[Hac-announce] Advice from epidemiologist Katelyn Jetelina--Fwd: Thinking through the holidays this year

Manny Sholem Ratafia manny at ratafias.com
Thu Nov 3 09:00:02 EDT 2022


Here is advice on staying healthy through the holidays despite COVID 
(and also RSV and the flu) from epidemiologist Katelyn Jetelina. As 
usual, her summary is clearly written and is practical.--Manny

"Fight for the things that you care about, but do it
in a way that will lead others to join you."
― Ruth Bader Ginsburg



-------- Forwarded Message --------
Subject: 	Thinking through the holidays this year
Date: 	Thu, 3 Nov 2022 11:34:21 +0000
From: 	Katelyn Jetelina from Your Local Epidemiologist 
<yourlocalepidemiologist at substack.com>
Reply-To: 	Katelyn Jetelina from Your Local Epidemiologist 
<reply+1cta03&a13t&&9d1b58b878591a2866f98891504799d2dd6c89ab17511712c8981b1c63824513 at mg1.substack.com> 

To: 	manny at ratafias.com



Thinking through the holidays this year
It’s been a while since I’ve shared my own chronicles of navigating this 
pandemic. I dread doing so, because I receive so much hate after. But 
it’s getting harder and harder to ignore the questions as we navigate 
the “choose your own adventure” phase of the pandemic. We are all just 
trying to figure this out as we go. And, unfortunately, the “normal” 
viruses are back, too. 
  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

	
	

	
Open in app 
<https://open.substack.com/pub/yourlocalepidemiologist/p/thinking-through-the-holidays-this?utm_source=email&redirect=app-store> 
or online 
<https://substack.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.cNgOEdjlG6sjH0T7YfunV_ZgnRz_RynBrFRHYsfImaw?> 


<https://substack.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.cNgOEdjlG6sjH0T7YfunV_ZgnRz_RynBrFRHYsfImaw?> 


/Si quiere leer la versión en español, pulse aquí 
<https://substack.com/redirect/564572cf-1e88-4b5f-9ca3-777c3757de99?r=a13t>./

------------------------------------------------------------------------


  Thinking through the holidays this year
  <https://substack.com/app-link/post?publication_id=281219&post_id=81987555&utm_source=post-email-title&isFreemail=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJpYXQiOjE2Njc0NzUyODYsImV4cCI6MTY3MDA2NzI4NiwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.q5Y-chu0RiA_IBHr8uJK3bo_6n3HUzg2nBGhhZwoSz0>

Katelyn Jetelina 
<https://substack.com/redirect/99f1f1f3-67cb-4d6b-beb5-68ed2c91636e?r=a13t>

Nov 3

	
<https://substack.com/redirect/99f1f1f3-67cb-4d6b-beb5-68ed2c91636e?r=a13t>

<https://substack.com/app-link/post?publication_id=281219&post_id=81987555&utm_source=substack&isFreemail=true&submitLike=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJyZWFjdGlvbiI6IuKdpCIsImlhdCI6MTY2NzQ3NTI4NiwiZXhwIjoxNjcwMDY3Mjg2LCJpc3MiOiJwdWItMjgxMjE5Iiwic3ViIjoicmVhY3Rpb24ifQ.8YTFGcPFgSiqbE9-0cJRXGGH2TET_Jzs3ur_Qe4k8Iw&utm_medium=email> 


	
	
<https://substack.com/app-link/post?publication_id=281219&post_id=81987555&utm_source=substack&utm_medium=email&isFreemail=true&comments=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJpYXQiOjE2Njc0NzUyODYsImV4cCI6MTY3MDA2NzI4NiwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.q5Y-chu0RiA_IBHr8uJK3bo_6n3HUzg2nBGhhZwoSz0&utm_source=substack&utm_medium=email> 


	
	
<https://substack.com/app-link/post?publication_id=281219&post_id=81987555&utm_source=substack&utm_medium=email&utm_content=share&action=share&triggerShare=true&isFreemail=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJpYXQiOjE2Njc0NzUyODYsImV4cCI6MTY3MDA2NzI4NiwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.q5Y-chu0RiA_IBHr8uJK3bo_6n3HUzg2nBGhhZwoSz0> 


