Coronavirus Tidbits #236 3/12/23

Announcements:

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.

Reminder, Resilience: One Family's Story... is increasingly pertinent, as some of our politicians shift rightward. All proceeds go to Holocaust education.

Available here.

 

 

 

 

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My 2" of fame--I screwed up my courage to give oral testimony (via Zoom) to MD legislature on abortion shielding bills.

Whatever--point is to do whatever we can to stop the wave of hate mongering bills being passed that will limit our rights. There are multiple ways to help. See NOPE, Indivisible, etc., linked below.

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Help get Dem turnout for Wisconsin Supreme Court election!

Because of a deadlocked WI state government, the WI Supreme Court will arbitrate a host of super-important issues such as:  abortion rights, gerrymandered election maps, the governor’s appointment powers – and perhaps even the state’s 2024 presidential election.  With a conservative justice retiring, pro-democracy advocates hope to take the seat and its 10 year tenure.  This would position the Court to reverse a host of anti-democratic decisions.  This election has been termed, “the most important election in America in 2023” by the New York Times.

What we can do. The Wisconsin Democratic Party has lists of opportunities; as does Swing Left and others  See Mobilize for many of them.  Note: the opportunities below are certainly not all-inclusive.

News 

Bye-bye, Data:

The major providers of data on daily Covid-19 cases and deaths either aren’t going to do it anymore or are switching to less frequent reporting. At their best, they’ve alway been snapshots, but Johns Hopkins is shutting down its tracker today, CDC will update its stats only weekly (which may be bumpier due to delays at its sources), and Our World in Data has switched over to WHO’s weekly updates.

All this comes as few home testing results are reported to public health entities, adding a big asterisk to those case totals and making that snapshot blurrier.

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Covid backlash hobbles public health and future pandemic response

Lawsuits and legislation over COVID-19 response measure have weakened public health authority and the ability to respond to future pandemics, the Washington Post reported yesterday. It noted that at least 30 states have passed laws since 2020 limiting public health authorities and that more than half the country is barred from issuing mask mandates, closing schools, and taking other response steps.

https://www.washingtonpost.com/health/2023/03/08/covid-public-health-backlash/

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Long COVID is much less likely after omicron than after initial pandemic variant

https://medicalxpress.com/news/2023-03-covid-omicron-pandemic-variant.html?

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Study associates long COVID with physical inactivity

by Theo Ruprecht, FAPESP

The link between symptoms of COVID-19 and physical inactivity is increasingly evident. An article recently published in the journal Scientific Reports by researchers at the University of São Paulo (USP) in Brazil describes a study in which COVID-19 survivors with at least one persistent symptom of the disease were 57% more likely to be sedentary, and the presence of five or more post-acute sequelae of infection by SARS-CoV-2 increased the odds of physical inactivity by 138%.

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rats are susceptible to infection with SARS-CoV-2 

Bad news for big cities...

with Alpha, Delta and Omicron variants of SARS-CoV-2 and wild rats in the New York City municipal sewer systems and elsewhere in the city have been exposed to SARS-CoV-2.

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Indoor air is full of flu and COVID viruses. Will countries clean it up?

The current pandemic has focused attention to the importance of healthy indoor air and could spur lasting improvements to the air we breathe.

Nature   Dyani Lewis

Bars in Belgium could be among the healthiest places to have a drink, come July. That’s when a new law goes into effect, requiring public venues to meet air-quality targets and display real-time measurements of carbon dioxide concentrations — a proxy for how much clean air is piped in.

Consumers in Belgium will get even more information in 2025, when gyms, restaurants and indoor workspaces must all show air-quality ratings given through a certification system. In the event of a future pandemic, Belgium’s rating system could determine whether or not a venue is closed.

