Coronavirus Tidbits #225 12/25/22


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.

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New Post:

Planning A Caribbean Vacation? Here Are Some Infections To Consider Protecting Yourself Against



Pre-procedure and pre-admission COVID-19 testing no longer recommended for asymptomatic patients

Health care facilities should no longer routinely screen symptom-free patients for COVID-19 upon admission or before procedures and rely instead on enhanced layers of infection prevention interventions, according to a recommendation from the Society for Healthcare Epidemiology of America (SHEA) published today in Infection Control & Hospital Epidemiology.

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Scientists find key reason why loss of smell occurs in long COVID-19

The reason some people fail to recover their sense of smell after COVID-19 is linked to an ongoing immune assault on olfactory nerve cells and an associated decline in the number of those cells, a team of scientists led by Duke Health report.

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Long-term (180-Day) Outcomes in Critically Ill Patients With COVID-19 in the REMAP-CAP Randomized Clinical Trial,

4,869 with COVID-19 randomized to receive one or more therapeutic interventions: treatment with an IL-6 receptor antagonist (tocilizumab or sarilumab), led to a greater than 99.9% probability of improved 6-month mortality, while antiplatelet agents had a 95% probability of improving 6-month survival.

Moreover, the study also showed that treatments which improve survival, such as interleukin-6 receptor antagonists, do not come at the expense of survival with increased disability or poorer health-related quality of life.

In contrast, longer-term outcomes were not improved with therapeutic anticoagulation, convalescent plasma, or lopinavir-ritonavir, and were worsened with hydroxychloroquine alone or in combination with lopinavir-ritonavir. Corticosteroids did not confer a high probability of improved longer-term survival, although enrolment into this domain was closed early in response to external evidence.

JAMA (2022). DOI: 10.1001/jama.2022.23257

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Myocardial Injury in Patients With COVID-19 

patients with COVID-19 with elevated troponin during phase 3 (Omicron) tended to have improved outcomes when compared with patients in earlier waves of the pandemic. This improvement could be attributed to the implementation of the COVID-19 vaccines, advances in COVID-19 treatment options, provider experience, and less virulent variants.

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Cardiac Injury Caused by COVID-19 Less Common Than Thought via @medscape

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Results of Long COVID Rehab Program 'Impressive'

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Just out  @TheLancet
Failure of Molnupiravir to reduce Covid hospitalizations or deaths in a very large randomized trial (N>25,000 participants, mean age 57, 99% vaccinated)
While the time to recovery was shortened, the price to pay is a very high rate of #SARSCoV2 mutations induced (its obligatory mechanism). That alarming rate has been amply documented by  @LongDesertTrain
"Our study demonstrates that [Molnupiravir] this commonly used antiviral can supercharge viral evolution in immunocompromised patients, potentially generating new variants and prolonging the pandemic."
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Ryan Hisner  @LongDesertTrain  Nov 28
Approval for molnupiravir (MOV) use should be revoked worldwide. Not only has it proven ineffective, it seems clearly to be creating sequences such as the one below, which in ~2 months acquired 72 mutations, more than its lineage had accumulated in ~3 years of evolution. 
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Jeremy Faust on this study:
This is the first randomized controlled human trial that has studied Covid-19 outcomes among *only vaccinated* people that we’ve ever seen. That’s an absolutely astonishing fact, if you think about it.
This gives us an unusual chance to look at all-cause mortality and all-cause hospitalization among infected vaccinated people during the Omicron era... And to compare that the pre-Omicron and pre-vaccine era...
The news is absolutely excellent. Among participants—people over age 50 with medical conditions placing them in the high-risk category and who had confirmed SARS-CoV-2—only 8 deaths occurred among 25,054 patients. That’s an infection fatality rate of 0.032%, or 1 in 3,132 cases.
This is incredibly positive news. In the previous major study of this drug—which, again, assessed high-risk Covid-19 patients who were unvaccinated—the all-cause infection fatality rate in placebo recipients was a staggering 1.2%, or 1 in 78....
It’s also a sad/real possibility that death rates are now lower in part bc many highest-risk people died during the pre-Omicron era. Thus the survivor population is actually healthier on avg—a predicted phenomenon called “pull forward," “mortality displacement,” or “harvesting."
Regardless, this all suggests that today, the risk of death from Covid-19 appears to be nearly two orders of magnitude lower in high-risk older groups than it was just a year ago—*assuming they are vaccinated*.
Last year’s Molnupiravir study of unvaccinated high-risk Covid-19 patients recorded a hospitalization rate of 9.7% (68/699 patients, just a little better than 1 10 patients). In today’s study, the rate was 0.78% in the control arm (98/12,525, or around 1 out of 128 patients).
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Hospital-acquired Covid:

Hospital acquired Covid now accounts for 39% of Covid admissions. Hospital acquired covid counts have increased faster than other Covid admissions since the start of November. Last week's changes in admissions: - Total Covid  36% - Hospital acquired 44% - Other  32% 
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and remember 39% of COVID HAIs result in death, because they are a vulnerable population.
The mortality rate was higher in the HA group than in the NHA group (39.1% v. 25.9%, p = 0.001), while the rates of ICU admission (8.3% v. 19.1%, p = 0.001) and requirement for mechanical ventilation (3.6% v. 13.0%, p = 0.001) were lower.
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Nasal irrigation: see Tips
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The US is facing a shortage of infectious disease doctors

Only 56% of adult and 49% of pediatric infectious disease training programs were filled, even though most other specialties filled all or nearly all their programs, the (Infectious Disease) society said.

The U.S. is expected to have a severe shortage of infectious disease specialists over the next decade, according to projections by the federal Health Resources and Services Administration.

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@jeffgilchrist  Dec 22
What is going on with our immune cells after COVID-19 infection? This thread will explore some of the impacts of COVID infection on our immune system even after people are recovered including: - Missing naive T-cells - Exhausted T-cells - Loss of B-cell maturation

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Biden administration releases doses of Tamiflu from national stockpile

Flu season has hit especially hard this year, though it may be peaking in some parts of the country. According to the Centers for Disease Control and Prevention, there have been at least 15 million illnesses, 150,000 hospitalizations and 9,300 deaths from flu this year...

Flu season is typically between October and May, and peaks in December and January. But this year it arrived at least six weeks early, with more severe illness. Hospitalizations have been high across all age groups, but the highest rates were among adults age 65 and older, and children age 4 and younger. ...

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@HelenBranswell  Dec 23
Fewer hospitalizations & positive #flu tests point to a continued decline in flu activity, @CDCgov reported today. Sadly, though, 17 more children have died from flu since early November, bringing the season total to 47 to date.
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Increase in Pediatric Invasive Group A Streptococcal Infections

This increased number of pediatric iGAS cases in some jurisdictions has occurred in the setting of increased circulation of respiratory syncytial virus (RSV), influenza viruses, SARS-CoV-2, and other respiratory viruses. While the overall number of cases has remained relatively low and iGAS infections remain rare in children, CDC is investigating these reports.

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The Bittersweet Defeat of Mpox

The epidemic has largely subsided, but largely because queer men seem to have learned more from AIDS and Covid-19 than the authorities did.

Wired Maryn McKenna, DEC 22

For a few weeks this summer, the world worried that monkeypox might become the next global pandemic. At the peak in early August the US was recording 600 cases a day, and the health authorities’ fumbling response echoed the early days of Covid-19. Vaccines were slow to arrive and in short supply for most of the fall. Testing was bottlenecked. Antiviral drugs, though they existed, were almost unobtainable because they hadn’t been federally authorized for the disease. While most cases were among gay and bisexual men, there were fears that the rarely fatal but often extremely painful infection, which can can take weeks to subside, might spread to the broader population.

Things today look very different, at least for now. By mid-December, mpox, as the World Health Organization has now renamed it, had appeared in 110 countries, but the spread had dramatically slowed. The US, which had recorded 29,740 cases as of December 21—more than a third of the global total—was registering barely a handful each day.

While one reason is that access to vaccines and testing improved, and another is that mpox is inherently much harder to transmit than Covid, the biggest, most agree, is that the people most at risk took their protection into their own hands in those crucial early weeks when the authorities were flailing. “The success was the community mobilization,” says Joseph Osmundson, a queer activist, molecular microbiologist, and clinical assistant professor at New York University.

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Rickettsialpox in North Carolina: A Case Report

@AbraarKaran  Dec 4


still an incredible, negligent last of testing.



