SL 818

Hi all. I’m sort of back. Let me throw out some links to get my brain back to work/blog mode again.

If you are going to join the substack revolution, then read the New Yorker article about it, read the New York Times article about Heather Cox Richardson, read her latest post about the Lakota Indian Massacre (wow), and subscribe to mine!

I’m pretty disgusted with the ineptitude behind the vaccine rollout. I’m hearing horror stories, including one that showed up on the gossip blogs; a CEO from a major beer company paid some hospital worker for a black market shot.

Reading: The Best of Me, David Sedaris Watching: The Bridgerton, Babylon Berlin, Cosmos, Wonder Woman 1984, and Soul Cooking: Cream of Mushroom Soup

Picture: We had the smallest Christmas Dinner ever. Just four of us. It was small, delicious, and MUCH less work for me.

60 thoughts on “SL 818

  1. One of the teens wound up in the hospital with kidney stones and an infection the day after Christmas, but they’re back now after several nights away. My husband (who drew hospital duty) says that there were a couple of spare beds out in the hall labeled “surge.” That wing was pretty empty, but I see from the internet that about 30% of the hospital beds locally are occupied by COVID patients. At least in the non-COVID zone, you are allowed one visitor per calendar day.

    I don’t know what the deal is with the hospital, as a) the number of COVID hospitalizations is very high but b) they seem to have a couple of spare ICU beds. I’m surprised there are any spare ICU beds, given the number of COVID patients. There are also more hospitalizations than matches up with the current local case count–new local cases have been going down while COVID hospitalizations have been going up. My guess is that less sick COVID patients are being brought in from elsewhere–a couple weeks ago, I remember reading that about 20% of local COVID hospital patients were from outside the county.

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    1. Thanks! Kid has to go back in a couple weeks to get the actual stones done. They couldn’t do it this stay because of the infection.

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      1. Cranberry said, “Best wishes for a speedy recovery!”

        Thanks! Kid’s all booked now for the kidney stone procedure. Kid only has four recovery days between that and the start of school–I hope that will be enough.

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  2. https://www.nbcnews.com/news/us-news/7-year-old-kennedy-maxie-dies-less-week-after-atlanta-n1252473

    A 7-year-old black girl was fatally shot by a stray bullet while Christmas shopping in an affluent Atlanta neighborhood on Dec. 21.

    “The girl was in critical condition for days before succumbing to her injuries on Saturday.”

    “Atlanta police confirmed to NBC News that the girl’s shooting death was one of a record-breaking number of homicides investigated by the department in 2020.

    “As of the end of the week 52 reporting period we are at 154 homicides compared with 99 for the same period of 2019,” Atlanta Police Officer Steve Avery said in a statement. “That is an increase of 61%.””

    Back in July, an 8-year-old black girl named Secoriea Turner was shot to death by protesters near the burnt-out Atlanta Wendy’s where Rayshard Brooks had been killed by police.

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  3. This is kind of uncanny. I think I mentioned before that the McKenna kitchen cabinets are almost identical to the Maison Y81 kitchen cabinets, and the Maison Y81 Christmas dinner consisted of roast beef, mashed potatoes, spinach, and red wine. (We didn’t have salad, and we had brunekager for dessert, which the Mckennas probably didn’t, but it’s still striking.)

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    1. Close. Filet mignon, mashed potatoes with sautéed mushrooms/sherry, broccoli rabe/garlic slices, salad with homemade croutons. Sliced pineapple. Assorted cookies.

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  4. I don’t know how well this will work in practice, but it’s a good sign:

    https://www.khou.com/article/news/health/coronavirus/vaccine/texas-covid-19-vaccine-near-me/285-3e4e9294-d29a-4e10-ad17-d0bfa6616bb2

    A Houston TV station says,

    “Seniors 65 and older as well as people with underlying medical conditions will be able to get their shots as part of phase 1B of vaccine distribution in Texas.
    The Texas Department of State Health Services posted an interactive map online that shows where the vaccines have been delivered in Texas. Officials say 350 providers will have the vaccine by the end of this week.”

