First, there is now a Resources Page here for the most commonly asked questions I’m getting.
Happy to continue to answer your questions/concerns as best I can, so don’t be shy about that.
Covid-19, Brazil’s Bolsonaro, And Herd Immunity
If Bolsonaro is charged with crimes against humanity in part for pushing herd immunity. Should other leaders be, too?
An interview w Dr. Deisy Ventura, Prof of Ethics at the Faculty of Public Health, University of São Paulo
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Pediatric Community Acquired Pneumonia: Lower Amoxicillin Dose and Shorter Duration May Be Effective
For mildly-moderately ill children, 3 days treatment with Amoxil appears no worse than 7 days, with fewer side effects.
Good communication from a trusted source:
I got the COVID-19 vaccine today! My wing is feeling a little sore, but it'll give my body an extra protective boost that keeps me and others healthy.— Big Bird (@BigBird) November 6, 2021
Ms. @EricaRHill even said I’ve been getting vaccines since I was a little bird. I had no idea!
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Unvaccinated? Don’t Count on Leaving Your Family Death Benefits
These days, workers who refuse to get vaccinated against covid-19 may face financial repercussions, from higher health insurance premiums to loss of their jobs. Now, the financial fallout might follow workers beyond the grave. If they die of covid and weren’t vaccinated, their families may not get death benefits they would otherwise have received.
New York’s Metropolitan Transportation Authority no longer pays a $500,000 death benefit to the families of subway, bus and commuter rail workers who die of covid if the workers were unvaccinated at the time of death.
“It strikes me as needlessly cruel,” said Mark DeBofsky, a lawyer at DeBofsky Sherman Casciari Reynolds in Chicago who represents workers in benefit disputes.
Other employers have similar concerns about providing death or other benefits to employees who refuse to be vaccinated.
In Massachusetts, the New Bedford City Council sought to extend accidental death benefits to city employees who died of covid, but the mayor didn’t sign that legislation because, among other things, it didn’t prohibit payment if the worker was unvaccinated.
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COVID-19 alpha variant detected in dogs and cats with suspected myocarditis
A new study in the Veterinary Record reveals that pets can be infected with the alpha variant of SARS-CoV-2, which was first detected in southeast England and is commonly known as the UK variant or B.1.1.7. This variant rapidly outcompeted pre-existing variants in England due to its increased transmissibility and infectivity.
The study describes the first identification of the SARS-CoV-2 alpha variant in domestic pets; two cats and one dog were positive on PCR test, while two additional cats and one dog displayed antibodies two to six weeks after they developed signs of cardiac disease. Many owners of these pets had developed respiratory symptoms several weeks before their pets became ill and had also tested positive for COVID-19.
All of these pets had an acute onset of cardiac disease, including severe myocarditis (inflammation of the heart muscle).
still an incredible, negligent last of testing.
Drugs and Vaccines:
We on the CDC ACIP just voted 14 to 0 in favor of Pfizer COVID-19 vaccination for children aged 5 to 11. This helps explain why – pic.twitter.com/i2zRmMRcMH— Camille Nelson Kotton (@KottonNelson) November 2, 2021
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What would @DrPaulOffit say to a parent who isn't sure they want to vaccinate their kids? Listen and learn more on today's In the Bubble with @ASlavitt. 🎙️https://t.co/AJveHOMl4L pic.twitter.com/jsVcv7rlUZ— In the Bubble (@inthebubblepod) November 1, 2021
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Decline in effectiveness for Moderna, Pfizer, Janssen vaccines; and mortality consequences
a study from the Public Health Institute, the Veterans Affairs Medical Center and the University of Texas Health Science Center, published today in the journal Science, has analyzed COVID infection by vaccination status among 780,225 Veterans.
Researchers found that protection against any COVID-19 infection declined for all vaccine types, with overall vaccine protection declining from 87.9% in February to 48.1% by October 2021.
- The decline was greatest for the Janssen (Johnson & Johnson) vaccine, with protection against infection declining from 86.4% in March to 13.1% in September
- Declines for PfizerBioNTech were from 86.9% to 43.3%
- Declines for Moderna were 89.2% to 58%.
