Coronavirus Tidbits #223 12/11/22


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.



Which Respiratory Virus Do I Have?

— There's a range of possibilities, and it's not easy to tell them apart

[Good summary]

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Nanobody treatment shows promise against SARS-CoV-2 infection

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41.6 percent of adults have serology indicative of past COVID-19 infection

More than 40 percent of U.S. adults have serology indicative of past COVID-19 infection, of whom 43.7 percent report never having had COVID-19,

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Paxlovid Has Been Free So Far. Next Year, Sticker Shock Awaits.

Currently $530 each, a discount for buying in bulk. Pfizer's Covid shots will quadruple in price, from the discount rate the government pays of $30 to about $120.

Federal law restricts Medicare Part D — the prescription drug program that covers nearly 50 million seniors — from covering the covid treatment pills.

[Why would this be? Makes no sense to not cover the elderly, the people most at risk, unless you want to knock them off]

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COVID-19 vaccines halve the risk of reinfection, study finds

Among those who have recovered from a coronavirus infection, vaccinated people have a halved risk of becoming infected a second time or contracting COVID-19 again with severe symptoms compared to those who are not vaccinated.

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New receptor 'decoy' drug neutralizes COVID-19 virus and its variants

Scientists at Dana-Farber Cancer Institute have developed a drug that potently neutralizes SARS-CoV-2, the COVID-19 coronavirus, and is equally effective against the Omicron variant and every other tested variant. The drug is designed in such a way that natural selection to maintain infectiousness of the virus should also maintain the drug's activity against future variants. [It is not an antibody, but an ACE2 receptor decoy.]

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China eases strict COVID measures as global cases hold steady

China's National Health Commission (NHC) today announced the lifting of many of its signature "zero COVID" measures, which comes in the wake of widespread protests and ongoing outbreaks in several cities.

In other global developments, the World Health Organization (WHO) in its regular weekly update said activity remained stable last week, with levels on the rise in just one world region: the Americas.

Some of the changes announced today include allowing people with mild or asymptomatic infections to isolate at home, rather than in state facilities, and no longer requiring people to show proof of a negative test for entry into public places, according to the BBC.

Other steps include allowing rapid tests to replace polymerase chain reaction (PCR) tests in most instances, limiting lockdowns to narrowly targeted areas, shortening the lockdown period for outbreak areas, and allowing schools to remain open unless there are outbreaks on campus.

Authorities today also emphasized the need to vaccinate older people.

In the US, one of the hot spots is Los Angeles County, where cases have doubled since Thanksgiving, according to the Los Angeles Times. Hospitalizations are rising but haven't reached a level that would trigger an indoor mask mandate.

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11% of COVID-19 survivors have residual lung damage, study finds

A new study in the American Journal of Respiratory and Critical Care Medicine reveals about an 11% incidence of residual lung damage—known as interstitial lung disease—after COVID-19 hospitalization. Interstitial lung disease is a broad category of lung damage and disease defined by fibrotic scarring. The damage is often irreversible.

"For some people these fibrotic patterns may be stable or resolve, while for others they may lead to longer term lung fibrosis progression, worse quality of life and decreased life expectancy. Earlier detection of progression is essential to improving outcomes," said study lead author Iain Stewart, PhD, of Imperial College London in a press release.

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Models predict massive wave of disease and death if China lifts ‘zero COVID’ policy

Country’s severe approach to pandemic is inflaming the populace, but lifting it carries huge risks


Surprised and stung by protests against draconian “zero-COVID” policies, Chinese authorities are gingerly moving to ease the burden of lockdowns, quarantines, and constant testing. But 3 years into the pandemic, China shows no sign of planning a major course change. Mathematical models suggest why: The country is still ill-prepared for living with SARS-CoV-2. Easing restrictions today would likely trigger a massive wave of infections, overwhelm health care facilities, and bring a high death toll.

“China has not achieved high vaccination rates, has not used the best type of vaccines, and it has been very slow in communicating [to the public] the eventual need to transition from elimination to suppression and mitigation,” says public health scientist Nick Wilson of the University of Otago, Wellington, in New Zealand. Other countries that initially followed the zero-COVID strategy, including New Zealand, used it to buy time to ramp up vaccination rates, stockpile antivirals, and boost intensive care capacity.

