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<title>30 March, 2023</title>
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<title>Covid-19 Sentry</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>Looking under the lamp-post: quantifying the performance of contact tracing in the United States during the SARS-CoV-2 pandemic</strong> -
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Contact tracing forms a crucial part of the public-health toolbox in mitigating and understanding emergent pathogens and nascent disease outbreaks. Contact tracing in the United States was conducted during the pre-Omicron phase of the ongoing COVID-19 pandemic. This tracing relied on voluntary reporting and responses, often using rapid antigen tests (with a high false negative rate) due to lack of accessibility to PCR tests. These limitations, combined with SARS-CoV-2s propensity for asymptomatic transmission, raise the question how reliable was contact tracing for COVID-19 in the United States? We answered this question using a Markov model to examine the efficiency with which transmission could be detected based on the design and response rates of contact tracing studies in the United States. Our results suggest that contact tracing protocols in the U.S. are unlikely to have identified more than 1.65% (95% uncertainty interval: 1.62%-1.68%) of transmission events with PCR testing and 0.88% (95% uncertainty interval 0.86%-0.89%) with rapid antigen testing. When considering an optimal scenario, based on compliance rates in East Asia with PCR testing, this increases to 62.7% (95% uncertainty interval: 62.6%-62.8%). These findings highlight the limitations in interpretability for studies of SARS-CoV-2 disease spread based on U.S. contact tracing and underscore the vulnerability of the population to future disease outbreaks, for SARS-CoV-2 and other pathogens.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.27.23287812v1" target="_blank">Looking under the lamp-post: quantifying the performance of contact tracing in the United States during the SARS-CoV-2 pandemic</a>
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<li><strong>Single-cell analysis of bronchoalveolar cells in inflammatory and fibrotic post-COVID lung disease</strong> -
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Rationale: Persistent pulmonary sequelae are evident in many survivors of acute coronavirus disease 2019 (COVID-19) but the molecular mechanisms responsible are incompletely understood. Post-COVID radiological lung abnormalities comprise two broad categories, organising pneumonia and reticulation, interpreted as indicative of subacute inflammation and fibrosis, respectively. Whether these two patterns represent distinct pathologies, likely to require different treatment strategies is not known. Objectives: We sought to identify differences at molecular and cellular level, in the local immunopathology of post-COVID inflammation and fibrosis. Methods: We compared single-cell transcriptomic profiles and T cell receptor (TCR) repertoires of bronchoalveolar cells obtained from convalescent individuals with each radiological pattern of post-COVID lung disease (PCLD). Measurements and Main Results: Inflammatory and fibrotic PCLD single-cell transcriptomes closely resembled each other across all cell types. However, CD4 central memory T cells (TCM) and CD8 effector memory T cells (TEM) were significantly more abundant in inflammatory PCLD. A greater proportion of CD4 TCM also exhibited clonal expansion in inflammatory PCLD. High levels of clustering of similar TCRs from multiple donors was a striking feature of both PCLD phenotypes, consistent with tissue localised antigen-specific immune responses, but there was no enrichment for known SARS-CoV-2 reactive TCRs. Conclusions: There is no evidence that radiographic organising pneumonia and reticulation in PCLD are associated with differential immmunopathological pathways. Inflammatory radiology is characterised by greater bronchoalveolar T cell accumulation. Both groups show evidence of shared antigen-specific T cell responses, but the antigenic target for these T cells remains to be identified.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.28.23287759v1" target="_blank">Single-cell analysis of bronchoalveolar cells in inflammatory and fibrotic post-COVID lung disease</a>
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<li><strong>Coronavirus pathogenesis in mice explains the SARS-CoV-2 multi-organ spread by red blood cell hitch-hiking</strong> -
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SARS-CoV-2 infection causes a multisystemic disease that affects numerous organs beyond the respiratory system. Thus, it is well known that COVID-19 is associated with a wide range of hematological disorders; however, it remains unclear how the SARS-CoV-2 virus is able to navigate from tissue to tissue. In this work, we performed a comprehensive analysis of the pleiotropic effects of a prototypical coronavirus in its natural host, the validated preclinical model of murine hepatitis virus (MHV). Throughout this study we compared our results with the real-world data from COVID-19 patients (including autopsies). Thus, the presence of viral RNA was only detected in less than 25% of the human serum samples, whereas all had multiple positive nasal swabs for SARS-CoV-2. Notably, we found viral RNA not only in lungs, but also in heart and kidney of deceased COVID-19 patients. Subsequently, we investigated the association between viral organotropism and clinical manifestations employing the MHV murine model. Results from RT-qPCR and viral infectivity showcased the presence of viral RNA and infectious particles in multiple organs including liver, lung, brain, heart, kidney, spleen and pancreas, and even the blood of infected mice. Surprisingly, when comparing plasma and red blood cells (RBCs)-enriched fraction, higher viral load levels were detected in RBCs, with decreased RBC count, and hematocrit and hemoglobin levels in infected mice. Next, we treated infected mice with hemin triggering more aggressive symptoms. Strikingly, when combining hemin treatment with chloroquine (a compound that known to interact with the heme group and induces a conformational change in its structure) the infection and its clinical manifestations were distinctly attenuated. Computational docking suggested that heme is able to bind to MHV Spike protein in a similar way to the one, experimentally observed for SARS-CoV-2. Overall, our results lead to a global perspective of COVID-19 beyond the canonical focus on the respiratory system, and strongly support the multi-organ extent of coronavirus infection through specific interactions with RBC hemoproteins.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.29.23287591v1" target="_blank">Coronavirus pathogenesis in mice explains the SARS-CoV-2 multi-organ spread by red blood cell hitch-hiking</a>
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<li><strong>Diagnosing and remediating harmful data shifts for the responsible deployment of clinical AI models</strong> -
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Harmful data shifts occur when the distribution of data used to train a clinical AI system differs significantly from the distribution of data encountered during deployment, leading to erroneous predictions and potential harm to patients. We evaluated the impact of data shifts on an early warning system (EWS) for in-hospital mortality that uses electronic health record (EHR) data from patients admitted to a general internal medicine service. We found model performance to differ across subgroups of clinical diagnoses, sex and age. To explore the robustness of the model, we evaluated potentially harmful data shifts across demographics, hospital types, seasons, times of hospital admission, and whether the patient was admitted from an acute care institution or nursing home, without relying on model performance. Interestingly, we found that models trained on community hospitals experience harmful data shifts when evaluated on academic hospitals, whereas the models trained on academic hospitals transfer well to the community hospitals. To improve model performance across hospital sites we employed transfer learning, a strategy that stores knowledge gained from learning one domain and applies it to a different but related domain. We found hospital type-specific models that leverage transfer learning, perform better than models that use all available hospitals. Furthermore, we monitored data shifts over time and identified model deterioration during the COVID-19 pandemic. Typically machine learning models remain locked after deployment, however, this can lead to model deterioration due to data shifts that occur over time. We used continual learning, the process of learning from a continual stream of data in a sequential manner, to mitigate data shifts over time and improve model performance. Overall, our study is a crucial step towards the deployment of clinical AI models, by providing strategies and workflows to ensure the safety and efficacy of these models in real-world settings.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.26.23286718v1" target="_blank">Diagnosing and remediating harmful data shifts for the responsible deployment of clinical AI models</a>
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<li><strong>Effectiveness of nirmatrelvir-ritonavir for the treatment of patients with mild to moderate COVID-19 and at high risk of hospitalization: Systematic review and meta-analyses of observational studies</strong> -
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Abstract Objective To assess the effectiveness of nirmatrelvir-ritonavir in the treatment of outpatients with mild to moderate COVID-19 who are at higher risk of developing severe illness, through a systematic review with meta-analyses of observational studies. Methods A systematic search was performed, in accordance with the Cochrane search methods, to identify observational studies that met the inclusion criteria.  The outcomes of mortality and hospitalization were analyzed. Search was conducted on PubMed, EMBASE, and The Cochrane Library. Two reviewers independently screened references, selected the studies, extracted the data, assessed the risk of bias using ROBINS-I tool and evaluated the quality of evidence using the GRADE tool. This study followed the PRISMA reporting guideline. Results A total of 16 observational studies and 1,482,923 patients were finally included. The results of the meta-analysis showed that in comparison to standard treatment without antivirals, nirmatrelvir-ritonavir reduced the risk of death by 62% (OR= 0.38; 95% CI: 0.30-0.46; moderate certainty of evidence). In addition, a 53% reduction in the risk of hospital admission was observed (OR = 0.47; 95% CI: 0.36–0.60, with very low certainty of evidence). For the composite outcome of hospitalization and/or mortality, there was a 56% risk reduction (OR=0.44; 95% CI: 0.31-0.64, moderate certainty of evidence). Conclusion The results suggest that nirmatrelvir-ritonavir could be effective in reducing mortality and hospitalization. The results were valid in vaccinated or unvaccinated high-risk individuals with COVID-19. Data from ongoing and future trials may further advance our understanding of the effectiveness and safety of nirmatrelvir-ritonavir and help improve treatment guidelines for COVID-19.
</p>
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.27.23287621v1" target="_blank">Effectiveness of nirmatrelvir-ritonavir for the treatment of patients with mild to moderate COVID-19 and at high risk of hospitalization: Systematic review and meta-analyses of observational studies</a>
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<li><strong>Exploring the Impact of the Covid-19 Pandemic on Health-Related Behaviours: A Person-Centred Analysis of Two British Longitudinal Cohort Studies</strong> -
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The current study explored the impact of the Covid-19 pandemic on health-related behaviours in the United Kingdom. We conducted a repeated measures latent class analysis with five indicators of health-related behaviours; frequency of alcohol consumption, binge drinking, smoking, BMI and sleep, to identify distinct subgroups of individuals with similar patterns of change across three timepoints during the first 9 months of the pandemic. We hypothesised that various psychosocial risk factors, such as a history of adverse childhood experiences would predict membership in latent classes with a higher probability of engaging in risky health behaviours, and that protective factors, like social support, would be associated with membership in classes with less risky health behaviours. We identified 5 latent classes, and multinomial logistic regression analyses revealed multiple predictors of class membership. Our findings did not support the relationship between poor mental health and the adoption of risky health behaviours. Keywords: Repeated Measures Latent Class Analysis, Covid-19, Adverse Childhood Experiences, Health Related Behaviours
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.28.23287685v1" target="_blank">Exploring the Impact of the Covid-19 Pandemic on Health-Related Behaviours: A Person-Centred Analysis of Two British Longitudinal Cohort Studies</a>
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<li><strong>Modelling Disease Mitigation at Mass Gatherings: A Case Study of COVID-19 at the 2022 FIFA World Cup.</strong> -
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The 2022 FIFA World Cup was the first major multi-continental sporting Mass Gathering Event (MGE) of the post COVID-19 era to allow foreign spectators. Such large-scale MGEs can potentially lead to outbreaks of infectious disease and contribute to the global dissemination of such pathogens. Here we adapt previous work and create a generalisable model framework for assessing the use of disease control strategies at such events, in terms of reducing infections and hospitalisations. This framework utilises a combination of meta-populations based on clusters of people and their vaccination status, Ordinary Differential Equation integration between fixed time events, and Latin Hypercube sampling. We use the FIFA 2022 World Cup as a case study for this framework. Pre-travel screenings of visitors were found to have little effect in reducing COVID-19 infections and hospitalisations. With pre-match screenings of spectators and match staff being more effective. Rapid Antigen (RA) screenings 0.5 days before match day outperformed RT-PCR screenings 1.5 days before match day. A combination of pre-travel RT-PCR and pre-match RA testing proved to be the most successful screening-based regime. However, a policy of ensuring that all visitors had a COVID-19 vaccination (second or booster dose) within a few months before departure proved to be much more efficacious. The State of Qatar abandoned all COVID-19 related travel testing and vaccination requirements over the period of the World Cup. Our work suggests that the State of Qatar may have been correct in abandoning the pre-travel testing of visitors. However, there was a spike in COVID-19 cases and hospitalisations within Qatar over the World Cup. The research outlined here suggests a policy requiring visitors to have had a recent COVID-19 vaccination may have prevented the increase in COVID-19 cases and hospitalisations during the world cup.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.27.23287214v1" target="_blank">Modelling Disease Mitigation at Mass Gatherings: A Case Study of COVID-19 at the 2022 FIFA World Cup.</a>
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<li><strong>The effects of weather and mobility on respiratory viruses dynamics before and after the COVID-19 pandemic</strong> -
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The flu season is caused by a combination of different pathogens, including influenza viruses (IVS), that cause the flu, and non-influenza respiratory viruses (NIRVs), that cause common colds or influenza-like illness. These viruses have similar circulation patterns, and weather has been considered a main driver of their dynamics, with peaks in the winter and almost no circulation during the summer in temperate regions. However, after the emergence of SARS-CoV2, in 2019, the dynamics of these respiratory viruses were strongly perturbed worldwide: some infections almost disappeared, others were delayed or occurred “off-season”. This disruption raised questions regarding the dominant role of weather while also providing an unique opportunity to investigate the relevance of different driving factors on the epidemiological dynamics of IVs and NIRVs, including viral interactions, non-pharmacological individual measures (such as masking), or mobility. Here, we use epidemiological surveillance data on several respiratory viruses from Canada and the USA from 2016 to 2023, and tested the effects of weather and mobility in their dynamics before and after the COVID-19 pandemic. Using statistical modelling, we found evidence that whereas in the pre-COVID-19 pandemic period, weather had a strong effect and mobility a limited effect on dynamics; in the post-COVID-19 pandemic period the effect of weather was strongly reduced and mobility played a more relevant role. These results, together with previous studies, indicate that at least some of the behavioral changes resulting from the non-pharmacological interventions implemented during COVID-19 pandemic had a strong effect on the dynamics of respiratory viruses. Furthermore, our results support the idea that these seasonal dynamics are driven by a complex system of interactions between the different factors involved, which probably led to an equilibrium that was disturbed, and perhaps permanently altered, by the COVID-19 pandemic.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.28.23287799v1" target="_blank">The effects of weather and mobility on respiratory viruses dynamics before and after the COVID-19 pandemic</a>
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<li><strong>Transient loss and recovery of oral chemesthesis, taste and smell with COVID-19</strong> -
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Anosmia is common with respiratory virus infections, but loss of taste or chemesthesis is rare. Reports of true taste loss with COVID-19 were viewed skeptically until confirmed by multiple studies. Nasal menthol thresholds are elevated in some with prior COVID-19 infections, but data on oral chemesthesis are lacking. Many patients recover quickly, but precise timing and synchrony of recovery are unclear. Here, we collected broad sensory measures over 28 days, recruiting adults (18-45 years) who were COVID-19 positive or recently exposed (close contacts per U.S. CDC criteria at the time of the study) in the first half of 2021. Participants received nose clips, red commercial jellybeans (Sour Cherry and Cinnamon), and scratch-n-sniff cards (ScentCheckPro). Among COVID-19 cases who entered the study on or before Day 10 of infection, Gaussian Process Regression showed odor identification and odor intensity (two distinct measures of function) each declined relative to controls (close contacts who never developed COVID-19), but effects were larger for intensity than identification. To assess changes during early onset, we identified four COVID-19 cases who enrolled on or prior to Day 1 of their illness: this allowed for visualization of baseline ratings, loss, and recovery of function over time. Four controls were matched for age, gender, and race. Variables included sourness and sweetness (Sour Cherry jellybeans), oral burn (Cinnamon jellybeans), mean orthonasal intensity of four odors (ScentCheckPro), and perceived nasal blockage. Data were plotted over 28 days, creating panel plots for the eight cases and controls. Controls exhibited stable ratings over time. By contrast, COVID-19 cases showed sharp deviations over time. No single pattern of taste loss or recovery was apparent, implying different taste qualities might recover at different rates. Oral burn was transiently reduced for some before recovering quickly, suggesting acute loss may be missed in data collected after acute illness ends. Changes in odor intensity or odor identification were not explained by nasal blockage. Collectively, intensive daily testing shows orthonasal smell, oral chemesthesis and taste were each altered by acute COVID-19 infection, and this disruption was dyssynchronous for different modalities, with variable loss and recovery rates across modalities and individuals.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.27.23287763v1" target="_blank">Transient loss and recovery of oral chemesthesis, taste and smell with COVID-19</a>
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<li><strong>Deep repertoire mining uncovers ultra-broad coronavirus neutralizing antibodies targeting multiple epitopes</strong> -
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Development of vaccines and therapeutics that are broadly effective against known and emergent coronaviruses is an urgent priority. Current strategies for developing pan-coronavirus countermeasures have largely focused on the receptor binding domain (RBD) and S2 regions of the coronavirus Spike protein; it has been unclear whether the N-terminal domain (NTD) is a viable target for universal vaccines and broadly neutralizing antibodies (Abs). Additionally, many RBD-targeting Abs have proven susceptible to viral escape. We screened the circulating B cell repertoires of COVID-19 survivors and vaccinees using multiplexed panels of uniquely barcoded antigens in a high-throughput single cell workflow to isolate over 9,000 SARS-CoV-2-specific monoclonal Abs (mAbs), providing an expansive view of the SARS-CoV-2-specific Ab repertoire. We observed many instances of clonal coalescence between individuals, suggesting that Ab responses frequently converge independently on similar genetic solutions. Among the recovered antibodies was TXG-0078, a public neutralizing mAb that binds the NTD supersite region of the coronavirus Spike protein and recognizes a diverse collection of alpha- and beta-coronaviruses. TXG-0078 achieves its exceptional binding breadth while utilizing the same VH1-24 variable gene signature and heavy chain-dominant binding pattern seen in other NTD supersite-specific neutralizing Abs with much narrower specificity. We also report the discovery of CC24.2, a pan-sarbecovirus neutralizing mAb that targets a novel RBD epitope and shows similar neutralization potency against all tested SARS-CoV-2 variants, including BQ.1.1 and XBB.1.5. A cocktail of TXG-0078 and CC24.2 provides protection against in vivo challenge with SARS-CoV-2, suggesting potential future use in variant-resistant therapeutic Ab cocktails and as templates for pan-coronavirus vaccine design.
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🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.03.28.534602v1" target="_blank">Deep repertoire mining uncovers ultra-broad coronavirus neutralizing antibodies targeting multiple epitopes</a>
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<li><strong>Impact of vaccinations, boosters and lockdowns on COVID-19 waves in French Polynesia</strong> -
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Estimation of the impact of vaccination and non-pharmaceutical interventions (NPIs) on COVID-19 incidence is complicated by several factors, including the successive emergence of SARS-CoV-2 variants of concern and changing population immunity resulting from vaccination and previous infection. We developed an age-structured multi-strain COVID-19 transmission model framework that could estimate the impact of vaccination and NPIs while accounting for these factors. We applied this approach to French Polynesia, which unlike many countries experienced multiple large COVID-19 waves from multiple variants over the course of the pandemic, interspersed with periods of elimination. We estimated that the vaccination programme averted 54.3% (95% CI 54.0-54.6%) of the 6840 hospitalisations and 60.2% (95% CI 59.9-60.5%) of the 1280 hospital deaths that would have occurred in a baseline scenario without any vaccination up to May 2022. Vaccination also averted an estimated 28.4% (95% CI 28.2-28.7%) of 193,000 symptomatic cases in the baseline scenario. We estimated the booster campaign contributed 3.4%, 2.9% and 3.3% to overall reductions in cases, hospitalisations and hospital deaths respectively. Our results suggested that removing, or altering the timings of, the lockdowns during the first two waves had non-linear effects on overall incidence owing to the resulting effect on accumulation of population immunity. Our estimates of vaccination and booster impact differ from those for other countries due to differences in age structure, previous exposure levels and timing of variant introduction relative to vaccination, emphasising the importance of detailed analysis that accounts for these factors.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.29.23287906v1" target="_blank">Impact of vaccinations, boosters and lockdowns on COVID-19 waves in French Polynesia</a>
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<li><strong>Who is responsible for nurse wellbeing in a crisis? A single centre perspective</strong> -
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Background: Leadership during the COVID-19 pandemic often manifested as a command-and-control style of leadership which had detrimental emotional impacts on staff particularly the nursing workforce. Organisational responsibility for staff wellbeing would be necessary in another pandemic and leadership emerged as a key indicator of the overall health of an organisation and its workforce. Leadership can have detrimental effects on staff wellbeing or it can greatly boost their ability to handle a crisis. We sought to explore the interrelationship between leadership and nurses wellbeing in an inner-city university hospital during the initial wave of the pandemic. Methods: Secondary analysis of interview data collected during a hospital-wide evaluation of barriers and facilitators to changes implemented to support the surge of COVID-19 related admissions during wave 1. Data were collected through semi-structured video interviews between May and July 2020. Interviews were analysed using Framework analysis Results: Thirty-one nurses participated including matrons (n=7), sisters (n=8) and specialist nursing roles (n=16). Three overarching themes were identified: impact on nurses, personal factors and organisational factors. The impact on nurses manifested as distress and fatigue. Coping and help-seeking behaviours were found to be the two personal factors which underpinned nurses wellbeing. The organisational factors that impacted nurses wellbeing included decision-making, duty and teamwork. Conclusions: The wellbeing of the workforce is pivotal to the health service, and it is mutually beneficial for patients, staff, and leaders. Addressing how beliefs and misconceptions around wellbeing are communicated, and accessing psychological support is a key priority to support nurses during pandemics.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.29.23287904v1" target="_blank">Who is responsible for nurse wellbeing in a crisis? A single centre perspective</a>
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<li><strong>ACEI or not to ACEI: Review on using ACEI and ARBs on COVID-19 patients</strong> -
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Abstract Purpose and motivation of this study: Angiotensin-converting enzyme inhibitors (ACEI) and Aldosterone receptor blockers (ARBs) are one most commonly used drugs for the treatment of cardiovascular disease among other comorbidities. As multiple studies have shown that covid virus binds to the ACE2 receptor for entry into the cell. ACEI and ARBs are shown to modulate the ACE2 receptor hence, it is important to see if there are any correlations between the use of medicine and the infectivity of COVID-19. The purpose of this study is to find if the use of ACEI /ARBs can in fact increase or decrease the spread of COVID-19. Method: This is a systemic review study during which all studies which helped us answer the question, of how the use of ACEI and ARBs can affect the transmission of the COVID-19 virus, were analyzed and reviewed to draw a conclusion about clinical safety and requirements of ACEI and ARBs in COVID-19 patients. Result: After a complete review of all the available data very conflicting results were found. Many studies showed an increase in the transmission of COVID-19 while others showed a decreased risk of COVID-19 transmission with ACEI and ARBs use. Both results were statistically significant. Conclusion: With these conflicting results the question we started with comes up again. Should we or should we not use ACEI &amp; ARBs with covid patients? What should be the best clinical response with the use of ACEI &amp; ARBs if it modulates transmission? To answer these, one must look not only at the statistically significant results of studies but also at the disease progression without ACEI &amp; ARBs treatment regimes. Due to the small amount of data, there is currently no clear conclusive evidence to suggest that ACE inhibitors either increase or decrease the risk of COVID-19 transmission or the severity of the disease. Thus, more and larger studies should be developed to find a concrete answer. Until that these medicines should not be discontinued as the morbidities of cardiovascular diseases are high, and the use of ACEI and ARBs is central to the treatment.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.25.23287550v1" target="_blank">ACEI or not to ACEI: Review on using ACEI and ARBs on COVID-19 patients</a>
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<li><strong>Potential for bias in (sero)prevalence estimates</strong> -
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Objectives: The COVID-19 has led to many studies of seroprevalence. A number of methods exist in the statistical literature to correctly estimate disease prevalence in the presence of diagnostic test misclassification, but these methods seem to be less known and not routinely used in the public health literature. We aimed to show how widespread the problem is in recent publications, and to quantify the magnitude of bias introduced when correct methods are not used. Methods: We examined a sample of recent literature to determine how often public health researcher did not account for test performance in estimates of seroprevalence. Using straightforward calculations, we estimated the amount of bias introduced when reporting the proportion of positive test results instead of using sensitivity and specificity to estimate disease prevalence. Results: Of the seroprevelance studies sampled, 87% failed to account for sensitivity and specificity. Expected bias is often more than is desired in practice, ranging from 1% to 10%. Conclusions: Researchers conducting studies of prevalence should correctly account for test sensitivity and specificity in their statistical analysis.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.11.24.22282720v3" target="_blank">Potential for bias in (sero)prevalence estimates</a>
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<li><strong>Factors associated with acceptanceof COVID-19 vaccination among women in Guinea: Analysis of the first vaccination phase in March 2021.</strong> -
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Vaccination remains the primary strategy for ending the COVID-19 pandemic. However, vaccination rates are still low in low-income countries. The primary goal of this study was to describe the status of COVID-19 vaccine acceptance and hesitancy among women in Guinea and to identify associated predictors. We conducted a cross-sectional study in five Guinean cities (Conakry, Mamou, Kindia, Kankan and N9zérékoré) across the four natural regions between Mar 22 and Aug 25 2021. Participants aged 18 were randomly recruited from the healthcare workers (HCWs) and the general population (GP). We used multivariate logistic regression to identify facilitators and barriers to acceptance of COVID-19 vaccination and a classification and regression tree (CART) to extract the profile of predictors. We included 2,208 women among the HCWs and 1,121 in the GP. Most HCWs (63%) were already vaccinated, compared to only 28% of GP. The main factors associated with acceptance of a COVID-19 vaccine in the HCWs were an absence of pregnancy ORA = 4.46 [CI95%: 3.08, 6.52] and positive subjective norms ORA = 2.34 [CI95%: 1.92, 2.84]. Regarding the GP, the main factors were the ability to receive the vaccine ORA = 5.20 [CI95%: 3.45, 8.01] and being adult ORA = 2.25 [CI95%: 1.34, 3.79] associated with acceptance of vaccination. Vaccination rates were higher in the HCWs. Favourable subjective norms and ability to receive the vaccine were facilitators of acceptance of COVID-19 vaccination, while youth and pregnancy were barriers to the approval of the COVID-19 vaccine.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.27.23287835v1" target="_blank">Factors associated with acceptanceof COVID-19 vaccination among women in Guinea: Analysis of the first vaccination phase in March 2021.</a>
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</ul>
<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Clinical Performance Evaluation of the CareSuperb™ COVID-19 Antigen Home Test</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Device: CareSuperb COVID-19 Antigen Home Test Kit<br/><b>Sponsor</b>:   AccessBio, Inc.<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of Safety &amp; Efficacy of MIR 19 ® Inhalation Solution in Patients With Mild COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: MIR 19 ®;   Combination Product: Standard therapy<br/><b>Sponsor</b>:   National Research Center - Institute of Immunology Federal Medical-Biological Agency of Russia<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>LACTYFERRIN™ Forte and ZINC Defense™ and Standard of Care (SOC) vs SOC in the Treatment of Non-hospitalized Patients With COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Sesderma LACTYFERRIN™ Forte and Sesderma ZINC Defense™;   Drug: Placebo<br/><b>Sponsors</b>:   Jose David Suarez, MD;   Sesderma S.L.;   Westchester General Hospital Inc. DBA Keralty Hospital Miami;   MGM Technology Corp<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>MP0420 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: MP0420;   Drug: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Molecular Partners AG;   University of Minnesota<br/><b>Active, not recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>AZD7442 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: AZD7442;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   AstraZeneca;   University of Minnesota<br/><b>Active, not recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>PF-07304814 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: PF-07304814;   Drug: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Pfizer;   University of Minnesota<br/><b>Suspended</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>VIR-7831 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: VIR-7831;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Vir Biotechnology, Inc.;   GlaxoSmithKline;   University of Minnesota<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>BRII-196/BRII-198 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: BRII-196;   Biological: BRII-198;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Brii Biosciences Limited;   University of Minnesota<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>LY3819253 (LY-CoV555) for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: LY3819253;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Eli Lilly and Company;   University of Minnesota<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effect of a Health Pathway for People With Persistent Symptoms Covid-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Other: usual care and follow-up by a nurse;   Other: Personalized Multifactorial Intervention (IMP)<br/><b>Sponsor</b>:   Centre Hospitalier Universitaire de Saint Etienne<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>RCT for Yinqiaosan-Maxingganshitang in the Treatment of COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Chinese Herb;   Diagnostic Test: Placebo<br/><b>Sponsor</b>:   Chinese University of Hong Kong<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Short-term Effects of Transdermal Estradiol on Female COVID-19 Patients</strong> - <b>Conditions</b>:   COVID-19;   Hormone Replacement Therapy<br/><b>Interventions</b>:   Drug: Climara 0.1Mg/24Hr Transdermal System;   Other: Hydrogel patch<br/><b>Sponsors</b>:   Istanbul University - Cerrahpasa (IUC);   Turkish Menopause and Osteoporosis Society;   Karakoy Rotary Club;   Rebul Pharmacy<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Clinical Study on Safety and Effectiveness of Mesenchymal Stem Cell Exosomes for the Treatment of COVID-19.</strong> - <b>Condition</b>:   COVID-19 Pneumonia<br/><b>Intervention</b>:   Biological: Extracellular Vesicles from Mesenchymal Stem Cells<br/><b>Sponsor</b>:   First Affiliated Hospital of Wenzhou Medical University<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study of the Safety, Tolerability and Efficacy of NP-101 in Treating High Risk Participants Who Are Covid-19 Positive.</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: NP-101;   Other: Placebo<br/><b>Sponsor</b>:   Novatek Pharmaceuticals<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Teletechnology-assisted Home-based Exercise Program for Severe COVID-19</strong> - <b>Conditions</b>:   COVID-19;   Telerehabilitation<br/><b>Intervention</b>:   Behavioral: Teletechnology-assisted home-based pulmonary rehabilitation<br/><b>Sponsor</b>:   National Taiwan University Hospital<br/><b>Not yet recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Multifaceted involvements of Paneth cells in various diseases within intestine and systemically</strong> - Serving as the guardians of small intestine, Paneth cells (PCs) play an important role in intestinal homeostasis maintenance. Although PCs uniquely exist in intestine under homeostasis, the dysfunction of PCs is involved in various diseases not only in intestine but also in extraintestinal organs, suggesting the systemic importance of PCs. The mechanisms under the participation of PCs in these diseases are multiple as well. The involvements of PCs are mostly characterized by limiting intestinal…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Synthesis, molecular docking, and binding Gibbs free energy calculation of β-nitrostyrene derivatives: Potential inhibitors of SARS-CoV-2 3CL protease</strong> - The outbreak of novel coronavirus disease 2019 (COVID-19), caused by the novel coronavirus (SARS-CoV-2), has had a significant impact on human health and the economic development. SARS-CoV-2 3CL protease (3CLpro) is highly conserved and plays a key role in mediating the transcription of virus replication. It is an ideal target for the design and screening of anti-coronavirus drugs. In this work, seven β-nitrostyrene derivatives were synthesized by Henry reaction and β-dehydration reaction, and…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Engineering Nanomolar Potent Protein-based Inhibitors for Papain-like Protease Guided by Residue Correlation Network</strong> - We developed a rational protocol with a minimal number of mutated residues to create highly potent and selective protein-based inhibitors. Guided by an interaction and dihedral correlation network of ubiquitin (Ub) and MERS coronaviral papain-like protease (PLpro) complex, our designed ubiquitin variant (UbV) with 3 mutated residues (A46F, K48E, and E64Y) resulted in a ~3,500-fold increase in functional inhibition as compared with the wildtype Ub (wtUb). Further optimization with C-terminal R74N…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Development of monoclonal antibody-based blocking ELISA for detecting SARS-CoV-2 exposure in animals</strong> - The global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a significant threat to public health. Besides humans, SARS-CoV-2 can infect several animal species. Highly sensitive and specific diagnostic reagents and assays are urgently needed for rapid detection and implementation of strategies for prevention and control of the infection in animals. In this study, we initially developed a panel of monoclonal antibodies (mAbs) against SARS-CoV-2 nucleocapsid (N)…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Cell Surface Nucleocapsid Protein Expression: A Betacoronavirus Immunomodulatory Strategy</strong> - We recently reported that SARS-CoV-2 Nucleocapsid (N) protein is abundantly expressed on the surface of both infected and neighboring uninfected cells, where it enables activation of Fc receptor-bearing immune cells with anti-N antibodies (Abs) and inhibits leukocyte chemotaxis by binding chemokines (CHKs). Here, we extend these findings to N from the seasonal human coronavirus (HCoV)-OC43, which is also robustly expressed on the surface of infected and non-infected cells by binding…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Totally-green cellulosic fiber with prominent sustained antibacterial and antiviral properties for potential use in spunlaced non-woven fabric production</strong> - The worldwide spread of COVID-19 has put a higher requirement for personal medical protective clothing, developing protective clothing with sustained antibacterial and antiviral performance is the priority for safe and sustaining application. For this purpose, we develop a novel cellulose based material with sustained antibacterial and antiviral properties. In the proposed method, the chitosan oligosaccharide (COS) was subjected to a guanylation reaction with dicyandiamide in the presence of…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Risk perception of compound emergencies: A household survey on flood evacuation and sheltering behavior during the COVID-19 pandemic</strong> - Compound hazards are derived from independent disasters that occur simultaneously. Since the outbreak of COVID-19, the coupling of low-probability high-impact climate events has introduced a novel form of conflicting stressors that inhibits the operation of traditional logistics developed for single-hazard emergencies. The competing goals of hindering virus contagion and expediting massive evacuation have posed unique challenges for community safety. Yet, how a community perceives associated…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ginsenosides, potential TMPRSS2 inhibitors, a trade-off between the therapeutic combination for anti-PD-1 immunotherapy and the treatment of COVID-19 infection of LUAD patients</strong> - Background: Acting as a viral entry for coronavirus to invade human cells, TMPRSS2 has become a target for the prevention and treatment of COVID-19 infection. Before this, TMPRSS2 has presented biological functions in cancer, but the roles remain controversial and the mechanism remains unelucidated. Some chemicals have been reported to be inhibitors of TMPRSS2 and also demonstrated other pharmacological properties. At this stage, it is important to discover more new compounds targeting TMPRSS2,…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Efficient CRISPR-Cas13d-Based Antiviral Strategy to Combat SARS-CoV-2</strong> - The current SARS-CoV-2 pandemic forms a major global health burden. Although protective vaccines are available, concerns remain as new virus variants continue to appear. CRISPR-based gene-editing approaches offer an attractive therapeutic strategy as the CRISPR-RNA (crRNA) can be adjusted rapidly to accommodate a new viral genome sequence. This study aimed at using the RNA-targeting CRISPR-Cas13d system to attack highly conserved sequences in the viral RNA genome, thereby preparing for future…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Repurposing <em>Astragalus</em> Polysaccharide PG2 for Inhibiting ACE2 and SARS-CoV-2 Spike Syncytial Formation and Anti-Inflammatory Effects</strong> - The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a serious threat to global public health. In an effort to develop novel anti-coronavirus therapeutics and achieve prophylactics, we used gene set enrichment analysis (GSEA) for drug screening and identified that Astragalus polysaccharide (PG2), a mixture of polysaccharides purified from Astragalus membranaceus, could effectively reverse COVID-19 signature genes….</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Regulatory T Cells (Tregs) and COVID-19: Unveiling the Mechanisms, and Therapeutic Potentialities with a Special Focus on Long COVID</strong> - The COVID-19 pandemic has caused havoc all around the world. The causative agent of COVID-19 is the novel form of the coronavirus (CoV) named SARS-CoV-2, which results in immune system disruption, increased inflammation, and acute respiratory distress syndrome (ARDS). T cells have been important components of the immune system, which decide the fate of the COVID-19 disease. Recent studies have reported an important subset of T cells known as regulatory T cells (Tregs), which possess…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ex Vivo Immune Responsiveness to SARS-CoV-2 Omicron BA.5.1 Following Vaccination with Unmodified mRNA-Vaccine</strong> - (1) Background: The high incidence of SARS-CoV-2 infection in vaccinated persons underscores the importance of individualized re-vaccination. PanIg antibodies that act against the S1/-receptor binding domain quantified in serum by a routine diagnostic test (ECLIA, Roche) can be used to gauge the individual ex vivo capacity of SARS-CoV-2 neutralization. However, that test is not adapted to mutations in the S1/-receptor binding domain, having accumulated in SARS-CoV-2 variants. Therefore, it might…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Comparison of Immunogenicity and Reactogenicity of Five Primary Series of COVID-19 Vaccine Regimens against Circulating SARS-CoV-2 Variants of Concern among Healthy Thai Populations</strong> - To compare immunogenicity and reactogenicity of five COVID-19 vaccine regimens against wild-type SARS-CoV-2 and variants of concern (VoCs) among Thai populations, a prospective cohort study was conducted among healthy participants aged ≥18 years who had never been infected with COVID-19 and were scheduled to get one of the five primary series of COVID-19 vaccine regimens, including CoronaVac/CoronaVac, AZD1222/AZD1222, CoronaVac/AZD1222, AZD1222/BNT162b2, and BNT162b2/BNT162b2. Anti-receptor…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immunogenicity and Safety of the Third Booster Dose with mRNA-1273 COVID-19 Vaccine after Receiving Two Doses of Inactivated or Viral Vector COVID-19 Vaccine</strong> - The changes in the severe acute respiratory syndrome coronavirus 2 and the tapering of immunity after vaccination have propelled the need for a booster dose vaccine. We aim to evaluate B and T cell immunogenicity and reactogenicity of mRNA-1273 COVID-19 vaccine (100 µg) as a third booster dose after receiving either two doses of inactivated COVID-19 vaccine (CoronaVac) or two doses of viral vector vaccine (AZD1222) in adults not previously infected with COVID-19. The anti-receptor-binding-domain…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Binding of SARS-CoV-2 Structural Proteins to Hemoglobin and Myoglobin Studied by SPR and DR LPG</strong> - One of the first clinical observations related to COVID-19 identified hematological dysfunctions. These were explained by theoretical modeling, which predicted that motifs from SARS-CoV-2 structural proteins could bind to porphyrin. At present, there is very little experimental data that could provide reliable information about possible interactions. The surface plasmon resonance (SPR) method and double resonance long period grating (DR LPG) were used to identify the binding of S/N protein and…</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>After the Nashville School Shooting, a Faithless Remedy for Gun Violence</strong> - “I don’t see any real role that we could do other than mess things up, honestly,” Representative Tim Burchett, of Tennessee, said. “We gotta change people’s hearts.” - <a href="https://www.newyorker.com/news/daily-comment/after-the-nashville-school-shooting-a-faithless-remedy-for-gun-violence">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Revisiting the Brock Turner Case</strong> - In the midst of the #MeToo movement, California voters recalled a judge for being lenient on sexual assault. As a new documentary argues, that recall campaign had unintended results. - <a href="https://www.newyorker.com/news/our-columnists/revisiting-the-brock-turner-case">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>If Alvin Bragg Indicts Donald Trump, What Will the Case Look Like?</strong> - The trial could hinge on the “catch and kill” practices at the National Enquirer. - <a href="https://www.newyorker.com/news/our-columnists/if-alvin-bragg-indicts-donald-trump-what-will-the-case-look-like">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Israel’s Transformative Protest Movement</strong> - A wide-ranging resistance has halted Prime Minister Benjamin Netanyahu’s plans to remake the judiciary. - <a href="https://www.newyorker.com/news/letter-from-jerusalem/israels-transformative-protest-movement">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Starbucks Union Fight Comes to Congress</strong> - A hearing on illegal union-busting pitted Howard Schultz, the coffee company’s former C.E.O., against Bernie Sanders. - <a href="https://www.newyorker.com/news/daily-comment/the-starbucks-union-fight-comes-to-congress">link</a></p></li>
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<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Swarm isn’t a love letter to Black women. It’s hate mail.</strong> -
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<img alt="Two women seen in the mirror of a dressing room." src="https://cdn.vox-cdn.com/thumbor/OU-kp4ruSuJyn6NhFfcd-goverA=/108x0:1849x1306/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72130108/Screen_Shot_2023_03_29_at_12.18.55_PM.0.png"/>
<figcaption>
Dominique Fishback (front) and Chloe Bailey in <em>Swarm.</em> | Warrick Page/Prime Video
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
If Donald Glover wants to prove he respects Black women, Swarm isn’t it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uWDAsr">
In 2013, when I was a freshman at Howard University, one of my friends was borderline obsessed with Childish Gambino’s music. Before that, I hadn’t heard much about Gambino — or his alter ego, then-comedian Donald Glover — but I was surprised when, in the midst of a conversation praising his artistry, my friend, who is also a Black woman, flatly said that the rapper didn’t like Black women, something she said was evident not only in his dating choices (at the time, the rumor was that he only dated Asian or white women) but in his lyrics. “Everyone knows that,” she said dismissively, with no anger or jealousy in her voice.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="O28JIO">
Now, a decade later, I remembered my college friend’s words after I finished watching <em>Swarm</em>, the new Amazon Prime TV show about a Black woman serial killer superfan named Dre (Dominique Fishback) co-created by Glover — who has since established himself as a talented creator and director — and Janine Nabers. Nabers, a Black woman, previously worked with Glover writing for his FX show <em>Atlanta</em>, a series that has been praised for its <a href="https://www.ebony.com/fx-atlanta-review/">tender and complex depictions of Black men</a> and widely critiqued for its <a href="https://www.buzzfeednews.com/article/shamiraibrahim/atlanta-season-four-donald-glover-black-women">caricatures of Black women</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EPcnsf">
<em>Swarm</em> — with its two-dimensional main character, storyline cluttered with misogynistic and racist tropes, and dubious conclusions about Black women fandoms — is perhaps the show that, for me, solidified the opinion my college friend expressed a decade ago. Glover’s hostility toward Black women no longer feels like an allegation. Because his work is so obvious, it serves as the archive of this aggression. Glover all but confirmed these concerns when he told <a href="https://www.vulture.com/article/dominique-fishback-dre-swarm.html">Vulture</a> that he had given Fishback very little direction or insight into Dre (she confirmed this in the same article), telling her, “You don’t have to find the humanity in your character. That’s the audience’s job … Think of it more like an animal and less like a person.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="djsAab">
Referring to a human being as an “it” or an animal is almost always a red flag that points to an individual’s deeper feelings, and it doesn’t feel like a coincidence that Glover, who has continuously been criticized for dehumanizing portrayals of Black women, would quite literally hinder an actor’s ability to find the humanity in a Black woman character.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vdXLPC">
Not only did Glover relate Dre to an animal, but he specified which one, after dismissing the character of Dre as not “that layered.” He said, “I wanted her performance to be brutal. It’s a raw thing. It reminds me of how I have a fear with dogs because I’m like, ‘You’re not looking at me in the eye, I don’t know what you’re capable of.’” With these damning quotes, Glover’s misogynoir is no longer subtext. It’s canon.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/hVd7z8-6QX84cRb_KOpfbofzCGk=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24545309/YLLW_S1_FG_104_00041618_Still034R_700.jpg"/> <cite>Courtesy of Prime Video</cite>
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Dominique Fishback as Dre in <em>Swarm</em>, a character co-creator Donald Glover calls “not that layered.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="t9WjBO">
Even though <em>Swarm</em> was co-created by a Black woman, featured a stunning performance by a Black woman (Fishback), and had Black women like Malia Obama in the writers’ room, <em>Swarm</em>’s misogynoir felt like a deeper, more direct insult to Black women than Glover’s previous projects. Instead of merely popping up on the occasional lyric or episode, hostility and mockery toward us permeate the show.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oyV1Tk">
<em>Swarm</em> is set in Houston, Texas, and follows Dre, a young superfan of pop star Ni’jah (Nirine S. Brown), who in the show serves as a cringey mirror of the real-life Beyoncé. Dre has two important women in her life: Ni’jah and Dre’s foster sister, Marissa (Chloe Bailey), and they’re fatally intertwined. After listening to Ni’jah’s surprise release visual album about her rapper husband Caché’s infidelity <a href="https://www.vox.com/2016/4/28/11518702/lemonade-beyonce-explained">(sound familiar?)</a>, Marissa dies by suicide, seemingly so impacted by both the album and her own boyfriend of three months (played by Damson Idris) cheating on her that she cannot live any longer.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dRv7tr">
With Marissa, the object of her psychosexual obsession, gone, Dre starts to unravel. Grief-stricken and kicked out of the funeral by Marissa’s biological family, Dre sets out in pursuit of meeting Ni’jah. This transforms into a cross-country killing spree, with Dre murdering people who speak badly about Ni’jah. “Who’s your favorite artist?” becomes her villainous catchphrase. If the answer isn’t Ni’jah, you’re likely to get a lecture on why it should be, and then bludgeoned to death. Dre finds her victims anywhere: her dead sister’s cheating boyfriend, Black male influencers and mechanics in the Twitter comments, a coworker’s white abusive boyfriend, the co-worker herself. Her murders aren’t complex. Anyone who is against Ni’jah, annoys Dre, or stands in Dre’s way of seeing Ni’jah doesn’t tend to live long. This, Glover says, is his attempt at examining extreme fan culture, whose adherents are often referred to as stans, a term originating from a <a href="https://www.musicgrotto.com/is-stan-a-true-story/">classic Eminem song</a> (I’ll return to that later). The problem is that this depiction of stan culture isn’t just problematic, it’s inaccurate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ajKhhR">
There are countless issues with <em>Swarm</em>, but perhaps its most glaring one is how it fails to understand or speak truthfully to its supposed subject, employing what feels like irresponsible misinformation. Each episode — save episode six, which is a mockumentary about Dre’s violence — features a facetious play on the classic Hollywood disclaimer, asserting the events in the show as true and claiming “Any similarity to actual persons, living or dead, or actual events, is intentional.” This switcheroo immediately feels tired and unoriginal, like what a sophomore-year film student might find desperately inventive. It also confuses viewers in a most unproductive way. There were even a few people online who seem to be wondering whether <a href="https://twitter.com/search?q=dre%20real%20killer&amp;src=typed_query">Dre is a real killer</a> still on the loose.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mhrE6T">
But none of the events portrayed in <em>Swarm</em> — save perhaps the incidents surrounding Ni’jah’s/Beyoncé’s husband being unfaithful — are true stories. That hasn’t stopped the creators from being coy about the falsity underlying their latest project. Glover has described the stories as “true-ish” and said <em>Swarm</em> is a “<a href="https://www.vanityfair.com/hollywood/2023/01/donald-glover-show-swarm-first-look">post-truth”</a> TV series. Nabers <a href="https://www.vulture.com/article/swarm-ending-explained-janine-nabers.html">told Vulture that</a>, “The pilot story is a real event and the finale is a real event, and they exist in the world of internet rumors or a YouTube video or Twitter.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wzTOz3">
If we leave aside for a minute that something existing as a rumor on the internet makes for a “real event” is a nearly Trumpian contradiction, as nonsensical as the phrase <a href="https://www.vox.com/policy-and-politics/2018/2/9/16991410/trump-fox-nunes-fbi-warner-texts">“alternative facts</a>,” neither the pilot nor the finale are true stories either. As <a href="https://www.shondaland.com/inspire/a43275160/swarm-janine-nabers/">Nabers admitted to Shondaland</a>, both Marissa’s suicide and existence were rumors that were never confirmed — although yes, the character does share the name of a woman who, urban legend holds, died following the release of <em>Lemonade</em> — and there certainly were no reports or rumors of a foster sister killing people in the aftermath. In the finale, Dre, now calling herself Tony and living as a masculine-presenting lesbian, runs onto the stage at a Ni’jah concert. In real life, there was a man named Anthony who <a href="https://www.eonline.com/news/963143/man-rushes-stage-at-beyonce-and-jay-z-on-the-run-ii-tour-concert">ran onto the stage during a 2018 Beyoncé and Jay-Z concert</a>, but there is nothing to suggest the real-life Anthony was a murderer or a violent person. The plotline most firmly rooted in reality is probably the one where Dre bites Beyoncé, but <a href="https://www.vogue.com/article/we-finally-know-who-bit-beyonce">Beyoncé was allegedly bit by an actress</a>, not a fan.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fq5YDt">
These are incredibly flimsy rumors to base an entire series off of, yet they alone are the creators’ justification to declare the series to be based on reality and a reflection of stan culture. It matters that these stories aren’t true, and that even gossip versions can’t be credited to violent stans. How can you claim to write a show that is exploring fandoms and mental health when you are stuffing it with an amalgamation of rumors and partially true stories, and calling it a meaningful statement?
</p>
<div class="c-float-right">
<aside id="R75zsd">
<q>Perhaps the fear of the stan’s potential for great violence is more about the artist’s resentment of their own visibility</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DuA8l8">
Glover is an inventive and important artist (I’ve previously praised <a href="https://www.vox.com/23032541/atlanta-afro-surrealism-donald-glover">his exploration of Afrosurrealism in <em>Atlanta</em></a>), but sometimes he masks simple immaturity as a meta commentary. Consider his controversial <a href="https://www.interviewmagazine.com/culture/donald-glover-interviews-donald-glover">2022 Interview article where he interviewed himself</a>. I’m sure he meant it to be daring. While it did cause a flurry of conversation, at its core it was tiring and confusing, and the ensuing social media noise spoke more to his troll-ish leanings than to his ability to give readers any real insight.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZyT59F">
That interview was also one of the times that Glover addressed the criticisms of misogynoir he’s received for years. In the interview, Glover asked himself, “Are you afraid of Black women?” and replied to himself “Why are you asking me that?” Glover continued, still speaking to himself, “I feel like your relationship to them has played a big part in your narrative.” Replying again, he said, “I feel like you’re using Black women to question my Blackness.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9rirhQ">
It was nonsensical, but also a way to make light of the very real concerns and questions the public has had for over a decade about his portrayal of Black women in songs and on TV. Even the phrasing of Black women playing “a big part in [his] narrative” is framed as though the interest in Glover’s relationship to and with Black women comes entirely from outside his work and isn’t a reaction to deliberate choices he’s made in his work. Glover is playing the role of precocious auteur here, stomping his feet, not wanting to respond meaningfully to any criticism but still desiring to be regarded as a great artist, courting controversy and resenting the inevitable visibility the controversy garners.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tn4o9b">
In this, Glover and even minor writers like Malia Obama are simultaneously too close and too removed from the subject matter — fame, and the people who worship the famous — to make an intelligent and compelling statement about it from a stan’s perspective. Glover admitted that they didn’t have an expert in fandom advise on the show and <a href="https://www.vulture.com/article/donald-glover-swarm-interview-dre-dominique-fishback.html">suggested to Vulture</a> that the fame of some in the writers’ room qualified them to write about stans from this perspective. “We have people who are famous in the writers’ room and people you’d barely know. Everybody had a story about how they were roasted. Everyone had the same story of being like, ‘This person said something, and then some people jumped on the bandwagon, and it affected me,’” he said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EZr20W">
Glover has greatly benefited from hypervisibility, and yet perhaps understandably feels aggrieved by it. But through a lens where one sees themselves as a perpetual victim of visibility, whether that is a correct assessment or not, the behaviors of the public will perhaps always feel more aggressive or dangerous than they are.
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8h3nsb">
Glover knows what his reputation is with regards to Black women, and yet with <em>Swarm</em>, he chose to take a Black, queer, mentally ill woman and make her the avatar of violent stans. All of those intersections of oppression — Black, LGBTQIA+, and people with a mental illness — are far more likely to be victims of violence rather than perpetrators.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7kA5NB">
Glover isn’t the first person to use art to explore violent fandom, but there’s reason to believe that many artists who do so aren’t critiquing society, but rather battling with their own inner conflict and guilt. Like <em>Swarm</em>, “Stan,” which some call Eminem’s magnum opus, was also not based on a real story. The song features the ramblings of a mentally ill fictional Eminem fan, who sees the rapper as his role model. Stan grows increasingly frustrated by the lack of response to his letters, so much so that he one day decides to kill his pregnant girlfriend and himself, emulating the song “’97 Bonnie &amp; Clyde,” where Eminem raps about murdering his wife Kim and driving their daughter to dispose of the body. None of this had happened. But the song was influenced by Eminem receiving disturbing fan mail that made him feel haunted by the idea that one of his fans would, one day, decide to copy the extreme violence depicted in his songs. “Stan” was an attempt to course-correct, an expression of guilt, rather than a true account.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TJgBL1">
Glover’s own work isn’t nearly as violent as Eminem’s. But there’s something to be said about how, for the celebrity, perhaps the fear of the stan’s potential for great violence is more about the artist’s resentment of their own visibility, apprehension, or guilt about past actions, and the paranoia that comes with such an inhuman level of surveillance. To the celebrity, fandom is violent because of its sheer scale of demand and visibility. They lack the ability to see each fan as an individual and instead see them as a hive, as a swarm moving as one ominous cloud of danger, and through that lens, everything is magnified.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="heIs2F">
Perhaps this is also how Glover has come to see Black women, as a dangerous horde of screeching banshees that he must endure, but never capitulate to. Through this lens, it’s also often easy for many to dismiss the concerns about his misogynoir as romantic jealousy. While I won’t deny that this can sometimes exist — a feeling of entitlement to someone sexually because of their race — it is not what is happening to Glover. Black women are not upset because he is an object of desire we want to possess; we are upset because in his work, he has made us objects of horror and ridicule, or as mere plot devices to move Black men’s stories forward.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7TyMC2">
A disclaimer of my own: I am not a member of the Hive. I tend to listen to Beyonce’s new albums about a week after everyone else. And yet, I struggled to articulate what felt so hostile about Glover (supposedly a friend of Beyoncé’s, <a href="https://www.vulture.com/article/swarm-ending-explained-janine-nabers.html">according to Nabers</a>) using the momentum of her upcoming tour that honors Black queer music to portray a Black queer fan of hers as a murderous “dog.” Even the image of Beyoncé that Ni’jah has been cast in feels more like a mockery and less like a respectful nod. No effort was made to distinguish Ni’jah from Beyoncé. The literalism is lazy writing, and ironically makes the portrayal ring false, since Ni’jah captures all the aesthetics and mere facts of Beyoncé’s public life but almost none of the elements of why Black women enjoy Beyoncé’s music.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LRstO2">
The political and racial significance of <em>Lemonade</em> is stripped here, removing the Black Southern specificity of the album and how it explored generational trauma, slavery, and police brutality. By casting Ni’jah’s album<em> Festival</em> as just an album about infidelity, the work of real-life poet Warsan Shire, who penned the poems that accompanied <em>Lemonade</em>’s visual album, is also erased here. Provocative, haunting, and sometimes disturbing, the Somali-British poet’s work is arguably some of the best we’ve seen from a Black woman poet in decades, and bore no small weight on the intensity with which many Black women, including myself, identified with Beyoncé’s 2016 album.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xSkjD8">
Still, no one is required to pay homage to Beyoncé. She is not sacred. However, why would a friend and peer construct a poorly made parody of what was, according to every indication, an incredibly personal album exploring infidelity, generational trauma, miscarriage, and motherhood? I have no intelligent insight to offer but this — it felt low, and mean.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZJ0tgg">
When I tweeted about the misogynoir in <em>Swarm</em>, countless internet strangers rushed in to accuse me of erasing the Black women who worked on the show, including co-creator Janine Nabers and writer Malia Obama. But Black women are also capable of rendering other Black women into caricatures for the screen. Furthermore, <a href="https://www.shondaland.com/inspire/a43275160/swarm-janine-nabers/">according to Nabers</a>, “[Glover] pitched the idea, and he directed the pilot, but his DNA is all over the show. He and I sat down before we even had a writers’ room and broke down each story together; we knew what the ending of the show was right away too. And that was great because that allowed us to have a clear blueprint to relay when we assigned our writers, all of whom are Black.” So it’s safe to say that while <em>Swarm</em> has many Black women on the team, Glover’s vision and philosophy are integral parts of the show and should not be dismissed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2AtkTX">
And yet, that is what Black women are being asked to do — dismiss the idea of Glover being misogynistic as “silly,” <a href="https://www.vulture.com/article/swarm-ending-explained-janine-nabers.html">according to Nabers</a>, and to also embrace this show as some symbol of female power. “At the end of the day, I would hope that Black women watch this show and feel like they are seeing a part of Black femininity they haven’t seen before, and they’re drawn to it,” <a href="https://www.vulture.com/article/swarm-ending-explained-janine-nabers.html">Nabers told Vulture</a>. This is in contrast to <a href="https://www.vulture.com/article/donald-glover-swarm-interview-dre-dominique-fishback.html">Glover telling Vultur</a>e that he didn’t care about the audience or the internet or Beyoncé stans’ reaction to Swarm, saying, “I just refuse to take that into account because then we wouldn’t be able to make the things we want to make.”
</p>
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<aside id="xx2GGv">
<q>Nabers called the show “a love letter to Black women”</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TI4SXu">
Reading this, it feels like “the audience” or “the internet” or even the specific group of “Beyoncé stans” are almost coded ways to both portray Black women critics — who would obviously be the ones with the most to say about this show — as too large in numbers to have their own minds worth listening to, and also so insular and irrational as to render their opinions irrelevant.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wUDn9N">
In another comment, Nabers called the show “a love letter to Black women,” which is an actual silly thing to say. Nabers later compares the love Dre has for Marissa to the love she has for her mother and sister, seemingly forgetting that the show starts with Dre non-consensually watching Marissa copulate with her boyfriend. She says that it’s supposedly important for Black women to be seen as serial killers on screen because it’s never been done before, apparently oblivious to the fact that <em>Swarm</em> is merely the latest in a long line of media to depict Black people as violent animals. These are nonsensical contradictions coming from both creators, a mishmash of words about empowerment and mental health and craft, all to disguise that they were given a bunch of money to troll viewers. The only genuinely amazing thing to come out of this venture is the awareness of Fishback’s acting talent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a3ofLA">
If <em>Swarm</em> is a love letter to Black women, it is the kind of love letter you report to the authorities to receive a restraining order against the sender, the kind of worrying letter sent by a fan who doesn’t really understand the artist. And if Glover doesn’t understand Black women or fan culture, perhaps it’s best he refrains from writing about either.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oTOthB">
<em>Nylah Burton is a Chicago-based writer who covers entertainment, travel, and lifestyle. She has bylines in Vulture, Travel + Leisure, and Vogue. You can find her on </em><a href="https://urldefense.proofpoint.com/v2/url?u=https-3A__www.instagram.com_yumcoconutmilk_&amp;d=DwMFaQ&amp;c=7MSjEE-cVgLCRHxk1P5PWg&amp;r=PH_TsfDq5up8YqA2pN3P60XFtgtzgDfK9zPr2Dq0tSI&amp;m=JQ5AKFyFGzuTeN-HDSAkgA6SlkcqR6vtRcaVC0_9pHfLEXAZwGITugXoC7Wy-ShY&amp;s=ZAwK7hnyIS7wtEM8gjvmht8XUxfZGKWXsXC0dScvxLU&amp;e="><em>Instagram</em></a><em>. </em>
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<li><strong>Never pay a medical bill without asking these questions first</strong> -
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<img alt="An illustration of a shadowy figure in a suit holding a giant pair of scissors. The scissors cut through a massive price tag with the Caduceus symbol on it." src="https://cdn.vox-cdn.com/thumbor/c6n0U6bSv-gzUMJY7U5egZmjy-8=/240x0:4779x3404/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72130043/GettyImages_166083126.0.jpg"/>
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Getty Images/iStockphoto
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If you think you’re being overcharged on medical bills, you probably are.
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The <a href="https://www.vox.com/a/health-prices">cost of medical care in the United States</a> is notoriously steep. From prescription drugs to knee replacements, the <a href="https://www.vox.com/policy-and-politics/2019/12/17/21024614/us-health-care-costs-medical-prices">US outspends all other wealthy countries</a> for nearly every procedure or medical service. These exorbitant costs are shouldered by patients, with about half of American adults <a href="https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/">reporting difficulties affording health care costs</a>, according to Kaiser Family Foundation polling. Among the 19 percent of American households that carried medical debt in 2017, the <a href="https://www.census.gov/library/stories/2021/04/who-had-medical-debt-in-united-states.html">median amount owed was $2,000</a> per household, according to US Census Bureau data. KFF surveys also show that excessive medical prices disproportionately affect those who are uninsured, Black and Hispanic adults, and people with lower incomes.
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The expense of medical care, paired with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242565/">lack of transparency around how much these services will cost and why</a>, can add to the shock and terror that comes with a medical bill. However, patients have tools and <a href="https://www.vox.com/2014/8/6/5971899/the-secret-to-negotiating-a-lower-medical-bill">negotiating power</a> to reduce these costs both before services are rendered and after they receive a bill. While many patients may resign themselves to paying the bill, there are a bevy of other cost-cutting options to exhaust first. “You should never ever pay any medical bill right away,” says Caitlin Donovan, the senior director of the <a href="https://www.npaf.org/">National Patient Advocate Foundation</a>.
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Unfortunately, the responsibility is solely on the patient or their guardian to advocate for themselves; hospitals and medical providers will often not readily offer cost-reducing alternatives. Knowing the right questions to ask can help patients reduce or even avoid huge medical bills.
</p>
<h3 id="h20k5v">
What to ask while you’re still at the hospital, doctor’s office, or pharmacy
</h3>
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There are questions you can ask providers and pharmacists before you get a test, procedure, or prescription filled to ensure you’re not paying more than you need to. In emergency situations, some of these questions won’t apply since there may not be time to shop around when it comes to lifesaving care. In non-emergency circumstances, the first thing a patient can do to avoid a large bill for something as simple as an office visit is to visit providers that are in-network with your insurance if you have it. Your insurance carrier’s website or app will have a search tool for in-network providers. Also check the list of accepted insurances on the physician’s website. If you’re still unsure if a doctor is in-network, <a href="https://www.forbes.com/sites/christinalamontagne/2015/02/09/how-can-i-verify-if-a-provider-is-in-my-coverage-network/?sh=53241e092962">call your insurance carrier</a> and speak with a representative. “A lot of the time when we see people with really big bills,” says Casey Schwarz, the senior counsel for education and federal policy at the <a href="https://www.medicarerights.org/">Medicare Rights Center</a>, “it’s because they’re trying to access something that’s either not covered or out of network.”
</p>
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These bargaining tactics require a significant amount of time and energy, and are made considerably more difficult when you’re not feeling well or English isn’t your first language. Under the Affordable Care Act, patients who speak limited English are <a href="https://www.hhs.gov/sites/default/files/1557-fs-lep-508.pdf">entitled to a free qualified interpreter</a> and translated medical documents. Health care providers <a href="https://www.unitedlanguagegroup.com/blog/the-affordable-care-act-and-language-access">must inform patients that they offer interpreting services</a>. When booking an appointment, <a href="https://etranslationservices.com/uncategorized/are-medical-offices-required-to-provide-medical-interpreters/">tell the scheduler you will need an interpreter during your visit</a>.
</p>
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For non-emergency procedures and appointments at in-network physicians, here are some financial questions to ask before you leave the office.
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<strong>How much will this cost? </strong>
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Since 2021, federal law has <a href="https://www.cms.gov/hospital-price-transparency">required all hospitals to list pricing information online</a> for services, such as blood work or X-rays, provided during <a href="https://www.cms.gov/files/document/hospital-price-transparency-frequently-asked-questions.pdf">inpatient admission and outpatient visits</a>. These posted costs include the insurance prices and cash prices — that is, to pay without using insurance — which are <a href="https://www.nytimes.com/2021/08/22/upshot/health-care-prices-lookup.html">often lower than insurance prices</a>. However, studies found <a href="https://jamanetwork.com/journals/jama/fullarticle/2792987">many hospitals did not list their prices</a>, or if they did, the <a href="https://www.healthsystemtracker.org/brief/ongoing-challenges-with-hospital-price-transparency/">data was confusing and inconsistent</a>. A <a href="https://www.patientrightsadvocate.org/february-semi-annual-compliance-report-2023">review from the price transparency nonprofit PatientRightsAdvocate.org</a> found that just a quarter of the country’s largest hospitals listed all of their prices for every single insurance carrier.
</p>
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You should be able to access the price list on the hospital’s website (which can be a tricky process in itself; the <a href="https://www.nytimes.com/2021/08/22/upshot/health-care-prices-lookup.html">New York Times has some tips on how to parse the data</a>) but if you can’t, get in touch with the billing department to ask for the price. Make sure you’re looking at a spreadsheet of costs and not using the estimator tool, which Cynthia Fisher, the founder and chairman of <a href="https://www.patientrightsadvocate.org/">PatientRightsAdvocate.org</a>, says produces inaccurate estimates.
</p>
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“Everybody should know what is that discounted cash price,” Fisher says. “What is my insured rate? How does my insured rate compare to other insurance rates? And guess what? You have the right to not accept that insurance rate if it’s egregiously higher.” In practice, this means informing the billing department that <a href="https://cashpracticehelp.groovehq.com/help/legal-can-a-patient-opt-out-of-insurance-even-if-were-an-in-network-provider">you do not want to use your insurance</a> and will pay out of pocket.
</p>
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Beyond the listed prices within hospital systems, if you are uninsured or will probably pay cash, health care providers must provide you with a “<a href="https://www.cms.gov/nosurprises/consumers/understanding-costs-in-advance">good faith estimate</a>” in writing before you’re treated, says Dawn Greene, the operations manager at medical bill advocate service <a href="https://www.resolvemedicalbills.com/">Resolve</a>. These estimates include the cost of the procedure and any associated costs, like lab tests or anesthesia for a surgery. Should your final bill total $400 or more over the estimate, you can file a dispute with the provider. Those disputes should start with a call to the billing department.
</p>
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For those with high-deductible insurance plans who are generally healthy and have historically never hit their deductible, it may be cheaper to pay cash, without using insurance, for a procedure or medication. “Let’s say that you have a serious medical issue, you’re going to be taking a lot of expensive medicines all the time, and you’re for sure going to hit your deductible. It’s better to go through your insurance so you can hit your deductible sooner and then you don’t have to pay for anything,” says Carolyn McClanahan, founder of financial planning firm <a href="https://lifeplanningpartners.com/">Life Planning Partners</a>. “But if you’re a normally healthy person, and you just come down with something short term, then if you have a high-deductible plan, it is probably better to pay cash.”
</p>
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Check online databases like <a href="https://www.healthcarebluebook.com/ui/home">Healthcare Bluebook</a> and <a href="https://www.fairhealthconsumer.org/">Fair Health Consumer</a>, which provide fair price estimates for many kinds of office visits and procedures based on your location, to make sure you’re being offered a fair price. The online tool <a href="https://www.solvhealth.com/clearprice">Solv</a> provides patients the costs for common procedures in their area if they’re not using insurance.
</p>
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Should the listed cost for your insurance carrier or the cash price be beyond what you can spend, ask to see the financial assistance or charity care policy. “People don’t realize how many of them actually qualify for financial assistance from hospitals,” Donovan says. Each state or hospital will have their own eligibility requirements for financial assistance. In New Jersey and Massachusetts, for example, <a href="https://www.consumerfinance.gov/data-research/research-reports/understanding-required-financial-assistance-in-medical-care/">patients are eligible for free care if they have a family income of up to 200 percent of the federal poverty level</a>. (The <a href="https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines">poverty guideline</a> for a single person is $14,580 in 2023 and $30,000 for a family of four.) Even if you make more than that, you could still be eligible for a discounted rate.
</p>
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If you’re still not comfortable with the price, you can research costs at other hospitals to find one that fits your budget. This can be time-consuming and frustrating, especially if you’re sick. While Donovan is not a proponent of shopping for care, she says patients can save money on imaging costs by opting for X-rays, ultrasounds, MRIs, and CT scans at freestanding clinics outside of hospital systems. So if it’s not urgent, it’s worth looking for the cheapest facility. You can call and ask for their rates over the phone, Donovan says.
</p>
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<strong>How can I lower the cost of this medication?</strong>
</p>
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Your doctor probably won’t know the exact cost of medication when they’re prescribing it — especially when it comes to what your insurance will or won’t cover — but they’ll know if there is a generic brand or even an over-the-counter medicine available that will undoubtedly be cheaper. You can even <a href="https://www.opm.gov/frequently-asked-questions/insure-faq/health/can-i-ask-the-pharmacy-to-substitute-a-generic-drug-for-the-drug-prescribed-by-my-doctor/#:~:text=Each%20state%20has%20a%20law,may%20not%20be%20aware%20of.">ask the pharmacist</a> if there is a <a href="https://www.drugtopics.com/view/the-pharmacist-s-role-in-generic-substitution">generic or OTC version of the drug</a> they can give you instead. “Sometimes [doctors] prescribe pain medicine that’s actually equivalent to three Advil, 600 milligrams,” Fisher says. “Why pay for an expensive prescription when you probably have it at home in your medicine cabinet?”
</p>
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Fisher recommends asking the pharmacist the price of the medication if you were to pay cash versus if it were to be covered through insurance. Often, the cash rate is much lower, she says. You can also ask the pharmacist if they have access to any discount cards or coupons from the drug manufacturer, Donovan says. Keep in mind that <a href="https://www.drugtopics.com/view/working-with-discount-cards-and-manufacturer-coupons">discount cards cannot be used with insurance</a>.
</p>
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Platforms like <a href="https://www.goodrx.com/">GoodRx</a> offer price comparisons for medications at pharmacies near you and provide coupons for discounted medications. You <a href="https://www.goodrx.com/insurance-and-goodrx">won’t be able to use your insurance with GoodRx coupons</a>. Mark Cuban’s platform <a href="https://costplusdrugs.com/">Cost Plus Drugs</a> lists discounted drug prices; your doctor will have to write the prescription to the company’s pharmacy partner, which will then mail you the medication. Cost Plus Drugs <a href="https://costplusdrugs.com/faq/">accepts Capital Blue Cross, Rightway, and other select insurances</a>. Again, paying cash for these discounted options may be considerably cheaper than going through insurance.
</p>
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Patients with Medicare are <a href="https://www.npr.org/sections/health-shots/2018/05/09/609150868/why-cant-medicare-patients-use-drugmakers-discount-coupons">unable to use coupons from the manufacturer for drugs</a>. However, many people are eligible for the <a href="https://www.medicare.gov/medicare-savings-programs">Medicare Savings Program</a>, which reduces drug costs down to a flat rate, says Schwarz, of the Medicare Rights Center.<strong> </strong>You can apply for the Medicare Savings Program through your state Medicare agency. There is an additional <a href="https://www.ssa.gov/medicare/part-d-extra-help">Extra Help program</a>, which also reduces drug costs, that patients can enroll in through the Social Security Administration.
</p>
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If you were prescribed medication for an ongoing or extended period of time, ask your doctor at your annual checkup if the medication is still necessary, McClanahan says. Eliminating or lowering the dosage of a drug will also lower your expenses. However, you should never defy your doctor’s instructions to take name-brand medication or scale back on dosage in order to save money.
</p>
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<strong>Do I really need this test or procedure? </strong>
</p>
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Sometimes doctors will order a litany of tests in order to diagnose a potential issue. The costs for even routine blood work can add up, depending on the labs ordered. Tell your physician you’re concerned about the cost of the tests, Donovan says, and ask something along the lines of, “I’m worried about finances. Are we getting a lot of value added for these tests?” For example, Donovan was told she would need monthly ultrasounds during one of her pregnancies — a considerable expense. “I was like, ‘That seems like low-value, high-cost care,’” she says. The physician quickly said the monthly ultrasounds weren’t necessary unless she experienced any complications.
</p>
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“Here’s the thing about providers,” Donovan says, “as soon as you sound like you know what you’re talking about, all of a sudden they’re going to treat you like you know what you’re talking about.”
</p>
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McClanahan suggests inquiring about what exactly the doctor is hoping to see in the test. “If they can’t answer that question, do you really need that test?” she says.
</p>
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<strong>Can we keep the conversation limited to what the billing department would consider a preventative visit?</strong>
</p>
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As a part of most health insurance plans, <a href="https://www.healthcare.gov/coverage/preventive-care-benefits/">preventative services</a> — like annual checkups, immunizations, and common screenings — are free. However, after reviewing a doctor’s notes from an appointment, some billing departments will categorize — or code — a free preventative visit as another type of appointment entirely, resulting in a bill. A doctor simply asking you how you feel emotionally can change the coding of a visit. “So many people come to us with that very same problem,” Fisher says.
</p>
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Fisher says patients should feel empowered to tell their doctor, “This is my annual checkup. Let’s keep our conversation within the bounds of that type of visit,” while they’re in the exam room with their doctor.
</p>
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If you’re being asked to pay while on the way out of the office, remind the person asking you for money that you were here for a preventative visit and to change the code on the visit. Should you receive a bill in the mail weeks later, call the doctor’s billing department and explain the situation: The appointment was coded incorrectly and you should not be charged. You may need to call your insurance company as well.
</p>
<h3 id="P3GKCr">
How to negotiate a medical bill
</h3>
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Opening a medical bill and seeing an astronomical number can come as a shock. After the procedure or appointment, patients must double-check the accuracy of billing departments and <a href="https://www.vox.com/2019/3/22/18261698/how-to-fight-expensive-medical-bill">exhaust all other options to lower the bill</a> before paying. Here’s where to start and what to ask for.
</p>
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<strong>Can I see an itemized bill?</strong>
</p>
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“It’s estimated that about 60 percent of medical bills that are issued have <a href="https://www.experian.com/blogs/ask-experian/common-medical-bill-errors/">errors</a>,” says Greene, of Resolve. Always ask to see an itemized bill to make sure you’re being charged correctly. Were you double charged for something? Charged for a service you did not receive? You can also compare the costs on your bill with the hospital’s posted prices to ensure you’re not being overcharged. “If they say a CT scan is $5,000 on their website and they’re charging you $6,000, then you know that there’s an issue with the billing and you bring that to the hospital’s attention,” Greene says.
</p>
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If you’re going through insurance, compare the bill with the explanation of benefits (EOB) you received from your insurance. The explanation of benefits outlines what costs your insurance will cover. “Never pay any bill until you get that,” Donovan says, “and then you just compare that amount on the EOB to the amount you’re being billed. If those amounts don’t match … you should start making phone calls.” There’s no hard and fast rule on who to call first — your insurance or the provider’s billing department — but make sure you’re bringing up the issue with both of these departments, Donovan says. Even if your insurance denies claims for medically necessary tests or procedures — as <a href="https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims">recent ProPublica reporting found is common at Cigna</a> — you should appeal the rejection.
</p>
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Fisher recalls a patient who came to PatientRightsAdvocate.org to help dispute a $15,000 EpiPen charge from a hospital visit. Once the patient alerted the hospital of his insurance carrier, the price dropped to $4,900 — still considerably higher than the $70 he would have spent at a pharmacy with a prescription. The patient referenced the hospital’s price list and found the maximum the hospital could charge patients for an EpiPen was $600 without insurance, and $300 if he used his insurance. “He wrote a letter to his insurer and the hospital showing that they way overcharged him,” Fisher says. “They both wrote back saying that there must have been a glitch in the system.” The patient’s bill for the EpiPen was eliminated, Fisher says. Referencing the fair market price listed at <a href="https://www.healthcarebluebook.com/ui/home">Healthcare Bluebook</a> and <a href="https://www.fairhealthconsumer.org/">Fair Health Consumer</a> can also be a useful negotiating tool to lower your bill.
</p>
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<strong>Can I get on a payment plan? </strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RwfCEu">
Hospitals are usually willing to work with patients to receive any amount of a bill, Donovan says, so you should negotiate a payment plan if the lump sum is too large after checking for any errors. Consider all of your other expenses before agreeing to a monthly payment amount. If the billing department employee you’re speaking with isn’t receptive to your needs, Donovan suggests ending the conversation and calling back in a day or so — you might get an employee who’s more amenable. (This advice works for any of the interactions you may have with the billing department.) Again, ask to see information about financial aid as well because you likely qualify for some amount of assistance.
</p>
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The nature of the American medical system requires a lot of patients: ensuring they’re staying in-network, double-checking bills for errors, advocating for low-cost care. Organizations like the <a href="https://www.patientadvocate.org/connect-with-services/case-management-services-and-medcarelines/">Patient Advocate Foundation</a> and <a href="https://www.resolvemedicalbills.com/how-we-work/">Resolve</a> work with patients to negotiate their bills with hospitals, so don’t be afraid to ask for help.
</p>
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“Patients have the right not to be discriminatorily overcharged,” Fisher says. “No one should accept medical debt.”
</p></li>
<li><strong>The influencers getting rich by teaching you how to get rich</strong> -
<figure>
<img alt="An illustration in shades of green and yellow, showing a pair of eyes with dollar signs in them, surrounded by open internet browser tabs containing images of piles of cash and happy people." src="https://cdn.vox-cdn.com/thumbor/Mk8ypKV-w6saOU2N7XhuW8a1wq0=/240x0:1680x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72129973/R2_Final_InfluencerCourses.0.jpg"/>
<figcaption>
Paige Vickers for Vox
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Inside the lucrative, distinctly nonacademic world of online classes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UA7NyF">
A digitized woman with long blonde hair dances in front of a blank spreadsheet. She’s showing you how to <a href="https://www.tiktok.com/@miss.excel/video/7180436234089745710">remove blank columns</a>, or maybe to <a href="https://www.tiktok.com/@miss.excel/video/7169270919851199790">combine cells</a>, or perhaps how to create a new formula to <a href="https://www.tiktok.com/@miss.excel/video/7034160112734473519">help you format an entire row</a>. She is ecstatic to be there.
</p>
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The woman is 30-year-old Kat Norton, better known as “Miss Excel,” who in 2020 began going viral for her high-energy, 15-second TikTok dances superimposed with hacks for navigating the popular data software program Microsoft Excel. Within months, she’d launched her very own digital class: the Excelerator Course, made up of 100 sub-10-minute video tutorials and packaged for the price of $297. Students can complete the tutorials and corresponding workbooks at their own pace, on their own time. They choose between the original or the advanced course (or shell out $997 for a course on the full Microsoft Office Suite), going from a total Excel newbie to a pro in just 12 hours.
</p>
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The classes were a hit, particularly among her core audience of 25- to 35-year-olds who were looking to bulk up their resumes or improve their marketability; many of them were working from home due to the pandemic and considering a potential career change. And Norton is the platonic example of an online course teacher: She’s proficient in an in-demand skill and, perhaps most importantly, she’s very good at selling it.
</p>
<div class="c-float-left c-float-hang">
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<blockquote cite="https://www.tiktok.com/@miss.excel/video/7209726603872505134" class="tiktok-embed">
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<a href="https://www.tiktok.com/@miss.excel?refer=embed" target="_blank" title="@miss.excel"><span class="citation" data-cites="miss.excel">@miss.excel</span></a>
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Did you know all 3?!
</p>
<a href="https://www.tiktok.com/music/Blow-Your-Mind-Mwahchallenge-6568746626930871041?refer=embed" target="_blank" title="♬ Blow Your Mind (Mwahchallenge) - Dua Lipa">♬ Blow Your Mind (Mwahchallenge) - Dua Lipa</a>
</section>
</blockquote>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="K3Z6RE">
But no one, not even Norton, could have predicted what a gold mine she’d stumbled upon: Within two months of opening the original course, she says, she earned more from class sales than she made at her corporate day job (which included, among other things, training people how to use Excel) which she’s since quit to be Miss Excel full time. She now estimates she works about 15 hours a week, spending the rest of the time exploring the outdoors in Sedona, Arizona, with her boyfriend, who handles sales for the company. So far, they say they’ve enrolled more than 16,000 people; there have been multiple occasions on which they brought in more than six figures in a single day, claims confirmed by documentation reviewed by Vox. “It’s when I do the webinars,” she says of the live classes she streams from wherever she wants whenever she wants, “those are the massive cash influx days.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="D9i0Zb">
Norton and many other influencers are cashing in on the online course boom, a cottage industry in which anyone can learn a money-making or otherwise life-improving skill — the Microsoft Office suite, <a href="https://shop.hilarykrueger.com/messaging-and-marketing-magic-2023">email marketing</a>, “<a href="https://julie-balsamo.mykajabi.com/gowithyourgut">gut health</a>,” <a href="https://crystalbritt.com/fairplay-1">equitable household labor</a>, <a href="https://www.mtbfconsulting.academy/">how to get a tech job</a>, <a href="https://youniversalhealthandwellness.showit.site/empowered-af">self-confidence</a> — from someone they already trust. These courses, hosted on one of the dozens of make-your-own course platforms like <a href="https://teachable.com/">Teachable</a> or <a href="https://kajabi.com/">Kajabi</a>, can run from a few hundred bucks to thousands of dollars, from a day-long “intensive” to a months-long course. What most of them have in common is that they’re undertaken completely independently — for the majority, students aren’t part of a specific cohort, but can sign up and complete the work whenever they want. All of the coursework is typically prepared long before they ever sign up: the videos, the worksheets, the content — all are premade and prerecorded, meaning that every time someone new joins the program, the teacher makes money. If a creator gets lucky, they can spend only a few weeks or months building a course that will continue to earn them profit for years to come.
</p>
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It makes sense, then, why so many of these classes are about business; even online courses devoted to “boosting your confidence” are pretty explicitly geared toward improving one’s marketability. The online course creator is a distinctly American character, one who preaches that the surest way to financial stability is self-employment, and more important than any singular interest — science, art, sports, whatever — is your ability to sell it to everyone else.
</p>
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You could, if you really wanted to, write off all influencer online courses as cynical cash grabs by people who know their followers will fork over any amount of money for their tutelage. But that wouldn’t tell the whole story. The <a href="https://www.youtube.com/damondominique">travel YouTuber Damon Dominique</a>’s foreign language courses, for instance, are full of funny and beautifully edited videos in which he teaches students conversational French or Spanish, interspersed with entertaining stories about his escapades hitting on men at European raves. Like Norton of Miss Excel, Dominique already had a background in language teaching, but decided to launch a course when the pandemic made it difficult to film travel videos.
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For creators like Dominique, online courses are a welcome respite from the erratic and unpredictable nature of making content on internet platforms. “There’s a change in the algorithm every few months, and right now it’s all moving toward short-form video,” he says. It took him about six months to organize, film, and edit the course, offered on the digital course platform Teachable, which, like most course platforms, <a href="https://teachable.com/pricing">takes either</a> a percentage of the revenue or costs creators a few thousand dollars per year to use, depending which pricing model they choose. So far, more than 5,000 people have taken his $199 French course.
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Teachable doesn’t consider itself as a replacement for higher education, per se, but it does hope to supplement it. “Most people never go to college, and they need a solution that works with them and their life,” explains Teachable general manager Mark Haseltine. “The challenge with traditional education is it’s so expensive, and it’s on the school’s time, not the individual’s time. A lot of professors are more concerned about their own reputation.” Influencers, he argues, are experts at engaging with their audiences, who in turn trust them to educate in a way they’re already familiar with.
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Academics, however, don’t always see influencers as the best professors. “Some of [these influencers] do have legitimate training in their field, and some don’t, but they’re able to position themselves as credible experts by using these acceptable boundaries and patterns for communication authenticity,” explains <a href="https://www.vox.com/the-goods/23618956/influencer-industry-emily-hund">Emily Hund</a>, a research affiliate at the Center on Digital Culture and Society at the University of Pennsylvania’s Annenberg School for Communication. “In the realm of parenting stuff, there are so many people selling parenting courses from every possible angle. On one hand, it’s great when it comes from an actual trained psychologist because now more people can access helpful tips. On the other hand, every day you’re getting content about what might be wrong with your kid. It creates this strange dynamic, this shift to selling ways of thinking and ways of approaching the world.”
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<q>The idea is that if you sign up for a course by Brendon Burchard, you too could someday become a Burchard</q>
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Consider, for instance, the kind of person most closely associated with influencer courses. YouTuber Jake Paul advertised his “Financial Freedom Movement” course in 2020 with a fiery screed against traditional schooling: “I’m sick of our education system and how it’s teaching kids 0 real life skills for them to secure there (sic) own future,” <a href="https://twitter.com/jakepaul/status/1228583658140790785?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1228583658140790785%7Ctwgr%5E779ac79847cf320aac6a29061096afc969fdd4f6%7Ctwcon%5Es1_&amp;ref_url=https%3A%2F%2Fwww.buzzfeed.com%2Flaurenstrapagiel%2Fjake-paul-financial-freedom-movement">he tweeted</a>. His solution? <a href="https://www.buzzfeed.com/laurenstrapagiel/jake-paul-financial-freedom-movement">A $20 per month course</a> where kids can learn skills like becoming an Uber driver or food delivery worker to support themselves while they network their way to social media stardom. (The program’s website is no longer functioning.)
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Or take YouTuber and motivational speaker Brendon Burchard, who for $997 a year can teach you how to be a millionaire. Specifically, he will teach you to become an influencer, using “seven-figure marketing strategies” to market, well, yourself. The idea is that if you sign up for a course by Burchard, you too could someday become a Burchard: someone who tweets about “ownership mindset” and “high performance habits” and produces YouTube videos about “the power of encouragement.” Evangelical Christian influencer Bethany Beal’s $1,900 “She Works Smart” course is more explicit: The <a href="https://www.sheworkssmart.com/">end goal is</a> for you to start your own online course business “so that you can make money on autopilot.”
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And boy, are people trying to make money on autopilot. Online courses can run the gamut from shady (<a href="https://www.vox.com/the-goods/23318861/andrew-tate-tiktok-instagram-youtube-banned">professional misogynist</a> and <a href="https://www.vox.com/culture/2023/1/4/23539528/andrew-tate-arrest-jail-rape-human-trafficking">alleged sex trafficker Andrew Tate</a>’s $50 per month “Hustler’s University,” where students learn crypto trading and dropshipping) to explicitly criminal (there is at least one six-week course in which <a href="https://www.cnet.com/news/privacy/credit-card-fraud-school-digital-shadows-scam-cyber-criminal/">$945 will get you an in-depth lesson</a> on how to steal credit cards and use them to pay for fancy vacations). They’ve earned the online course industry a bit of a bad rap on the wider internet; in <a href="https://www.youtube.com/watch?v=c3xSJuoUnN8">YouTube videos</a>, <a href="https://medium.com/@wannabe.influencer1/i-was-scammed-by-a-celebrity-influencer-6612d61e1a9e">Medium posts</a>, <a href="https://www.reddit.com/r/blogsnark/comments/khs4hz/influencers_who_sell_courses/">Reddit threads</a>, and <a href="https://twitter.com/bradenkopf/status/1639271961661505536">tweets</a>, people vent their frustrations about being endlessly marketed to in this specific way. “All of these influencers peddling this shit contributes to people putting less and less value into teaching and more into just marketing themselves as products,” describes <a href="https://www.reddit.com/r/blogsnark/comments/khs4hz/influencers_who_sell_courses/">one Reddit commenter</a>. “It’s an MLM but in human form.”
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Nicole Ouellette, the founder of a marketing consulting company called Breaking Even Communications, was introduced to influencer courses through the small business owners she worked with, many of whom said they’d paid for expensive business courses from people like Burchard or financial influencer Grant Cardone. “At first I thought, maybe these people know more than I do,” Ouellette says, laughing. “And then I started looking into it.”
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What irked her most about them was that her clients were made to believe that the only reason the advice didn’t “work” was that they didn’t do it properly. “I’ve said this in business meetings before: ‘If there was one thing that ‘worked,’ I would tell you what it is, make you pay me $10,000 for it, and lie on a beach.’” She found that the courses her clients took followed the same formula and gave the same advice: find your target market, “<a href="https://en.wikipedia.org/wiki/Start_with_Why">start with why</a>,” and build your “click funnel.” (“Click funnel” is a term that comes up often in online marketing speak; the basic idea is turning your existing connections into paying customers by sending them increasingly irresistible emails.)
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Another thing that can help? A recession. “People get a little more desperate for money and think they need to start a side hustle,” says Ouellette. “I’ve had more than one business owner sitting in my conference room, crying, asking if I can save their business. These courses seem very tempting, especially if an influencer says that the last two courses were full and there’s a waiting list. You think they really know what they’re talking about.”
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<a href="https://www.instagram.com/p/Cpu6ZNjsCw5/?utm_source=ig_embed&amp;utm_campaign=loading" style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" target="_blank">A post shared by Grant Cardone (<span class="citation" data-cites="grantcardone">@grantcardone</span>)</a>
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My Tech Best Friend was one such course claiming to make people money, specifically to teach them the skills needed to obtain high-paying tech jobs. Charlie Howe was already working in the field when she discovered the program through other young Black tech workers on Twitter, where she saw people talking about how they went from little to no tech experience to making upward of $90,000 salaries. Last August, she enrolled in the months-long program for a discounted early bird rate of $3,700.
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Immediately, she says, she was put off by My Tech Best Friend’s founder, Mary Awodele, who Howe describes as “very rude, nasty, and condescending.” “When she sent out communication to us, she was basically calling us illiterate or dumbasses,” she says of her 770-person cohort. While the course itself was “great,” Howe later discovered that much of it had been <a href="https://techcrunch.com/2022/11/23/mytechfrenemy/">plagiarized from other courses</a>. In November, Awodele posted <a href="https://twitter.com/CharlieisLETHAL/status/1592683328473550848">a video</a> to her Instagram in which she implied that she’d rather be called the n-word than have one of her students secure a job in tech without informing her. (<a href="https://techcrunch.com/2022/11/23/mytechfrenemy/">TechCrunch spoke</a> to a dozen other people who also said that Awodele was “hostile and led harassment campaigns against those who spoke out against her.”) After posting a Twitter thread about her frustrations, Howe started receiving threats to her phone. Screenshots of the texts, which came from three different numbers, include personal insults and veiled threats, such as “you ugly ass disgusting stinky ass bitch. Just know you got something coming for you.” She’s currently in the process of trying to get her money back.
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<q>“If there was one thing that ‘worked,’ I would tell you what it is, make you pay me $10,000 for it, and lie on a beach”</q>
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Awodele had built a following of tens of thousands on Black tech Twitter, forging relationships and, as Howe describes, “creating hype around herself” by misrepresenting her actual experience in tech. She’s far from the only influencer accused of using her reputation to exploit her followers, nor is Howe the only person who’s felt scammed by influencers capitalizing on the online courses boom.
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<a href="https://www.theguardian.com/lifeandstyle/2021/oct/06/life-coaching-brooke-castillo-unregulated-industry">One woman paid $18,000</a> to attend an online course that was described by its founder, self-help influencer Brooke Castillo, as “the Yale of life coaching schools.” She ended up realizing within a month that most of the course materials were recycled from Castillo’s existing content, that the teachers hired by Castillo were often distracted and unavailable, and that they met complaints by insisting that the problem was the student’s fault. She tested her suspicion that the program was nothing more than a cash grab by intentionally trying to fail the final exam, but passed anyway. “It felt like get em in, get em in, sell, sell, sell. And once they’re in, it’s like — well, I gotta go sell to more people,” she told <a href="https://www.theguardian.com/lifeandstyle/2021/oct/06/life-coaching-brooke-castillo-unregulated-industry">the Guardian</a>.
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Another woman <a href="https://www.refinery29.com/en-gb/money-manifesting-life-coaching-instagram">told Refinery29</a> that she’d paid around £1,200 for the lifestyle influencer Sarah Akwisombe’s “No Bull Business School” as well as £199 a month for her “Smashing It” “six month success accelerator,” only to find that the advice included stale, irrelevant tips like “getting up at five in the morning and doing loads of cardio or getting rid of people in your life who don’t support you.” In 2018, the travel influencer Aggie Lal launched a $497 12-week course aimed at growing Instagram followers. <a href="https://www.buzzfeednews.com/article/stephaniemcneal/instagram-influencer-master-class-criticism">Students said that some</a> of the tips included advice like, “when posing for pictures, try not to look pregnant” and insulting comments like, “people who work at Starbucks aren’t living up to their potential.” Thirty-five students ended up signing a petition demanding refunds.
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<a href="https://www.instagram.com/p/Ckq3iS5pzBd/?utm_source=ig_embed&amp;utm_campaign=loading" style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" target="_blank">A post shared by Bethany | Online Course Coach (<span class="citation" data-cites="sheworkssmart">@sheworkssmart</span>)</a>
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That scammers can sell courses that appear just as legitimate as Miss Excel or Dominique’s French class is both an asset to and a hindrance for the online course boom. It doesn’t take too much imagination to envision a world where instead of college, many people invest a few hundred or thousand bucks into piecemeal courses they find online about subjects they’re interested in. (Educational vloggers Hank and John Green <a href="https://www.nbcnews.com/news/hank-john-green-study-hall-crash-course-youtube-rcna67412">recently launched a program</a> that does just that, allowing attendees to earn credit at Arizona State University.) It’s a little more difficult to imagine the rigorous standard-setting and professor-vetting of an average university applying to any influencer who wants to launch their own course.
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The tension between the online course industry’s vision of a fully remote, learn-on-demand society and the central principles of liberal arts education, which prioritizes intellectual curiosity and critical, nuanced thinking, does mirror the clashing worldviews of self-employed influencers and those interested in working within traditional corporate or public sectors. There is a sense among online course teachers and the ed tech sector at large that education is important insofar as it can earn you money, that it is possible to distill a master’s in business or a decade working as a software engineer into a single webinar or bootcamp.
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<q>There is a sense among the ed tech sector at large that education is important insofar as it can earn you money</q>
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This perspective also aligns with the highly individualistic nature of self-help gurus in the Tony Robbins tradition, where nothing more than a change in attitude can “unlock your potential” and make you a millionaire. When Norton talks about her enormous success with the Miss Excel program, she credits the spiritual guidance she learned at a yoga retreat in Morocco, as well as the teachings of Joe Dispenza, who writes books and gives lectures on the power of manifestation. (Though Dispenza portrays himself as an expert in quantum physics and neuroscience, he is by trade a chiropractor and <a href="https://www.rollingstone.com/culture/culture-news/michelle-phan-youtube-beauty-guru-wheelchair-joe-dispenza-pseudoscience-1347580/">has ties to a New Age school</a> that the <a href="https://www.splcenter.org/fighting-hate/intelligence-report/2014/ramtha-riled">Southern Poverty Law Center describes as</a> espousing homophobic and antisemitic views.)
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“It’s crazy how things can change if we just work on our mindset,” says Norton, describing the intense, debilitating anxiety she felt as a child and how she was able to overcome it. “I feel like so many people get stuck on that edge, and don’t realize they can reprogram those thoughts that are keeping them in place. The only limits we have are the ones we’re placing. Once you clear that out, the peace happens and it starts getting you on your destiny path and into your highest timeline.”
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The thing about influencer-led online courses is that if this kind of jargon — “highest timeline,” “manifestation,” etc. — doesn’t resonate with you, you can find plenty of other content creators who will speak to you in ways that do. This is the appeal of the industry as a whole, after all: an à la carte, mix-and-match style of education, where you get to pick professors based on how likable they seem online, and where you get to “cut through the bullshit” and get straight to the part where your life gets better. And everyone knows what this industry considers “the bullshit” part of college: It’s the part where you learn how to think critically, how to explore, how to converse, how to live, how to discern between people interested in you and people who are interested in your money.
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Norton has big plans beyond Microsoft Excel. Companies have started bringing her in to speak to their teams, getting them excited about work and helping them evolve their mindset. “I went from being shy and uncomfortable in my own skin at my corporate job to dancing on the internet and making way more money than I ever thought,” she says. “And I was like, ‘Whoa, if I could do this, like, other people could do this.’”
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<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>King’s Ransom, Juliette and Serrano impress</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Double National wheelchair tennis crown for Balachandar Subramanian</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Olympian Oscar Pistorius eligible for parole, could be free this week</strong> - ‘Blade Runner’ Oscar Pistorius, who was convicted of murder in girlfriend Reeva Steenkamp’s Valentine’s Day 2013 killing, could leave prison if his parole is granted</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>ICC World Cup 2023 | Pakistan won’t play in India, wants Sri Lanka or Bangladesh to host its matches: Source</strong> - “We will not travel to India for [ODI] World Cup matches if BCCI doesn’t send their team to Pakistan for Asia Cup,” a PCB source said</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Indonesia stripped of hosting FIFA U-20 World Cup eight weeks ahead of start</strong> - Israel’s participation in the official draw for FIFA U-20 World Cup groups provoked political opposition in Indonesia, leading to Indonesia’s removal as host</p></li>
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<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Tribal organisations to observe bandh in Parvatipuram-Manyam district on Friday</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>PM to launch much awaited MMTS Phase 2 services on April 8</strong> - Pending release of funds from State government the railway is expected to operate the services with the available rolling stock</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Remembering Vaikom Satyagraha: A movement that spearheaded social reforms in two States</strong> - As the year 2024 marks the centenary of the Vaikom Satyagraha, Kerala Chief Minister Pinarayi Vijayan and Tamil Nadu Chief Minister M.K. Stalin are to jointly inaugurate the centenary celebrations, during a function to be held at Vaikom on April 1, 2023.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Arunachal Government announces reward for information on jailbreakers who killed a constable</strong> - The members of a faction of the National Socialist Council of Nagaland killed a constable while escaping from a jail in Tirap district on March 26</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Four-time MLA S.R. Srinivas of Gubbi constituency joins Congress</strong> - Mr. Srinivas was elected to the 15th Legislative Assembly on a JD(S) ticket</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Russia arrests US journalist Evan Gershkovich on spying charge</strong> - Evan Gershkovich was working for the Wall Street Journal, which vehemently denies the accusation.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Bankers convicted of helping Putin’s friend</strong> - A cellist who is godfather to the Russian leader’s daughter deposited huge sums in Swiss accounts.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Spanish anger over TV star Ana Obregón’s surrogate baby in US</strong> - Ana Obregón comes in for criticism after news emerges she has had a baby girl via surrogacy aged 68.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pope Francis: Health improving after night in hospital</strong> - The Vatican says he ate breakfast, carried out work and read the newspapers on Thursday morning.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Dmitry Muratov: Nuclear warning from Russia’s Nobel-winning journalist</strong> - Dmitry Muratov says Russian propaganda is preparing people to think nuclear war isn’t a bad thing.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>My quest to re-create Street Fighter’s long-lost pneumatic controls</strong> - True fighting gamers land harder hits by slamming their fists on huge “bash pads.” - <a href="https://arstechnica.com/?p=1923290">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Buttons are back at Porsche as we see the 2024 Cayenne interior</strong> - After the all-touchscreen Taycan, it’s a welcome change. - <a href="https://arstechnica.com/?p=1927378">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>NASA delays flight of Boeing’s Starliner again, this time for parachutes</strong> - “It’s just a matter of going through all that data.” - <a href="https://arstechnica.com/?p=1927687">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Lenovo gives up on its dream of Android gaming phones</strong> - Phones brought special gaming-centric Android hardware, but nobody made games for it. - <a href="https://arstechnica.com/?p=1927757">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>After two years, Autodesk Maya and AutoCAD become Apple Silicon-native</strong> - Autodesk has never said why this took so long compared to competitors. - <a href="https://arstechnica.com/?p=1927703">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>My girlfriend left me because of my abandonment issues…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Oh wait. She’s back. She just went to get some milk.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Risperdali"> /u/Risperdali </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/126iu7t/my_girlfriend_left_me_because_of_my_abandonment/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/126iu7t/my_girlfriend_left_me_because_of_my_abandonment/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why do vampires never cause unwanted pregnancies?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Because they need permission to come inside.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/SeamusMcCullagh"> /u/SeamusMcCullagh </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/1265zm1/why_do_vampires_never_cause_unwanted_pregnancies/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/1265zm1/why_do_vampires_never_cause_unwanted_pregnancies/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why do Americans fish with a gun?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So they get the whole school.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/GhostlyRuse"> /u/GhostlyRuse </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/125qoxx/why_do_americans_fish_with_a_gun/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/125qoxx/why_do_americans_fish_with_a_gun/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why wasn’t Steve Jobs allowed to fart at home?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
His house didn’t have windows!
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/CauliflowerOk3993"> /u/CauliflowerOk3993 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/126fg0h/why_wasnt_steve_jobs_allowed_to_fart_at_home/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/126fg0h/why_wasnt_steve_jobs_allowed_to_fart_at_home/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why was Sideshow Bob so jealous of Moe?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He always wanted to be a bartender.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/wellrat"> /u/wellrat </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/1260bgb/why_was_sideshow_bob_so_jealous_of_moe/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/1260bgb/why_was_sideshow_bob_so_jealous_of_moe/">[comments]</a></span></p></li>
</ul>
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