The law, enacted in July 2022, is the boldest in a string of moves that countries have taken in the wake of the COVID-19 pandemic to make indoor spaces safer in the face of infectious diseases caused by viruses such as SARS-CoV-2 and influenza.

https://www.nature.com/articles/d41586-023-00642-9

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But a new randomized, placebo-controlled trial of metformin has yielded exciting results—the first drug to be shown to help prevent Long Covid. Over a thousand people with mild-to-moderate Covid were randomly assigned to 2 weeks of metformin (500 mg pills, 1 on day 1, twice a day for 4 days, then 500 mg in AM and 1000 mg in PM for 9 days) or placebo. There was a 42% reduction of subsequent Long Covid as you can see by the event curve below, which corresponds to an absolute decrease of 4.3%, from 10.6% reduced to 6.3%.

Of note, the participants in the trial were fairly representative of the people who most often go on to manifest Long Covid, outpatients with a median age of 45 years and 56% were female. The low risk subgroups of people age <30 years or with a normal BMI were excluded. There were no treatment by subgroup interactions—that is there were overlapping 95% confidence intervals for the direction of benefit for metformin for all subgroups; no clear evidence that metformin worked better or worse for each. That’s consistency, although the statistical power for an interaction term is limited with only ~1,000 patients and a larger trial would be needed to know whether any of the subgroups below had differential effects with metformin. The findings in the trial also reinforced the higher risk of unvaccinated vs vaccinated status to get Long Covid (14 vs 7% , respectively, among placebo assignees). The diagnosis of Long Covid in the trial relied upon it being documented by a medical provider. The mechanism of metformin’s apparent benefit is unknown, but perhaps is related to its impact on reducing oxidant stress and inflammation, or suppressing viral replication, as has been demonstrated in the lab and in vivo models with the SARS-CoV-2 virus.

There are no other adequately sized or rigorous trials that have evaluated metformin to date. So the question is, without an independent replication, whether this trial’s data should be considered sufficient to now recommend metformin in clinical practice. My view is yes, since the risk of side effects for 2 weeks of metformin is near zero (from both the trial itself and the huge experience with metformin over decades for chronic use) and the cost is remarkably low, in fact as low as $1-2 dollars for the 2 week course. The only other drug to date with some promising data to prevent Long Covid is Paxlovid, but that is from a large observational database, not derived from a randomized trial. Ideally, a 2X 2 factorial design trial would be conducted to test metformin plus paxlovid, either drug alone, or placebo. And to emphasize, we still have no drug validated to treat Long Covid, only 1 that now appears likely to help prevent it.

https://erictopol.substack.com/p/a-break-from-covid-waves-and-a-breakthrough

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Canada’s chief science adviser estimated that 10-20% of people with COVID-19 develop long COVID. “Some patients have not recovered two to three years after the initial infection and it is uncertain whether a proportion may ever fully recover,” Nemer said in the report, adding that the lack of consensus on a clear definition and diagnostic criteria can make it difficult to lodge claims for social assistance, disability supports, and insurance.

“significant impacts on the labour market and the Gross Domestic Product (GDP), in addition to health costs and demands.”

https://www.insurancebusinessmag.com/ca/news/breaking-news/new-report-warns-long-covid-could-be-mass-disabling-event-439109.aspx

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Other:

The world's first mRNA vaccine for deadly bacteria

medicalxpress.com/news/2023-03-w

Interesting because it should enable more rapid vaccine development against bacteria like plague and antibiotic resistant bacteria. Promising development.

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@HelenBranswell   Mar 10

Traveling to Israel??? Be aware of Polio and uptodate on vaccines

.@HealthNYGov is urging any NY State residents traveling to Israel to be sure they're fully vaccinated against #polio after Israel reports a case of paralytic polio in a child infected with a vaccine-derived virus.
Adults who completed the polio vaccine series as children and are planning to travel to countries with increased risk may receive a one-time booster dose of polio vaccine (IPV).

How the brain senses a flu infection — and orders the body to rest

Scientists trace the neurons in the throat that detect signs of infection and relay this information to the brain.

Nature   Liam Drew   08 March 2023

A case of influenza can make even the toughest people take to their beds and lose their appetites. Now, scientists have identified neurons in mice that notify the brain of a flu infection, triggering decreases in movement, hunger and thirst1.