Importantly, vaccination of any type was protective against death among individuals who did become infected. The relative benefit of vaccination for protection against death was greater for persons under 65 but was also very strong for persons over 65.
The study showed that the risk of death from COVID infection was highest in unvaccinated Veterans, regardless of age and comorbidities. While some breakthrough infections resulted in death, vaccination remained protective against death in those who became infected during the Delta surge.
For those under 65 years old, vaccines overall were 81.7% effective against death.
- Protection against death was greatest for the Pfizer vaccine, at 84.3%.
- Moderna was the next most effective, at 81.5%.
- Janssen was 73% effective.
For those 65 and over, overall vaccine effectiveness against death was 71.6%.
- Moderna was 75.5% effective.
- Pfizer was 70.1% effective.
- Janssen was 52.2% effective.
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Huge news for the global COVID fight.— Atul Gawande (@Atul_Gawande) November 4, 2021
Covaxin is an inactivated virus vaccine.
Effectiveness is 93% vs severe disease; 65% vs symptomatic Delta infection.
Can be stored in a fridge. Cost in India is $4.
And output will reach 70M+/month by Jan.
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Coronapod: China’s crucial COVID vaccines start to falter
Two inactivated virus vaccines from China account for half the world’s inoculations against COVID, now their protection may be waning.
More that 3 billions doses of China’s CoronaVac and Sinopharm vaccines have been administered across the globe, playing an especially important role in Latin America and South East Asia, as well as China. These vaccines use inactivated virus particles to expose the immune system to Sars-CoV-2, but they do not appear to generate the same levels of neutralising antibodies as other vaccine platforms such as those based on mRNA. Now studies are suggesting that this protection may be waning more quickly than with other vaccines, which has sparked a conundrum – in many countries the only vaccines available are CoronaVac or Sinopharm. In this episode of Coronapod we ask how researchers are trying to get a handle on what is going on and how they might adapt to counteract waning immunity from these crucial vaccines.
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Largest real-world study of third dose of COVID-19 vaccine effectiveness
Largest real-world study of third (“booster”) dose of COVID-19 vaccine effectiveness against severe illness published by Israel’s Clalit Research Institute in The Lancet
The Clalit Research Institute, in collaboration with researchers from Harvard University, analyzed one of the world’s largest integrated health record databases to examine the effectiveness of the third dose of the Pfizer/BioNTech BNT162B2 vaccine against the Delta variant of SARS-CoV-2. The study provides the largest peer-reviewed evaluation of the effectiveness of a third “booster” dose of a COVID-19 vaccine in a nationwide mass-vaccination setting. The study was conducted in Israel, an early global leader in third-dose COVID-19 vaccination rates.
Many countries are currently experiencing a resurgence of SARS-CoV-2 infections despite hitherto successful vaccination campaigns. This may be due to the greater infectiousness of the delta (B.1.617.2) variant of SARS-CoV-2, and to waning immunity of vaccines administered months earlier. In the face of the current resurgence, several countries are planning to administer a third booster dose of mRNA COVID-19 vaccine.
This study suggests that a third vaccine dose is effective in reducing severe COVID-19-related outcomes compared to individuals who have received two vaccine doses at least 5 months ago. It is the first to estimate the effectiveness of a third dose of an mRNA COVID-19 vaccine-BNT162b2 specifically-against severe outcomes with adjustment for various possible confounders, including comorbidities and behavioral factors. The study’s large size also allows a more precise assessment of the vaccine’s effectiveness across different time periods, different subpopulations (by sex, age and number of comorbidities), and different severe outcomes (which are rarer and thus require greater sample size). A recent clinical trial conducted by BioNTech included a smaller sample size and did not estimate the third-dose’s effects for more severe outcomes.
The study took place from July 30, 2021 through Sept 23, 2021, coinciding with Israel’s fourth wave of coronavirus infection and illness, during which the Delta (B.1.617.2) variant was the dominant strain in the country for new infections (with very few exceptions).
The results show that, compared with individuals who received only two doses five months prior, individuals who received three doses of the vaccine (7 days or more after the third dose) had 93% lower risk of COVID-19-related hospitalization, 92% lower risk of severe COVID-19 disease, and 81% lower risk of COVID-19-related death. Vaccine effectiveness was found to be similar for different sexes, age groups (ages 40-69 and 70+) and number of comorbidities.