On Ashish Jha and masks:

Wow. The White House COVID-19 Response Coordinator told

journalists that "there is no study in the world that shows that masks work that well." This is wrong, and dangerous misinformation @AshishKJha46. You need to retract your statement and issue a correction.

Here's the transcript of @AshishKJha46 saying in a @PhillyInquirer  interview that "there is no study in the world that shows that masks work that well." (h/t@Alexander_Tin Link to full video:


@JReinerMD   :

Dr Jha’s statement is incorrect. For instance here’s a study published last month in

@NEJM  showing how the lifting of mask mandates in Boston area schools was associated with a significant increase in COVID cases. Masks do work.

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Does Using Corsi–Rosenthal Boxes to Mitigate COVID-19 Transmission Also Reduce Indoor Air Concentrations of PFAS and Phthalates?

While CR Boxes were deployed, concentrations of seven PFAS (N-EtFOSE, N-EtFOSA, FBSA, PFBS, PFHxS, PFOS, PFNA) were 28–61% lower and concentrations of five phthalates (DMP, DEP, DiBP, BBzP, DCHP) were 29–62% lower. Concentrations of five PFAS and one phthalate increased 23–44% during the intervention period, but the 95% CI of most of these estimates included the null. Daytime sound levels increased 5.0 dB when CR Boxes were operating. These results indicate that CR Boxes reduced exposure to several lower-volatility phthalates and sulfonated PFAS previously reported to be found in office building materials and products, with potentially distracting increases in sound levels.

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@sameo416  Dec 16
Private bill in the Quebec assembly to ensure health and safety of students by regulating air quality. 6 months after assent, every school must have CO2 sensors in every classroom. Data collected and forwarded to Minister weekly, made public on the ministry website.
CO2 maximum 1000 ppm. During a WHO declared pandemic, limit drops to 800 ppm. Must have an approved 'action protocol' to respond to CO2 above permitted limit.
12 months after assent, every classroom must have "the number of air exchangers or purifiers" specified in regulation. That regulation must consider the size of the room and the number of students (this sounds like it was drafted with some engineering input!)
The Minister is responsible for supplying and installing these units. Units inspected every six months, reports made public. Faults must be addressed, reporting made public each year NLT 30 June.

Epidemiology/Infection control:

Researchers compile world's first 'atlas' of airborne microbes study inventorying bacterial presence in air samples

Tips, general reading for public:




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Rapid initiation of nasal saline irrigation to reduce severity in high-risk COVID+ outpatients


Objective: To determine whether initiating saline nasal irrigation after COVID-19 diagnosis reduces hospitalization and death in high-risk outpatients compared with observational controls, and if irrigant composition impacts severity.

Methods: Participants 55 and older were enrolled within 24 hours of a + PCR COVID-19 test between September 24 and December 21, 2020. Among 826 screened, 79 participants were enrolled and randomly assigned to add 2.5 mL povidone-iodine 10% or 2.5 mL sodium bicarbonate to 240 mL of isotonic nasal irrigation twice daily for 14 days. The primary outcome was hospitalization or death from COVID-19 within 28 days of enrollment by daily self-report confirmed with phone calls and hospital records, compared to the CDC Surveillance Dataset covering the same time. Secondary outcomes compared symptom resolution by irrigant additive.

Results: Seventy-nine high-risk participants were enrolled (mean [SD] age, 64 [8] years; 36 [46%] women; 71% Non-Hispanic White), with mean BMI 30.3. Analyzed by intention-to-treat, by day 28, COVID-19 symptoms resulted in one ED visit and no hospitalizations in 42 irrigating with alkalinization, one hospitalization of 37 in the povidone-iodine group, (1.27%) and no deaths. Of nearly three million CDC cases, 9.47% were known to be hospitalized, with an additional 1.5% mortality in those without hospitalization data. Age, sex, and percentage with pre-existing conditions did not significantly differ by exact binomial test from the CDC dataset, while reported race and hospitalization rate did. The total risk of hospitalization or death (11%) was 8.57 times that of enrolled nasal irrigation participants (SE = 2.74; P = .006). Sixty-two participants completed daily surveys (78%), averaging 1.8 irrigations/day. Eleven reported irrigation-related complaints and four discontinued use. Symptom resolution was more likely for those reporting twice daily irrigation (X2 = 8.728, P = .0031) regardless of additive.

Conclusion: SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate.



