Hand Washing the Proper Way


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According to the World Health Organization, properly washing your hands means washing as long as it takes to sing “Happy Birthday” twice — 20 seconds or so.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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U.S. could require 7 billion respirators & face masks…we have only 20 technicians at each hospital


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Excerpts from National Geographic

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U.S. has only a fraction of the medical supplies it needs to combat coronavirus.

The country could require seven billion respirators and face masks over the course of the outbreak.

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Three hundred million respirators and face masks. That’s what the United States needs as soon as possible to protect health workers against the coronavirus threat. But the nation’s emergency stockpile has less than 15 percent of these supplies.

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Last week, U.S. Health and Human Services Secretary Alex Azar testified before the Senate that the Strategic National Stockpile has just 30 million surgical masks and 12 million respirators in reserves, which came as a surprise considering that the stockpile’s inventory is generally not disclosed for national security reasons. Asked by National Geographic about the discrepancy, a senior official with the Strategic National Stockpile said the department intends to purchase as many as 500 million respirators and face masks over the next 18 months.

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Even such a promised surge in production may not be enough—and it may not come soon enough. A widely overlooked study conducted five years ago by the U.S. Centers for Disease Control and Prevention found that the United States might need as many as seven billion respirators in the long run to combat a worst-case spread of a severe respiratory outbreak such as COVID-19….

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The panicked demand and lack of supplies was predictable. China manufactures roughly 50 percent more medical and pharmaceutical supplies than its nearest competitor, the U.S., according to data supplied to National Geographic by Euromonitor International. But the Asian country now needs those precious supplies for its tens of thousands of cases, at a time when manufacturing has slowed across the country….

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Based on the models, U.S. health care workers would need two to seven billion respirators for the least- to most-severe possible scenarios. That’s up to 233 times more than what’s currently in the Strategic National Stockpile.

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“The demand that would be required in a severe pandemic is so unlike the amount that’s used on a day-to-day basis,” says Lisa Koonin, an epidemiologist and founder of Health Preparedness Partners. She worked for the CDC for more than 30 years and is a co-author on these reports. “For the respirators and surgical masks, we’re talking orders of magnitude greater need for a severe pandemic.”…

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Along with the billions of respirators, the CDC predicted that U.S. patients and health care workers might need as many as 100 to 400 million surgical masks, as well as 7,000 to 11,000 mechanical ventilators. The latter are used during life support for the most severe cases of respiratory disease, after a patient’s lungs stop working on their own. A report published Friday in the New England Journal of Medicine states that about 2.3 percent of early coronavirus patients underwent mechanical ventilation.

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But ventilators, respirators, and even basic masks are only helpful when used by expert hands—and that presents another potential shortfall for the U.S….

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“In a severe pandemic, we certainly could run out of ventilators, but a hospital could just as soon run out of respiratory therapists who normally operate these devices,” says Toner. The Bureau of Labor Statistics estimates that the U.S. employs 134,000 respiratory specialists, or approximately 20 of these technicians for every hospital in America….

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“One of [the CDC’s] conclusions was, it’s not so much the number of ventilators as the number of people needed to operate the ventilators. That’s the choke point,” Toner adds….

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[Mayo Clinic] goes “through a lot of gloves in health care, and the numbers can be staggering,” Toner says. “Particularly with a disease like this where some people are advocating double gloving, you’ll burn through gloves twice as fast.”…

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The material on this site is for informational purposes only.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  

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Borowitz Report: New strain of fact resistant humans


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Subject: New strain of fact resistant humans….

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MINNEAPOLIS (The Borowitz Report)—Scientists have discovered a powerful new strain of fact-resistant humans who are threatening the ability of Earth to sustain life, a sobering new study reports.

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The research, conducted by the University of Minnesota, identifies a virulent strain of humans who are virtually immune to any form of verifiable knowledge, leaving scientists at a loss as to how to combat them.

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“These humans appear to have all the faculties necessary to receive and process information,” Davis Logsdon, one of the scientists who contributed to the study, said. “And yet, somehow, they have developed defenses that, for all intents and purposes, have rendered those faculties totally inactive.”

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More worryingly, Logsdon said, “As facts have multiplied, their defenses against those facts have only grown more powerful.”

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While scientists have no clear understanding of the mechanisms that prevent the fact-resistant humans from absorbing data, they theorize that the strain may have developed the ability to intercept and discard information en route from the auditory nerve to the brain. “The normal functions of human consciousness have been completely nullified,” Logsdon said.

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While reaffirming the gloomy assessments of the study, Logsdon held out hope that the threat of fact-resistant humans could be mitigated in the future. “Our research is very preliminary, but it’s possible that they will become more receptive to facts once they are in an environment without food, water, or oxygen,” he said.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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Policies unintended consequences. Ethical distribution of limited resources.