The study also included a population-level analysis which found that infection rates began to drop for each age group 7-10 days after that age group became eligible for the third dose.
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Pfizer’s COVID-19 Vaccine Generates $36 Billion in Revenue
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U.S. Spends $1.29 Billion on Lilly’s Neutralizing Antibody Therapy
As part of the new agreement, Lilly will supply a minimum of 400,000 doses no later than December 31, 2021. Furthermore, an additional 614,000 doses of bamlanivimab with etesevimab for administration together has been scheduled for delivery no later than January 31, 2022.
This neutralizing antibody therapy is authorized for emergency use to treat mild to moderate COVID-19 or post-exposure prophylaxis of COVID-19 in specific individuals.
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Pfizer’s COVID-19 Oral Antiviral Prepares to Launch
New York-based Pfizer Inc. today announced its investigational novel COVID-19 oral antiviral candidate, PAXLOVID™, significantly reduced hospitalization and death, based on an interim analysis of the Phase 2/3 EPIC-HR study of non-hospitalized adult patients with COVID-19, who are at high risk of progressing to severe illness.
The scheduled interim analysis showed an 89% reduction in risk of COVID-19-related hospitalization or death from any cause compared to placebo in patients treated within three days of symptom onset, the study’s primary endpoint.
And 0.8% of patients who received PAXLOVID were hospitalized through Day 28 following randomization (3/389 hospitalized with no deaths), compared to 7.0% of patients who received placebo and were hospitalized or died (27/385 hospitalized with seven subsequent deaths).
The statistical significance of these results was high (p<0.0001).
Similar reductions in COVID-19-related hospitalization or death were observed in patients treated within five days of symptom onset; 1.0% of patients who received PAXLOVID were hospitalized through Day 28 following randomization (6/607 hospitalized, with no deaths), compared to 6.7% of patients who received a placebo (41/612 hospitalized with ten subsequent deaths), with high statistical significance (p<0.0001).
In the overall study population through Day 28, no deaths were reported in patients who received PAXLOVID compared to 10 (1.6%) deaths in patients who received placebo.
Furthermore, at the recommendation of an independent Data Monitoring Committee and consultation with the U.S. FDA, Pfizer stated it would cease further enrollment into the study due to the overwhelming efficacy demonstrated in these results.
Moreover, Pfizer plans to submit the data as part of its ongoing rolling submission to the U.S. FDA for Emergency Use Authorization as soon as possible.
If approved or authorized, PAXLOVID™, which originated in Pfizer’s laboratories, would be the first oral antiviral of its kind, a specifically designed SARS-CoV-2-3CL protease inhibitor.
And subject to approval or authorization, it could be prescribed more broadly as an at-home treatment to help reduce illness severity, hospitalizations, and deaths and reduce the probability of infection following exposure among adults.
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Merck and Pfizer COVID Pills Compared as Paxlovid Appears to Cut Deaths
Pfizer has announced that its upcoming COVID drug, Paxlovid, seems to reduce the risk of hospitalization and death based on preliminary analysis of an ongoing study of its effectiveness.
The announcement comes just a day after the U.K. approved the use of another COVID-19 treatment pill by U.S. pharma companies Ridgeback and Merck. That pill is known in the U.K. as Lagevrio, but it is generally known as molnupiravir.
Both Paxlovid and molnupiravir are virus inhibitors, meaning they act to prevent the COVID virus from reproducing in the body. They are both taken orally and are designed to be given to COVID patients.
Paxlovid works by blocking the activity of a certain COVID enzyme called SARS-CoV-2-3CL, according to Pfizer. The COVID virus needs this enzyme in order to replicate.
Molnupiravir works by merging itself with the COVID virus and causing errors in its genetic code, preventing it from replicating.
Do you need to wear a mask indoors where you live? Check this map 😷https://t.co/Xlf9N9RP80— Dr. EFleming (@DrEFleming7) November 4, 2021
📌UK study: ~1 in 4 people who were infected & tested PCR positive for COVID19 did NOT go on to develop IgG antibodies. Particularly if they were asymptomatic & elderly.— Dr. Ali Nouri (@AliNouriPhD) October 30, 2021
Want a sure way to develop antibodies against #SARSCoV2? Get vaccinated💉!