The fierce protests have triggered some changes. Several provinces have started to allow people to enter public transportation, restaurants, and shopping centers without proof of a negative COVID-19 test, for example, and some close contacts of patients will be allowed to isolate at home instead of being sent to quarantine centers. Those measures are “a small but important step, and I believe more steps will follow,” says a Chinese scientist who asked to remain anonymous. “This will alleviate some of the pandemic fatigue and reduce the burden on the economy and society.”

But models show why the Chinese government still wants to keep a lid on. A study based on vaccination rates in March, published in Nature Medicine in May, found that lifting zero-COVID restrictions at that point could “generate a tsunami of
COVID-19 cases” over a 6-month period, with 112 million symptomatic cases, 2.7 million intensive care unit (ICU) admissions, and 1.6 million deaths. Peak demand for ICU beds would hit 1 million, more than 15 times the current capacity.

The unvaccinated would account for 77% of the fatalities, according to the authors, primarily at Fudan University. Boosting vaccination rates could slash the toll, but China’s elderly population has remained wary of vaccination. Even today, only 66% of those ages 80 and older have received two doses—versus 90% of the population as a whole—and just 40% have taken boosters.

Hong Kong provides a cautionary tale: A big Omicron outbreak early this year caused nearly 6000 deaths, 96% of them in people 60 or older. At the time, Hong Kong’s vaccination rates were even lower than the mainland’s. In the first 3 months of this year, the city had a COVID-19 death rate of 37.7 per million population, among the highest anywhere.

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Severe COVID could cause markers of old age in the brain

Key genes that are active in the brains of older people are also active in the brains of people who developed serious COVID-19.

Nature Heidi Ledford 05 December 2022

Severe COVID-19 is linked to changes in the brain that mirror those seen in old age, according to an analysis of dozens of post-mortem brain samples1.

The analysis revealed brain changes in gene activity that were more extensive in people who had severe SARS-CoV-2 infections than in uninfected people who had been in an intensive care unit (ICU) or had been put on ventilators to assist their breathing — treatments used in many people with serious COVID-19.

The study, published on 5 December in Nature Aging, joins a bevy of publications cataloguing the effects of COVID-19 on the brain. “It opens a plethora of questions that are important, not only for understanding the disease, but to prepare society for what the consequences of the pandemic might be,” says neuropathologist Marianna Bugiani at Amsterdam University Medical Centers. “And these consequences might not be clear for years.”

COVID vaccine hesitancy linked to 'nocebo' side effects

Vaccine hesitancy about COVID-19 vaccines is a positive predictor of negative side effects with vaccination—an example of the "nocebo" effect—according to a study today in Scientific Reports.

Nocebo, a play on placebo, is a phenomenon in which people experience negative effects on health when they have negative views or expectations surrounding medical interventions.

The study was based on surveys of a representative sample of 756 older Israeli adults (mean age, 69 years) who were questioned following a second Pfizer vaccine dose and after their booster at least 6 months later. Older adults were selected for the study because they have the highest vaccine uptake because they are most likely to suffer complications from COVID-19 infections, the authors said.

The authors found that hesitancy about the second Pfizer dose resulted in nocebo side effects for 16% of study participants. There were sex differences seen among those who reported side effects, with women reporting increasing side effects after both the second vaccine injection and the booster dose.

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Infections 10 times higher in unvaccinated than those receiving Jynneos

In the first study, researcher show mpox cases were 9.6 times higher among unvaccinated men compared to those who had received two vaccine doses, and 7.4 times higher than in those who had received only the first dose.

Of note, the researchers said the evidence indicates there was no difference in protection between subcutaneous and intradermal injections, which were introduced this past summer as a way to stretch vaccine supply.

In the second study, safety monitoring of the Jynneos vaccine was gathered after 1 million doses in the United States, administered from May 22 to Oct 21. Only 14 reports were classified as serious.

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Uganda receives first Ebola vaccine trial doses

the doses arrived just 79 days after the outbreak was declared and that the clinical trial will be conducted by a team from the University of Makerere, with support from the health ministry and the WHO. Currently, there are no licensed vaccines or treatments for the Sudan Ebola strain.