In 53 Years AIDS has Killed 40+ Million People. In 3 Years COVID has Killed 21+ Million. Everyone in the world is terrified of getting AIDS, but not so much COVID. COVID has killed people 8x times faster than AIDS. Keep wearing Condoms stop wearing Masks.
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On John Conly, WHO's, COI: I guess the hand hygiene tech is supposed to be commercialized, then? In that case it's pretty important for covid not to be airborne.
@kprather88  Oct 21
Someone asked me why I feel one reason for the slow admission of #COVIDIsAirborne is due to a COI. Answer: Because the chair of the infection control committee for the @WHO has stake in a company that puts hand washing machines on the walls of hospitals (John Conly). (1/2)

This is the same man who says N95's are bad for you because you get acne. So when

@WHO finally acknowledged #COVIDisAirborne on 12/23/21 with an asterisk next to it--saying IPC did not approve--why did no one launch a major investigation into this crime against humanity? (2/2)
Here is the link to his interests/research in hand sanitizer dispensers for infection control. Conly is the Director and founder of W21C:
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@PeoplesCDC  Dec 21
We need a mask mandate. Mask mandates work, period: It is time to do what’s right rather than what’s politically expedient.
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@DJJudd  Dec 19
Per a WH official— today, President Joe Biden and First Lady Jill Biden host a Hanukkah reception at the White House, marking a new tradition by adding the first-ever White House menorah to the White House collection (and first-ever Jewish artifact to be added to the WH archives)
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28 Republicans Vote Against Bill To Protect Child Sex Abuse Survivors

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TFG/Jan 6:

Pelosi:  Dec 22

"I was speaker and minority leader under President Bush, under President Obama, under what’s his name."
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@MuellerSheWrote  Dec 19
The 1/6 committee refers trump and others to the DoJ for 18 USC 1512c2 (obstructing), 2383 (insurrection), 1001/371 (conspiracy to make false statements), and 371 (conspiracy to defraud the US). The committee refers FOUR members of congress to the Ethics committee.
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@WhaleChart  Dec 17
BREAKING: ​Trump stole the images of his trading cards from stock photos. People have found watermarks on the NFTs they forgot to remove.
In creating his NFT collection, former President Trump seems to have borrowed images from across the internet, including clothing brands on Amazon and Walmart - PCMAG
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@charlie_savage  Dec 21
The House report on IRS not auditing Trump left unanswered whether the “mandatory” presidential audit program was generally broken or Trump got special treatment. Turns out Obama got audited all 8 years & Biden’s already been audited twice. W/ @arappeport
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@surlybassey  Dec 21
A reminder that the IRS disproportionately audits Black taxpayers from the South who make less than 30 k a year….
twitter’s content moderation panel looks different these days - @ianbremmer  Dec 18
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@BGrueskin  Dec 16

Whatever you do, don't retweet this archive list of tweets from Linette Lopez, an

@Insider  reporter who was just suspended from Twitter after many months of reporting about Tesla's problems.
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@ericfreyss  Dec 18 
Any attempt to remove my tweets that link to my other social media accounts, not violating any law, would actually make #twitter an editorial media, and no longer a social media platform, with civil and criminal liability for *any* illegal content therein.
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@JuddLegum  Dec 18
IMPORTANT: @elonmusk's new policy preventing linking to competitors is in DIRECT VIOLATION of European Union rules. Penalty can be a fine of up to 20% of Twitter's annual revenue
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@parismarx  Dec 12
Elon Musk donated $5.7 billion at the end of 2021, but kept the recipient a secret. New reporting shows the money went to his personal charity, meaning he didn’t actually lose control over it — but it did net him a $4.6 billion tax break. The man is a leech on society.
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@KashPrime  Dec 21
The fracturing of the scientific community on Twitter is a disaster, akin to the burning of the Library of Alexandria. For the first time in history, you had real-time conversations between scientists across thousands of specialties. Now its fading away:
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@oliviasolon  Dec 20
Google funded a lawsuit (now dropped) to prevent journalists from finding out that the company uses 29% of an Oregon city's water to cool its data centers
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Physical and Occupational Therapy Are on the Medicare Chopping Block

Proposed 4.5% cut to their therapy providers in 2023 under the Medicare Physician Fee Schedule. If this cut is implemented, the physical and occupational therapy community will experience cuts totaling approximately 9%opens in a new tab or window by 2024. The continued practice of annual Medicare cuts threatens the sustainability of the country's physical and occupational providers, especially in rural and underserved areas where they are needed most.

