As many children remain symptomless despite contracting the virus, many have underestimated their role in spreading the virus. Annette-Gabriele Ziegler says kindergartens and schools must therefore adopt much stricter preventive measures to help contain the pandemic. These include social distancing, ventilating classrooms, and teaching small groups of pupils. She says that in addition, schoolchildren should be screened more rigorously for the virus even if they are symptomless. Source: Toronto nurses upset over COVID-19 vaccine access, allege frontline medical staff not being prioritized – Toronto | Globalnews.ca
Will be housed by Trump University and Trump Airline – ROTFLMAO!
President Trump suggested Friday night that he may seek to build his own online platform after Twitter permanently suspended his account less than two weeks before the end of his presidency.
Seems he has become paranoid and even more dangerous than thought.
As the coronavirus continues to spread across the globe, claiming nearly 2 million lives, Brazilian President Jair Bolsonaro has called vaccines into question and referred to them as “nonsensical,” according to Bloomberg. “These are experimental vaccines with no scientific evidence. You can’t impose this on people,” Bolsonaro said. “We have to be responsible. We can’t […]
The post Bolsonaro Doesn’t Trust COVID-19 Vaccine, Despite Surging Death Toll In Brazil appeared first on Remezcla.
Annette-Gabriele Ziegler, who led the research project, says: “We carried out antibody tests on children and found that more than six times as many had contracted the coronavirus than previously assumed.”
Between January and July 2020, the researchers tested blood samples from some 12,000 Bavarian schoolchildren for SARS-CoV-2. Study participants ranged from just 1 year old to 18 years old. One-third of those who lived with family members who had tested positive for the virus had traces of SARS-CoV-2 antibodies in their blood.
Approximately half of these children remained symptomless. Antibodies against SARS-CoV-2, incidentally, can be detected only after between one and four weeks after infection.
As many children remain symptomless despite contracting the virus, many have underestimated their role in spreading the virus. Annette-Gabriele Ziegler says kindergartens and schools must therefore adopt much stricter preventive measures to help contain the pandemic. These include social distancing, ventilating classrooms, and teaching small groups of pupils. She says that in addition, schoolchildren should be screened more rigorously for the virus even if they are symptomless.
David Lee, chief executive officer at Otto Kaiser Memorial Hospital in Kenedy speaks with staff in the ER. Lee said they are are luckier than many to have the local H-E-B pharmacy and hospitals in Cuero and Floresville that were willing to help inoculate a few dozen workers at his hospital.
Credit: Chris Stokes for The Texas Tribune
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More than two dozen hospitals in rural Texas, from the Panhandle to South Texas, are still waiting on doses of the COVID-19 vaccine to distribute to their front-line workers and community members, hospitals and health care advocates say.
Those that are lucky enough to be near another provider with shots available are relying on neighborly generosity — encouraged but not mandated by the state — to inoculate front-line workers, who are sometimes dealing with overflow patients from urban areas alongside their own coronavirus patients.
But many small, rural providers don’t have neighbors with doses to spare, leaving them waiting or scrambling to find vaccine for their most high-risk front-line health workers, even as other counties have reportedly distributed excess vaccine doses to politicians and healthy members of the public.
Rural health care advocates say they understand that the logistics involved in the largest vaccination program in the nation’s history will involve some unavoidable inequities at first, but they note that many of their communities have been disproportionately ravaged by the pandemic.
Local residents display signs supporting Karnes County first responders.
Credit: Chris Stokes for The Texas Tribune
“There’s no question there are massive inequities in this,” said Don McBeath, director of government relations for the Texas Organization of Rural & Community Hospitals. “While I think [state health officials] have made a concerted effort, and it has gotten better, the bottom line is that we still have nurses and doctors working in some rural communities around sick COVID patients, and they can’t get their hands on vaccines themselves. Something’s wrong.”
Advocates and rural hospital officials say the reasons for the lapse range from approval delays caused by technical issues with the application process to smaller providers’ inability, early on, to use or store the Pfizer vaccine, which initially was the only vaccine available.