The doses are from the Sabin Vaccine Institute (SVI), according to Reuters. The SVI vaccine is a modified chimpanzee adenovirus (ChAd3) vector vaccine. Health officials had earlier cleared plans to study three candidate Ebola Sudan vaccines. The others are from Merck and Oxford University.

In the middle of November, a WHO working group recommended that ring vaccine trials prioritize the Merck candidate first, owing to the safety and efficacy of the VSV-EBOV platform used for the Zaire Ebola vaccine, followed by the SVI vaccine, then the Oxford vaccine.

A sharp decline in Uganda's Ebola cases presents an obstacle to ring vaccination trials.

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New virus discovered in Swiss ticks

The Alongshan virus was discovered in China only five years ago. Now researchers have found the novel virus for the first time in Swiss ticks. It appears to be at least as widespread as the tickborne encephalitis virus and causes similar symptoms. The team is working on a diagnostic test to assess the epidemiological situation.


still an incredible, negligent last of testing.

Drugs and Vaccines:

FDA OKs updated COVID booster for kids as young as 6 months

The US Food and Drug Administration (FDA) today announced that it has authorized emergency use of both updated mRNA COVID-19 vaccine boosters in children as young as 6 months old—with a caveat excluding those who have already received three doses of the Pfizer-BioNTech vaccine.

The step comes ahead of a potential rise in COVID activity surrounding the holidays and amid large spikes in other respiratory viruses. The Centers for Disease Control and Prevention (CDC) still needs to sign off on the recommendation before the youngest kids can receive the new bivalent (two-strain) boosters.


CO2 Monitors

I've been using an Aranet 4, which is good but pricey.

On my trip this week (first flight) with United, CO2 levels were horrid.

Outdoor air is ~415. It steadily rose on the ramp and boarding to a high of 2895. Common rec is to leave a room if CO2 level goes > 800-1000. Normally, after boarding/in mid-flight, I've been told the air quality is pretty good. On our flight it plateaued at 1600-1700. We never removed our masks even for a sip of water.

A thread from Dr. Jeff Gilchrist, a biomed researcher:

@IndianaTuxhas created a great CO2 monitor at a more affordable price and is very responsive to questions and feedback. He even implemented some of the suggestions I had made, which came in the form of a firmware update. 22/
The monitor also handily calculates the rebreathed fraction of air (RFA) which is how much air you would be inhaling that comes out of other people in an indoor space. It also converts RFA to how many litres per hour of other people's breath you are inhaling. 23/
You can learn more about how to do those calculations yourself using this spreadsheet shared air calculator ( ). When the CO2 levels are at 975 ppm you can see that every breath people take in that room contains 1.5% of the collective breath of others. 24/
This may not sound like much except the typical amount of air inhaled per day means you are breathing in 6 litres every hour of other people's breath. If ventilation was horrible and CO2 levels were 3152 ppm that would be 30 litres every hour of other people's breath. 25/
No wonder so many people get infected indoors with poor or no ventilation breathing in that much aerosols from someone who might be infected in the room now or who had been there an hour ago and already left. 26/
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@Poppendieck  Dec 8
All US Federally owned buildings will now be required to use MERV 13 filtration and "verify" ventilation.
"These standards apply to new buildings and all system replacements and modernizations of existing GSA-controlled Federal buildings."
I asked: So not old buildings? Asking as some federal workers are being asked to go back to work in a maskless environment—because @CDCDirector and @CDCgov
said masks are unnecessary. Unforgivable lies from people I had respect for. #COVIDisAirborne
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Thermostats and Fans:

@joeyfox85  Dec 6
People don’t realize that flipping a thermostat from auto to on, or removing the recirculate from the car fan, can be the difference between getting sick or remaining healthy. It’s one button that a small amount of education can fix.
Your home furnace usually doesn't have ventilation. Auto mode is okay unless you are using it to clean the air. Public spaces should always have ventilation and the fan should always be on.
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@CleanAirStars  Mar 20
The one simple trick in vehicles to help reduce the risk of airborne transmission of viruses is to ensure air conditioning is set to fresh air (not recirculate) and have the fan set to the highest speed possible. Ask your Taxi or @Uber drivers and help get the message across.