	
Save 
<https://substack.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.Wx4_FwVY64cNGrWCE1HCzQ_Gn60BlkmsotN1Zr4xy5g?> 


	
	
▷  Listen 
<https://open.substack.com/pub/yourlocalepidemiologist/p/thinking-through-the-holidays-this?utm_source=email-ufi&play_audio=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJpYXQiOjE2Njc0NzUyODYsImV4cCI6MTY3MDA2NzI4NiwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.q5Y-chu0RiA_IBHr8uJK3bo_6n3HUzg2nBGhhZwoSz0> 


It’s been a while since I’ve shared my own chronicles of navigating this 
pandemic. I dread doing so, because I receive so much hate after. But 
it’s getting harder and harder to ignore the questions as we navigate 
the “choose your own adventure” phase of the pandemic. We are all just 
trying to figure this out as we go. And, unfortunately, the “normal” 
viruses are back, too.

This is what my little family is doing this holiday season to stay 
healthy and enjoy time with our loved ones. I hope it’s useful.


	<https://substack.com/redirect/f4579d03-fa71-4c32-baab-eedb8307f349?r=a13t> 	

Photo by Spencer Davis 
<https://substack.com/redirect/82c9bd79-6f3c-40c0-a9be-54bdc00c513c?r=a13t>on 
Unsplash 
<https://substack.com/redirect/52e4ba70-177b-4812-85fd-caf26d07a125?r=a13t>


        Goal 1: Protect the vulnerable

There are still~2,600 Americans dying 
<https://substack.com/redirect/c455a9d3-10c1-4046-a5a6-f01e96eb923e?r=a13t>each 
week from COVID-19. The vast majority are older and vaccinated 
<https://substack.com/redirect/23837bc1-1713-4f4b-b1b5-4c6e77673a80?r=a13t>(but 
not up to date). As an epidemiologist, I refuse to accept this as the 
“new normal.” So my professional bias influences my priorities: Ensure 
the vulnerable around us (like grandparents) do not end up in the 
hospital with COVID-19 (or flu or RSV). This means we are going to do 
everything in our power to *break transmission chains*before gathering 
for the holidays. This includes…

At least three weeks before event:

  *

    Ensure everyone is up-to-date on their flu shot and fall booster
    (especially the older adults). The fall booster rate is currently
    7.3%
    <https://substack.com/redirect/435ca131-2442-456a-a5ed-31f8602f1496?r=a13t>(20%
    <https://substack.com/redirect/435ca131-2442-456a-a5ed-31f8602f1496?r=a13t>for
    those aged 65+).

One week prior to the event:

  *

    /*Wear an N95 mask. */In public. Everywhere I go. This will help
    ensure we don’t bring COVID-19 (or flu) to Thanksgiving dinner. It
    will also help make sure I don’t miss the event because I’m sick.
    Don’t rely on case levels
    <https://substack.com/redirect/50a59cd3-e230-4543-b2f5-c8b4a03420f3?r=a13t>to
    influence masking decisions; at this point, they don’t accurately
    reflect transmission.

  *

    /*Cadence testing. */Use COVID19 at-home antigen tests two days
    before seeing grandparents and the morning of. Test everyone.
    Including my toddlers who scream when I approach their nose.

      o

        For people who have the virus and are /asymptomatic/, the
        average antigen test will catch44%
        <https://substack.com/redirect/9d394dc1-aa3d-45c1-8119-575f1fc4d409?r=a13t>to70%
        <https://substack.com/redirect/6d0408c7-9a46-4060-8db6-f2dc475cb90d?r=a13t>of
        cases. This isn’t perfect, so we don’t rely solely on this
        layer. /But /it sometimes works.

      o

        /*If I’m positive a few days before the event.*/We see strong
        evidence (here
        <https://substack.com/redirect/0c447f4f-64d8-47c5-97a2-a97788699841?r=a13t>,
        here
        <https://substack.com/redirect/6be3cde6-f57a-4140-b548-df33823df3e9?r=a13t>)
        that an Omicron infection lasts, on average, 8-10 days. Some
        people will be infectious for less, and some will be infectious
        for more. You won’t know unless you test. Antigen tests are very
        good at telling us when we’re not infectious anymore (very few
        false positives). If I get a negative after a positive, then I
        would trust that I’m not contagious anymore and go to the event.
        With Paxlovid, we are seeing rebounding
        <https://substack.com/redirect/89cc297f-88da-402b-890a-208250259b16?r=a13t>.
        So for anyone who tests negative after Paxlovid, I would
        continue to test for another couple of days. If you turn
        positive again, assume you’re infectious until you turn negative
        again.

Day of the event:

  *

    /*Ventilation and filtration*/are powerful tools
    <https://substack.com/redirect/3902da57-5377-4037-9eb2-fe74b13333ed?r=a13t>.
    This is especially important in the middle of winter when people
    head indoors. You can use a CO2 monitor if you want to take safety
    at your family event to the next level.

  *

    /*If we have symptoms*/*, stay home. *This is lonely during the
    holidays, but the best thing to do. When symptoms are present,
    COVID-19 antigen tests are great at detecting highly infectious
    people: the average antigen test will catch 78
    <https://substack.com/redirect/940ce4bd-35ba-406e-a010-f5d9630862c2?r=a13t>%
    <https://substack.com/redirect/6d0408c7-9a46-4060-8db6-f2dc475cb90d?r=a13t>to
    97%
    <https://substack.com/redirect/6d0408c7-9a46-4060-8db6-f2dc475cb90d?r=a13t>of
    cases in the first week of symptoms. False negatives are more common
    at the beginning of infection, especially with Omicron. If you have
    symptoms and test negative, it’s a good idea to re-test in 24-48
    hours. But, because flu and RSV levels are high right now, there’s a
    good chance it could be something other than COVID-19, too. Just
    stay home.

After the event:

  *

    If an older adult gets infected, make sure they know about Paxlovid
    and get it within 5 days of symptoms, even just the sniffles.


	man wearing maroon, white, and blue stripe long-sleeved shirt lifting 
up baby wearing gray onesie 
<https://substack.com/redirect/08d5ccc6-5093-46f9-ac33-76ec7c3d0d97?r=a13t> 
	

Photo by Johnny Cohen 
<https://substack.com/redirect/bea965f2-028a-49e0-a0f9-329c06011936?r=a13t>on 
Unsplash 
<https://substack.com/redirect/52e4ba70-177b-4812-85fd-caf26d07a125?r=a13t>


        Goal 2: Limit disruptions

We are trying as much as possible to prevent disruptions in our lives 
due to sickness. We want to go on our trip. We want to go to holiday 
parties. We want to help the crowded and broken healthcare systems 
<https://substack.com/redirect/8a8a5e2e-33ad-4e47-a9e0-45b048195dd9?r=a13t>right 
now.

This means we are all up to date on vaccines.

This also means wearing masks. (Yes, still.) I wear one probably 40% of 
the time when I go to Target, but if there’s an event we’re really 
looking forward to, I wear it religiously (I usually dial up about four 
days before the event). This also means wearing a mask while traveling 
for work so I can come home, not get sick, and spend time with my girls.

Having two little ones and avoiding sickness gets harder and harder 
because they are in childcare. This is just a reality that I have to 
accept: they may bring something home. I’m going to do all /*I*/can to 
not bring it home. I know parents of older kids struggle what to do 
because there are competing realities: masks help reduce the odds of 
disruption (including missed school). But peer pressure is real, and 
they probably don’t wear them when you’re not around, anyways.

We are booking our holiday travel. With boosters, there is very little 
SARS-CoV-2 could do in the next couple months to cancel our trip. (A 
severe mutations may be an exception.) I know people travel with 
COVID-19 and sickness. Staying home is the least I can do to help 
someone else’s grandparents. We are prepared to cancel flights if we get 
sick. Make this an expectation with travel this winter.


        Other considerations

I’m a healthy young adult who has been incredibly lucky. I recognize not 
everyone has similar situations. If you…

  *

    /*Are the vulnerable person, like an older grandparent:*/The
    pandemic is not over for you. And I’m sorry. I would consider
    wearing a mask throughout winter. This will help with COVID, the
    flu, and (we think) RSV. If everyone who attends Thanksgiving dinner
    embraces Goal #1 above, the risk to you is very low.

  *

    /*Have a child under 6 months:*/The pandemic is not over for you
    either. And RSV and flu should be concerning, too. The biggest
    advice I have for you is not to let people kiss or hold your baby.
    They’ll live.

  *

    /*Have limited means: */One tragic reality is that tools are being
    stripped away from people who can’t afford to pay for them. Free
    antigen tests are gone. Free masks are gone. Vaccines are still
    free, but many places are asking for proof of insurance. Cancelling
    flights can be super expensive. I recognize taking all of the steps
    above involves privilege. Instead, choose one or two precautions. It
    will help.


        Bottom line

Yes, we are still in a pandemic. Yes, the “normal viruses” are back. We 
can enjoy the holidays this year while staying healthy: get vaccinated, 
mask (at /least/leading up to the event), ventilate, test and stay home 
when you’re sick. This seems like a lot— especially when it looks like 
the greater public isn’t doing anything— but it really isn’t. It’s still 
worth navigating this petri dish to ensure our loved ones are protected.

Love, YLE

------------------------------------------------------------------------

/“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, 
MPH PhD—an epidemiologist, data scientist, wife, and mom of two little 
girls. During the day she works at a nonpartisan health policy think 
tank, and at night she writes this newsletter. Her main goal is to 
“translate” the ever-evolving public health science so that people will 
be well equipped to make evidence-based decisions. This newsletter is 
free thanks to the generous support of fellow YLE community members. To 
support this effort, subscribe below:/

Upgrade to paid 
<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vc3Vic2NyaWJlP3Rva2VuPWV5SjFjMlZ5WDJsa0lqbzBOamM1T1RNc0ltbGhkQ0k2TVRZMk56UTNOVEk0Tml3aVpYaHdJam94Tmpjd01EWTNNamcyTENKcGMzTWlPaUp3ZFdJdE1qZ3hNakU1SWl3aWMzVmlJam9pWTJobFkydHZkWFFpZlEuNVZRTFVibTVVUkZxWElsOW5Yc3ZlWDloQkw1RjJXRmZSUlF6SC1LRXVWYyZ1dG1fc291cmNlPXBvc3QiLCJwIjo4MTk4NzU1NSwicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY2NzQ3NTI4NiwiZXhwIjoxNjcwMDY3Mjg2LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.J_ZeX2jvA1N8CJhjnpy_H9V11a9c6xsv_7ip5I7rmDI?&utm_medium=email&utm_source=subscribe-widget&utm_content=81987555>

You’re a free subscriber to Your Local Epidemiologist 
<https://substack.com/redirect/1edeab40-7d0e-4906-8841-8262d3296d53?r=a13t>. 
For the full experience, become a paid subscriber. 
<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vc3Vic2NyaWJlP3Rva2VuPWV5SjFjMlZ5WDJsa0lqbzBOamM1T1RNc0ltbGhkQ0k2TVRZMk56UTNOVEk0Tml3aVpYaHdJam94Tmpjd01EWTNNamcyTENKcGMzTWlPaUp3ZFdJdE1qZ3hNakU1SWl3aWMzVmlJam9pWTJobFkydHZkWFFpZlEuNVZRTFVibTVVUkZxWElsOW5Yc3ZlWDloQkw1RjJXRmZSUlF6SC1LRXVWYyZ1dG1fc291cmNlPXBvc3QiLCJwIjo4MTk4NzU1NSwicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY2NzQ3NTI4NiwiZXhwIjoxNjcwMDY3Mjg2LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.J_ZeX2jvA1N8CJhjnpy_H9V11a9c6xsv_7ip5I7rmDI?&utm_source=substack&utm_medium=email&utm_content=postcta>

Upgrade to paid 
<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vc3Vic2NyaWJlP3Rva2VuPWV5SjFjMlZ5WDJsa0lqbzBOamM1T1RNc0ltbGhkQ0k2TVRZMk56UTNOVEk0Tml3aVpYaHdJam94Tmpjd01EWTNNamcyTENKcGMzTWlPaUp3ZFdJdE1qZ3hNakU1SWl3aWMzVmlJam9pWTJobFkydHZkWFFpZlEuNVZRTFVibTVVUkZxWElsOW5Yc3ZlWDloQkw1RjJXRmZSUlF6SC1LRXVWYyZ1dG1fc291cmNlPXBvc3QiLCJwIjo4MTk4NzU1NSwicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY2NzQ3NTI4NiwiZXhwIjoxNjcwMDY3Mjg2LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.J_ZeX2jvA1N8CJhjnpy_H9V11a9c6xsv_7ip5I7rmDI?&utm_source=substack&utm_medium=email&utm_content=postcta>

Like 
<https://substack.com/app-link/post?publication_id=281219&post_id=81987555&utm_source=substack&isFreemail=true&submitLike=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJyZWFjdGlvbiI6IuKdpCIsImlhdCI6MTY2NzQ3NTI4NiwiZXhwIjoxNjcwMDY3Mjg2LCJpc3MiOiJwdWItMjgxMjE5Iiwic3ViIjoicmVhY3Rpb24ifQ.8YTFGcPFgSiqbE9-0cJRXGGH2TET_Jzs3ur_Qe4k8Iw&utm_medium=email> 


	
	
Comment 
<https://substack.com/app-link/post?publication_id=281219&post_id=81987555&utm_source=substack&utm_medium=email&isFreemail=true&comments=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJpYXQiOjE2Njc0NzUyODYsImV4cCI6MTY3MDA2NzI4NiwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.q5Y-chu0RiA_IBHr8uJK3bo_6n3HUzg2nBGhhZwoSz0&utm_source=substack&utm_medium=email> 


	
	
Share 
<https://substack.com/app-link/post?publication_id=281219&post_id=81987555&utm_source=substack&utm_medium=email&utm_content=share&action=share&triggerShare=true&isFreemail=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjgxOTg3NTU1LCJpYXQiOjE2Njc0NzUyODYsImV4cCI6MTY3MDA2NzI4NiwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.q5Y-chu0RiA_IBHr8uJK3bo_6n3HUzg2nBGhhZwoSz0> 


	

© 2022 Your Local Epidemiologist
548 Market Street PMB 72296, San Francisco, CA 94104
Unsubscribe 
<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly95b3VybG9jYWxlcGlkZW1pb2xvZ2lzdC5zdWJzdGFjay5jb20vYWN0aW9uL2Rpc2FibGVfZW1haWw_dG9rZW49ZXlKMWMyVnlYMmxrSWpvME5qYzVPVE1zSW5CdmMzUmZhV1FpT2pneE9UZzNOVFUxTENKcFlYUWlPakUyTmpjME56VXlPRFlzSW1WNGNDSTZNVFkzTURBMk56STROaXdpYVhOeklqb2ljSFZpTFRJNE1USXhPU0lzSW5OMVlpSTZJbVJwYzJGaWJHVmZaVzFoYVd3aWZRLlI4VzVpajhYazRGZXUyclgxczJndmo2aDhHdU12R0w2dXB2WEdsMXA1dnMiLCJwIjo4MTk4NzU1NSwicyI6MjgxMjE5LCJmIjp0cnVlLCJ1Ijo0Njc5OTMsImlhdCI6MTY2NzQ3NTI4NiwiZXhwIjoxNjcwMDY3Mjg2LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.ydUpxphrfgmH9bhnWiJJAPThd2yKfFTbfvapmfmtfnM?>

Get the app 
<https://substack.com/redirect/8d3d7633-cd71-46ad-9b0e-cec30524e74f?r=a13t>Start 
writing 
<https://substack.com/redirect/4b323f54-7362-4147-ab81-e5f71ffbe2fc?r=a13t>

	


<http://www.avg.com/email-signature?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient> 
	Virus-free.www.avg.com 
<http://www.avg.com/email-signature?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient> 


<#DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://cthumanist.org/pipermail/hac-announce/attachments/20221103/2259f0b5/attachment-0001.html>


More information about the Hac-announce mailing list