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Medicine Science

CDC Adopts Near Real-Time Flu Tracking System 102

Posted by kdawson
from the you've-got-the-flu-swine dept.
CWmike writes "The US Centers for Disease Control and Prevention launched an effort this week to better and more easily track for H1N1 and other seasonal influenza activity throughout the US. The CDC said it is now tracking data on 14 million patients from physician practices and hospitals stored on a database hosted by GE Healthcare. The data is submitted daily from physicians' offices and hospitals that use GE's electronic medical record system. The data is then uploaded to GE Healthcare's Medical Quality Improvement Consortium, a database repository designed with HIPAA-compliance parameters of patient anonymity and best practices, where it can be the subject of medical data queries. The CDC can perform queries to look for flu-like symptoms being reported by physicians, and then disseminate the data for health care providers and local government officials throughout the country, who can alert businesses and others about flu outbreak hot spots. The CDC also hopes its analysis of the data helps it better understand the characteristics of H1N1 outbreaks and to determine who is most at risk for developing complications from the virus. Prior to implementing the new system, the CDC relied heavily on tracking insurance claims data, which could take days or weeks to make its way to the agency's medical staff for analysis. The medical data is normalized so that, for example, reports of hypertension, HTN, and high blood pressure all mean the same thing when a researcher enters a query against the data."
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CDC Adopts Near Real-Time Flu Tracking System

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  • by eldavojohn (898314) * <[moc.liamg] [ta] [nhojovadle]> on Friday November 06, 2009 @10:04AM (#30005206) Journal
    You can find the latest map on the CDC site [cdc.gov] and look at how helpful it is! Apparently everyone's boned except for DC, Georgia, Guam, Hawaii, Puerto Rico and the US Virgin Islands. Since there's no report of flu in the Virgin Islands, I propose the government provides free plane tickets for anyone who isn't infected so that they might escape the wave of vomit brewing in our fair country.

    But in all seriousness their report does have some decent data on it [cdc.gov].
    • by BigBlueOx (1201587) on Friday November 06, 2009 @10:28AM (#30005384)
      there's no report of flu in the Virgin Islands

      Uh. Dood. According to the CDC, there was no report of any kind received from the Virgin Islands. That's right, silence! Now what do you suppose *that* means, eh? That's right, EVERYONE in the Virgin Islands has already died from the flu and probably turned into hideous flesh-eating monstrosities!
      Do NOT go there.
      It would be bad.
    • by Idbar (1034346)
      Are they correlating this data with the fear of people [slashdot.org] of getting H1N1 in an airplane?
      • by causality (777677) on Friday November 06, 2009 @11:34AM (#30005982)

        Are they correlating this data with the fear of people [slashdot.org] of getting H1N1 in an airplane?

        I recently sent an e-mail to a local radio station after they read a news item stating that, so far this year, 12 people have died from the swine flu in my state. I sent them a letter because that's all that the news item said. It did not mention that about 1600 die of the regular old influenza every year. With all the hysteria about this issue I think some perspective is very badly needed. It's just piss-poor journalism to report a raw figure with no context like this.

        Your comment about the fear of H1N1 made me think about the various ways that it's being encouraged. To me that's just media sensationalism, which is not really unusual because it sells. Is H1N1 a threat to some people? Probably so; I am not a doctor so I should not say too much on that. Do I personally feel threatened by it? Not in the slightest. It'd be a nuisance to me, but not a threat. There's no way I am going to cower in fear and alter my life over it. It is their own damned laziness but the fact is most people aren't going to do their own research on this one. If there were more perspective and context in media reports about H1N1, it would be much easier for others to make up their own minds as I have done.

        Even if this is or were a true threat to life and limb, acting like a bunch of panicked animals is the wrong way to reduce a threat.

        • Re: (Score:1, Insightful)

          by Anonymous Coward

          I had an epiphany while trying to describe attitudes like yours to someone else yesterday. I was trying to put into words why it aggravates me so much when it suddenly hit me. I was watching 3 or 4 live streams last year when the outbreak was first detected, and we were being bombarded with press conferences as one state after another started announcing how many cases they were treating. As it happens, I was in the middle of making my first serious attempt at writing a novel about a pandemic and all the hys

          • by CKW (409971)

            It'd be a tragedy, and I might loose a couple good friends, but the golden lining of the pandemic killing a couple million people in Western countries would be that it's more likely the dead would be the ones prone to believing in conspiracy theories and the like. The rest of us having gone and gotten immunized.

            Finally -- Darwin Awards on a massive systematic scale.

            • by causality (777677)

              It'd be a tragedy, and I might loose a couple good friends, but the golden lining of the pandemic killing a couple million people in Western countries would be that it's more likely the dead would be the ones prone to believing in conspiracy theories and the like. The rest of us having gone and gotten immunized.

              Finally -- Darwin Awards on a massive systematic scale.

              Ah yes the good old "any alternative viewpoint must be a conspiracy theory" bit. I wish some of you would find a different playbook, because these easily-refuted [wikipedia.org] tactics [wikipedia.org] are rather tedious and boring. At any rate, I think that H1N1 has been overhyped and that, speaking only for myself (you want medical advice, talk to a doctor because I am not a doctor) the threat it poses has been greatly exaggerated. That's a conspiracy theory?

              I'll give an analogy. What if I said that Windows Vista was overhyped?

          • by causality (777677)

            I had an epiphany while trying to describe attitudes like yours to someone else yesterday. I was trying to put into words why it aggravates me so much when it suddenly hit me. I was watching 3 or 4 live streams last year when the outbreak was first detected, and we were being bombarded with press conferences as one state after another started announcing how many cases they were treating. As it happens, I was in the middle of making my first serious attempt at writing a novel about a pandemic and all the hysteria it may cause. Of course, now that we're in the middle of one, there's really no point to finishing the book. Having said that, I had researched dozens of reports, information sites from both government and non-government entities, and other things like various states' emergency response plans. It was actually pretty cool having the various states' plans open while "following along" through live streaming on the net. Then someone wrote a post somewhere that aggravated me to my core. He wrote, "call me when there are 36,000 dead because that's how many die every year."

            What his, and apparently your, thoughts about this don't take into account is that we may pass the typical number of fatalities on a single day as the body count rises from say, 28,000 to 42,000. In that hypothetical situation, you and that guy are ready to start caring. What are you going to do the next day when the count climbs from 42,000 to 60,000? At what point do you shit yourself? I watched a symposium on pandemic flu given by the NIH as part of my research, and I learned an interesting fact. During the 1918 Spanish flu outbreak, approximately 4,500 people died in the City of Philadelphia during the course of *one week*.

            Yet you two don't want to do anything until the death toll passes the normal annual figure. Please don't take my word for it. Do your own research. Spend just a little bit of time reading up on the topic. Think about the logistics, and hopefully you will form an opinion that you feel is well-informed and is something you can defend. But just turning your back and calling it scaremongering is irresponsible and dangerous. A lot of people are going to die during the second wave. If we wait until you suggest before taking action, it will be way too late.

            It was way before my time, but if I had lived during the 1950s-1960s I would have voluntarily accepted a polio vaccine. Why? Because polio is a horrible crippling illness that can maim someone for life. That's a real threat.

            For what I am about to say now, it must be understood that I am speaking only for myself. I am not a doctor. Therefore, I would not dream of telling someone else what they should do about a medical issue. You as an individual must handle this as you see fit, which is exactly wha

          • by dgatwood (11270)

            What his, and apparently your, thoughts about this don't take into account is that we may pass the typical number of fatalities on a single day as the body count rises from say, 28,000 to 42,000. In that hypothetical situation, you and that guy are ready to start caring. What are you going to do the next day when the count climbs from 42,000 to 60,000? At what point do you shit yourself? I watched a symposium on pandemic flu given by the NIH as part of my research, and I learned an interesting fact. During

          • by Golddess (1361003)

            Yet you two don't want to do anything until the death toll passes the normal annual figure.

            You're putting words in peoples mouths. No one said to do nothing, just that making Swine Flu into a bigger deal than the regular flu (did your research reveal that the regular flu virus is different every year?) is pointless.

            Or is there something about the Swine Flu virus that makes it more dangerous than "just another flu virus variant"?

            • by causality (777677)

              You're putting words in peoples mouths.

              That's an extremely common technique around here. Well, that and ad-hominem attacks. I don't think it's deliberate so much as it's a product of ignorance about argumentation and reasoning. Anyone who resorts to such tactics is substituting them for useful debate. Ergo, they are taking a very weak position even if they otherwise would have had a valid point. Still, since you know how to deal with that, it means you know how to deal with almost anyone here.

              That

        • by gilgongo (57446)

          I recently sent an e-mail to a local radio station after they read a news item stating that, so far this year, 12 people have died from the swine flu in my state. I sent them a letter because that's all that the news item said. It did not mention that about 1600 die of the regular old influenza every year. With all the hysteria about this issue I think some perspective is very badly needed. It's just piss-poor journalism to report a raw figure with no context like this.

          It also has something to do with the piss-poor state of people's understanding of statistics in general. Your story is a classic example of how society needs to put a lot more emphasis on education when it comes to stats. I'd even put forward a "law" of information theory regarding this: the actionable value of data increases by the amount of its supporting data. So in this example, saying that 12 people have died of swine flu has a value of 0 (it has no context so it's meaningless). Saying that 1600 die of

          • by causality (777677)

            I recently sent an e-mail to a local radio station after they read a news item stating that, so far this year, 12 people have died from the swine flu in my state. I sent them a letter because that's all that the news item said. It did not mention that about 1600 die of the regular old influenza every year. With all the hysteria about this issue I think some perspective is very badly needed. It's just piss-poor journalism to report a raw figure with no context like this.

            It also has something to do with the piss-poor state of people's understanding of statistics in general. Your story is a classic example of how society needs to put a lot more emphasis on education when it comes to stats. I'd even put forward a "law" of information theory regarding this: the actionable value of data increases by the amount of its supporting data. So in this example, saying that 12 people have died of swine flu has a value of 0 (it has no context so it's meaningless). Saying that 1600 die of regular flu every year increases its value by 1, saying that last year 2500 people died of regular flu increases it by +1 again, saying that flue deaths this century have averaged 0.007% of that of the annual rate 100 years ago increases it +1 again, etc.

            Sir, I'd mod you up to +5 if I had points. I think the real issue there is that if the public schools don't teach this, the average person won't know it. This is much to our collective shame. I have always believed it is a big mistake to wait for someone to come along and teach you important things out of the kindness of their hearts when basic literacy is the only requirement for educating yourself. It's a passive "spectator" approach to life and it means that many important things are left undone.

            T

    • by Seth Kriticos (1227934) on Friday November 06, 2009 @10:37AM (#30005472)

      Why on earth does the CDC need to use flash for a still, non interactive image??

      • Re: (Score:1, Informative)

        by Anonymous Coward

        You've never done software development for a government organization, have you?

        I've seen sites like this put together in the past by large teams of "professional software development consultants". Even for a site that amounts to nothing more than an image that's changed a few times daily, you'll have reams and reams of architectural diagrams and documentation. You'll have massive class hierarchies. Four tiers (because three aren't abstract enough), each implementing MVC and loads of other design patterns. A

      • by nametaken (610866) on Friday November 06, 2009 @11:10AM (#30005786)

        You don't have clearance to see the flashy dots from the tracking beacons we were injected with.

      • by gaspyy (514539) on Friday November 06, 2009 @11:21AM (#30005894)

        At first I thought the map updated dynamically via an xml, but it seems we have a flash movie that dynamically loads a big JPEG image and shows it - nothing more.

        Improper use of a technology, nothing new.

        Should I also count how many times I've seen a big js framework like jQuery being used for a trivial thing? I mean, load an entire 100Kb library to do something that could be done with 2-5 lines of javascript anyway...

        • by mi (197448)

          Improper use of a technology, nothing new.

          Well, if that's done by the people, who are advising us on what they believe to be a life-and-death decisions, their improper use of technology is noteworthy, even if not, indeed, "new".

        • by Mr. DOS (1276020)

          Actually, jQuery's only 55KB and goes down to 19KB if the browser supports gzipping if the server's configured to compress stuff, but I get your point. The difference there is that jQuery, unlike Flash, makes everything easier for the developer (creating a Flash document is easier than an img tag how?), and more importantly, takes care of discrepancies between JavaScript interpreters in different browsers (providing you use pure jQuery). Also, it doesn't require any extras from the browser's perspective: yo

      • by ftobin (48814) *
        Interestingly, if you have flash disabled (e.g., via NoScript), a JPG does show up instead of the flash image.
    • by zip_000 (951794)
      Either the map has changed or you suck at geography!

      That is South Carolina, not Georgia.
    • or.

      you could just look at the google trends to see what CDC will be reporting next week

    • by Quirkz (1206400)
      Georgia? Did you mean South Carolina, or has the data changed in the last 2 hours?
    • Wow, everywhere has widespread flu activity! Just like every other year at this time! Everyone run for your lives!!
    • Since there's no report of flu in the Virgin Islands [...]

      Dude, get with the times. Ever since Chuck Norris went there, they're just called "The Islands."

      -b

  • Real Time? (Score:1, Funny)

    by Anonymous Coward
    Why did that green dot just appear over my house on that map?
  • is GE can then take the database info and use it to go after their credit card customers who might be sickest, that way ensuring they'll get their dough before the patients croak.

    • Re: (Score:2, Insightful)

      by maxume (22995)

      Here's the thing: Why the fuck would anybody have a GE credit card?

      • I really needed four new tires :-(
      • Re: (Score:3, Insightful)

        by Cornwallis (1188489)

        Because its the only one they could get after their other nine cards were maxed out?

        • Re: (Score:2, Insightful)

          by maxume (22995)

          Oh, so the evil the mega-corporation did was to loan someone who wanted money some money. What bastards.

          (I use a credit card, but I don't carry a balance, I think people who do are crazy, the idea that someone would max out 9 credit cards out of 'necessity' isn't very credible, clearly they need to find a way to spend less money, or to earn more money)

          • by wwfarch (1451799)
            I generally agree with this sentiment but I don't think carrying a balance at all is necessarily crazy. For example, when I first moved out on my own I had to buy a whole lot of things just to get on my feet. For this, I carried a balance. Maxing out 9 cards is obviously not in the same league as this though (unless each card has a balance of like $500).
            • by maxume (22995)

              Sure. A key aspect of it is that you planned to (relatively) quickly pay off the balance, you were using the credit to move your spending forward, not to increase your spending power.

      • Here's the thing: Why the fuck would anybody have a GE credit card?

        Because GE is a bank. That's what banks do.

        What, you thought they made lightbulbs? Ha! I'll bet you also think that IBM (you know, the consulting company) makes computers!

        • by maxume (22995)

          I would tend to think of jet engines, and industrial and medical equipment. Or maybe NBC Universal. But I knew that had a large finance division, I was just antagonizing the OP for displaying an attitude that consumer credit card debt was somehow the sole fault of the corporation extending the credit and not in any way the responsibility of the cardholder.

  • I see.. (Score:1, Funny)

    by Galestar (1473827)
    Time travelling higgs-boson-baguette-dropping-birds you say?
  • General Electric Healthcare?

  • This is purely antidotal but a colleague got sick and when to the doctor. The doctor, without testing, said he had H1N1. So is that the kind of data that's being used or is this coming from verified tests? Even if the doctors are telling the CDC it's verified who is checking that they actually did the tests?
    • by Whalou (721698) on Friday November 06, 2009 @10:57AM (#30005654)

      This is purely antidotal but a colleague got sick and when to the doctor.

      If it's antidotal, he's probably cured now.

    • Re:Good data? (Score:5, Interesting)

      by RMH101 (636144) on Friday November 06, 2009 @10:57AM (#30005658)
      In the UK you're banned from entering your doctor's surgery with flu-like symptoms. You get redirected to the NHS's Pandemic self-diagnosis expert system, which asks you about 10 questions (of which the important one is "do you have more than 2 of the following symptoms: fever, headache, nausea" etc). At the end it spits out a unique reference number for your flu-buddy to go and pickup your prescription of Tamiflu from a chemists. That's it. I did it last week for my partner - she's fine now.
      The thing is, this will lead to overprescribing, and also is probably likely to encourage people to self certify themselves ill when they aren't - so they can have a week off work (no sicknote required for Swine Flu, as you can't get in to see your doctor) and get their supply of Tamiflu in before stocks run out...
      • Re: (Score:3, Informative)

        by Neoprofin (871029)
        That's the problem I've had with the explosion of reported cases of swine flu. From what I'm told the phone lines aren't even manned by anyone who works in the health care industry, and there's roughly a 100% chance that if you call in with anything remotely flu like you'll be a reported case of swine flu before you get off the phone.
        • Re: (Score:2, Interesting)

          by CKW (409971)

          Have you not looked at the raw statistics?

          Right now, if you have flu, you have swine flu. Only something like 1/1,000 flu cases is "some other" flu. 99% of all cases tested, test positive for swine flu.

          • by Neoprofin (871029)
            Yes, and if you have a fever and a headache there's a good chance you've "got swine flu" too, except that you've actually just got a really bad hangover and a prescription for Tamiflu.
      • by TubeSteak (669689)

        The thing is, this will lead to overprescribing, and also is probably likely to encourage people to self certify themselves ill when they aren't - so they can have a week off work (no sicknote required for Swine Flu, as you can't get in to see your doctor) and get their supply of Tamiflu in before stocks run out...

        I know more than a few doctors and after the initial panic (in the USA), they mostly just stopped testing for H1N1.

        Taking Tamiflu sucks almost as bad as the H1N1 flu (which I learned from one of my Doctor friends)
        and both will put you out of rotation for ~10 days.

        • I know more than a few doctors and after the initial panic (in the USA), they mostly just stopped testing for H1N1.

          You're right. CDC guidelines don't suggest testing everyone. Really just the sickest patients. The problem being that 1) it's expensive 2) the rapid tests are really pretty bad with significant false negative rates and the better tests take too long to be useful.

          So you are seeing H1H1 + some percentage of seasonal viral illnesses of various types. The interesting thing to me as an ER doc

    • by radtea (464814)

      Even if the doctors are telling the CDC it's verified who is checking that they actually did the tests?

      Yeah, the thing that caught my eye was the claim in the summary: "The medical data is normalized so that fir example reports of hypertension, HTN, and high blood pressure all mean the same thing when a researcher enters a query against the data."

      "Mean the same thing", eh? To whom? Meaning is a verb: it is what knowing subjects do with data, information, raw stuff.

      People mean anything they want by anyt

    • Re: (Score:3, Informative)

      by shadow349 (1034412)

      Back in July, the CDC told the states to not to bother to test people for H1N1; they should just count people that appear to have H1N1 symptoms as a positive test result since it is a "OMG! We're all fucked! Pig are flying and they have teh flu!" situation.

      Of course, the fact that this overestimates the reported occurence of H1N1 by a factor of 5 to 50 times [cbsnews.com] is of no concern to us peasants.

    • This is purely antidotal but a colleague got sick and when to the doctor. The doctor, without testing, said he had H1N1.

      This is actually a reasonably diagnosis.

      From statistical sampling of the population (with strain typing) that's been done so far, the normal seasonal flu strains are not really circulating yet, while H1N1 has been observed to be spiking in frequency. I think there's some diagnosis guideline out there that your family doctor should assume any flu case is H1N1, at this time of the year.

    • by skiingyac (262641)

      Right now, something like 1% of all flu in the US that is attempted to be subtyped is NOT H1N1. See http://www.cdc.gov/flu/weekly/ So basically, if the person has the flu, it is almost definitely H1N1.

    • There's a chart. In summary:

      * If you don't have a fever or body aches or chills or a headache, you have a cold.
      * If you have a runny nose and are slightly tired, and sneezing or a sore throat, and a slow onset of a few days, you have the normal flu.
      * If it shows up over 3-6 hours, with chills, severe aches, headache, and a fever, it's swine flu.

      They're really quite different. No test is needed for most cases...

    • Follow the money
      The CDC states that only a PCR test can distinguish between seasonal flu and H1N1,
      PCR tests cost between 100 to 300 dollars and takes about 2 days. ( the costs in India were said to be about 200 dollars.
      The PCR machines are expensive; from 50,000 to 100,000 dollars.
      They require trained staff
      They can only do so many tests ia a day
      The WHO talks about "confirmed" cases; but not about the lack of PCR machines in most of the world.

      (Hearsay) a distant relative, a nurse in the USA, says that when t

  • While fir is a great building material, I don't think it applies in these examples
  • The entirety of the USA has swine flu!

    What, that's not what the map shows?
    • by foobsr (693224)
      The entirety of the USA has swine flu!

      Well, after all, quote [medicalnewstoday.com]:
      "Swine Flu Should More Accurately Be Called North American Flu".

      CC.
  • I sneezed and a team of STS (Special Tissue Services) operatives rappelled down and entered through the window feet first to present a tissue and a squirt of antibacterial hand foam. When they clocked the pepper pot and my cheese bagel much hilarity ensued.
  • So google's flu results [google.org] will be validated a few days faster. People start feeling crappy, do some self diagnosis via google, then see a doctor who then files a report when then is summarized and reported by the CDC.
    • by Miros (734652) *
      I hope someone does some regression analysis on this and writes a paper. I would be very interested in how well the google trends data fits with the new rapid CDC data assuming that one of them is a lagged indicator of the other. How well would the data fit? What are the likely sources of error? Omitted variables? Fascinating questions.
    • by ehud42 (314607)

      One interesting thing I have noted in the trends is how 'off the chart' the flu trends are this year - I suspect google may not be able to apply an appropriate media hype attenuator to the results this year. But this is a good thing, as google will probably aggregate the search data with media reporting data and adjust their hype-limiter so that when the next overhyped pandemic / outbreak occurs the results will be more accurate and timely than the current official sources.

      • by Miros (734652) *
        How does Google go about adjusting for hype now? Does anyone know?
        • by Miros (734652) *
          Actually just thinking about answering my own question; having real lagged data to the trend data could be useful in correcting for the hype no? Hype is essentially another variable in the regression analysis. I'm not sure where the data would come from for it but if you could estimate the hype factor for recent past data and had some measure of present hype you may be able to correct for some of it right?
    • by geekoid (135745)

      "do some self diagnosis via google, "
      worst advice ever.

      Swine fly isn't the easiest to diagnose.

      Sometime people have fever, sometimes they don't. Sometimes they vomit, sometime they don't.

      Anecdote:
      Before this year I didn't know anyone, or know anyone who knew anyone that dies from the seasonal flu.
      I know 2 people who are dead from H1N1 and know 1 person who knew someone who dies. All healthy. 2 were reported with minor symptoms, then suddenly they got bad and died.

      To be expected when you have a nasty flu mov

  • Crash it (Score:5, Funny)

    by YahoKa (577942) on Friday November 06, 2009 @11:20AM (#30005876)
    Real time flu tracking, eh? Let's all sneeze at once and see if we can crash it.
  • There's already a "near realtime flu tracking system." It's called Twitter.
  • by JustNiz (692889)

    so where are the pretty graphics? Say a map of the US with color codng for hotspots?

  • Reading CDC's website, it's quite interesting to see that according to them 36,000 people on average die from seasonal flu and that's during the flu season. H1N1 only caused what, roughly 500-600 deaths since begining of the year and according to them it's active the whole year. http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm [cdc.gov] Hmm, is anyone else getting flashbacks to Wag the Dog? No?
    • Remember the 36,000 is in a vaccinated populas.

      The swine flu has only been going since April, not the beginning of the year.
      It is hitting a different demographic.
      More children died from August to October from swine flu then die all year from season flu.
      This has happend off flu season.
      We are entering flu seaon with almost no vaccinated population
      It's a pandemic.

      Pandemic are know for bouncing around for a few year and changing.

      This is poised to be very nasty. So what are they suipposed to do? Do nothing and r

  • Did Google CEO's mention quite a few months back that they were implementing data mining search technology to track viral pandemics against what people's keyword searches were for on Google? I wonder what happened of that. Maybe it'll show up on my new Google Dashboard.
  • I'm sure that there are lots of studies from manufacturers of hand cleaners and other potions that there products kill xx% of flue viruses. I know I'm being bombarded by directions all the way from my HR department to the CDC on how to prevent getting swine flu. While I'm sure that some of those narrow studies are correct that lots of alcohol will kill the virus, does any of this really make any difference with preventing transmission of the flu. There are lots of assumptions built into suggestions that
    • by geekoid (135745)

      "does any of this really make any difference with preventing transmission of the flu.

      Yes. As does washing with soap and water preferably in warm water.

      ". There are lots of assumptions "
      no there aren't.

      ". Are there any real world population studies to see if this makes any difference?"
      many. We know they coughins is one of the best ways to transmit colds a flues. We know that touching somene is a great way to spread colds and flu. We know very few people shake elbows.

      We also know the N95 masks do almost nothi

  • "But I don't want to get on the cart"

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