Similar neurons connecting to other parts of the body might notify the brain of other infections, too, the authors say. The work was published on 8 March in Nature.

“This study flips previous thinking on its head,” says Ishmail Abdus-Saboor, a sensory biologist at Columbia University in New York City who was not involved in the research. “This is paradigm-shifting in terms of how we think about sickness behaviour.”

The new results don’t tell the full story. The infection-sensing tonsil neurons are responsible for sickness behaviour only during a flu infection’s first stage, which affects the upper airway and lasts roughly a week. As the virus moves into the lower respiratory tract over the course of the illness, another nerve pathway takes over the job of driving sickness behaviours. “If we could find a way to block that second pathway, that, in combination, could have tremendous clinical impact,” Liberles says.

https://www.nature.com/articles/d41586-023-00675-0

Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

High-risk Canadians Offered COVID-19 Boosters for Spring 2023

Canada's national vaccination advisory body recently announced high-risk individuals could get another COVID-19 booster shot starting this spring.

The new recommendations from the National Advisory Committee on Immunization (NACI) on March 3, 2023, outline that an additional vaccine dose may be offered at a standard interval, six or more months from the last COVID-19 vaccine dose or SARS-CoV-2 infection, whichever is longer,

This recommendation is for people at a higher risk of severe illness, including immunocompromised adults and seniors.

NACI wrote that bivalent, omicron-containing, mRNA-based COVID-19 vaccines are the "preferred" option for booster shots.

At this time, the NACI isn't recommending an additional spring booster for people in the general population who've already received all their previous recommended doses,

https://www.precisionvaccinations.com/2023/03/07/high-risk-canadians-offered-covid-19-boosters-spring-2023

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Cost of China-made drug ingredients more than doubled 

Since the COVID-19 pandemic began, prices of some active pharmaceutical ingredients (APIs) exported from China have more than doubled, The Times of India reports.

Chinese export of the affected APIs, including those for important oral and injectable antibiotics, over-the-counter pain- and fever-reducing medications, and the diabetes drug metformin, has been complicated by pandemic-related supply-chain chaos and, more recently, the lifting of the country's zero-COVID policy.

India is nearly 100% dependent on China for these APIs, increasing the cost of making high-volume drugs such as azithromycin, amoxicillin, and rifampicin. In turn, India supplies over 20% (by value) of the world's generic drugs and is the leading manufacturer of vaccines.

Together, India and China manufacture the APIs needed to make 60% to 70% of the generic drugs on the US market, according to the Resilient Drug Supply Project (RSDP) at the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), publisher of CIDRAP News.

Role of inflation, rising energy costs

After China lifted its strict public health measures in early December, the resulting COVID-19 surge slowed manufacturing and increased in-country demand for medications such as the antiviral Paxlovid, which is used to treat COVID-19. Other affected medications include pain- and fever-reducing drugs, the latter of which have also been in short supply elsewhere, including in the United States.

In December alone, China-made APIs became 12% to 25% more expensive, according to the Economic Times. For example, prices of the APIs for the antibiotics azithromycin and amoxicillin rose 15% and 13%, respectively.

The steep rise in prices may also be partially explained by factors such as inflation and increased prices of the materials used to make APIs (eg, solvents), which have been driven up by high energy and transportation costs, the Times said.

https://www.cidrap.umn.edu/resilient-drug-supply/cost-china-made-drug-ingredients-more-doubled-during-pandemic

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The albuterol shortage is about to get worse

A plant closure in Illinois eliminates a source of liquid albuterol, which is used by hospitals to treat asthma and RSV in children.

