Lara Jirmanus, MD MPH
@larazjmd
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Primary care doc in MA, community organizer, and social medicine researcher/educator. Faculty @Harvardmed. Parent. (she/her) Views my own https://t.co/7dCgkoPxs5
Massachusetts, USA
Joined July 2014
The last functional hospital in Northern Gaza #KamalAdwanHospital has been destroyed by #Israel after having been under siege for over 2 months. Healthcare workers have been abducted and summarily executed according to @EuroMedHR .
Kamal Adwan Hospital attack: harrowing testimonies of field executions, sexual harassment by the Israeli army in northern Gaza
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Last weekend I needed a new dishwasher installed, but the installation techs arrived wearing cloth masks, one with the mask falling off his face. When I asked them to wear high-quality #N95s (which I offered), or at least something that would cover the nose, they REFUSED. đ§”.
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Last week I was supervising EMTs on a home visit service & a woman called to request her father be seen. He was in his 90s, confused, no other symptoms. Only when I called to confirm the address she mentioned she had COVID, but she "didn't think that was it.".
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.@CDCDirector and @ashishkjha repeatedly insist that we have the tools to protect ourselves from #COVID19 but by downplaying the risk of COVID infection, you place vulnerable people, like my family members, in harm's way.
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It isn't the family's fault that they couldn't protect him. @CDCgov @ashishkjha, @CDCdirector, health pundits, and elected officials are all responsible for propagating misinformation downplaying COVID. The effect: we throw older adults, like my patient, under the bus.
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One of them said: "I'm the boss here and we wear our own masks. If you need us to wear something different we will leave, and you can wait until the pandemic is over to get a new dishwasher.".
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Wearing a high quality #N95 mask protects the wearer but only for about 2.5hrs if others around them are unmasked, and my baby can't wear a mask. (h/t @JuliaRaifman for the slide)
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At a bare minimum, public health policy should make it possible for people at high risk of illness and death from COVID to protect ourselves while getting our basic needs met.
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1⣠In older adults especially, weakness can be the main symptom of COVID. The weakness could be due to a low oxygen level, even without apparent shortness of breath. 2⣠Please, disclose ALL cold symptoms or recent COVID infections to health workers so we can wear appropriate PPE.
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As a @PeoplesCDC member this is reductionist, red-baiting nonsense. My question to @emmaogreen: if we are so fringe, then how after 3 years of pandemic (& misinformation downplaying COVID from @CDCgov ), a majority of US voters still support requiring masks to prevent surges?
A while ago, someone I know started sending around links to the People's CDCâa coalition that styles itself as a model of what the CDC would look like if it actually **followed the science** on pandemic restrictions. I was fascinated. (1/x) .
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Residents in the home include my parents who are both over 70 with chronic medical conditions, and two unvaccinated children under 5.
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COVID is very serious for older adults, who increasingly suffer the majority of COVID deaths. We need a society which keeps them safe, and one-way masking isn't enough.
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Burdening people with weakened immune systems and household members to "protect themselves" is patently inadequate. Most people can't meet their basic needs without being repeatedly exposed to COVID, which is airborne and transmitted in the air we share.
With Evusheld not currently authorized, CDC recommends people with weakened immune systems and household members take multiple prevention measures to protect themselves against COVID-19. More:
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We should make essential spaces safe for all by wearing masks to protect each other. If a masked person spends a prolonged period in a crowded, poorly-ventilated, indoor setting with many unmasked people, they can still catch COVID-19, even in an N95 mask
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Even for low risk folks, #LongCovid may affect 1 in 5 people. And vaccines only decrease the risk of Long COVID by 15% at best.
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Just tried to send a 2-week old baby in mild respiratory distress to a community ER. The ER doc told me they are having trouble transferring pedi patients to big hospitals & to send directly to a children's hospital. This is only the beginning of #COVID19/Flu season #Medtwitter.
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And @CDCDirector @ashishkjha and other public health leadership should be telling the public that using layerd protections like masks, and improved ventilation can effectively prevent disability and death from #COVID19.
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"We may give somebody a powerful medication that takes away their entire immune system and thenâŠthey have to go to a hospital where they sit next to people that are unmasked that could give them a disease that could kill them," @theodorepak.
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Masks work to prevent transmission of airborne and respiratory pathogens like COVID-19. Universal masking works better than one way masking to decrease transmission. Also not everyone can mask (like children/babies), so others should mask to protect them.
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Amazing that @nytimes and @BostonGlobe reporting false information. We have hundreds of people and video that shows the one counterprotestor holding an Israeli flag said âKill the Jewsâ⊠and the papers report whatever narrative can be used to discredit the anti-genocide movement.