Report: https://t.co/l03exSATVI pic.twitter.com/G5d4mdwgKV
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CoVID-19 vaccines lower risk of infection with delta variant, but infection can still be passed on in household settings
- Study of 621 people in the UK with mild COVID-19 infections found that people who received two vaccine doses could still pass the infection on to vaccinated and unvaccinated household members.
- The analysis found that 25% of vaccinated household contacts tested positive for COVID-19 compared with 38% of unvaccinated household contacts. The infectiousness of vaccinated cases with breakthrough infections was similar to unvaccinated cases.
- Infections in vaccinated people cleared more quickly than those in unvaccinated people but resulted in a similar peak viral load – when people are most infectious – probably explaining why the delta variant remains able to spread despite vaccination.
- The authors urge unvaccinated people to get vaccinated to protect themselves from severe disease and those eligible for a booster to receive it as soon as offered. They also call for continued public health and social measures to curb transmission, even in vaccinated people.
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New study shows environmental and social factors contribute to higher rates of pneumonia in children
A new study led by researchers in the Louisiana State University Superfund Research Program demonstrates that children who are exposed to a certain type of environmental air pollution are more likely to contract community acquired pneumonia, or CAP, and to be hospitalized for longer periods of time. Social factors, including race and socioeconomic status, were also found to be associated with living in high-risk areas for CAP.
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COVID-19 Reinfection Vs. Vaccine Breakthrough Cases, Whats the Difference?
The U.S. Centers for Disease Control and Prevention (CDC) and the Council of State and Territorial Epidemiologists recently provided an official case definition for a reinfection case. They define reinfection as when a person tests positive for COVID-19 more than 90 days after a previous positive test.
Previously, if a person tested positive for COVID-19 more than once, they were counted only once.
‘It is important for people to get vaccinated even if they have had COVID-19 in the past. Even if someone had COVID-19 in the past and recovered, they are at risk for reinfection, and each infection brings risks to a person’s health and the health of people around them,’ says the CDC.
Furthermore, reinfections are different than ‘Breakthrough Infection,’ says the CDC.
A COVID-19 Breakthrough Infection happens when a fully vaccinated person gets infected with COVID-19.
The CDC reported on October 18, 2021, COVID-19 vaccine fatal Breakthrough Cases reached 10,857.
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Children, adults equally vulnerable to coronavirus infection, but children less likely to become sick
Study shows relatively high rate of household transmission when at least one member is infected.
New research addresses the misconception that children are less susceptible to infection with the new coronavirus. According to a recent report in JAMA Pediatrics, children and adults have similar risks of becoming infected with SARS-CoV-2, but a much larger proportion of infected children do not show symptoms of COVID-19. When one household member is infected, there is a 52% chance they will transmit it to at least one other person with whom they live.
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Ventilation matters: Engineering airflow to avoid spreading COVID-19
As we approach two full years of the COVID-19 pandemic, we now know it spreads primarily through airborne transmission. The virus rides inside tiny microscopic droplets or aerosol ejected from our mouths when we speak, shout, sing, cough, or sneeze. It then floats within the air, where it can be inhaled by and transmitted.
In Physics of Fluids, they report computer simulations of airflow within a public washroom showing infectious aerosols in dead zones can linger up to 10 times longer than the rest of the room. These dead zones of trapped air are frequently found in corners of a room or around furniture.
Washrooms generate aerosols and are present within offices, restaurants, schools, planes, trains, and other public spaces. They have been identified as a potential source of infection transmission within densely populated areas in India.
Tips, general reading for public:
Wash your hands.
Rinse and repeat.
Shut That Toilet Lid When You Flush!
Thorough hand washing and sanitising are now second nature thanks to COVID-19, but a new study has also highlighted the dangers of open toilet lids, uncovered rubbish bins and defective plumbing drains in spreading infections in public washrooms.
A global review of the risks of bacterial and viral transmission in public bathrooms has found that bioaerosols can potentially be transmitted throughout a multi-storey building by defective plumbing and that leaving toilet lids open after flushing can disperse contaminated droplets beyond a metre.