Epidemiology/Infection control:

@MeetJess  Dec 8
Trauma patients who show no symptoms for COVID, yet test positive for the virus, have significantly higher rates of cardiac events, stay in the hospital longer, and incur higher hospital charges than do similar trauma patients who test negative for COVID

Tips, general reading for public:






@AnishaKMD  Dec 2
No amoxicillin. No amox-clav. No cefdinir. No high-flow circuits. No oseltamivir. Limited nurses. Limited ICU beds. Limited services. Limited life-saving care. Tell me again how everything is fine? #PedsInCrisis
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@EricTopol   Dec 4
Covid is associated with a >60% increased risk of newly diagnosed diabetes A systematic analysis replicated by 2 independent groups #PASC #LongCovid
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@ZackBornstein  Dec 5
I don’t understand how COVID is spiking again after we’ve tried everything from pretending it’s over to pretending it never happened
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@pronounced_ing Dec 8
So  @Harvard  just sent out an email that says "COVID is not going away"... and then cancelling all COVID tracing and mitigation measures university wide. Brilliant.
"Students and employees will no longer need to report a positive COVID-19 case to HUHS. Anyone who tests positive will manage their isolation independently by referring to Centers for Disease Control and Prevention (CDC) guidance."
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@danielschuman  Dec 4
I'm sorry, but what the hell? The House Armed Services Committee Chair Adam Smith is open to rolling back the Pentagon policy of discharging troops who refuse to follow orders and get their initial COVID vaccinations?
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@katha1970  Sep 23
Finally! New @WHO guideline specifies: NO EXERCISE THERAPY for #PostCovid patients if they suffer from POST-EXERTIONAL SYMPTOM EXACERBATION. Hope this will protect more patients from becoming bedbound by wrongly applied #rehab measures like GET
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@luckytran   Dec 5
It's encouraging @CDCgov is considering revising its bad Community Levels map. But in addition to including other viruses, it needs to fix two big flaws: - Masking should be recommended BEFORE hospitals are full - It needs to account for COVID cases being undercounted up to 20x
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@gilmcgowan  Dec 7
“Anyone who doesn’t take seriously the risk of COVID infection is in denial about the risk of long COVID and its potentially disabling effects.” Renowned doctor and scientist ⁦@EricTopol⁩ pulls no punches in this must-read column. #CovidIsNotOver
Show this thread
Defense budget:
@RBReich  Dec 8
$12 billion: The cost of expanding the Child Tax Credit to 19 million children who had not been able to receive the full benefits $858 billion: The cost of the latest defense bill Can you guess which one Congress claims it can't afford to fund?
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@ErinInTheMorn Dec 3
Reminder that the cops will NOT keep us safe. WE keep us safe. It is a shame that militants get to walk around Columbus parading their victory and brandishing weapons at a drag event. This gathering was organized in the immediate aftermath of Club Q.
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@sesmith  Dec 5
Oklahoma Aims to Ban Gender-Affirming Care Even for Adults
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@taliaotg  Dec 5
Seems pretty wild that Proud Boys and Capitol insurrectionists gathered in Staten Island to harass a Drag Story Hour event and the only article about it came from unpaid indie reporters with @protest_nyc.
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@AriDrennen  Dec 5
New: an email from the CEO of Boston Children’s Hospital confirms yet another bomb threat against the facility, which was first targeted for providing lifesaving trans healthcare by Libs of TikTok and Matt Walsh back in August.
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Dearborn man charged for ‘anti-semitic’ rant outside synagogue Temple Beth El

