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\title{Biophysical Basis of Thermometry Limitations to Control COVID-19 are
Overcome at Transmissive Skin Overlying Brain-eyelid Thermal Tunnels}



\author[1,2]{M Marc Abreu}%
\author[3]{Ricardo L Smith}%
\author[1]{Trevor M Banack}%
\author[1]{Anna L Clebone}%
\author[1]{Ala S Haddadin}%
\author[1]{Tyler J Silverman}%
\author[4]{Feng Dai}%
\author[1,5]{David G Silverman}%
\affil[1]{Department of Anesthesiology, Yale University School of Medicine}%
\affil[2]{Department of Ophthalmology and Visual Science, Yale University School of Medicine}%
\affil[3]{Department of Morphology and Genetics, Paulista School of Medicine, Federal University of São Paulo}%
\affil[4]{Yale Center for Analytical Sciences, Yale School of Public Health, Yale University}%
\affil[5]{John B. Pierce Foundation Laboratory, Yale University}%


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  \date{April 29, 2026}


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\begin{abstract}
Essential to management of pandemics, noninvasive thermometry has been
hampered by inaccuracies and inconsistencies, due to measurements on low
thermal conductivity (\emph{k}) surfaces we show here, which have
precluded effective assessment of febrile states for centuries.
Discovery of brain-eyelid thermal tunnels (BTT) identified undisturbed
thermal transmission from brain. We here report a series of integrated
anatomic, histologic, thermal emissive, thermal physiologic and
thermometric studies designed to identify, characterize and overcome the
biophysical limitations of surface thermometry as currently used
worldwide to control COVID-19, which primarily relies on non-contact
forehead thermometry. However, the forehead has thick and variable
dermis (\textasciitilde{}2000 \selectlanguage{greek}µ\selectlanguage{english}m to \textasciitilde{}2500 \selectlanguage{greek}µ\selectlanguage{english}m) and fat
layers (\textasciitilde{}1100 \selectlanguage{greek}µ\selectlanguage{english}m to \textasciitilde{}2800 \selectlanguage{greek}µ\selectlanguage{english}m) resulting
in low-\emph{k} insulation equivalent to wood. During thermal emission,
the highest skin temperature at forehead, present in only
\textasciitilde{}3.1\% of forehead, averaged 1.07\selectlanguage{ngerman}±0.49°C (mean±SD) less
than over BTT (p=0.008, two-tailed paired t-test). Thermometric studies
(without correction factor) revealed 1.97°C higher temperature at BTT
site (BTT°) than forehead. Facial fanning caused 3.5°C reduction in
forehead temperature, which do not compromise BTT site, attributable to
impact on non-BTT surface sites by highly variable surface vasculature.
Cerebral hemisphere dominance studies uncovered higher BTT° in the
dominant side (P\textless{}0.001 for 0.14°C difference). Like BTT,
superior palpebral vein region has thin dermis (\textasciitilde{}900 \selectlanguage{greek}µ\selectlanguage{english}m)
and is fat-free, however, BTT has higher intensity light emission due to
heat transfer from underlying brain tunnel. Findings bring a new
dimension for combating COVID-19 that is aligned with physics and
biology, and without any cost whatsoever and undue burden, current
worldwide suboptimal low-\emph{k} thermometry can be immediately and
conveniently enhanced by brain-enabled thermo-physical based
high-\emph{k} signal conversion, which can be easily implemented by any
country, community or individual in the world.~%
\end{abstract}%



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Rich media available at \url{https://vimeo.com/462269350}

Rich media available at \url{https://vimeo.com/462269319}

Rich media available at \url{https://vimeo.com/462269295}

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