The Pfizer vaccine can only be shipped in orders of 975 doses — way more than many small communities needed to vaccinate their front-line workers — and have to be stored in special sub-zero freezers that most rural hospitals don’t have.
The later arrival of the Moderna vaccine, which comes in smaller batches and can be stored in standard refrigerator conditions, helped alleviate some of those challenges, but delays in shipments, combined with the demand overwhelming the supply, has left these hospitals without doses to distribute to their own workers or other eligible residents in their communities.
Roughly 1.4 million doses have been shipped to Texas since mid-December, while more than 8 million people are in the groups that now qualify for the shots. Health care workers and residents of nursing homes and long-term care facilities, a group labeled as 1A, were prioritized for the first round of vaccines. People who are elderly and those with underlying conditions, a group known as 1B, were the next to be listed as eligible. The next group of eligible Texans still has not been announced.
Gov. Greg Abbott and Texas Health Commissioner John Hellerstedt in late December urged health care providers to open up their distribution to more people and keep doses from “sitting on hospital shelves.” Hospital administrators have said doses are being given out as fast as possible and that no doses are being unused.
“The irony of the process is that DSHS is pushing hospitals to get shots into arms, but it’s kind of hard to do so if you don’t have the vaccine,” said Don Bates, CEO of Golden Plains Community Hospital in Borger, north of Amarillo.
Bates’ hospital has received no doses yet, but has relied on the local United Supermarkets Pharmacy for getting shots to about 50 of his front-line health care workers who wanted it.
Hutchinson County, where Golden Plains is located, is home to 21,000 people. Some 1,217 confirmed or probable COVID-19 cases have been reported in the county by state health officials. It borders Hansford County, where 642 cases have been identified as confirmed or probable, in a county of just over 5,000. In nearby Amarillo, hospital capacity is stretched, according to public health officials.
“The state failed to recognize that folks in rural communities travel to the larger communities often for work, shopping, dining, conferences and travel,” Bates said. “Our testing positivity rate has been just as high as some urban areas.”
Bates said he expresses his frustration regularly during calls with the Texas Department of State Health Services.
“I think sometimes the Panhandle of Texas is forgotten,” he said. “We’re treated like the proverbial red-headed stepchild.”
Chris Van Deusen, a DSHS spokesperson, said the agency was working with the rural and community hospital association on problems being experienced “as they arise.”
“I know there are still a number of hospitals working to complete their enrollment as a vaccine provider,” he said in an emailed statement. “Rural hospitals serve an important role in providing care in their communities, and we will allocate vaccine to them as they enroll. We will continue to work with [rural and community hospital association] and the facilities directly to help them complete that process.”
The state’s expert vaccine allocation panel, which makes recommendation to the state on which providers get vaccines shipped to them each week, “routinely” discuss the need for all Texans, regardless of location, to have access to the vaccine, said Carrie Kroll, vice president of advocacy, quality and public health for the Texas Hospital Association and an ad hoc consultant to the panel.
“Ensuring equitable distribution in terms of geography has been a priority, as has the epidemiology of the disease, including which populations are most at risk either because of their age or health status,” she said.
Her organization has been advocating that rural hospitals be included, and while they recognize the challenges, they are “very concerned” that some hospitals don’t yet have any doses to distribute to their workers.”The bottom line is that, first and foremost, all hospitals need to be able to protect and vaccinate their front lines,” she said. “We’d like to see doses at every hospital in Texas right now.”
The majority of rural hospitals in Texas, which McBeath said total 157 across the state, will have gotten at least some doses either delivered, shipped or allocated by the end of this week.
Some rural facilities, like Otto Kaiser Memorial Hospital in Karnes County, have been approved providers for weeks but haven’t received any doses to distribute yet. Otto Kaiser was approved by state health services on Dec. 18, but has yet to appear on any list for the first four weeks of the vaccine distribution.