A police officer originally let the man go and even fist-bumped him

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Domestic terrorism:
@mmpadellan  Dec 4
Imagine depriving 40,000 residents in Moore County, NC of power because people were so afraid of drag queens they shot up THREE power stations, cutting power to houses and hospitals. That's terrorism.
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@A_Wilkins  Dec 4
Cell phone signal has been heavily disrupted and some providers, such as Verizon, are completely down in some parts of the county.
Many rural residents get water from wells, and the pumps are down. We will slowly lose water pressure until we lose water altogether so are using reserve water we set aside for essentials and filling up buckets of water from the pond to fill toilet reservoirs to flush them.
Local pharmacies are moving critical meds to people’s homes with generators and refrigerator space.
Police are being called in from across the state to help manage intersections, and I assume to assist with normal emergency services in general while power is out.
Projected problems: spoiling of food in grocery stores, restaurants, and most critically people’s homes. Looting has already happened at a local Walmart. Schools will probably be canceled tomorrow.
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@BillPascrell  Dec 4
The reason we didn’t cap insulin at $35 is because republicans blocked it.
(But Starting New Year's Day, seniors covered by Medicare will begin paying $35 per prescription per month for their insulin.)
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@Anthony  Dec 4
The best Hunter Biden email is the one where Tucker Carlson asks Hunter to help get his kid into college
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@ericareport   Dec 6
208 Republicans just voted against a bill that would allow immigrants who served in the US military to become Americans.
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@HowardMortman  Dec 6
During Congressional Gold Medal ceremony for Jan. 6 police, representatives of those receiving awards shake hands with Schumer then walk past McConnell and McCarthy.
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@NormOrnstein  Dec 4
As expected, not a single mention on the front page of the Washington Post or the New York Times of a former president calling for shredding the Constitution to seize the presidency illegally. To quote the Post, “democracy dies in darkness.“
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@ericareport   Dec 5
Donald Trump REFUSES to give his DNA to clear himself of a rape accusation against E. Jean Carroll.
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@DashDobrofsky  Dec 5
In 1923, Hitler and roughly 3,000 Nazis stormed Munich in an attempted coup d'état to violently seize power. Though Hitler was charged with Treason, he was let out 4 years earlier than originally sentenced. I bring this up now because America faces a similar dilemma with Trump:
While the current threat Trump poses as a political outsider is less salient than when he held executive power — history shows it is unwise to dismiss the latent power of a demagogue. After all, the same could have been said about Adolf Hitler in 1923:
After a failed January 6th coup d'état, America has entered its post Beer Hall Putsch era. Arrest him before he becomes Hitler.
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Elon Musk/Twitter:
@ericareport  Dec 3
Elon Musk told the United Nations that he would give them $6 billion to end world hunger if they showed him a detailed plan of how they would use the money. They gave him their plan, but they never got the money. Instead he bought Twitter for $44 billion.
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@justinbaragona  Dec 8
"Now, [Bari] Weiss has been given access to Twitter's employee systems, added to its Slack, and given a company laptop, two people familiar with her presence said. The level of access to Twitter systems given to Weiss is typically given only to employees..."
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@RepAdamSchiff  Dec 8
On Elon Musk's Twitter: - Slurs against Black people have tripled - Slurs against women are up 33% - Slurs against Jewish people are up 61% - And slurs against gay men are up 58% These numbers are abysmal – and unacceptable. Today, @RepMarkTakano and I are demanding action.
@therecount  Dec 5
Justice Alito jokes with Justice Kagan that, "You do see a lot of Black children in Ku Klux Klan outfits all the time," during oral arguments in a free speech case.
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@JanaStarr828  Dec 6
So apparently selling a wedding cake to an LGBTQ couple is participating in the marriage, but selling a gun to a shooter isn't participating in the crime.
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@ericareport  Dec 7
Cops in Alabama arrested an 82-year-old woman for not paying her trash bill. Martha Louis Minefield says that when the police handcuffed her, they told her not to cry. The Police Chief defended the arrest in a press release. Martha Louis Minefield owed $77.
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@charlesornstein  Dec 8
Pause to really think about what this means... From 2015 to 2019, Arizona's Department of Child Safety investigated the family lives of 1 of every 3 Black children in Maricopa County, according to an analysis by @ProPublica and @NBCNews.
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@elfsternberg Dec 3
DeSantis' lawyers were forced by the court to define "woke." The lead lawyer described it as "The belief there are systemic injustices in American society and the need to address them."