    “The map shows where it’s been delivered. You can also narrow down the list to see which community clinics, hospitals, long-term care facilities and pharmacies have received doses of the vaccine.”

    “The state of Texas has been given the green light to move onto phase 1B of vaccine distribution, which local hospitals expect to begin in the next few days.
    Health providers will be contacting patients who are eligible to get shots to schedule appointments.
    If you do not have a primary care physician, the state says people can also call locations that have the vaccine directly to ask for an appointment.”

    It will be interesting to see how well this goes.

    The Israelis have already vaccinated over 5% of their population and about 25% of residents 60 and over.

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    1. This is very exciting!

      https://www.kxan.com/news/coronavirus/local-pharmacies-can-start-vaccinating-people-in-1b-phase-immediately/

      “Texas health officials are giving local pharmacies the go-ahead to start vaccinating those in Phase 1B for COVID-19 while Phase 1A is still underway.”

      “On Tuesday, Texas Department of State Health Services Commissioner Dr. John Hellerstedt released the following statement to local providers with shipments of the COVID-19 vaccine:

      “All providers that have received COVID-19 vaccine must immediately vaccinate healthcare workers, Texans over the age of 65 and people with medical conditions that put them at a greater risk of severe disease or death from COVID-19. No vaccine should be kept in reserve.”

      “While Phase 1A of Texas’ COVID-19 vaccine distribution includes frontline and healthcare workers, as well as some first responders, funeral home workers and school nurses, Phase 1B includes those over 65 and people with certain medical conditions.”

      “Clark [a pharmacist] says if a dose is available that cannot be filled by someone in phase 1A at the time, then they will move onto someone in phase 1B.”

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      1. y81 said, “That is fabulous. Our governor is kind of an idiot, so I don’t know if he will do anything this intelligent.”

        I am hopeful, but fingers crossed!

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  5. As to the gossip about the beer company CEO, I’m either cynical or pragmatic, take your choice.

    I mean, is anyone naive enough to believe that the algorithm messed up in assigning vaccine to Stanford medical workers? Really? Big Medical research depends upon the graces of billionaires. There are more billionaires within a stone’s throw of Stanford than anywhere else on earth. I imagine the pressure from “close friends” of the institution was overwhelming, let alone from all their concierge medical services.

    Which is to say, I’m sure the beer exec is not the only one. In this area, on the other coast, it seems the ultimate in name dropping is to have an in with “the best doctors” in the best hospitals. Wealth is health.

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    1. I am naive enough to believe that the heuristic messed up in assigning the vaccine at Stanford. The specific issue seems to the use of “location” as a ranking item when residents/fellows do not have a “location” in their official directories. The bias comes in not having questioned the algorithm, I think, rather than in having designed it purposefully to de-prioritize residents. Frankly, hospitals are facing significant staffing crises, so prioritizing a pathologist who works remotely from their computer over the resident who they need to actually treat their patients would be a poor business choice.

      And, is Stanford alleged to have made the vaccine available to billionaires? I haven’t heard anything on those grounds.

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      1. https://www.statnews.com/2020/12/03/how-rich-and-privileged-can-skip-the-line-for-covid19-vaccines/

        Early access to coronavirus vaccines is likely to be no different, medical experts and ethicists told STAT. It could happen in any number of ways, they said: fudging the definition of “essential workers” or “high-risk” conditions, lobbying by influential industries, physicians caving to pressure to keep their patients happy, and even through outright bribery or theft.

        The worst attempts to nefariously procure a vaccine may come a few months into distribution, once vaccines are available that don’t require ultra-cold storage and local pharmacies and physician practices get allotments. “There absolutely will be a black market,” said bioethicist Arthur Caplan of New York University. “Anything that’s seen as lifesaving, life-preserving, and that’s in short supply creates black markets.”

