

in decreasing

that aerosol spread.

The biggest one

is wearing masks.

So, the mask will block

most of the forward

aerosol transmission,

and what is not

contained

by the mask

leaks mostly upward

around the nose

toward the ceiling,

and a little bit out the

side,

versus forward

towards your colleagues.

We have found that

the woven surgical mask,

the regular ones that we

see

most people wearing thes

and especially our

performers,

will block about 64

percent

of the aerosol.

So, what they found is,

with wearing the mask,

and then distancing

circumferentially the

singers

and the instrumentalists

six feet apart,

it was very, very

effective

in decreasing

transmission.

Can I stop you one

moment there?

What I was just thinking

as you were explaining

how they were beginning

that mitigation process

is,

and perhaps

you'll speak to this

more later,

is when they're required

to do this

for safety/health

reasons,

does it have an effect

on the musical output?

Yeah, I can talk about

that.

These mitigations are

actually--

That's part of the

study,

is to figure out

what you can put in

place

that has the maximum

amount

of removal or blocking

of aerosols,

but does not degrade

the sound

of the instrument.

-Perfect.

-So,

the three-layer

surgical masks

are great because they

closely cover the nose

and chin,

and they are recommended

for singers.

However, for singers,

this is a real

challenge,

because when

they breathe in,

the mask is sucked up

against their mouth

and makes it

very, very difficult.

Plus, having the force

of your breath

coming back at you

while you're singing

can be very challenging.

So, multiple mask

designs

are being studied

by the Coalition

to see which ones

might be the best.

I can already tell you

that

the singers have been

extraordinarily

inventive.

(chuckling)

But with all of these

ideas

of safety in mind

in terms of mask fit,

three layers,

or N95 material, even if

it's not completely fit,

as we call,

fit tested for surgery,

to help mitigate

viral transmission

in church choirs

and in the educational

setting.

So, that's what they're

doing,

they're looking at,

for singers,

these different kinds of

masks

to try to find something

that's ideal.

The same is going on

with instruments.

They have looked

at different bell covers

that make it still easy

to play,

but block

the aerosol

transmission.

They have looked

at how the

instrumentalists

can interface

with the instrument,

which is putting the

mouthpiece

into their mouth

without having

a lot of transmission.

So, what they've

designed,

and seems to be

extremely effective,

as we can talk about

in a minute,

is that the

instrumentalists

will wear

two surgical masks.

The one closest to them

will have a horizontal

slit

so they can get their

instrument

into their mouth,

and while they're

playing,

that is the only mask

that they're using.

However, hooked on their

ear

and when they're not pla

is an intact surgical

mask,

so when they're sitting,

they're just breathing

and waiting

for their turn to play,

they have

this extra mask

that is blocking

aerosol flow.

So, the other things

that they've looked at

very, very carefully

is environmental

mitigation.

I will tell you that

a lot of our local

college

vocal programs

are using

these mitigations.

Specifically,

limiting performance

time,

or lesson time

to 30 minutes,

and then changing space.

So, the reason

that one wants to do

that

is that,

with the leak around the

mask,

there is going

to be aerosol

that's disseminating

through the room.

Their recommendation,

based on their knowledge

of aerosol transmission,

or potential

for infection,

is that, after 30

minutes,

there should be

the possibility

of enough aerosol

in the room

that we need to have

a time to clear it.

So, the 30 minutes

is really based on the

fact

that most commercial

buildings

have a two-to-three

air exchange rate per

hour.

So, that means

that it's anywhere

between 20

and 30 minutes.

We know that

your air exchange, for

example,

is three exchanges an

hour,

then the air in the room

is exchanged every 20

minutes.

So, after 30 minutes,

what they recommend

is that everybody

leave the room,

you wait for 20 minutes,

and then you can

go back into that room,

and hopefully what

you've done

is you have another room

that you can go into

and continue

your lessons

or your rehearsal.

But, most of the

colleges

are doing

video voice lessons,

or outdoor rehearsal,

and again, moving the

venue.

Even outdoors,

they recommend

that you move the venue

after 30 minutes.

However, one of the

webinars

that we did,

sponsored by

Performing Arts

Medicine,

was bringing it indoors,

because now it's cold

outside.

And the airflow, again,

in the performance space

is very important.

If you look

at the website

for the Coalition,

they talk a lot about

the air exchange rates,

HEPA filters,

and ultraviolet light.

All of these things

can also help decrease

and kill the virus.

So, these are some

very important things.

Additionally, again,

Dr. Srebric has been

very, very interested

in trying to see

if there's other kinds

of mitigations

they can use

to help protect,

and blow air away

from singers

so that they don't

have to be masked.

She shared with us

one of her--she said,

"This is my first

approximation.

I just used what I had."