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Concluding paragraphs from The Washington Post, March 2, 2020:

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The coronavirus could hit the U.S. harder than other wealthy countries

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Our inequities create unique vulnerabilities —

as does our current political climate

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…To reduce exposure, people with the virus must come forward. They must also identify their contacts. Fear that this may result in deportation or harm for loved ones may make this essential step impossible for many. As we learned during the Ebola and Zika responses in New York City, without the active engagement of immigrant communities that have the closest ties to the countries with the highest burden, prevention efforts could falter.

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We don’t mean for this analysis and its grim outlook for what lies ahead to create additional fear or panic in the United States. Indeed, there is much to be reassured by: For many young, healthy Americans, as well as children, the risk of serious illness and death is low, and health departments across the country are accurately assessing risk and implementing prevention measures.

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.Yet at the national level, we need an intentional, human-rights-based response that pays attention to health equity. This will require honest conversations about the potential human rights challenges posed by quarantine and other measures as well as more discussions about the ethical distribution of limited resources. It may also require some self-reflection on how policies can have unintended consequences for public safety and public health.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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CDC blasted for removing public data on tests for coronavirus


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Lawmaker blasts CDC for removing public data on number of Americans tested for virus

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The Centers for Disease Control and Prevention has abruptly stopped disclosing the number of Americans tested for the novel coronavirus, a move one lawmaker has called “unacceptable.”

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In recent days, the agency has posted statistics to its website detailing the impact of the virus as it spread across the United States. Figures include a breakdown of confirmed and presumed patients and the total number of deaths, cases and tests administered.

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But as Rep. Mark Pocan (D-Wis.) noted Monday, one of those numbers suddenly vanished from the site.

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“Americans are dying,” Pocan wrote in a letter to CDC director Robert R. Redfield. “We deserve to know how many people have been tested.”.His letter cited comments made Sunday by Scott Gottlieb, the former commissioner of the Food and Drug Administration, who said there could be “hundreds or low thousands” of coronavirus cases in the U.S.

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Given this possibility, Pocan said, “knowing that CDC testing is keeping pace with the likely number of cases is imperative to maintaining public trust.”

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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Coronavirus: Expect people you know to die. Take it seriously. Stay calm


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“Coronavirus: an email to my family”

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by an infectious disease epidemiologist.

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“I wrote this originally to share with my family.”

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…”I graduated from the CDC’s Epidemic Intelligence Service and have over 17 years of experience in the field, most of that with CDC.”

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Who should you listen to?

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The CDC and your state health department are your best place for information about COVID-19. (Listen to them before you listen to me.) Be cautious about other sources of information – many of them will not be reliable or accurate.

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How bad is this going to be?

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It’s possible that COVID-19 will be similar to a bad flu year but there are a number of indications that it will be very much like the 1918 Flu Pandemic. To put that in perspective, the 1918 flu did not end civilization as we know it but it was the second-deadliest event of the last 200 years. Expect people you know to die.

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However, there is one critical difference between COVID-19 and the 1918 flu – the 1918 flu virus hit children and young adults particularly hard. COVID-19 seems to be most severe in older adults. Children and young adults generally have mild infections. We are grateful for this.

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What can we expect?

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This is not the zombie apocalypse. Core infrastructure (e.g., power, water, supermarkets, internet, government, etc.) will continue to work, perhaps with some minor disruptions. 

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There will be significant economic disruption: a global recession is very possible and there will probably be significant shortages of some products. The healthcare system will be hit the hardest. The number of people who are likely to get sick is higher than our healthcare systems can probably handle.  

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Daily life will be impacted in important ways. Travel is likely to be limited and public gatherings will probably be canceled. Schools will probably be closed. Expect health departments to start issuing these orders in the near future, especially on the West Coast.

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The acute pandemic will probably last at least for several months and quite possibly for a year or two.

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What can we do?

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We can’t keep COVID-19 from being a global pandemic but the more we can do to slow the spread of the disease, the less severe the impact will be. With that in mind, here are the things you can do:

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Stay calm but take it seriously. This will likely be bad but it’s not the apocalypse.

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Stay home if you’re sick or someone in your house is sick. 

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Leave medical supplies for healthcare workers. You shouldn’t be stockpiling masks or other medical supplies. They are needed in hospitals to keep our healthcare workers healthy.

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Wash your hands. Get in the habit of frequently washing your hands thoroughly and covering your cough.

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Minimize your exposure. Now that we’re starting to see community transmission in the U.S., it’s probably time to start cutting back on your exposure to other people. Depending on your circumstances, consider:

  • Canceling non-essential travel

  • Avoiding large-scale gatherings

  • Working from home if possible

  • Minimizing direct contact with others including hand shakes and hugs

  • Reducing your trips out of the house. If possible, shop for two weeks of groceries at once or consider having your groceries delivered. Stay home and cook instead of going to a restaurant.
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Remember, keep calm and prepare. This is likely to be bad but if we respond calmly and thoughtfully we can handle it.