        Here’s more information about the Stanford algorithm. It is a public relations debacle. Note that many other institutions got it right: https://www.technologyreview.com/2020/12/21/1015303/stanford-vaccine-algorithm/

        Some residents are bypassing the university health-care system entirely. Nuriel Moghavem, a neurology resident who was the first to publicize the problems at Stanford, tweeted on Friday afternoon that he had finally received his vaccine—not at Stanford, but at a public county hospital in Santa Clara County.
        “I got vaccinated today to protect myself, my family, and my patients,” he tweeted. “But I only had the opportunity because my public county hospital believes that residents are critical front-line providers. Grateful.”

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  6. The UK is apparently vaccinating with one dose and keeping their fingers crossed that the second will arrive in time to administer second doses.

    Is Texas doing the same? Or by saying they’ll go to Phase 1B if Phase 1A individuals aren’t available, does that just mean letting people skip ahead at the particular facility that has a batch of vaccines? That presumably means that a TX resident looking for the vaccine should get on as many waiting lists as they can get to (as with organ transplants, though I think they may have modified the rules for transplants).

    I love the interactive map.

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  7. bj said,

    “The UK is apparently vaccinating with one dose and keeping their fingers crossed that the second will arrive in time to administer second doses.”

    Oooh! I did not know that.

    “Is Texas doing the same? Or by saying they’ll go to Phase 1B if Phase 1A individuals aren’t available, does that just mean letting people skip ahead at the particular facility that has a batch of vaccines?”

    I have not heard anything to that effect, but it is true that telling providers not to hold back doses suggests that that is the strategy.

    It sounds like there’s some pushback from HEB:

    https://www.chron.com/coronavirus/article/H-E-B-coronavirus-vaccine-1b-covid-15836318.php

    They want more vaccine deliveries before they start vaccinating 1B (the second priority group)–which is not unreasonable.

    “I love the interactive map.”

    Me too! I zoomed in on my county and found about 15 vaccination sites, including our college student health center, the urgent care about 5 minutes from our house, and the grocery store that’s 5 minutes away. Of course, who knows when this all goes “live.”

    In other county news, I was reading today that about 1/3 of the COVID patients at our county hospitals are from other counties. I was relieved to learn this, because the disparity between shrinking local cases and swelling hospital cases was driving me a little nuts. What I still don’t know is how far they’re coming from–is this just neighboring counties or much further away? There’s getting to be a bit more headroom in the local ICUs.

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    1. This is less happy news:

      https://ohiocapitaljournal.com/2020/12/30/60-of-ohio-nursing-home-workers-refuse-vaccine/

      “Gov. Mike DeWine on Wednesday said that a whopping 60% of nursing home workers who have been offered the vaccine have refused it. The news comes amid disappointing vaccination numbers across Ohio, which was told by the Trump administration that it would receive more than 530,000 doses of the vaccines by the end of December. Just 94,000 so far have been administered.”

      It would be interesting to know what exactly is going on.

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      1. Health care workers are a bit notorious for refusing flu vaccines so this doesn’t surprise me. A friend is corporate counsel for a hospital system in Tucson and every year they fire nurses for refusing the flu vaccine.

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      2. Tulip said, “Health care workers are a bit notorious for refusing flu vaccines so this doesn’t surprise me. A friend is corporate counsel for a hospital system in Tucson and every year they fire nurses for refusing the flu vaccine.”

        I’ve heard a number of anecdotal stories about flu-shot refusal among nurses (my BFF’s MIL was a flu-shot refusing RN).

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      3. I’d be fine with a $500 federal-funded bonus for nursing home workers that get the shot.

        (Qualified people aren’t lined up around the block to work in nursing homes right now, so I’m thinking that refusers can’t realistically be fired.)

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      4. Nurses and health care workers have had very high rates of Covid. They’re also much more likely to be subject to frequent testing than the rest of us. It could well be that those who know they’ve already had the virus feel that they don’t need a vaccine, and that it should go to people who have no protection.

        https://www.latimes.com/science/story/2020-10-27/among-healthcare-workers-covid-19-hardest-on-nurses

        Just to say–no need to jump to the conclusion that they’re all anti-vax.