She has a singer

sitting at a table

with two box fans,

one on each side,

blowing the aerosol

away.

She says,

"This is just what I

had,

and obviously you can't

hear

the singer singing

because of the noise

of the box fans."

But, it's great

that they are looking

at these kinds of things

to help our singers

be able to perform.

If we could find things

that they could do

so that they could be

in a theater-type

interactive performance

would be fantastic.

Indeed, necessity is the

mother

of invention, no?

Yes, yes.

So, I think the thing

that I found

very, very exciting

is that people go,

"Well,

is this really important

These mitigations

actually do work.

Dr. Spede shared with us

some of the things

that he's been

monitoring

in band and orchestral

practices,

and there has been

an incident

where two

of the clarinetists,

and I will say

that clarinets

are one of the highest

aerosol emitters

of the wind instruments,

were COVID positive

during the practice.

One of them was

completely asymptomatic,

and the other had been

feeling a little crummy

and went to

the student health

center

and was told that

he didn't have COVID

and they didn't test

him.

Later on that evening,

he felt worse and went

to the emergency room

and was COVID tested

and was positive.

No student

in that orchestra

-was infected by COVID.

-Because of those

-mitigation processes--

-Because of the

mitigations.

They were wearing the

masks,

they were doing the bell

they were observing

the time constraints,

and no viral

transmission occurred.

That is huge

because that means that

we can have

limited but safe

rehearsals for our

students.

This will really help

all of our young artists

not lose their skills.

One of the things

that was brought up

in the British

Association

of Performing Arts Medic

was a study where

they showed that

musicians,

high-level musicians,

after two weeks

of not doing anything,

like no singing,

or no instrumental

practice,

had a significant

degradation in their

skills,

and it took them

a long time to recover.

Wow, that's incredible!

So, only two weeks,

and you can have,

for a high-level

performer,

a significant

degradation

in their skills.

One of the things

you noted is

the study designers

were very centered on

making sure that they

found some solutions,

but as you noted

earlier,

talking about

degradation,

not degrading the actual

sound of the

performance.

Is that correct?

That's correct.

They've tried

multiple things,

especially with

the bell covers.

There were some that had

very heavy material,

and that was not

good for the sound.

What they noted was that

they could have a

lighter

material bell cover

and it did the same

thing.

They went

even as far to having

a very, very thin bell

cover,

which was essentially

nylon pantyhose

that they put

over the bell.

It was effective, but

because

it stretched after a whi

you could never

guarantee

the effectiveness.

But now, these bell

covers

that they're recommendin

are commercially

available

for bands.

That's wonderful.

It's just so, so

exciting.

Again, for singers,

looking at the masks,

looking at airflow

in the performance space

is really very critical.

They are working on

that,

which is very exciting.

It's hard, even for

dancers,

to work with masks.

Actually, one of my

colleagues

is the physician

for the Rockettes.

They have them

practicing

with masks at home.

They're just starting to

bring

them back into the theat

to do some rehearsals.

There's lots of

different

mitigations that they us

in terms of having them

come

with their street

clothes

over their leotards

so that they don't have

to

go into a changing room

and have that

locker room experience

that you usually

have backstage.

They each have a little

area

to put their street clot

and they just take it

off,

leave it there,

do their dancing,

go back, put it on,

and leave the studio.

I can imagine that

that would be a

challenge,

but they're probably

grateful

for the masks because

all performers,

it's an expressive

discipline.

Even when you're

dancing,

your face is still

part of that whole

performance,

so I would imagine that

is

rather challenging to th

And yet, they still--

I hope the Rockettes are

able to do something

phenomenal

during the holiday

season.

Well, I think they're

looking very seriously

at it,

or, if not now, for

next,

this summer.

But it is a problem.

One of the things that

we really have talked

about

is the fact

that you can't see

the lower third

of the face with the

masks.

There are some

translucent masks.

All of those things

are being looked at,

but I don't have

any of that data

-right at the moment.

-Okay.

I think that all of us

are really excited that

there have been, now,

vaccines that are

approved

for use,

at least in England,

and soon

in the United States,

the Pfizer and the

Moderna,

and potentially

the AstraZeneca

vaccines.

This, of course,

will be phenomenal

to give everyone

protection

so that we could

eventually move to

a maskless performance.

But people

need to realize that

that's going to

take many months

if not over a year

to get enough

people vaccinated

so that it's safe

to take the masks off.

It's true,

patience is in order,

even as we find

some wonderful solutions

to help us get through

these hard times.

This is such an

important study,

and the results

are quite interesting.

I believe they are

transferrable

to all sorts of other ve

including courtrooms,

classrooms,

on the athletic field.

I'm really excited about

what you all are doing,

and even some of

the commercialization

of some of the devices

coming out now.