I did hear "kill the Jews," said by a counter-protester holding an Israeli flag, seemingly as a provocative joke in response to the group's pro-Palestine chants. Not sure if that's the specific incident @Northeastern leadership is referring to
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As @heavyredaction and @kilojoule_ point out, this moment is not normal. We should not and cannot pretend our way out of this pandemic.
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We are still in a surge. as @MWRA_update local #Massachusetts wastewater data shows, current numbers haven't dipped much below the mid-May peak which was as high as the delta surge in August 2021.
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The latest @PeoplesCDC weekly weather report shows that the entire nation is in a surge with over 94% of the country at high or substantial rates of transmission according to the @CDCgov .
COVID This Week for June 21, 2022 focuses on the Global South and the US South. Presented by Rita Valenti, RN with research by Les Schaffer, PhD.
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The only way out of the pandemic is to put the public back in public health @DrTomori @AzizaAhmed (fin).
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"The information about outbreaks should be public ⊠We track other infections. We should be tracking hospital-acquired COVID, as well."
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We should all be so blessed to have older adults in our lives. We as a society should do better to prevent COVID transmission & protect them. Recent deaths in nursing home outbreaks show we aren't taking COVID seriously enough. @maura_healey @KateWalshHHS.
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And don't forget that #LongCOVID, which can follow even mild infections, and can include brain fog, heart attacks, blood clots and other potentially disabling symptoms which can affect even young, healthy adults and children.
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We need urgent action to improve indoor air quality in all essential spaces, and especially in nursing homes. Not to mention that we should be requiring N95 respirators for workers and visitors in nursing homes to protect the residents. @maura_healey @KateWalshHHS.
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Especially in healthcare settings, which are the most likely place to encounter a COVID-positive person, and a person at risk of developing severe illness from COVID, we should keep masks. @peoplescdc #KeepMasksinHealthcare #KeepMasksinHealthcareMA
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@RobbieForChange lamented in a public lecture yesterday that US public health policy is constrained by what Americans are willing to do. đ€ I would argue the chief constraint is @CDC inappropriately messaging safety with a pretty pastel map while we are in a surge đ§”
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If @POTUS & electeds want to end the pandemic, they should ensure public spaces are safe for all & everyone has access to healthcare, paid sick leave, clean indoor air, N95 respirators, COVID vaccines, tests and treatments. Until then we should #KeepthePHE
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Time to bring back #masks in schools. Itâs too early for pediatric units to be this full. As I told âŠ@ByJessBartlettâ© âYou put a bunch of kids in poorly ventilated schools and of course people will get sick. This is happening because we planned itâŠâ
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Folks have been asking what I did in response. I told the man that this it our private property, and we should be able to keep it safe. We already had air purifiers running and windows open. That's when he walked out.
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And a YouGov/Economist poll in November 2022 showed that Americans also support wearing masks in airports. so why is anyone trying to remove masks in healthcare, where they should be part of standard precautions? #KeepMasksInHealthcare
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A December 2022 poll showed the U.S. public still supports masks to prevent surges
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While it's nice to see efforts to prevent nosocomial infection on @BostonGlobe front page, why the focus on rare Mycobacterium abscessus, while much more deadly, hospital-acquired #COVID19 infections occur in US academic medical centers? @ByJessBartlett.
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Just out! @Harvard redefines the word âprotestâ.â. a group activity, for exampleâeven a silent oneâ that is explicitly using a space to make a point is engaging in a demonstration or protest.".What happens at universities that doesnât fit this definition?
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Black (71%) and LatinX (59%) folks are even more likely to support wearing masks on public transport than white people (52%). This doesn't sound like the problem is what the "American people" are willing to do. .
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Thanks for the encouragement! Next time I will specify, people have to wear masks inside my house or I take my business elsewhere.
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Our latest oped - @theodorepak @AWangMPH @PeoplesCDC .@CDCgov Itâs high time to count hospital-acquired #COVID19 and to demand that hospitals try to prevent it #BringBackMasksInHealthcare.
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@gregggonsalves @AnnalsofIM Please, share important commentary! Epidemiologist leaders recommend masks for ALL patient encounters as "a new standard of care" @IbukunMD #DavidKHenderson #SarahHaessler #DavidJWeber (science & patient autonomy >>hospital administrators recs based on $$)
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"We are being, in a real sense sacrificed, for other people's convenience. If decisions are being made about us, we don't just need a seat at the table, we need to be at the head of the table." -@killickwrites .h/t @oliviayarvis
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âThe responsibility shouldn't be on patients, who may already be sick and vulnerable in hospitals, to mitigate the spread of COVID-19âŠIt's the health care policymakers and leaders who are ultimately accountable for downplaying the risks of COVID in health settings,"@AWangMPH.