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      5. “no need to jump to the conclusion that they’re all anti-vax.”

        This is definitely true. We don’t have data on this, and we shouldn’t generalize.

        However, I do have some anecdata. My sister-the-nurse in a Long Island hospital says that many of her co-workers refuse to get the vaccine because they don’t trust it.

        Also, my understanding is that nurses in her hospital have *not* been tested regularly. When we had a family weekend at the farm in August, we had a lot of discussion about us all being tested before going, and my sister-the-nurse had not been tested (and also told a story about how if a nurse did want to get tested at the hospital, it was a big deal).

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      6. My sister-the-nurse reports:
        “I have never been COVID tested. No nurses are regularly tested.” (By no nurses, she is speaking only for her hospital.)

        (I can’t believe she wasn’t tested before the farm trip. Did I know that? Ugh. Well, at that point she wasn’t working with COVID patients at all.)

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      7. Tulip, I’m not putting words in your mouth. Anecdotally, the family of nurses I know has one member who has had to be threatened with termination over refusal to take the flu vaccine.

        However, a 60% refusal rate in Ohio is stunning.

        There has also been a case of purposeful vaccine destruction by a health care worker: https://www.jsonline.com/story/news/local/milwaukee/2020/12/30/wisconsin-covid-19-vaccine-thrown-out-intentionally-aurora-employee-grafton-clinic-fired/4095107001/

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    2. I’m impatiently waiting for the post-holiday case count mess to get cleaned up. Having two big holidays one week apart is such a pain.

      I’m also hoping that the vaccine stuff starts running more smoothly once we get past New Year’s.

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  8. This is an interesting thread about the value of speed as opposed to being exactly fair:

    https://mobile.twitter.com/Farzad_MD/status/1344352826844192768

    “People are hardwired to get infuriated when they see injustice.
    But I fear that applying this lens to covid vaccine distribution will lead to more deaths not fewer.
    Stanford has screwed up, again. Some people who shouldn’t have gotten it, did.”

    “What’s the natural response then, from those all the way down the distribution chain, from state administrators to hospital execs worried about “wrong people” getting vaccinated first?
    You spend more time collecting data, parsing into finer and finer gradations
    You slow down.”

    “Hospitals and nursing homes don’t release more to staff until every i has been dotted.
    States don’t release more to hospitals and nursing homes until they’ve used up allotment
    feds don’t release more to states
    Amidst a vaccine shortage, available supply sits in warehouses.”

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  9. And in Florida, where the governor is choosing to follow his own guidance and vaccinate those over 65, they are opening up first come first served sites and elderly (but presumably mobile) people are lining up overnight to get the vaccines.

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    1. bj said, “And in Florida, where the governor is choosing to follow his own guidance and vaccinate those over 65, they are opening up first come first served sites and elderly (but presumably mobile) people are lining up overnight to get the vaccines.”

      Even just “take-a-number” would have improved that.

      I don’t think that sign-ups should be 100% online, because it’s likely to be an obstacle to the less electronically savvy elderly. I have to say, though, that the online portal for federal surge COVID testing was really good–a very clean, fast, easy process. I’ve also heard of at least one area using the same online platform that schools use (there’s one I’ve seen used for scheduling parent-teacher conferences that might work well) for their vaccination scheduling.

      Hopefully, Florida will iron this out in a few days.

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      1. I have to say that a number of the vaccination venues that I’ve seen listed online for my county do not have appropriate waiting space for large groups of people.

        There’s going to have to be a tip-top scheduling system to prevent crowding–and/or they’re going to have to use some larger venues (convention center, stadiums, etc.).

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      2. Given a choice between favoring mildly tech-savvy oldsters and favoring those oldsters hardy enough to wait in line overnight, I would go with the former.

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      3. ey81 said, “Given a choice between favoring mildly tech-savvy oldsters and favoring those oldsters hardy enough to wait in line overnight, I would go with the former.”

        I bet there’s huge overlap between the hardy and the tech savvy, though.