I think that a lot of

people

will really want to know

more in-depth about this

unprecedented research

study,

so we are going to share

links

to the video conversatio

with the lead

researchers,

and a video on the viral

transmission to our

audience.

That will be

part of the package

that we send out

to our audience.

Everyone will have

the opportunity

to read more

in-depth about this

and understand even more

how those aerosols

really do spread

quite a bit

without a mask on.

So, thank you very much

for

that information, Dr. Ha

Just to corroborate

what you've just said,

they have looked at--

because again,

this study was really

primarily geared

to putting students

back in the classroom

and performing

in the classroom,

but they also said

these are some

things that teachers

who are not performing,

or doing band or choir,

can also use.

The recommendations

for a classroom, again,

is that 30-minute

contact,

and then a change of

venue.

However, they recommend

that the teacher be

miked,

so that

they can only speak,

or they can preferably

speak,

in a conversational tone

versus projecting like

many teachers have to

as they project

across the classroom.

Additionally,

when students ask a

question,

they were asked,

the recommendation is

to,

again, ask your question

in a very conversational

tone

without a lot of

increased volume.

That's very good advice,

actually, very

thoughtful.

So, switching lanes a

bit,

tell us more about

the Evelyn Trammell

Institute, please.

The Evelyn Trammell

Institute

for Voice and Swallowing

is actually--the goal

of our institute

is to deliver

state-of-the-art care

for patients with voice

and swallowing problems.

We achieve this by

participating in

research

to advance the knowledge

in both the field of

voice

and the field of swallow

Not only do we

participate

in that research,

we're very active

in training

medical and allied

health professionals

in techniques of voice

and swallowing therapy

so that they can help us

with new ideas to

advance

scientific knowledge.

It's very interesting,

the Evelyn Trammell

Institute

for Voice and Swallowing

is not only for

the performing arts,

it's for everyday

people.

I'm thinking

about the elderly,

who especially are

confronted

with issues of swallowin

Is that true?

Yes, they have both

voice and swallowing

issues.

As we age,

we lose muscle mass

and muscle tone.

Although it seems

almost counterintuitive

that since we talk and

we

chew and swallow all the

that as we age that

those muscles would fail

us,

but you actually

do lose strength

in these muscles,

so that there are

many exercises

for both the voice

and also for swallowing

to strengthen the

muscles

of the tongue and the ph

the respiratory system,

so that you can

restore and build back

strength to swallow

effectively,

or to speak loudly.

And especially for

elderly choir members

to develop

enough breath support

to actually sing

more loudly

without abnormal

compensations

with accessory muscles

of the neck,

so that they sing

clear and loud

like they did

when they were 20

versus in a tight

sort of strained way

that often happens when

you're compensating for

breath.

Oh, that's good news.

I'm very happy to hear

that.

Tell us some more about

the common vocal issues

you deal with

as medical director

of the Trammell

Institute.

One of the most common

things

that I see is overuse.

These performers

perform all the time,

so as they're singing

loudly

and their vocal folds

are vibrating together,

the edge of the vocal

folds that contacts

can become a little

stiff

just from continual use.

That can sometimes

lead to them doing

abnormal

compensatory maneuvers

with excess

tongue tension,

more tension

in the neck,

and from that develop

nodules or polyps.

Sometimes it also

just exacerbates

some technical issues

they have

from incomplete training

in whatever

particular vocal style

that they're doing

at that particular

moment.

That's probably one of

the most common things

is that, and then

the nodules and the

polyps.

But a lot of it is also,

especially harkening

back

to the elderly,

a lot of their problems

can really be

a disassociation

of the breath

to the vocal folds,

so that they don't have

that power coming up

to vibrate the vocal

folds,

what we call

subglottic pressure,

because they've

disengaged that

mechanism.

They disengage it mostly

because there's, again,

the degradation

of the muscle tone

in the chest wall

and the diaphragm.

But the other thing that

is a huge problem

nowadays

is the forward head

posture

that we all have

because of our screens.

Our phones, our iPads,

our computers.

Studies have shown that

just putting your head

forward

about three or four

inches,

which is kind of what

you do

when you look down

at your cell phone,

you decrease your

lung volume by 30

percent.

What happens with that

if you're sitting

there--

That's why when they

want singers to be

standing up straight and

put

their music out in front

because if they have

their head down here,

they lose 30 percent

of their lung volume.

Then they have to use

excess pressure

of the accessory muscles

of the larynx and neck

in order to generate

that pressure

to get the vocal folds

to vibrate

and produce sound at the

level

that they want to produc

I bet folks have--

I'm sure folks have not

even thought about

the effect of posture.

Back to what

our parents told us,

-"Sit up straight!"

-Sit up straight.

Yeah, our biggest

technical advances

are actually, in some

ways,

some of our biggest enem

in that it really has

limited the ability

for people to breathe,

and to breathe normally,

or breathe fully rather.