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@DermHAG  Dec 23
Good a time as any to cut American physicians salaries across the board in the setting or record insurer earnings, a triple pandemic, poor access to quality affordable healthcare and inflation.

U.S. Life Expectancy Plunges to Lowest Level in 25 Years: CDC

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More than a third of U.S. parents now oppose routine school #vaccinations

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Some #Medicare enrollees getting new ID numbers due to #databreach

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Abortion/Reproductive care:

Planned Parenthood starts telemedicine abortions in Kansas

A Planned Parenthood affiliate announced Tuesday that it has started teleconferences with off-site doctors for patients seeking medication abortions at one of its Kansas clinics, a small step toward potentially much broader access in a state that has become a destination for the procedure after an August vote affirming abortion rights.

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Amid dire maternal mortality rates, Congress falls short on Medicaid postpartum care (paywall)

(no guarantee of postpartum care)

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It's Time for Birth Control Pills to Move Over the Counter


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@CAKitchener  Dec 14
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@GeneforTexas  Dec 18
We did this before under Governor Perry. State blocks money to Planned Parenthood (for contraceptives and pre-natal)... Next year there's a massive surge in welfare claimed from new mothers. Get ready Texas.
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@piper4missouri  Dec 19
Read it and weep for women/girls in Missouri. Abortion could be classified as “murder” from the moment of conception…fertilization.
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Dec 23: The FDA revised its guidance on the most commonly used emergency contraceptives, making clear they are not abortion pills.
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A lot of folks were wondering who the 5 senators were who voted against guaranteeing workers reasonable break time to pump breast milk. (It passed 92-5.) They were: --John Cornyn (R-Tex.) --Mike Lee (R-Utah) --Pat Toomey (R-Penn.) --Ron Johnson (R-Wisc.) --Rand Paul (R-Ky.)
24 voted against guaranteeing reasonable accommodations for pregnant workers.


Fentanyl test strips help prevent overdoses, why are they still controversial?


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A Chick-fil-A location is fined for giving workers meals instead of money

A Chick-fil-A in North Carolina has been fined $6,450 for paying workers with meals instead of money and violating child labor laws, the Department of Labor has announced.

An investigation by the DOL found that at a Chick-fil-A in Hendersonville, N.C., three employees under 18 were assigned hazardous tasks, such as operating, loading and unloading the trash compactor.

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Airbnb Announces Ban on Slave Cabin Rentals

The concern over slave cabins listings dates back to 2019.

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@MuslimAdvocates  Dec 21
Jews from the Ottoman Empire pioneered the Christmas-lights market a century ago — but nativism, antisemitism and anti-Muslim prejudice obscured this history.

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Book bans:

@MarshallProj  Dec 21
Books NOT allowed in Louisiana prisons:  George Jackson's "Blood in My Eye"  @prisonculture's "We Do This 'Til We Free Us"
Hitler's "Mein Kampf"  every book on @splcenter's racist lit. round-up Read about what prisons nationwide do & don't ban:

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Why is Florida’s governor ramping up his anti-vaccine rhetoric?

Opinion by G. Yamey:

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New Zealand:

New Zealand will phase in a near-total tobacco ban from next year.

Legislation passed by parliament on Tuesday means that anyone born after 2008 will never be able to buy cigarettes or tobacco products.

It will mean the number of people able to buy tobacco will shrink each year. By 2050, for example, 40-year-olds will be too young to buy cigarettes.

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@nyeusi_waasi  Dec 16
in the US-African summit, a memorandum was signed that will have the governments of Zambia and DR Congo surrendered the supply chain and production of copper and cobalt to American control.
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@POLITICOEurope  Dec 19
The UK government’s plan to deport asylum seekers to Rwanda does not breach the law, the High Court in London ruled today.
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@hallaboutafrica  Dec 21
Zimbabwe bans export of its valuable raw mineral lithium, essential for making electric car batteries, and tells world: "You want to make electric car batteries to combat climate change, make them in Zim!" Such policy is long overdue.
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@NasimiShabnam  Dec 21
Girls crying in agony as they’re told that they will have to leave the university & go home as the Taliban have BANNED female university education in Afghanistan.
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@NasimiShabnam  Dec 21
Male university students have walked out of their exam in protest against Taliban’s decision to BAN female students from university education. Several male professors have also resigned so far.
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@SuneEngel  Dec 21
It just got even worse for Afghan girls and women. The #Taliban have now banned ALL female education, even primary school. It also barred women from teaching, one of the last professions open to women, and from mosques & madrasahs. Our story: #afghanistan
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@adegrandpre  Dec 21
Biden says just now that more than 220,000 Ukrainian refugees have come to the US since Russia’s invasion began
@BFriedmanDC  Dec 21
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@ZarinaZabrisky  Dec 20