David Lee, hospital chief executive officer, speaks with Barbara James inside a tent set aside for triaging COVID-19 patients located just outside the ER ambulance bay at Otto Kaiser Memorial Hospital in Kenedy.
Credit: Chris Stokes for The Texas Tribune
The hospital has instead relied on nearby providers to vaccinate its front-line workers while officials wait their turn on a distribution list.
Facilities that were sent the vaccine are not required to share with the have-nots, but the state has encouraged them to do so in order to keep pushing out the vaccine as fast as possible, said Otto Kaiser CEO David Lee.
Lee said they are are luckier than many to have the local H-E-B pharmacy and hospitals in Cuero and Floresville that were willing to help inoculate a few dozen workers at his hospital.
“That’s kind of been their directive. When you run out of 1A (front-line workers), look in the neighboring county, look at closer facilities that might have some more names” of workers who want the shot, Lee said. “So I think that’s what folks are doing. We’re very grateful for that.”
The lack of vaccine doses also prevents the hospital from being able to share with its members of the community who may be eligible. Some 122 people in Karnes County, southeast of San Antonio, have received the first of the required two doses, according to DSHS. That’s in a county of more than 12,500 people over age 16, where 24 people have died and 1,266 cases have been confirmed, including 45 new cases in the last two weeks.
Cuero Regional Hospital helped vaccinate Lee’s front-line workers after another local facility shared its doses with Cuero Regional — a chain of cooperation that rural communities count on as a matter of culture, with or without state directives.
Citizens Medical Center, about 30 miles away in Victoria, received a large allotment of vaccines before Cuero did, and more than a dozen of Cuero’s health care workers were able to travel there to be vaccinated, said Emily Weatherly, a spokesperson for Cuero Regional.
Then Cuero Regional, which received 200 doses of the Moderna vaccine just before Christmas, administered the vaccine to half a dozen of Lee’s staffers. A hospital in nearby Floresville vaccinated the rest, Lee said.
Weatherly said that although her facility has been able to vaccinate health care workers, the hospital is now “eagerly anticipating” another shipment and has set up an online form where people can sign up for a waiting list.
The facility has been inundated with calls from the public, she said, but everyone is still playing the waiting game for the next round of new doses.
“We are at the mercy of the state,” she said.
Another issue outlined by the hospitals is an array of delays and difficulties in the process to apply and register as a vaccine provider with the state.
The process is no different for the larger or urban hospitals, but it presents a unique challenge to the smaller facilities that don’t have the resources to spend what some executives said could be weeks of follow ups to correct glitches.
In some cases, administrators said their applications were rejected due to technical errors but they were never notified, finding out on their own weeks later that they had to resubmit paperwork.
A man walks to his truck after visiting the local post office in Kenedy.
Credit: Chris Stokes for The Texas Tribune
Otto Kaiser Memorial Hospital in Kenedy at Karnes County.
Credit: Chris Stokes for The Texas Tribu
First: A man walks to his truck after visiting the local post office in Kenedy. Last: Otto Kaiser Memorial Hospital in Kenedy at Karnes County.
Credit: Chris Stokes for The Texas Tribune
Some of the problems arose from user error, like missing signatures, but the correction and notification process shouldn’t take weeks in a state where hundreds of people die every day and record numbers of people are hospitalized for COVID, administrators said.
“Suffice it to say that DSHS has made the enrollment process more cumbersome than it needed to be,” Bates said in an email to the Tribune. “The most ridiculous examples were first described to us as an ‘enrollment system error.’ We later found out it was because the hospital was using Internet Explorer instead of Chrome…for real.”
Each time the application is corrected it has to be signed again and then resubmitted, and then is subject to approval and processing times, Bates said.
Lee agreed that the process is rife with opportunities for user error but, more importantly, creates delays for strapped small hospitals trying to wade through the red tape and get their workers and residents vaccinated while also taking care of a surge of COVID-19 patients.