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    2. I’m hopeful our covid testing sites, which have been working pretty well, can be repurposed as vaccination sites (along with the scheduling system). But, the problems of vaccination are revealing aspects of our health care system that work poorly for delivering ordinary care to large groups of people. Storefront services (i.e. CVS, etc.) will help. I do wonder how the adverse reactions will be handled in these popup sites, though. So far, there have only been 3-4 out of 2 million. How will we handle if that’s a lower end estimate? or even if its 300-400 out of 200 million?

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      1. I think the current recommendation is that vaccine recipients should be observed for 15 minutes for an allergic reaction (and longer if they have a history of allergies).

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      2. bj said, “I think the current recommendation is that vaccine recipients should be observed for 15 minutes for an allergic reaction (and longer if they have a history of allergies).”

        I can’t find my source right now, but I’ve heard that the Israelis have recipients sit in their cars with the windows down and if they are experiencing distress, they’re supposed to flash their lights.

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    1. Dancing robots is fun and it’s interesting to see how much these Boston Dynamics robots have improved over the years. I was adjacent to research on human movement control in the past and a fascinating aspect of human motor control is how much adjustment and response there is. For example, the complex interactions among muscles that control the impact of the foot on the ground. For a very long time, I was always struck by how much less robots looked like natural motion (including natural animal motion) than puppets (which are controlled by humans, and thus more natural. These robots are getting there. But to provide further evidence, they should have had a group of people dancing the same routine — maybe there is, somewhere?. I’m guessing an animal couldn’t have been rained in the dog-robot’s routine, though.

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  10. What’s everyone doing for New Year’s Eve? Jonah went off on a second date. I hope he doesn’t come back with COVID. Ian and Steve and I are chilling. I’m working right now — books, words, photography backlogs. But I’ll knock it off at 5:00 and make some dinner and begin the drinking.

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    1. We will prepare a meal. Spouse got excited by jambalaya and is off getting some missing items. I also have too many frozen appetizers I plan to break out. I have all year been recording 1 second a day videos using the 1SE app). For today I’m twisting arms to pick a word for the year for the final clip.

      Plan to stay up til midnight.

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    2. Laura said, “What’s everyone doing for New Year’s Eve?”

      Not a lot. I remembered to pick up some sparkling grape juice and I believe that if we dig into our Christmas stores, we probably still have some sort of fancy sweets.

      Really yucky, chilly, rainy weather today.

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    3. Second session with our instructional DVD on swing dancing – the DVD and the willingness to participate was a Christmas present for me! Family Zoom involving a game of Dog Bingo (it’s regular bingo but the spaces are dogs). End of Schitt’s Creek season 4 and assortment of taped TCM movies. It’s good we have a lot of entertainment because we’re supposed to get an ice storm.

      Recently watched two documentaries from the early 60s, Primary (on JFK’s primary contest with Humphrey) and Crisis (about integrating the U of Alabama, zoning in on the day the two students were showing up to register). We got them off TCM but may buy the DVD with these and two others; they were fascinating. (https://www.criterion.com/films/28907-the-kennedy-films-of-robert-drew-associates).

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    4. I bought paint-by-number sets for us all to do tonight after we have takeout. I managed to do 2 useful things today, so I feel like I was productive.

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    5. Nothing much. I had a deal that was supposed to close today, but it didn’t. So I won’t get paid (for that deal) this year, which is unfortunate. Anyway, I’m tired. We’ll see if I make it to midnight. I’m pretty sure my wife will not.

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    6. “What’s everyone doing for New Year’s Eve”
      Cooked a lovely (or at least I say so) dinner for my mother & son [Porterhouse roast stuffed with blue cheese and spinach, with roast veggies, asparagus & yorkshire puddings, followed by pannacotta]
      Son was rude about the food (well, just generally 13-year-old rude about everything). Mother was rude about the housekeeping (she has the standards of a stay-at-home Mum who invested her sense of worth in how she and her house were presented – I have the standards of a solo-Mum who works and invests my sense of worth in what’s between my ears – and who has been spending most of the last 4 days of holidays asleep….