I see that a lot

in my aging patients.

My residents can tell

you

I'm constantly

sort of putting my hands

on their ribcage and

say,

"Take a deep breath."

They don't know how

anymore,

and so we sort of

have to talk about that.

It's very, very

interesting.

It truly is, it truly

is.

I would suggest to you

maybe a little yoga

would help out with

our everyday lives

and breathing properly

to save our vocal chords

and our throats.

There is research out

there

that one of our PhD

students

did with our aging patie

who had very thin vocal

folds,

known as vocal fold

atrophy.

We looked at inspiratory

muscular training

as being a way to

recondition

the respiratory mechanis

so that they wouldn't

need to have a surgery

to augment their vocal

folds.

That was very

successful.

Additionally,

the same type

of inspiratory

muscular training

is used to actually

tighten

the lower esophageal sph

to help prevent reflux.

These are prospective,

randomized studies

that have been done to

verify the efficacy of

this.

For people with reflux,

they actually did

the pH probe down

the nose for 24 hours

and the manometry probe

to measure the tightness

of the sphincter

before and after they

completed the training,

and noted that

it was very effective.

That is, I have to say,

that is one of the

reasons

why we do

the Science Never Sleeps

because not only does

your institute offer

information or

solutions for folks,

they continue

to study and learn

what are the best

innovations

to move forward the prac

and to help

their patients.

And I think that

what you just said

is a highlight of why

an academic health

center

like the Medical

University

of South Carolina

is so important to the

health

and well-being of our ci

We don't just offer

regular clinical

practice.

We offer

state-of-the-art

based on the research

of our faculty

and the residents,

and I think

that's outstanding.

Over your vast career,

what are some of the

most

surprising clinical inno

that have been

discovered

regarding how singers

protect and manage

their instrument,

the vocal chords?

One of the most fun

and surprising things

that has become

very much incorporated

into vocal pedagogy

is a technique called

straw phonation.

Straw phonation

basically is a way

for singers

to vocalize on a vowel,

but instead with

the straw in their mouth

either open to the air,

but often with the other

end

in about an inch of wate

What happens is

it prohibits them

from having

excessive tension

in the tongue

and in the neck.

It takes away these

compensatory measures

and allows them

to vocalize very freely.

If they're having

trouble,

for example,

transitioning from

their chest voice

up into their head voice

because they end up

tightening

at that transition,

which is very difficult,

it's a very complex

muscular interaction.

By releasing

that tension,

they learn how to

easily ascend the scale

without that tension.

It can help them

build their range.

It can help them, again,

with the register

transitions.

Also, because this

technique

causes a very high

amplitude

but very low pressure

rubbing of

the vocal folds

together,

it also massages

stiffness

out of the vocal folds.

And you're talking about

a straw like a sipping

straw?

Yeah, like a Starbucks

straw.

Hm, very simple!

Yeah, but we prefer it

to have a bend in it,

so that they stay

aligned,

and they get out of that

forward head posture.

I will say the caveat

about that is that

people shouldn't just

go out and try it,

especially if they have

concern about a vocal

problem.

The voice teachers who

are

using this with their st

are already sure that,

by hearing

their students

and knowing their

students over time,

that they don't have

a lesion on the vocal

fold,

like a polyp or a

nodule, okay?

If they thought

they were having that,

then that's--

I see plenty of them.

If you think

that your voice

has become rough

as a singer,

then it's better to have

your vocal folds looked

at

prior to trying to do

something like this

because the straw

phonation,

if you had a nodule or a

that constant contact,

even though it's very

gentle,

could potentially make

those lesions worse.

Good to know,

thank you for that

caution.

Dr. Halstead, it has

been our

pleasure to speak with y

about the great work

you and MUSC are doing

to mediate COVID-19

issues

related to the creative

especially as they

relate

to the joy of music and

We are most grateful for

your passion and

ingenuity,

as well as the gracious

musical contributions

of Mr. Rob Taylor,

Ms. Conant,

and the Taylor Festival

Choir,

and exceedingly grateful

for the innovative

and informative work

of Doctors Weaver and

Spede,

co-chairs of the

Performing Arts

Aerosol Study Coalition.

Again, we will put

the links out there

for those interested

in learning more

and seeing exactly how

the aerosol study

graphically shows how

the COVID-19

can be transmitted.

To our listeners,

on behalf of the Medical

University of South

Carolina,

and our Office of

the Vice President for

Research,

we wish everyone

a safe, joyful,

peaceful, and musical

and hope to join with

you again

via podcast or in person

for our MUSC Science

Café series

and Science Never

Sleeps.

We will leave you now

with more song

from the Taylor Festival

Choir.

Thank you all,

and we'll see you in

2021.