Akorn's Illinois facility was licensed to make liquid albuterol, which is used by hospitals for nebulizers, common devices that turn medicine into mist to be inhaled. The shutdown of that plant leaves just one remaining domestic supplier of liquid albuterol,

a sole manufacturer creates immense risk that a disruption could wipe out supply

https://www.washingtonpost.com/business/2023/03/01/drug-shortages-manufacturing-albuterol/

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Jack Turban:

Biden’s Proposal to Limit Online Prescribing Is a Raw Deal for the Most Vulnerable Patients

how the new Biden administration proposal to require in-person visits for stimulant #ADHD medications may inadvertently worsen health equity issues. 

https://newrepublic.com/article/171018/biden-telemedicine-adderall-buphenorphine-restrictions

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@thinkalot   March 10

This Stomach Bug Isn’t Responding to Antibiotics. Scientists Are Worried.

nyti.ms/3YDcMWu

This is worrying. #AntibioticResistance

Devices:

Understatement:
@cochranecollab  director says that their review interpretation on #mask efficacy was "inaccurate and misleading" and that the lead author of a mask review misrepresented its findings, apologizes for summary statement that was imprecise, They say they will update it. They say their review did NOT find masks don't work. Plus, Zeynep examines the actual evidence.

Epidemiology/Infection control:

Tips, general reading for public:

Ventilate.

Mask.

Vax.

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If you have ME/CFS, or Long Covid with #mecfs, and if you have to go to the ER or to urgent care, take this handout with you. You'll need it, since the ER doctors aren't likely to understand your needs.

batemanhornecenter.org/wp-content/upl

Politics:

Covid:

California Nurses Assoc Slams Decision to roll back masking and vax requirements.

“It’s surreal political leaders would put nurses, patients and community members at greater risk of developing conditions like heart disease, strokes, diabetes, pulmonary embolism, cognitive impairment and long-term immune dysfunction." news.yahoo.com/california-nur

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@LaurenWeberHP   Mar 8  Pandemic preparedness is destroyed
In the next pandemic, North Dakota can't make residents wear masks. Ohio health officials can't shutter businesses. The president can't force a vaccine or test mandate. Inside the 3 year culmination of public health handcuffing w/@JoelAchenbach.
at least 30 states have passed laws limiting public health authority so far.
The consequences are already playing out in Columbus, OH, where a child with measles was able to wander around a mall before showing symptoms in November, potentially spreading the contagious disease A 2021 law had stripped the ability to quarantine someone suspected of disease.

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@FordFischer   March 11
CW for thread: Language and violence Several anti-drag groups including avowed Neo-Nazis, "White Lives Matter," Proud Boys, Patriot Front, and non-affiliated conservative activists protested outside a drag show today at a public park in Wadsworth, Ohio.
"Pedophiles get the rope!" chanted an armed neo-Nazi group waving swastika flags at the families attending the all-ages event. "F***s go home!" "Sieg Heil," they chanted while pointing stiff-arm salutes at attendees. "There will be blood!" "Hey, there's a gay n****r right there!" yelled one of them.

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Abortion/Reproduction:

Chilling: Three #Texas women are sued for wrongful death after assisting with #abortion | The Texas Tribune

texastribune.org/2023/03/10/tex

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A federal judge (Kacsmaryk, same who will rule on #mifepristone) ruled that federally funded family planning clinics that provide #contraception to minors without parental consent violate Texas law.

https://www.npr.org/sections/health-shots/2023/03/09/1161981923/girls-in-texas-could-get-birth-control-at-federal-clinics-until-a-dad-sued?

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Rep. Katie Porter just blasted Walgreens for their abortion pill decision and threw her support behind Gov. Newsom’s decision to cut ties with the company. “California does not cower to extremists. We call them out.”

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@JoeMyGod   March 11
Florida Bill Would Require Rape Victims To Provide Proof Of Their Rape In Order To Procure Abortion Exception
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Antisemitism:

‘An extraordinary act of courage’: the #Aboriginal activist who protested against #Nazi Germany

theguardian.com/music/2023/mar

#Adelaide #Australia

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Book bans:

@healschools   Mar 4
In the face of growing attacks on the teaching of history, @thenewpress is partnering with the @ZinnEdProject to send books to #teachers and teacher educators in AR, FL, ID, IA, NH, OK, TN, TX & VA. Request a book at
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Child labor:
@MorePerfectUS   Mar 6
A bill to remove the need for a work permit for children under the age of 16 has reached Arkansas Governor Sarah Huckabee Sanders's desk. If she signs it, children as young as 9 years old could be hired to work in Arkansas without a currently required employment certificate.
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@hannahdreier
US companies are saying this week they had no idea migrant children were making their products. But finding these kids was often as easy as going to factory parking lots and talking with baby faced workers who freely admitted they were children.
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Climate/Environment:

@RepKatiePorter   
House Republicans want to redefine "conservation" to include mining and drilling, and they brought a witness to argue for reducing environmental review under a key law that protects our public lands.
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@MannyRutinel  March 1

Our victory against the  @EPA  has been picked up by  @Reuters! reuters.com/business/envir In this succinct and clear piece,

@leahjdouglas explains the context and the next steps for the EPA to finally address the highly-polluting slaughterhouse industry.
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@micahinATL   Mar 6
over FORTY PEOPLE have been charged with DOMESTIC TERRORISM for being part of or associated with the movement to Stop Cop City. Everyone who cares about justice in any form should care about this.
This is a huge fucking deal and it is the ruling class's strategy going forward to suppress social movements. People standing in a field last night were threatened with domestic terrorism charges if they didn't leave. That's what we're dealing with.
The Atlanta Solidarity Fund coordinates legal defense for criminalized protesters. Support their work here: atlsolidarity.org
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An independent autopsy has found that forest defender Manuel 'Tortuguita' Terán was sitting down with their hands up when they were shot and killed by Georgia State Patrol during raids on #StopCopCity tree-sits on January 18.

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@Claire_Phipps
The BBC has decided not to broadcast an episode of David Attenborough’s flagship new series on British wildlife because of fears its themes of the destruction of nature would risk a backlash from Tory politicians and the rightwing press
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Cost of living:
Pleasure watching Katie Porter rip Jamie Dimon, CEO of Chase: His full-time employee ends up significantly in debt each month
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Greed:
@AjKavanaugh
Health insurance profits, 2022:
United Health: $20,600,000,000
Cigna: $6,700,000,000
Anthem: $6,000,000,000
CVS Health: $4,200,000,000
Humana: $2,800,000,000
Centene: $1,200,000,000
Revenues have increased 300% since 2012. Still can't figure out why healthcare is so expensive?
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@greenhousenyt   Mar 9
“The situation is so absurd that the top 15 Wall St. hedge fund managers make more money in a year than all 120,000 kindergarten teachers in America combined. Wages are so low In 36 states, the average school teacher with a family of 4 qualifies for food stamps & public housing"
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LGBTQ
CPAC speaker calls for transgender people to be eraditated...
@BrynnTannehill 3/4
If Knowles had said, "For the good of society... Judaism must be eradicated from public life," and then followed it up with, "I just meant Judaism, not Jews", I don't think the ADL would respond with, "Oh, well, nevermind in that case. Carry on!" It means what you think it means
Look, he's probably sincere when he insists that he doesn't mean rounding up all the trans people and committing industrial scale murder. He means to make trans people disappear, or flee. But, that was also the goal in 1933-1934. 2/n
Germany didn't decide on the "Final Solution" until January '42 at the Wannsee Conference. In 1933-34 the German government cooperated with Jewish groups to move them to Palestine. ~2/3rds of German Jews had left the country by August 1939.
The Holocaust started with Germany removing Judaism from society first, which was inextricably linked with marginalizing, punishing, isolating, demonizing, segregating, and terrorizing Jews. It didn't move on to officially eradicating Jews as policy until 9 years later.
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Arkansas:
see Child labor, above
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California:
see Abortion - Katie Porter
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Colorado:
@therecount   Mar 9
Rep. Boebert (R-CO): “We have more than 25% of federal employees not logging into work.”
@USOPM Dir. Kiran Ahuja: “I do take issue with the characterization.”
Boebert: “It’s in this leaked document.”
Ahuja: “You’re basing that from 2020, which is in the last administration.”
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Florida:
see abortion

DeSantis seeks $98 million to fund Florida’s own military

https://www.clickorlando.com/news/investigators/2023/03/09/desantis-seeks-98-million-to-fund-floridas-own-military/

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@orlandosentinel   
CDC and FDA send letter to Florida’s Surgeon General Ladapo warning he is endangering lives trib.al/7x2kaiP
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Michigan:
@NoLieWithBTC   Mar 9
Michigan Democrats just gained full control of government for the first time in 40 years. They just passed universal background checks, codified LGBT rights, and enacted the right to join a union. Here they are zooming through bullshit GOP amendments:
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Ohio:
see LGBTQ:
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Tennessee:
@aldotcom   Mar 9
A full-page ad with Tennessee Gov. Bill Lee dressed in drag ran in one of the state’s largest newspapers Tuesday, just days after the Republican politician signed into law a bill targeting drag performances — the first of its kind in the nation.
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Texas:
see abortion, above
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Virginia:
@AzPetrich   Mar 8
A Virginia court has ordered a nursing mother of a 5 month old to stop breastfeeding, in order to better suit the divorcing father's custody demands. A Virginia court has ordered the mother of the 5 month old to use a bottle.
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West Virginia:
Currently, children can marry as young as 16 in West Virginia with parental consent. Anyone younger than that also must get a judge’s waiver. huffpost.com/entry/bill-to-?
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Ukraine:
@intermarium24   Mar 5
European Commission President von der Leyen announces agreement to set up Special Tribunal in the Hague
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‘For now, music is a weapon’: the Ukrainian musicians playing on as an act of resistance

Feel good du jour:

'Noah's Ark for plants' hits major milestone: 40,000 plant species now banked at Kew's Millennium Seed Bank

A world-leading seed conservation program led by the Royal Botanic Gardens, Kew is celebrating a major milestone today in its efforts to preserve rare, threatened, and important wild plants. As of March 1, the Millennium Seed Bank (MSB) has banked more than 2.4 billion individual seeds representing a total of 40,020 different species of wild plants.

Described by scientists as "Noah's Ark for plants," the MSB is the world's biggest wild seed storage facility, situated at the heart of Kew's 'living laboratory' and wild botanic gardens, Wakehurst, in rural Sussex. Within the bomb- and flood-proof building are 98,567 seed collections sourced from 190 countries and territories, across all seven continents, nine biogeographic regions, and 36 biodiversity hotspots. In fact, the MSB holds the Guinness World Records title for world's "largest seed bank."

https://phys.org/news/2023-03-noah-ark-major-milestone-species.html

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Judy Heumann's years of advocacy and lobbying ultimately led to the federal Americans With Disabilities Act.

She passed away last weekend at the age of 75.

you can't separate the fact that her parents were survivors of the Holocaust from her own personal advocacy and really raised her with the idea that people with disabilities deserve to be included, deserve to be at the table.

she was denied the right originally to attend kindergarten as a five-year-old herself, later, when she wanted to be a kindergarten teacher in college, she was also given a similar reason for not being able to go to college

years later, she was appointed by President Clinton to serve as the Assistant Secretary for the Office of Special Education and Rehabilitative Services. So she was put in charge of education for kids just like her.

https://www.wbur.org/hereandnow/2023/03/06/judy-heumann-disability-rights

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Meet the educator of the year who taught from her hospital bed. “She’s that one teacher that kind of changes your life.” gma.abc/3MJA1tA

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Cincinnati barber goes viral with video of special connection with young boy

Vernon gives haircuts to children with disabilities for free!

https://www.wlwt.com/article/cincinnati-barber-vernon-jackson-gifted-program-haircuts/42799092#

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@Goodable   
Dr. Adam Bodzin was preparing to perform a liver transplant when he found out the delivery van was blocked because of a marathon. What did he do? He ran half a mile — THROUGH THE MARATHON — picked up the liver, ran it back, and then performed the surgery.
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Perspective/Poem

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https://twitter.com/buitengebieden/status/1632014933356425223?s=20

Bits of beauty:

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