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If #N95s are not necessary, then why did they distribute them to Congress? â- @CDCDirector says #CDC mask recommendation will not change #COVID19 #MedTwitter
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"Itâs not an option for me or my father to avoid hospitals once masking is lifted. We shouldnât have to fear that the places we go to protect and recover our health might be the very places that expose us to a virus that could kill us." @Christine_ScD
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#COVID outbreak in California hospital only 3 weeks after California lifted health care mask requirements, with underestimated "community transmission" data still "low" #KeepMasksInHealthcare
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This is what leadership looks like: @NohaAboelataMD: "In what universe is it ethically appropriate for health care institutions to infect their own patients with SARS-CoV-2 when masking so effectively reduces its spread?"
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Our latest oped: Ending #maskmandate wonât bring us back to normal - Rather, it will lead to more preventable infections and outbreaks, at the expense of our societyâs most vulnerable. CommonWealth Magazine @Julianaspeaks #UrgencyOfEquity @lzj961.
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So before questioning what actions Americans are willing to take to protect each other, it may be worth considering whether you are clearly communicating the risks of #COVID19 and the life-saving benefits of public health protections. @AshishKJha46 @CDCDirector @RobbieForChange.
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Everyone #MaskUp indoors now to prevent the spread of COVID. The numbers in MA, recently increased in response to the school year starting without masks or mitigation measures in spite of our calls for more protections h/t @JuliaRaifman @jonlevyBU @FamCOSa
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Pundits who pushed "the pandemic is over" message should be unsurprised that their effective lobbying has dampened the appetite for Congressional COVID spending. This is a real problem for everyone, as we anticipate a fall surge
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As @CDCgov fails to set a high scientific and ethical standard for the rest of the nation, they shift the decision-making burden to under resourced local health departments, which are ill-equipped to deal with harassment and threats of workplace violence
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When the BPS parent group @FamCOSa asked to #BringBackMasks after Thanksgiving break and test before returning to school, the Boston Board of Public Health said they prefer to listen to the experts. You'll never guess what happened next. .
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High quality evidence supports mask mandates to keep kids safe in school. In Arkansas during AugustâOctober 2021, districts with universal mask requirements had a 23% lower incidence of COVID-19 among staff students.
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Why did Stefanik go after Penn, Harvard and MIT? What about Columbia? Stanford? Rutgers? Could it have been something about having women as presidents? Especially a black woman? đ§”.
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Right now almost the whole country is red meaning we should #MaskUp to slow COVID transmission and protect ourselves. h/t @hopebroidery & to help you find the @CDCgov transmission rates. .
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I also wondered why #DavidRemnick would assign a culture wars & religion writer a public health piece. Don't your readers deserve a serious look at the evidence, or would you lose the ironic, bougie New Yorker snark?
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But @CDCgov, @CDCDirector and @ashishkjha don't talk about the risk of #LongCovid, which can affect as many as 43% of people infected with #COVID19.
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@mandatemasksus @MassGenBrigham Patients can file a complaint with I talked to @AndreaForAG on the radio about concerns that this is systematic discrimination against disabled patients, seniors and immunocompromised patients and inhibits all of our access to safe healthcare without COVID.
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Even three of #Massachusetts largest medical associations warned it was time to take action to prevent pediatric hospital wards from being overwhelmed by bringing back public health protections, including #masks. That was 2 weeks ago.
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@MarilaGennaro It's more complicated than you think because they contract with companies and you don't even know who is coming until they call you 30 min before you arrive. I more worry about the high risk folks who don't feel comfortable asking for protection or don't know they are at risk.
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@EPA page on #COVID19 is so much more clear than @CDCgov. They explain that #CovidIsAirborne and thatâs why you need layers of protection including #vaccines, #Masks, #tests and #ventilation to reduce transmission!.
@MaryRay555 @Comm_in_Care @LazarusLong13 @GhostOfSocrates @JeromeAdamsMD @JenniferKShea @jljcolorado @jmcrookston @DrJudyStone @brosseau_lisa @WesElyMD @lzj961 @QuizzicalGirl @TheWHN @Orla_Hegarty @RPLerias @Sunny_Rae1 @SalamonSMD @NjbBari3 @NohaAboelataMD @zalaly @CDCDirector @kprather88 @NNUBonnie @michael_hoerger @amymaxmen @COVID_Advocacy @COVIDAdvocacyNY @emilygraymd_mph @mass_marion @joaquinlife @theacecoalition @PeoplesCDC @NACCHOalerts @C19LH_Advocacy
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And as you wonder why Americans are undervaccinated and underboosted, consider why you haven't partnered with more trusted community organizations to improve vaccine access, like this effort in MA which brought vaccine rates over the state average (fin).