Florida's Stop WOKE Act makes it illegal for anyone who takes state money, including teachers and most college professors, to espouse that unquestionably accurate belief.
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@MuellerSheWrote  Dec 4
@GovRonDeSantis lawyer has defined "woke" to the court as "a belief in systemic injustices in America & a need to address them." This is after being sued by a county state attorney Desantis suspended for "being woke."
In this case, DeSantis suspended him for saying he wouldn't prosecute abortion crimes. So in this case, "woke" means this attorney believes abortion laws are an injustice and feels the need to address them." 2/
But get this:@RonDeSantisFL  doesn't believe there are any systemic injustices in America. So let me ask @RonDeSantisFL  a question: do you think there are systemic injustices for white hetero christians? If so, does that make you "woke", too? Or is that a term for "others"?
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Warnock: "Just because people endured long lines ... the rain and the cold and all kind of tricks in order to vote, it doesn't mean that voter suppression doesn't exist. It simply means that you the people have decided your voices will not be silenced."
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@SchottHappens  Dec 6
Take a moment to appreciate tonight's win by Warnock because tomorrow, the Supreme Court will hear a case that could let state legislatures throw out federal election results they don't agree with. (Moore)
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@UnCagedCritique  Oct 23
Groundbreaking! Atlanta City Counsel to declare "justice impacted people" (formerly incarcerated) as a protected class, so as to ensure better employment, more stability and less recidivism.
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Man voting in Georgia is so different than in Illinois. When I lived in chicago, during early voting, I went to the local elementary school, waited in line about ten minutes, and they gave me a sheet of paper. I checked people off then I put it in the machine and left.
Not Georgia. We drove downtown because *every* other polling place had a line >90 minutes. We paid ten bucks to park. We went in the building, then emptied out pockets to go through a metal detector. We then saw a sign about where to park to get our parking validated. Inside.
We then waited in line ~80 minutes. We got to the end and we were given a form to fill out (?). We were told *not* to sign it until told. Then we were moved into a waiting room where we were given a ticket number, like when you are at the dmv.
We were told to get our IDs out and wait. We waited here for 15-20 minutes. When your number is called they took your form, did some stuff on the computer, then told you to sign the form. Then you get a little green card. You insert it into the machine.
Then you go through three or four prompts, including a very serious warning about perjury, a totally necessary warning given how huge a problem stolen identity is for the purposes of voting on behalf of someone else.
You then finally vote, and after an “are you sure” prompt you get a sheet. You then have to walk the sheet over to feed it into a machine. About half of these were working.
The bottleneck was clearly the weird application and waiting room thing. There are two dozen people at a time sitting to have their stuffed checked. Think of it as regular voting except when you got there they had to run a credit check for *each person* like you need financing.
It was easier finishing my PhD paperwork. Thankful for the kind people (nearly all black women) the shepherded the processes. But man if you are poor or disabled or whatever, good luck yo. That should have been easier. We finished tho.
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@MayaRockeymoore  Dec 8
Catholic church paid Maryland lobbyists more than $200K to help limit, prevent abuse lawsuits #shameful
@AntonioArellano  Dec 8
The governor of Texas just banned Tik-Tok on all state issued devices. Shouldn’t he have banned assault rifles before TikTok?
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@emmavaninwegen  Dec 5
CVS is being sued for asking customers to donate to the American Diabetes Association when they check out. Those donations are in fact *not* sent to the ADA, but instead reimburse the CVS for a legally binding obligation of $10M that CVS promised earlier
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Feel good du jour:

My Washington Post subscription allows me to freely share this story of the gift Daniel Patt has given #Holocaust survivors and their descendants with his "Numbers to Names" photo recognition project. Read here:
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Re: Brittney Griner's release from Russia -- an incredibly gracious response from the family of Paul Whelan: "The Biden Administration made the right decision to bring Ms. Griner home, and to make the deal that was possible, rather than waiting for one that wasn't going to happen."
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@MichaelWarbur17   Dec 3
HEDY LAMARR escaped from her Nazi husband by disguising herself as her own maid, became a top actress in Hollywood, then co-developed a radio guidance system for Allied torpedoes - the principles of which are incorporated into today's Bluetooth and GPS technology.
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@jeffreyyaaron  Dec 2
Someone came into our school today and paid off the lunch accounts of our refugee and low-income students and left money to pay them off through the rest of the year as well.
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Comic relief:

Bits of beauty:


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