Uncovered rubbish bins in public bathrooms are also flagged as a risk, especially if located under or close to electric hand dryers.
Researchers from the ANU and University of South Australia assessed 38 different studies from 13 countries that investigated the risk of infectious disease transmission in public washrooms. Their findings have been published in Science of the Total Environment.
1. Regardless of the outcome in VA today, everyone should familiarize themselves about hyper-politicization of school boards and the dark money groups behind it— Judd Legum (@JuddLegum) November 2, 2021
This playbook will be repeated in hundreds of races across the country in 2022
Follow along if interested.
Full thread at https://t.co/YF0Cbs96Kn?amp=1
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In a nutshell, here's the COVID death rate by Trump vote at the county level since 11/03/20: pic.twitter.com/n6eE8QdYpQ— Charles #GetCovered-ba 🩺 (@charles_gaba) October 31, 2021
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UPDATE: A 7th Republican who was at the Jan. 6 rally won an election last night. https://t.co/TrTdjyTjUr— HuffPost (@HuffPost) November 3, 2021
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Good morning in America, where Republicans accept their winning election results in Democratic-led states but still don’t accept their 2020 losses in Republican-led states.— Rep. Eric Swalwell (@RepSwalwell) November 3, 2021
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What happens in countries without Covid vaccines & spotty access to monoclonal antibodies?— Amy Maxmen, PhD (@amymaxmen) November 4, 2021
“Africa needs effective therapeutics for COVID-19 as an option more than any other continent," says @aeolagunju.
Brilliant reporting @abdultsanni from Nigeria.https://t.co/7S8Cj1m8NT
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Stern said that Michael Flynn was running the operation in multiple states, and it was being financed by Texas billionaire Al Hartman. He said he was initially given two main targets – Sen Pat Toomey and Congressman Brian Fitzpatrick. pic.twitter.com/k7n0y9md8k— Ron Filipkowski (@RonFilipkowski) October 31, 2021
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Only Justices Gorsuch, Thomas & Alito declined to enforce a vaccine mandate for Maine health-care workers that lacks a religious exemption, likely boding well for other state imposed rules, particularly in health care & related areas. https://t.co/vXp3d1gkjU— Joyce Alene (@JoyceWhiteVance) October 29, 2021
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🚨Do not look away from this video. This is Kevin McCarthy’s GOP. “When do we get to use the guns…to start killing these people” is the result of McCarthy not condemning — but rather stoking — election lies. The GOP no longer believes in voting, they’ve chosen violence. https://t.co/H982AZ8xqF— Rep. Eric Swalwell (@RepSwalwell) October 29, 2021
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Musk sure liked accepting $450M in Energy Dept loan in 2009.— Eric Boehlert (@EricBoehlert) October 26, 2021
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In Finland, they have an average of 161 weeks of paid family leave for mothers. In Hungary, it’s 160 weeks. In Norway, it’s 91 weeks. In Korea, it’s 64 weeks. In Germany, it’s 58 weeks. In Sweden, it's 55 weeks. In Canada, it’s 51 weeks.— Robert Reich (@RBReich) October 28, 2021
In the United States, it’s 0.