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Interesting what @POTUS thinks is necessary to protect himself vs the rest of us #urgencyofequity #ZientsMustGo.
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All the more reason for . Did you know that CDC now recommends children over 2 wear masks indoors?
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From the beginning of the pandemic CDC has oversold the promise of vaccines. A closer look at CDC data showed that 4 in 10 COVID deaths in Jan and Feb 2022 were among the vaccinated.
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High risk people shouldn't have to choose between meeting basic needs & #COVID19. Demand an emergency stay of the federal court order & restore the public transport #MaskMandate now! #MaskUp @CDCgov @CDCDirector @TSA_Pekoske @TSA @WHCOVIDResponse @AshishKJha46 @SecretaryPete.
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At best, vaccines may only decrease the risk of Long COVID by half.
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She could have discussed rather than dismissed the overwhelming evidence, which shows over 50% of people are still contagious after 5 days of COVID infection (which includes a study by @CDCMMWR) and more than 80% of people with symptoms test + on day 5!
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Shame on @MassDPH, DESE and @CDC for issuing recommendations for Massachusetts schools that are not backed by science. đą Masks keep kids healthy and in school as this study from Boston and Chelsea schools shows .h/t @DGBassani @ToriCowger @FXBHarvard.
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@AmerAcadPeds Thank you for your evidence-based thread. Itâs becoming more and more clear that #masks are MUCH MUCH safer than #COVID19.
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If @MassDPH & @maura_healey don't take action, my sickest patients may think twice about calling 911 because unmasked EMTs will enter their home and take them in an unventilated ambulance to hospital. Most COVID transmission is asymptomatic.
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What would it look like if instead, #Emmaogreen actually discussed the evidence, instead of @PeoplesCDC members' "potted plants?".Lets have a look. .
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@EricTopol @ct_degroot Here is the counterargument from leaders in Hospital Epidemiology from March 2023, which of course the press didn't cover, who still think we should prevent the 3rd leading cause of death (#COVID19). @IbukunMD #SarahHaessler #DavidKHenderson
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.@PeoplesCDC's nuanced warnings agree w/ airborne experts that N95s offer excellent protection. But individual masking is not a 100% guarantee. Not everyone can wear masks all the time & some people can't afford to risk a single COVID infection. So we have to protect each other.
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@Shanon04098546 @nb_covid_info Itâs totally true. Healthcare providers have to wear surgical masks but arenât required to wear better protection. Itâs crazy that in our own profession we donât follow the science and are potentially allowing nosocomial spread.
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As @Peoplescdc members @hopebroidery and Rita Valenti say, I don't think the US public knows that over 300 people are dying from COVID daily. If people knew how and when to protect each other, and how big a difference it makes, they would act differently.
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I guess @Mayorwu was worried the public wouldn't wear #masks anymore. but then this Economist / YouGov poll suggests folks support mask mandates on airplanes and in airports, and even a majority of people report wearing a #mask some of the time
Economist/YouGov poll, Nov 19-22. Would you support or oppose a policy that made it mandatory to wear masks in the following places? Airplanes. 57% - Support.32% - Oppose.10% - Not sure.
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Rather than comparing the US to China or New Zealand, one might compare the US to France, Germany or Canada. In the 3rd year of the pandemic they've kept deaths down lower than the US.
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While she was "calling up" all these experts, perhaps she could have called #Fauci, @CDCDirector or @POTUS and asked them why @CDCgov guidelines weren't good enough for them, but are good enough for the public?
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As I wrote in @thecrimson .âThough our campuses are much quieter than the campuses in #Gaza & the threats manyfold less, students @Harvard & around the countryâŠblock violent policies & investments with their bodiesâŠâ.
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Rather than finding #maskmandates "impractical" as @DrTomFrieden comments, 57% of Americans STILL support requiring masks to prevent COVID surges!
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As a Palestinian food writer, I believed culinary exchange could build empathy. Too often people âate at my table, then ignored my people.â Writes âŠ@reem_kassisâ© in this on point op-ed
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âI literally have to choose between lifesaving medical care and exposure to covid, which really isnât a choice,â said James, 42. âItâs a high-risk situation being forced on me with little to no ability to consent.â.
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Today I voted âNo Preferenceâ to send a message to @POTUS that I donât accept my tax dollars being used to kill and starve Palestinians. @NoPreferenceMA .#VoteNoPreferenceMA
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