      Did not scream at either of them. [That’s gotta be worth some brownie points with the Lord Above….]

      Took her home, watched the Life of Brian with Mr 13 (who was critical of the 70s production values – but I caught him sniggering at the one-liners), then put him to bed.

      Had a bath and stayed up to watch the fireworks (lovely view of the CBD from my lounge) and toast the New Year in with a dram of whiskey.

      Here’s hoping that 2021 is a whole lot better than 2020!

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  11. https://mobile.twitter.com/latimes/status/1344648353397702657

    “Roughly 20% to 40% of the L.A. County’s front-line workers who were offered the vaccine declined to get the shot.”

    “So many in Riverside County refused the vaccine — an estimated 50% — that officials met to strategize how best to distribute the unused doses.”

    “Vaccine doubts swirling among healthcare workers is a surprise to researchers who assumed hospital staff would be among those most in tune with the scientific data behind the vaccines.”

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    1. A surprise to researchers who expect to be treated like the final word. Has it really not occurred to them that years and years of being told that the slowness of the FDAs approval process is important and helps keep us safe would result in skepticism over something rushed through in record time?

      I hope, but doubt, that this will speed up the process going forward. Far more likely is that anyone who questions the slow process will get called SCIENCE DENIER, etc, just as people who are currently skeptical are being criticized now.

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      1. Lots of Democrats, including notably Gov. Cuomo, said that people should not trust the vaccine. Most nursing home workers are poor and/or minority, so if they listen to anyone, it would be the Democrats. When the public health bureaucracy responds to Gov. Cuomo and company’s skepticism by announcing that they’re focusing on giving the vaccine to black and brown communities, it only increases the suspicion.

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  12. The younger kids are making mochi (a sticky Japanese treat) with black sesame filling and (I’m guessing) coated with white sesame seeds. There’s also some talk of red bean paste.

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  13. We just got our federal stimulus check–$2327–just a smidge less than the full benefit for 4 people. (We have 5 people in our household, but the 18-year-old is currently a non-person for federal purposes.)

    We’re tucking the money away in the expectation that we will have some after-insurance expenses from a teen’s recent urgent care visit, 3 night hospital stay, and upcoming kidney surgery. Oh, yeah, and the youngest’s ongoing therapy expenses.

    No complaints about the quality of either teen’s medical experience (it was actually fantastic that the doc-in-a-box people found the kidney stones as fast as they did) or youngest’s therapy, but wow, the money goes fast!

    Under somewhat different circumstances, the stimulus money would have gone toward new siding and other exterior house repairs. We may still manage to fund some interior painting this summer using other money.

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  14. https://mobile.twitter.com/Alicia_Smith19/status/1345027500796100608

    Alicia Smith tweets, “Florida has opened up drive-thru vaccination centers to more quickly meet demand and get jabs into arms for people 65+ along along with healthcare workers.”

    “Georgia is planning to open up mass vaccination clinics to streamline administration of the covid vaccine as vaccination opens up to those 65+ in some areas. Some sites may open up as early as next week, and each site could vaccinate about 5k people a day.”

    https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

    Looking at the Bloomberg tracker, smaller population states are doing disproportionately well. Maine, for example, has 2.5% of their population vaccinated already.

    I see that quite a number of state health departments shut down completely for the holidays…

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  15. A number of small states are either done or close to done with doing their nursing homes.

    https://www.wtnh.com/news/health/coronavirus/ct-has-highest-percentage-of-people-vaccinated-against-covid-in-the-region-gov-urges-continued-safety-measures-during-nye-celebrations/

    A Dec. 30 article said:

    “Governor Ned Lamont said Connecticut is on track to complete vaccinating the first round of nursing home clinics by the end of the week.”

    West Virginia is on a similar track.

    Also, for all the heat South Dakota has taken for COVID management, they’ve already vaccinated at least 2.14% of their population, which makes them #2 in the country behind West Virginia (#1 with 2.5% of the population vaccinated). The US as a whole is at 0.97%.

    But all of those numbers will be changing soon!

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