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The Fifth Circuit has stayed enforcement of the Biden administration’s private-employer vaccine mandate — not because it actually applied the right test for such emergency relief, but simply by asserting that the mandate raises “grave statutory and constitutional issues.” pic.twitter.com/NGSknZ5CRH— Steve Vladeck (@steve_vladeck) November 6, 2021
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BREAKING: The FEC just ruled that foreign countries can fund U.S. referendum campaigns.— Jon Cooper 🇺🇸 (@joncoopertweets) November 2, 2021
Who else is FURIOUS that foreign influence over U.S. policies is now legal? ✋
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PSA: the Moderna vaccine doesn’t contain luciferase. And luciferase isn’t named after Lucifer 😈…it’s a common biological reporter that produces light which can be measured. Lucifer is Latin for “light bearer”. Luciferase is a natural enzyme that makes fireflies’ asses light up. https://t.co/7bD3Bypxt2— Dr. Angela Rasmussen (@angie_rasmussen) November 2, 2021
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A GOP Texas state lawmaker is asking schools to report whether they have any of the 850 books he identified that deal with sexuality, racism, abortion and U.S. history that he says "might make students feel discomfort, guilt … or psychological distress."https://t.co/7uxb6Z4c6X— NPR (@NPR) October 28, 2021
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These stories about Steven Donziger are appalling
An environmental lawyer who won a settlement against Chevron over dumping oil in Indigenous lands in the Amazon rainforest is starting a six-month prison sentence. pic.twitter.com/FwEVHZa56l— AJ+ (@ajplus) November 5, 2021
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It's the story of @sdonziger, a campaigning lawyer who sued @Chevron for its ecocide in Ecuador, a genocide against indigenous people, committed with cooperation from a brutal military dictatorship.https://t.co/V6XYzZ1nNa— Cory Doctorow (mostly) AFK (@doctorow) March 19, 2021
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Feel good du jour:
"A group of students noticed that for the past four years, their school janitor was walking to work rain or shine. After seeing this day in and day out, students started pooling their own money together to surprise him with a new truck!" 😭— Some Good News (@somegoodnews) October 23, 2021
📹: spreadgoodnews on IG pic.twitter.com/P7Nnswn51X
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Two love-birds caught on camera by their daughter. 🥺❤️— Some Good News (@somegoodnews) September 24, 2021
📹: queenmotivat on Instagram pic.twitter.com/iDsLZwz1kl
These ppl win Halloween. pic.twitter.com/sPwzrm5BA4— Sassy Carrie (@sassycarrie) October 31, 2021
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We asked him to play some Linkin Bark but in the end, it doesn’t even matter. pic.twitter.com/YHA7btrHCL— Metro (@MetroUK) October 31, 2021
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Spotted in downtown Phoenix today. This seems…normal? 🤷🏻♂️ pic.twitter.com/V6yORV7RBn— JimBoyle (@jameswboyle) November 3, 2021
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not really comic, but weird:
We're told the little guy was injured (I supposed breaking through a window will do that). So right now it's chilling and they are waiting for animal control and to arrive. pic.twitter.com/Kv4zEePUiF— Pat Dubois (@patdubois) November 4, 2021
"The Great Resignation" is not about people not wanting to work. It is about a dawning recognition that, for a larger and larger portion of this country, the American dream is dead, and with it, the inspiration of working toward a better future for oneself. Instead, work…/1— Kurt Eichenwald (@kurteichenwald) November 1, 2021
…becomes not the means towards reaching an aspiration – a spouse, children, a home, vacations, personal growth, a retirement. Instead, the greed culture has turned work for millions into just a means of survival, with wages stagnant, healthcare unaffordable, insurance….
….treated as a luxury, paid free time an impossibility, children unaffordable, homes a dream. Yes, work is important – but not without the promise of a future. Many young people see nothing but 40 years of the same, further enriching the obscenely rich. This system has…
…taught people how to survive without, because they don’t believe they will ever have. If they reasonably don’t believe they will ever be able to afford a house or to raise children, and never will have group insurance or a paid vacation, and can make it living with their…
…parents, and have already been taught by McResources (real thing) and Walmart how to apply for Food Stamps and Medicaid because those multibillion dollar corporations know they don’t pay enough for their employees to survive, and are already getting those benefits, and ….
…have the choice of just saying “forget it, im going to work on my painting or sewing or whatever, I am tired of being abused by my supervisor, I am tired of being screamed at by customers for things out of my control, I am tired of watching adults throw temper tantrums and…
…then being balled out by my company because I could have handled it better. I can survive without all of this. I can be happier without all of this. I am paid so little, my life won’t be that different.” THAT is why we have the Great Resignation. Because we, the Boomers….
(it continues…Full thread at https://t.co/hszRTWyAWR?amp=1
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After such a hard day yesterday, here is what dogs can teach us… Act happy when someone you love walks through the door. Be excited that there is food in your bowl. Show loyalty. Take walks every day. Nap when you need to. Bite only when necessary. Love with a full heart.— Joe Newberry (@JoeNewberry) November 3, 2021
Bits of beauty: