AuthorTopic: Knarf's Knewz Channel  (Read 1839341 times)

Offline Surly1

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"Do not be daunted by the enormity of the world's grief. Do justly now, love mercy now, walk humbly now. You are not obligated to complete the work, but neither are you free to abandon it."

Offline knarf

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Second Missouri hairstylist may have exposed 56 clients to COVID-19
« Reply #15991 on: May 24, 2020, 03:46:50 PM »
Health officials in Missouri announced over the weekend that a second hairstylist who works at a Great Clips in Springfield may have exposed over 50 clients to COVID-19 after it was discovered she worked at the salon for a week earlier this month while experiencing mild symptoms.

The Springfield-Greene County Health Department announced the news on Saturday, a day after the office revealed another hairstylist that works at the same salon had tested positive for COVID-19 and possibly exposed nearly 100 clients and employees to the virus.

The office said the second stylist had worked at the salon from May 16-20 for about 30 hours in total “while experiencing very mild symptoms but potentially infectious.”

“The individual and their clients were wearing face coverings. The 56 clients potentially directly exposed will be notified by the Health Department and be offered testing,” the office said.

The office said Friday that more than 90 clients and salon employees were “potentially directly exposed” as a result of the first case at the shop.

However, the department said then that it “is the hope of the department that because face coverings were worn throughout this exposure timeline, no additional cases will result.” 

The news comes several weeks after Missouri entered the first phase of its gradual reopening plan, allowing certain nonessential businesses, including salons, to reopen with certain restrictions in place.

https://thehill.com/homenews/state-watch/499396-second-missouri-hairstylist-may-have-exposed-56-clients-to-covid-19#.XsryRmeI7uU.twitter
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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The president, the Republican party and their Fox News cheerleaders care only for corporate profit

Most of Europe and all 50 US states are in various stages of “reopening”. But why, exactly?

The pandemic is still with us. After the first tentative steps to ease the lockdown in Germany – the most successful large European country in halting the spread of the virus, thanks to massive testing – the disease has shown signs of spreading faster.

At least Germany is opening slowly and carefully, as is the rest of the EU.

By contrast, the US – with the highest number of deaths and most haphazard response to Covid-19 of any advanced nation – is opening chaotically, each state on its own. Some are lifting restrictions overnight.

Researchers expect the reopenings to cause thousands of additional deaths.

Two weeks after Texas’ governor, Greg Abbott, began reopening, the state experienced the single-highest rise in cases since the beginning of the pandemic. Since Nebraska reopened on 4 May, Covid-19 cases in Colfax county alone surged 1,390%.

Experts warn that Dallas, Houston, Florida’s Gold Coast, the entire state of Alabama and several other places in the south that have rapidly reopened their economies are in danger of a second wave of coronavirus infections over the next four weeks.

Last Monday, Ford reopened its large North American assembly plants. On Tuesday, it closed and reopened its Chicago Assembly plant twice in less than 24 hours, after two workers tested positive for Covid-19. On Wednesday, Ford temporarily shut its Dearborn, Michigan truck plant after an employee tested positive, then promptly resumed operations.

So why “reopen” so abruptly, when Covid-19 continues to claim lives?

The main reason given is to get the economy moving again. But this begs the question of why an economy exists in the first place, other than to promote the wellbeing of people within it.

Both Ford plants are vital to the company’s profitability, and that profitability is important to jobs in the midwest. But surely the wellbeing of Ford workers, their families, the people of Chicago and Dearborn and others are more important.

A related argument is that workers are clamoring to return to their jobs. “People want to get back to work,” Trump has asserted repeatedly. Fox News host Sean Hannity claims people are “dying to get back to work”, seemingly unaware of the irony of his words.

Polls suggest otherwise. Americans whose jobs require them to leave home express trepidation about doing so: 60% fear exposing their families to Covid-19.

Many Americans must return to work because they need the money, but this doesn’t have to be the case. Rich economies can support their people for years if necessary. During the second world war, America shut down most of its economy for nearly four years.

The obstacle right now is a lack of political will to provide such support, at least until testing and tracing provide reasonable assurance the pandemic is contained.

Although nearly half of all US households report lost employment income since mid-March, extra jobless benefits enacted by Congress are only starting to trickle out now. Trump and the Republican Senate majority leader, Mitch McConnell, refuse to extend them beyond 31 July.

Meanwhile, states are denying benefits to anyone whose company has called them back.

Finally, Trump and his enablers argue that reopening is a matter of “freedom”. He has called on citizens to “liberate” their states from public-health restrictions. Fox News personalities have decried what they call denials of “basic freedoms”.

Armed protesters stormed the Michigan state capitol, demanding the “freedom” to work. At the Kentucky statehouse, protesters shouted “We want to work!” and “We’re free citizens!”

But the supposed “freedom” to work is a cruel joke when people are forced to choose between putting food on the table or risking their lives. It’s the same perverse ideology that put workers in harm’s way in the dawn of the industrial age, when robber barons demanded workers be “free” to work in dangerous factories 12 hours a day.

In truth, there is no good reason to reopen when the pandemic is still raging: not getting the economy moving again, or workers clamoring to return to work, or the cost of extended income support, or because workers should be “free” to endanger themselves.

Let’s be clear. The pressure to reopen the economy is coming from businesses that want to return to profitability, and from Trump, who wants to run for re-election in an economy that appears to be recovering.

Neither is reason enough.

https://www.theguardian.com/commentisfree/2020/may/24/donald-trump-fox-news-sean-hannity-dying-to-work-coronavirus?CMP=oth_b-aplnews_d-1
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

Offline knarf

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<a href="http://www.youtube.com/v/6OBY_qVebAI&fs=1" target="_blank" class="new_win">http://www.youtube.com/v/6OBY_qVebAI&fs=1</a>
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

Offline knarf

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Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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Trump gutted the checks on his power when they were most needed
« Reply #15995 on: May 24, 2020, 04:18:11 PM »
Trump's intervention with the FDA and the lucrative contract awarded to Battelle are the latest exhibits of how and why he sees oversight as a political enemy.

Several weeks ago, President Donald Trump forced the Food and Drug Administration to reverse a safety ruling and clear the way for one of the nation's premier defense contractors to sell, service and operate new machines that reprocess N95 face masks for health care workers.

Within two weeks, Battelle, the company that makes the machines, had a contract from the Pentagon's Defense Logistics Agency to recycle masks for up to 20 uses each at locations across the country. The no-bid deal, ordered up by the White House coronavirus task force, is worth up to $600 million.

But nurses, doctors and scientists who have spoken to NBC News about Battelle's hydrogen peroxide vapor chambers said the process it uses remains unproven over long-term use and using masks cleaned by it more than a couple of times could leave front-line health care workers vulnerable to contracting the coronavirus.

Time may tell whether Trump's intervention benefited health care workers and taxpayers as much as it helped him and the company. But it is already clear how Trump has killed oversight, and how he is taking advantage of its death to help himself politically in a re-election year.

He brazenly steamrolled FDA experts. His special task force in charge of medical supplies, which operates outside the authority of any existing agency, deployed emergency powers to award the Battelle contract without competition or any significant consideration of similar technologies. He has ordered task force members not to testify before Congress for the time being. And, last month, as part of a purge of the inspectors general who would be empowered to investigate aspects of the coronavirus response, he got rid of the Pentagon's top watchdog, who would oversee the deal.

There is effectively no independent oversight of the Battelle deal or others like it.

A president proud of his work and his intentions should welcome the validation of those checks. But Trump has neutralized them at a time when more money is being pumped out of Washington at a faster pace than ever before. Indeed, he just appointed his own legal counsel and senior adviser to oversee stimulus-law spending.

His detractors are horrified by the situation, but his loyalists see his roughshod run over competing power centers as the proper exercise of power by a just president.

Eric Havian, a whistleblower law expert at the law firm of Constantine Cannon, argues that while "temporary trimming of oversight is surely understandable" during a crisis, whistleblowers offer a "supplement to the government's oversight."

Under another president, that might work. But Trump canned the intelligence community inspector general who bucked him by backing a whistleblower during the Ukraine scandal. He has trashed whistleblowers who have come forward publicly. Those actions and others have made clear there will be brutal consequences for anyone in the administration who questions him.

The lack of oversight means voters will have less information by which to judge the president when they go to the polls. Trump surely understands that.

When he stepped in to help the company, he was desperate to show he was taking action after a slow-footed response to the disease's arrival in the United States. He was on the wrong end of a daily brawl with governors of both parties who pleaded for the federal government to provide supplies to their states amid harrowing shortages. Politically, he needed to first quiet a bipartisan chorus of criticism and then change its tune.

On March 29, the day after the FDA gave the company partial clearance to use its mask-recycling system, Ohio Gov. Mike DeWine, a Republican whose state houses the company's headquarters, got on the phone to complain to Trump. The language of the waiver prevented Battelle from deploying the machines outside its headquarters and limited the number of masks it could service in a day.

After talking to DeWine, Trump pressured FDA Commissioner Stephen Hahn to change the waiver, and it was done within hours. The three men applauded one another publicly. An FDA spokesperson told NBC News this week that the decision was based on "new information" but did not respond when asked if that information was scientific or political.

The political value of delivering for DeWine and Ohio was more clear — it's been 80 years since a winning presidential candidate didn't take the state. The same was true for Trump's direction of ventilators to the battleground states of Colorado and Arizona and his careful attention to the equipment needs of potentially decisive Florida.

The FDA waiver was just the start of the story. Within five days, the White House coronavirus task force had agreed to buy 60 machines for $1 million apiece. Five days after that, the task force decided to pay Battelle $413 million to include the cost of operating them, which was required by the FDA waiver.

The task force went ahead with the purchase despite an objection from a Health and Human Services Department expert on federal supply-chain finances, and by May 1 the ceiling on the deal had risen to $600 million, according to the Defense Logistics Agency.

From the perspective of Trump's politics, it doesn't matter whether the machines are as effective as Battelle says they are — or if the cost to taxpayers is justified.

He showed quick action after a delayed response to the virus, granted a lucrative deal to a powerful company in the midst of an economic crisis and turned criticism from a prominent Republican governor in a crucial swing state into praise. He also eased his own burden of trying to acquire new masks.

Over the long term, if nurses working with coronavirus patients get sick, it will be difficult, if not impossible, to prove it was the result of masks degraded as part of the recycling program. The FDA spokesperson told NBC News that the company has reported damage to 94 masks so far, representing less than two-hundredths of a percent of the number decontaminated.

It will also take time to find out whether taxpayers got a good deal for Battelle's work.

But because Trump has effectively gutted oversight of his administration, only voters can hold him accountable if his decisions were bad — or made for the wrong reasons.

https://www.nbcnews.com/politics/white-house/trump-gutted-checks-his-power-when-they-were-most-needed-n1213901
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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In a column for the New York Times, Charles Blow makes the case that Joe Biden would be smart to lay low — and thus avoid making major gaffes that could hurt his presumptive Democratic presidential nomination — and let the focus remain on Donald Trump who has cratered his re-election chances with his mishandling of the coronavirus health crisis.

Blow began his column by making a pointed observation by writing, “As the United States’ death toll raced toward 100,000, Donald Trump went golfing.”

Writing, “Trump put politics, his own political fortunes, over the lives of the American people, and the result has been catastrophic,” he further explained, “The number of deaths never had to reach such a staggering figure — and it will surely climb far beyond it — but it did because in the early days, Trump made excuses for the Chinese response, dragged his feet on an American response, and repeatedly made statements that defied truth and science.”

Defend democracy. Click to invest in courageous progressive journalism today.
Noting that president prematurely congratulated himself on March 10th when there were only 959 confirmed COVID-19 cases and 28 deaths — telling reporters “We’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away” — Blow claimed the president did too little until it was likely too late.

“The virus wasn’t aware of the politics of the moment. The virus wasn’t aware that he had been lying and deflecting. The virus wasn’t aware that it should wait until the American president was cowed into correct action. It was doing what viruses do: It was spreading and it was killing,” he explained. “Trump dragged his feet, trying to con his way through a pandemic, to rewrite reality, to pacify the public until the virus passed, and that has led to untold numbers of people dead who never had to die.”

“There is not only blood on Trump’s hands, he is drenched in it like the penultimate scene from the movie ‘Carrie,'” he charged.

According to the columnist, nothing Trump can say, including blaming the Chinese for the virus or governors in the U.S. battling to stem the tide of the pandemic-related deaths can absolve the president of his responsibility for the damage that has been done.

“In America, this is Donald Trump’s plague, and he is yoked with that going into the election in November,” he predicted.

You can read more here.

https://www.rawstory.com/2020/05/this-is-trumps-plague-and-the-blood-on-his-hands-will-doom-his-re-election-charles-blow/#.XsvvKLhkS14.twitter
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

Offline knarf

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Snoopy Writes Letter To The President
« Reply #15997 on: May 25, 2020, 10:22:24 AM »
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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Another Meltdown By You Know Who
« Reply #15998 on: May 25, 2020, 11:05:54 AM »
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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Locusts, COVID-19, flooding pose 'triple threat' in East Africa
« Reply #15999 on: May 25, 2020, 03:52:59 PM »
World Bank announces $500M program to help affected countries


Soldiers of the Uganda Peoples Defence Forces rest after spraying locust swarms with insecticides, in Otuke in northern Uganda on Feb. 17. Swarms of the insects have been rampaging across East Africa since the start of the year.

Locusts, COVID-19 and deadly flooding pose a "triple threat" to millions of people across East Africa, officials warned Thursday, while the World Bank announced a $500-million US program for countries affected by the historic desert locust swarms.

A new and larger generation of the voracious insects, numbering in the billions, is on the move in East Africa, where some countries haven't seen such an outbreak in 70 years. Climate change is in part to blame.

The added threat of COVID-19 imperils a region that already was home to about 20 per cent of the world's population of food-insecure people, including millions in South Sudan and Somalia.

Yemen in the nearby Arabian Peninsula is also threatened, and United Nations officials warn that if locusts are not brought under control there, the conflict-hit country will remain a reservoir for further infestations in the region.

Lockdowns imposed for the COVID-19 pandemic have slowed efforts to combat the locusts, especially imports of the pesticides needed for aerial spraying that is called the only effective control.


The insects have already destroyed crops in Kenya in the country’s worst infestation for 70 years.

"We're not in a plague, but if there are good rains in the summer and unsuccessful control operations, we could be in a plague by the end of this year," said Keith Cressman, senior locust forecasting officer with the United Nations Food and Agriculture Organization (FAO).

Now there's a risk that the locusts could make their way in the coming months into West Africa's sprawling and arid Sahel region just south of the Sahara Desert, he said. Chad, Niger and Mauritania could be affected — another burden for a region under growing threat from extremist attacks.

The FAO is preparing to increase its appeal for aid to $310 million US as the livelihoods of millions of people across Ethiopia, Kenya and elsewhere are at stake, including farmers and herders.


A man in walks in the flooded courtyard of the Katindo mosque in Goma, in the Democratic Republic of Congo, on March 22.

Already about 400,000 hectares of land have been protected from the locusts, or enough crops to feed about five million people, said Dominique Burgeon, FAO's director of emergencies, "but it is only one part of the equation."

The number of locusts continues to grow despite the control efforts, and if that work is not sustained, the combined threat with COVID-10 and flooding "could have a catastrophic effect," said FAO director-general Qu Dongyu.

New swarms expected
The FAO in its latest assessment says the situation in parts of East Africa remains "extremely alarming" because new swarms will form from mid-June onward, coinciding with the start of the harvest season for many farmers.

The World Bank's new $500-million program will benefit affected countries in Africa and the Middle East, and Uganda, Kenya, Djibouti and Ethiopia benefit from an initial disbursement of $160 million. Some of the money will go directly to farmers as cash payments. Plans to help Yemen and Somalia are at an "advanced stage," the bank said.

"This food supply emergency combined with the pandemic and economic shutdown in advanced economies places some of the world's poorest and most vulnerable people at even greater risk," World Bank Group president David Malpass said in a statement.

The recent floods in parts of East Africa have killed nearly 300 people and displaced 500,000, slowing locust control work and increasing the risk of the virus' spread, according to the International Federation of Red Cross and Red Crescent Societies.

"We are facing an unusually complex humanitarian situation," Simon Missiri, the group's Africa director, said in a statement.

https://www.cbc.ca/news/world/locusts-east-africa-1.5578974
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

Offline knarf

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China Forcing Christian Teachers to Renounce Their Faith so Students...
« Reply #16000 on: May 25, 2020, 03:59:37 PM »
Are Properly Indoctrinated in Communism

In the Chinese government's continuing effort to crush Christianity inside its borders, teachers are now being told to renounce their faith or face the consequences.

Bitter Winter reports this movement began in the communist country soon after President Xi Jinping underscored at a national education conference that the fundamental task for education is to train builders and successors of socialism. Since Xi's speech almost two years ago, the pressure on teachers to indoctrinate students has been building.

One example is a kindergarten teacher, a member of the state-run Catholic Church, who told the website she was afraid to go to church because of the mounting pressure she was receiving from the school's administration. She told Bitter Winter that she has been constantly threatened to give up her faith for the last seven months. She said she has received criticism from her superiors, which includes comments like, "some teachers continue to hold religious beliefs while the Communist Party feeds them."

"The state's control over ideology is becoming stricter and stricter, particularly in the field of education," the teacher said. "If teachers hold religious beliefs, not only follow the Communist Party, this becomes a political problem for the government."

The teacher's principal also warned her that funding from the government could also be withdrawn from the county if government officials learned about her faith. The funding is given as part of a Spiritual Civilization Award which is given to communities that are designated as "civilized," i.e., economically developed and free of religion.

"I learned that another county had all of its civilization awards revoked because an inspection team discovered two primary school students singing Christian hymns," the teacher told Bitter Winter.

"Teachers are required to indoctrinate children with patriotic ideology, make them believe and praise the Party," she continued. "Moreover, schools have assigned special personnel to monitor and report on religious teachers and students. They were told to give up their faith, and some have been designated as key targets of surveillance, the authorities fearing that they will develop 'counterrevolutionary influence,' collude with foreign forces, and cause chaos."

https://www1.cbn.com/cbnnews/world/2020/may/china-forcing-christian-teachers-to-renounce-their-faith-so-students-are-properly-indoctrinated-in-communism
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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Prime Minister Jacinda Ardern will join a conference call with other world leaders to discuss their successful responses to Covid-19.

New Zealand is part of an "early movers initiative" of nations succeeding in their fight against Covid-19 and looking to ease restrictions.

Prime Minister Jacinda Ardern will join the leaders of Australia, Austria, Norway, Israel, Denmark, Singapore, Greece and the Czech Republic will all be on the teleconference call on Wednesday evening NZT.

The group is dubbed the "early movers initiative" and Ardern said the nations involved were ones which went that "by and large went hard and early" in their response to Covid-19.

It will be the third conference of the group which was initiated by Austria and the teleconference will be hosted its chancellor Sebastian Kurz.

Ardern said the leaders would discuss measures each nation was taking to de-escalate restrictions.

The Government announced today an easing of the rules with limits on gatherings would be lifted to 100 people on Friday.

But Ardern signalled alert level 2 could be in place until at least June 22.

Also on Wednesday, Ardern will also hold a virtual summit with Singaporean Prime Minister Lee Hsien Loong to mark the one year anniversary of the New Zealand Singapore Enhanced Partnership.

Ardern said New Zealand's relationship with Singapore had been critical in recent months to ensure critical supplies, like Covid-19 testing kits and personal protective equipment, and to ensure trade links remained open.

https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12334686
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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More Americans turning to anxiety medication amid coronavirus pandemic
« Reply #16002 on: May 25, 2020, 04:31:37 PM »
Americans freaked out by the coronavirus crisis are increasingly turning to prescription drugs to calm their nerves, according to a report Monday.

Health-research firm IQVIA found that prescriptions for anti-anxiety drugs spiked 10.2 percent in March, to 9.7 million, compared with 8.8 million during the same month last year, the Wall Street Journal reported.

Meanwhile, prescriptions for antidepressants rose 9.2 percent, from 27.2 million to 29.7 million, from March 2019 to March 2020.

Even more startling increases were reported by other companies — Express Scripts, a pharmacy benefit manager owned by Cigna, said that prescriptions for anti-anxiety medications rose 34.1 percent between mid-February and mid-March, according to the Journal.

Prescriptions for antidepressants and sleep medications increased 18.6 percent and 14.8 percent, respectively, according to Express Scripts.

Meanwhile, psychiatrists working for Ginger — a company that provides employers with video- and chat-based mental-health services for their workers — wrote 86 percent more scripts for psychotropic drugs, primarily antidepressants, in March and April 2020 than they did in January and February.

Dr. Bruce Schwartz, deputy chair and professor of psychiatry and behavioral sciences at Montefiore Medical Center in New York, called the increased demand for the drugs “very problematic.”

“Many physicians have a low threshold for prescribing them,” he told the Journal. “Many people do develop a dependency on these medications.”

Dr. James Potash, director of psychiatry and behavioral sciences at Johns Hopkins Medicine, noted that the most popular anti-anxiety drugs were benzodiazepines such as Valium, Xanax, Ativan and Klonopin.

“They are powerful, and they are powerfully attractive in that they work instantly,” he said.

“You take Ativan, and 30 minutes later you are feeling dramatically less anxious.”

But Potash cautioned that although the drugs are effective for short-term treatment, users can develop a tolerance to their effects in as little as two weeks.

That can lead people to increase their intake, making it hard for them to stop gobbling down the pills — and leading to potentially dangerous withdrawal symptoms when they finally do.

Dr. Beth Salcedo, a psychiatrist and the past president of the Anxiety and Depression Association of America, said that the best ways to deal with anxiety included “exercising, eating well, avoiding alcohol and making sure we surround ourselves with our social support as much as possible.”

If those don’t work, she recommends a type of counseling known as “cognitive behavioral therapy,” possibly coupled with antidepressant medications like Lexapro and Prozac.

https://nypost.com/2020/05/25/americans-are-gobbling-anti-anxiety-meds-due-to-coronavirus/
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'

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Professional Help For Those Dependent/Addicted to Benzodiazepines
« Reply #16003 on: May 25, 2020, 04:56:38 PM »
I found this website from the YouTube video I posted about Jordan Peterson's horrible ordeal with taking a Benzodiazepine, on Surly's News yesterday.

http://www.doomsteaddiner.net/forum/index.php/topic,13577.15.html

Benzodiazepine Information Coalition

Excert:

Benzodiazepines are a class of medication known as “anxiolytics” and are listed as a schedule IV controlled substance. They are often prescribed for anxiety, insomnia, seizures, and alcohol withdrawal, but are used for a vast array of off-label uses such as restless leg syndrome, muscle spasms, tinnitus, dementia, mania, and akathisia. Commonly prescribed benzodiazepines include Klonopin (clonazepam), Ativan (lorazepam), Xanax (alprazolam), Valium (diazepam), Onfi (clobazam), Tranxene (clorazepate dipotassium) and Librium (chlordiazepoxide).

Most prescribing guidelines recommend against benzodiazepine use for more than 2-4 weeks consecutively. While we don’t know the exact number, as estimates vary, a large percentage of patients prescribed benzodiazepines long term (more than 2 to 4 weeks) will develop physical dependence and experience problems safely stopping the medications. No matter how much they desire to withdraw, many experience debilitating mental and physical withdrawal effects.

It cannot be predicted at the time of prescription or cessation which patients will be able to successfully withdraw from a benzodiazepine without life altering complications, but for those whose withdrawals are complex, cessation may become a lengthy, life-altering process. It is imperative that doctors and patients are educated about the available methods of tapering. (We offer a printable pamphlet providing a summary of patient-centered cessation here.) The methods discussed below have been developed through clinical experience, research, and by patients who have successfully completed a benzodiazepine taper.

An Important Note about Physical Dependence versus Addiction
Prescribed physical dependence is not addiction. Misdiagnosis and treating prescribed physical dependence as addiction frequently leads to patient harm through the imposing of dangerous forced or over-rapid cessation methods. More information can be found at:

Why Prescribe Benzo Patients Shouldn’t Go to Detox or Rehab
Benzodiazepine Related Problems; It’s Almost Never Addiction
Words Can Hurt Those on Benzodiazepines.
There is also FDA guidance to help distinguish the differences between physical dependence, addiction, and abuse:

Physical dependence is not synonymous with addiction; a patient may be physically dependent on a drug without having an addiction to the drug. Similarly, abuse is not synonymous with addiction. Tolerance, physical dependence, and withdrawal are all expected biological phenomena that are the consequences of chronic treatment with certain drugs. These phenomena by themselves do not indicate a state of addiction.

Additionally, the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) states:

“Dependence” has been easily confused with the term “addiction” when, in fact, the tolerance and withdrawal that previously defined dependence are actually very normal responses to prescribed medications that affect the central nervous system and do not necessarily indicate the presence of an addiction.

How Benzodiazepine Use Alters the Body
The underlying physical changes that result in benzodiazepine tolerance and withdrawal remain unknown. One hypothesis is that since benzodiazepines work by enhancing the neurotransmitter GABA (gamma-aminobutyric acid) at the GABA-A receptor, long-term benzodiazepine use may down-regulate GABA receptors, while discontinuation may, with time, upregulate them. GABA receptors are located throughout the body and have many roles. They are an important part of the body’s central nervous system and its response to stress.

Problems with Common Prescriber Cessation Methods
One common method is to instruct the patient to cut their dose by 1/4 weekly. With this method, the patient will be finished tapering in approximately 4 weeks. While some view this as a gradual reduction, the majority of experienced researchers, physicians, patients and prescribing guidelines consider a 4-week taper to be much too rapid. A taper lasting four weeks is usually not enough time for the body to adjust. In fact, this rapid tapering method was found in one study to be ineffective for at least 32-42% of patients who were prescribed benzodiazepines long term, with 90% experiencing withdrawal symptoms.

There are many instances of patients developing a protracted withdrawal syndrome (PAWS) from rapid tapers of this nature. This withdrawal syndrome can last anywhere from 18-24 months, or, in some cases, for years. Slower, more gradual dose reduction, can reduce the severity of withdrawal as well as the risk of PAWS. Beyond protracted withdrawal risks, patients are also put at risk of seizures, and sometimes even death, from over-rapid tapers.

Patients who are physically dependent may also have become so severely sensitized to benzodiazepines that even minute fluctuations in dosage can cause terrible suffering. Since pills are only scored in halves (and many not scored at all), and even halves can be inaccurate, attempting to split pills to evenly distribute the medication into 4 equal parts can exacerbate the severity and fluctuation of symptoms throughout a taper.

Another commonly prescribed method of tapering requires the patient to decrease one of their daily doses throughout the week, over the course of several weeks, until all doses have been removed. This protocol presents the same problems as with the 1/4 dose reduction per week method. Benzodiazepine Information Coalition has observed throughout years in online support groups, representing thousands of patients, that this approach more often than not causes a cluster of disabling mental and physical symptoms, which can persist for months or years. Additionally, instead of a careful, slow steady decline of drug serum levels, skipping doses, or leaving longer time gaps in between doses due to tapering away one dose, leads to even greater fluctuations—peaks and valleys in drug serum levels—sending patients in and out of withdrawal, often resulting in unnecessary pain and suffering.

Safer Tapering Methods
There are many effective tapering approaches for cessation of benzodiazepines for doctors and patients. Unfortunately most benzodiazepines do not come in forms or dosages compatible with easy cessation, so nearly all require manipulating the dosage through some method, be it cutting with a scale, compounding, or the use of liquid. We recommend tapering by no more than 5-10% every 2-4 weeks. This means that, on average, a taper will take about ten months or longer, depending on the patient’s starting dose and individual response.

The Ashton Manual
The Ashton Manual is probably the most well-known and respected method in the benzodiazepine community. It reports a 90% success rate.The Ashton protocol recommends using diazepam to taper, as the benefits of a long half-life are important for tapering. Diazepam’s half-life of up to 200 hours means it can help to prevent secondary issues, like interdose withdrawal (withdrawal symptoms that develop between doses), that can lead to major problems during cessation. Beyond a long half life, diazepam comes in smaller doses than the newer, shorter acting benzodiazepines for tapering. Clonazepam has a medium half-life, and the smallest dose available is 0.125 mg; alprazolam has a short half life, and the smallest dose is .25 mg. While these may seem like “small doses,” when one considers their equivalence to diazepam (0.125mg of clonazepam is approximately equivalent to 2.5 mg of diazepam and .25 mg of alprazolam is approximately equivalent to 5 mg of diazepam), they are not so small. Discontinuing from these dosage levels is not recommended, so they must be reduced by smaller than even halves or quarters of the lowest available manufactured doses available. For a discussion on the many problems arising from available dosage sizes, see Why Currently Available Benzodiazepine Doses Prevent Safe Withdrawal.

As with any recommended guideline, it is important to remember that the patient should be allowed to dictate the rate and pace of their taper depending on their individual response to dose reduction. If symptoms are severe or disabling, the taper may be suspended for a few weeks until symptoms subside. Oftentimes this resolves the problem and the patient may then resume their taper. It is not uncommon for benzodiazepine tapers to take longer than one might expect due to individual responses.

While Ashton recommends diazepam due to its long half-life for tapering, other guidelines recommend staying on the originally prescribed benzodiazepine if withdrawal symptoms are tolerable. As with any new medication introduced, there is a risk of an adverse reaction. Some patients do not respond well to diazepam. Additionally, the Ashton Manual is reportedly too fast for many patients, with some finding the schedule of reductions too large to adjust to at once. A stepwise substitution from a shorter half-life drug to a longer-acting benzodiazepine can take weeks to adjust to before patients can begin or resume their taper. This adds more time to what is already perceived as a painful, even life-altering project. Since benzodiazepine usage and withdrawal often creates numerous complex symptoms, it can be difficult to know if someone is suffering from an adverse reaction to new medication, or is simply symptomatic due to the neuroadaptations caused by long term exposure to benzodiazepines. So while the Ashton Manual has proven to be successful for many people, patients and prescribers should be prepared to make adjustments, or to explore other tapering options, such as those discussed below.

Dry Tapering
This is a popular method due to convenience and the potential initial complexity of other methods. It involves using a pill cutter or scale, and cutting or shaving off a pill to make reductions. There are various methods for dry tapering, including micro-tapering (removing smaller microgram amounts more frequently) and larger cut-and-hold tapers (removing larger milligram amounts, a percentage of the current dose all at once followed by a hold).

Tapering Strips
A newcomer to the cessation market are Tapering Strips, developed by Dr. Peter Groot in the Netherlands. These strips offer very gradual reductions. Taper rates can be adjusted according to patient need and ordered in advance. The benzodiazepines offered are Ativan (lorazepam), Valium (diazepam), Klonopin (clonazepam) Serax (oxazepam), Restoril (temazepam), and Imovane (zopiclon). As Tapering Strips is a Netherlands based operation, availability will vary by country. On their site, they state they will ship them outside of the Netherlands with a prescription in accordance with legislation in place for the patient’s country. The expected delivery time is one week. A video explanation of the strips from a benzodiazepine patient who successfully tapered using these strips in the UK can be viewed here.

Micro-Tapers
Online support communities have developed systems of “micro-tapering” to help distribute medication evenly throughout the day in order to avoid interdose withdrawal symptoms. Micro-tapering utilizes small daily microgram reductions that add up to a 5-10% overall reduction (from current dose) every month. Daily micro reductions also help to avoid the physical and mental turmoil that larger weekly reductions may create for those who are very sensitive. Keeping track of dose reductions usually requires a daily log or spreadsheet.

Dry Micro-taper
Some patients micro taper with a scale, removing a small amount, anywhere from 0.001 to 0.003 grams per day, or every few days. This method can be initially intimidating, but there are a few different approaches to accomplish it. There are videos and resources in support groups like BenzoBuddies available to explain the various methods. Many patients who find the Ashton Manual intolerable, but who are not able, for whatever reason, to utilize a liquid approach, choose this method.

Liquid Micro-taper
Oral diazepam solution (Roxane Laboratories) can be a valuable tool in micro-tapering and comes as a manufacturer 5mg/5mL (1mg per mL) solution in the US. Using a 1mL oral syringe, patients can, for example, measure as little as 0.05 mg to 0.1 mg less of the total dose every day, or every 3 or more days. (How much is reduced depends on the individual response of the patient, their dose, and desired rate of reduction). For an even more diluted solution and smaller dose reductions, this diazepam solution can be safely combined with water. For those who cannot tolerate oral diazepam solution, or cannot tolerate diazepam at all, a prescription for a liquid compound of the patient’s original benzodiazepine can alternatively be used.

Suspending vehicles such as “OraPlus” can be combined with crushed pills or the stock powder form of most benzodiazepines. Most compounding pharmacists will have access to a database that allows them to choose the appropriate suspending agent for each specific benzodiazepine. Liquid compounds may make it easier for the patient to control the rate of taper and require less work on their part compared to other tapering methods. We recommend choosing a pharmacist associated with the International Academy of Compounding Pharmacists or the Professional Association of Compounding Pharmacists.

Finally, there is the method known in the online support community as “liquid titration.” Some patients may not tolerate compounded liquids due to multiple factors, such as intolerance to the suspending vehicle. Others may have a difficult time finding a doctor who is willing to prescribe diazepam or a prescription for a compounded suspension of their current benzodiazepine, or patients may find the cost of compounded liquid is prohibitive. Many who have found themselves in this predicament have successfully tapered on their own by making a homemade suspension in water or milk. A pill is either crushed or allowed to disintegrate in a pre-measured mL amount of  liquid. Some only use water, while some use water with an added solvent (like alcohol). Using an oral syringe, a measured amount (in mLs) of liquid is removed from this suspension and discarded, the remainder ingested. These reductions are cumulative (although the size of them in mLs, or the mg/mL ratio of drug to liquid, can be easily adjusted to slow the taper rate down if need be) until the dose is small enough to stop. This method is less difficult than it sounds, and many have successfully tapered on their own using this method.

Tapering Strategies
Recommended Taper Rate
As mentioned before, it is often difficult to taper medications that are not designed for gradual reduction. The general guideline is to not exceed a 5-10% reduction of the current dose every 2-4 weeks. More information on the specifics of a 5-10% taper can be found here.

Conversion Rates for Benzodiazepines
Another tricky aspect of switching to a longer acting benzodiazepine is conversion. Ashton created a guide of estimated conversions. This guide can vary significantly from other charts as well as individual physician opinions. It is best to let the patient decide their optimal conversion dose (if they try a more conservative chart and feel underdosed or in withdrawal, they should be allowed to increase the dose until comfortable). Unlike opiates, benzodiazepine equivalents are not studied or mandated by the FDA, and individual responses may differ.

Medications to Alleviate Withdrawal Symptoms
Currently, there are no FDA-approved medications for alleviating the symptoms of benzodiazepine withdrawal. Add-on medications such as Neurotin (gabapentin), Lyrica (pregabalin), Catapres (clonidine), BuSpar (buspirone), and antidepressants may be suggested but are not required to taper. There is little to no evidence base for their effectiveness as withdrawal aids, and some may also require their own taper or create their own adverse effects. The British National Formulary guidance on benzodiazepines states, “The addition of beta-blockers, antidepressants and antipsychotics should be avoided where possible.”

Benzodiazepine Information Coalition’s experience from the reports of the many thousands of people in online benzodiazepine support groups have found that many patients withdrawing from benzodiazepines develop multiple sensitivities to other medications which seem to aggravate symptoms of withdrawal, with many of these medications requiring their own lengthy taper afterwards. With a sufficiently slow, patient-led taper, additional medications are usually ineffective and sometimes counter-productive.

Dosing Multiple Times per Day
Many patients find it particularly helpful to take their dose several times per day, depending on the half life of their particular benzodiazepine. For example, patients taking diazepam may benefit from evenly dividing their dose 2 or 3 times per day; those on clonazepam may benefit from dosing 3-4 times per day; whereas those taking lorazepam may need to dose 4-5 times per day. Some patients on alprazolam may require 5-6 doses per day just to maintain steady serum levels. Where possible, all doses should remain as even as possible in mgs as well. Patients who dose evenly and at regular intervals are more likely to successfully complete a benzodiazepine taper because they do not experience severe “drops” throughout the day between doses that may make discontinuation intolerable. These symptoms are commonly referred to as “interdose withdrawal.”

Conclusion
The most important thing in cessation is patient safety. There is no perfect method guaranteed to avoid a painful withdrawal, which is why preventing physical dependence to begin with is crucial, but many of the methods mentioned can lead patients to a tolerable taper, and all of them maximize the patient’s chance for successful cessation and complete healing. In some rare cases a rapid withdrawal might be considered a lesser evil—for example, if the patient becomes paradoxical, but this occurs extremely infrequently. Many patients have an understandable desire to withdraw from medication they no longer wish to take as quickly as possible, but with benzodiazepines, once signs of physical dependence are present, this is often the most risky and dangerous approach. Whether working closely with a prescriber, or withdrawing with limited assistance, each patient should taper at the rate that is most comfortable for them. No compliant patient should ever be made to taper or be forced off of benzodiazepines against their will, and the methods listed here should make it clear that, should a patient choose to withdraw, there are many ways to accomplish this without relying on rapid tapers, oversized reductions, or cold turkeying.

https://www.benzoinfo.com/2017/10/09/benzodiazepine-tapering-strategies-and-solutions/

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At this point it’s almost a pathology. Whatever the crisis, whatever the state of the economy, Republicans crave another tax cut for the rich.

The latest proposal is for a temporary “holiday” on capital gains taxes, as White House adviser Kevin Hassett pitched Sunday on CNN and President Trump had earlier proposed via tweet. A one-time, temporary capital gains tax holiday would do little to stimulate the economy, even according to the GOP’s usual line that tax cuts goose growth. The move could, on the other hand, permanently hobble the ability of future presidents to fund the government.

A “capital gain” refers to how much the value of an asset (such as a stock) has increased over time. Taxes on capital gains are triggered only when the asset is sold. So if you bought a few shares of Apple stock when it IPO’d in 1980, your shares would be worth a fortune today — but you don’t owe Uncle Sam a penny until you cash out.

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And perhaps not even then.

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Only a small sliver — about a quarter — of U.S. stock is taxable, because most equities are held in tax-exempt retirement accounts or by tax-exempt nonprofits or foreigners, according to the Tax Policy Center's Steven M. Rosenthal and Lydia Austin. Sales of assets that are taxable are taxed at preferential rates (that is, lower than what you pay on your wage or salary income) if the investments are held for more than a year.

The great majority of this taxable investment income accrues to the very richest Americans. Last year, for instance, the top 1 percent of households received three-quarters of all long-term capital gains. So that’s the population who’d primarily benefit when the White House suggests further capital gains tax cuts.

In fact, the government has already created other ways to help wealthy people avoid paying these taxes.

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If you happen to die before selling those Apple shares, for example, your kids can inherit them without anyone ever paying income taxes on the gains accumulated during your lifetime.

Or, thanks to the GOP’s 2017 tax law, you can sell your shares, reinvest the profits into a designated “Opportunity Zone” project and have the taxes on your Apple profits postponed or partially forgiven.

Even before the pandemic, the White House was proposing additional capital gains tax off-ramps. Now Hassett suggests this new iteration: For some temporary, to-be-determined length of time, rich people could sell their assets, realize whatever gains they’ve accumulated over the decades, and never pay taxes on the income.

Why is the GOP so fixated on capital gains tax cuts?

One possible explanation is self-interest: Some important Republican constituents live off their wealth rather than the sweat of their brows. The GOP is hardly the only party pushing tax breaks that benefit high-income constituents: The Democratic House’s latest coronavirus-relief bill, while weighted overall toward lower-income Americans, nonetheless included a tax break that almost exclusively helps high-income, blue-state residents.

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But Republicans insist that these tax breaks aren’t a cynical ploy to reward donors. They’re about boosting economic growth!

This was also the pitch for their 2017 corporate tax cuts. If only the feds take a smaller cut of investors’ returns, Hassett and others argued, investors would provide more capital to companies. Companies would then build more factories and buy more equipment, which would in turn make workers more productive and stimulate long-term economic growth.

Even if you believe this story (and the 2017 law’s track record provides reason for skepticism), a one-time, temporary capital gains holiday would only reward past investment decisions. It would not actually increase incentives to make new investments. Sure, the lucky guy who bought Apple stock in 1980 can now cash out tax-free. But the policy would do little to change future investment decisions and increase capital accumulation.

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It’s also unlikely to produce much in the way of a Keynesian-style, demand-side stimulus, because the high-income households disproportionately reaping the benefits are more likely to save their windfalls rather than spend them.

The Opinions section is looking for stories of how the coronavirus has affected people of all walks of life. Write to us.

It would, however, make budgeting more difficult for whoever’s in the White House when the holiday ends.

That’s because anyone with any unrealized gains today would use the holiday to sell and book those gains now, tax-free, thereby denying the government the ability to ever collect revenue on them. You can’t unring the bell. Absent some sort of (possibly unconstitutional) wealth tax, the holiday would deprive the treasury of taxes on the past 50 years or so of accumulated, unrealized capital gains.

This would permanently increase deficits, which in the long run would drag economic growth, according to University of Pennsylvania economist and Penn Wharton Budget Model director Kent Smetters.

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But in the long run we’re all dead, right? Might as well make one last cash grab on the way out the door.

https://www.washingtonpost.com/opinions/whatever-the-crisis-republicans-want-another-tax-cut-for-the-rich/2020/05/25/96d0c6ac-9eb8-11ea-81bb-c2f70f01034b_story.html?wpisrc=nl_undefined
Mark Twain — 'There are many humorous things in the world; among them, the white man's notion that he is less savage than the other savages.'