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Others have added: no more fist bumps or hand shakes. Elbow bumps or, as they are doing in China, toe bumps.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Coronavirus Test Kits Alarming Impurities, Contaminated


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From AXIOS

Test Kits May Have Been Contaminated

 March 1, 2020

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Behind the scenes: The FDA official who visited the Atlanta lab, Timothy Stenzel, is the director of the Office of In Vitro Diagnostics and Radiological Health.

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  • About a week ago, when the Secretary of Health and Human Services Alex Azar was under extreme pressure over the delays in getting coronavirus testing kits to market, Stenzel traveled to Atlanta to help troubleshoot whatever technical problems might have been occurring with the tests.

  • Stenzel was alarmed by the procedures he witnessed in the Atlanta laboratory and raised concerns with multiple CDC officials, per a source familiar with the situation in Atlanta.

  • Stenzel is a highly-regarded scientist and diagnostics expert. He was on the ground in Atlanta to deal with technical issues and happened to stumble upon the inappropriate procedures and possible contaminants. He is not a laboratory inspector and thus was not charged with producing an inspection report on the lab conditions.

  • But he raised the concerns and they have been taken seriously and risen to the highest levels of the U.S. government.

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On Thursday afternoon, the concerns about the Atlanta laboratory were raised in a conference call that included senior government officials from multiple agencies including the Department of Health and Human Services, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health.

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  • The call’s purpose was to figure out ways to mass produce the testing kits and get them to market quickly.

  • The Trump administration says it’s now figured out how to get over those hurdles. An HHS spokesperson promised that by the end of this week, “we will have the capacity to test up to 75,000 individuals” for the coronavirus

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What’s next: The FDA’s manufacturing concerns — which include the possible contamination of testing kits — have also resulted in the Trump administration ordering an independent investigation of the CDC’s Atlanta laboratory, according to senior officials.
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  • “HHS has launched an investigation and is assembling a team of non-CDC scientists to better understand the nature and source of the manufacturing defect in the first batch of COVID-19 test kits that were distributed to state health departments and others,” said an HHS spokesperson.

  • “HHS/CDC have been transparent with the American people regarding the issue with the manufacturing of the diagnostic and will be transparent with the findings of this investigation.” (But the administration was not transparent about the senior FDA official’s concerns about the conditions and procedures in the Atlanta laboratory.)

  • A senior administration official added that the government also moved the manufacturing of the coronavirus tests out of the Atlanta laboratory of CDC.

  • The official said that the CDC engaged with a third party contractor on Feb. 20 to help manufacture the testing kits. The official added that the FDA regulator, Stenzel, visited the Atlanta laboratory on Feb. 22.

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Between the lines: Until Thursday, the CDC’s guidance was to only test Americans for the coronavirus if they’d recently traveled to China — or had close contact with someone known to have the virus — and were symptomatic.

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  • Under this policy, the CDC initially refused to test a California patient who didn’t fit this criteria but had the coronavirus, although the CDC disputes that it denied doctors’ testing request.

  • As of Friday, South Korea had tested 65,000 people for the coronavirus; the U.S. had tested only 459, per Science Magazine. China can reportedly conduct up to 1.6 million tests a week.

  • Although the World Health Organization has sent testing kits to 57 other countries, the U.S. decided to make its own.

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There have also been problems with the tests themselves. On Feb. 12, the FDA announced that health labs across the country were having problems validating the CDC’s diagnostic test, Science reports in an in-depth account of what went wrong with the tests.

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The FDA announced yesterday that public health labs can create their own diagnostic test. Scott Becker, the CEO of the Association of Public Health Laboratories, told Science that he expects that public health labs will be able to do 10,000 tests a day by the end of the week.

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A WHO expert explains how China did it. “It’s all about speed.”
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Wash your damn hands.

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“You’re probably doing it wrong.”
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“Wash instead of sanitizing whenever possible” – good idea to review this page:
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“As for hand sanitizer, Larson says it’s important to know that sanitizers are only active as long as they’re on your hands. So even if it makes your hands feel annoyingly wet, keep the sanitizer on for at least 10 seconds.”

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The good news is dear leader is telling his people there is no problem in his crowds. All others remember keep at least 6 feet distance from others, probably more. Ain’t gonna happen at the grocer but give it time.

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The material on this site is for informational purposes only.
.
It is not legal for me to provide medical advice without an examination.

.
It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

..

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The advertising below is not mine.

In exchange, this blog is less expensive.

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