I was late for the train and forgot to add: the Xmas tree (Kyiv) is lit up by an exercise bike connected to a car generator. Passengers pedal away to lit up the tree because Russian attacks led to constant blackouts.

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Great perspective from Zelensky's speech to Congress:

“Your money is not charity but an investment in global security.” President Zelensky.

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"US spending of 5.6% of its defense budget to destroy nearly half of Russia’s conventional military capability seems like an absolutely incredible investment."

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@emptywheel  Dec 21


China megacity says people with symptomatic COVID can work 'as normal'

People with COVID-19 symptoms in one of China's largest cities can now go to work "as normal", state media reported Monday, a dramatic reversal in a country where a single case could previously send thousands into lockdown.

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China COVID deaths probably running above 5,000 per day - UK research firm Airfinity

BEIJING, Dec 22 (Reuters) - More than 5,000 people are probably dying each day from COVID-19 in China, health data firm Airfinity estimated, offering a dramatic contrast to official data from Beijing on the country's current outbreak.

The UK-based firm said it had used modelling based on regional Chinese data to produce figures that also put current daily infections in the country at above a million.

Its estimates were "in stark contrast to the official data which is reporting 1,800 cases and only seven official deaths over the past week," it said in a statement.

China's National Health Commission (NHC) did not immediately respond to a request from Reuters for comment. On Thursday it reported no new COVID-19 deaths and 2,966 new local symptomatic cases for Dec. 21.

A senior World Health Organization official said on Wednesday that China might be struggling to keep a tally of COVID infections as it experiences a big spike in cases.

An abrupt U-turn by China on its previous zero-COVID policy following protests has raised global concerns of widespread infections among a vulnerable, undervaccinated population. It has stopped mass testing and no longer reports asymptomatic cases.

Airfinity said its mortality risk analysis suggested between 1.3 to 2.1 million people could die in China's current COVID outbreak. Analyses by other modelling groups have also predicted as many as 2.1 million deaths.

Airfinity estimates the wave could have two peaks at 3.7 million a day in mid-January in regions where cases are currently rising and 4.2 million a day in March in other provinces.

This week, a leading Chinese medical expert said only deaths caused by pneumonia and respiratory failure after contracting COVID will be classified as having been caused by the coronavirus.

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@YanzhongHuang  Dec 20
A new strategy seems to be gaining momentum in China's efforts to cope with the viral wave. Instead of focusing on "flattening the curve", this strategy supports quickly infecting as many people as possible, which its supporters believe can help China achieve herd immunity before the Spring Festival esp. if 80% to 90% of the population are infected (which is like another round of mass vaccination) while minimizing the impact of absenteeism on the battered economy.
The Chinese name for this strategy is "快速达峰“ (quickly reaching the peak).
(So basically China went directly from Zero COVID to the Great Barrington Declaration.)
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Fears of a 'dark COVID winter' in rural China grow as the holiday rush begins



Feel good du jour:


@KQED Dec 24
One Diamond Heights resident has slowly — single-handedly — turned a two-block stretch of the neighborhood into a toy zoo of sorts.
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Baby rhino orphaned by poachers now has own calf

RHINO CONSERVATION: Congratulations to the team at

@CareforWildon the birth of another calf born to a rhino who was an orphan of poaching.  Video at:
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Doctor brings smiles to thousands of anxious NICU parents by playing Santa

Comic relief:

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Have you seen/heard Emily Blunt's story about the L&D Nurse telling her that her newborn is "gorgeous?" It's hilarious.


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What wine pairs best with finding out my in-laws are staying a day longer than I thought?
@OkinCity:  I have three for you that I highly recommend


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Bits of beauty:


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