Some application issues in early November delayed Otto Kaiser’s process because “it took the better part of six weeks get it all fixed, in spite of the fact that we were sending frequent emails to check on status and waiting 90 minutes on hold to speak to someone,” Lee said.
“I know that DSHS is slammed and distribution of the vaccine is a huge undertaking,” he said. “But the process and the associated lack of communication is hard to accept, and our health care workers and our community are being delayed access to the vaccine as a result.”
Staff writer Shannon Najmabadi contributed to this report.
Disclosure: H-E-B and Texas Organization of Rural & Community Hospitals (TORCH) have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.
Jeffrey Warnken, right, and his wife Sandra Warnken, who are both pharmacists, organize vaccine paperwork at 38th Street Pharmacy in Austin on Jan. 7, 2021. The pharmacy ran out of its initial allotment of 200 Moderna vaccine doses this week. “We did not waste one dose,” Jeffery Warnken said. “I didn’t hold any back.”
Credit: Jordan Vonderhaar for The Texas Tribune
Rannon Ching, pharmacist for Tarrytown Pharmacy in Austin, got the call at 8 a.m. on Dec. 23: Five hundred doses of the Moderna vaccine were arriving. Get ready.
“I found out two hours before the FedEx guy came,” he said. Ching frantically called some Austin senior care facilities on his way to work. Could his pharmacists come that afternoon?
By 10:30 a.m. his staff had the vials in hand. By 1 p.m. they vaccinated a doctor’s office. By 3, they’d started on the residents and staff at a nursing home.
“The first day, we immunized over 200 people within the first four hours of having the vaccine,” he said. Staff stayed until 9 p.m. that night entering immunization data for the state — by hand.
By the time Texas told the public five days later that the vaccine could be administered to group 1B, which includes anyone over 65 and those over 16 with certain health conditions, Ching’s pharmacy only had 20 doses left.
But the public didn’t know that. His pharmacy was swarmed — it received 100 phone calls within the first 15 minutes of being open the day after the announcement.
“The state said, ‘You can get your vaccine’ and people thought 3 million doses magically popped up into our freezers overnight,” Ching said.
Texas has largely left the vaccine rollout process in the hands of local providers like Tarrytown Pharmacy, one of more than 1,000 providers approved to vaccinate Texans. And outside of dictating the first two groups allowed to receive it, providers say the state has given little instruction or information on when allotments will arrive, how immunization operations should be organized and what principles ought to be followed in prioritizing within groups 1A and 1B.
As they spearhead vaccination in a state of 29 million people, hospitals, pharmacies and community health centers alike across Texas built new scheduling systems from scratch, struggled to sync their patient information systems with the state’s and answered to an increasingly anxious public wondering when their turn for the shot will come — all while helping fight the COVID-19 pandemic during its highest peak in Texas.
“Every space I have is booked. I have phones going off the hook saying, ‘Where’s mine?’” said Dr. James McCarthy, chief physician executive for the Memorial Hermann Health System in Houston. “The demand is insatiable right now. Everybody wants it today, and we just don’t have enough vaccines. It will take months.”
Pharmacist Jeffrey Warnken holds an empty Moderna COVID-19 vaccine container at his pharmacy in Austin.
Credit: Jordan Vonderhaar for The Texas Tribune
The state’s initial allocation of 1.2 million doses had been shipped by Jan. 3, according to state health officials, and another January shipment was expected to bring the state’s total allotment to 1.7 million. That’s still hundreds of thousands of doses short of the roughly 1.9 million necessary to provide just a first dose of vaccine to those Texas health care workers and residents of long-term care facilities eligible in group 1A.
But before many of those first in line had received a dose, the state allowed providers to start administering the vaccine to the second group — about 8 million people older than 65 or at least 16 with certain medical conditions. A Department of State Health Services official said there is some overlap between groups 1A and 1B (doctors and other health care workers over age 65, for example).
Overwhelmed by 1B
The sudden announcement to open vaccinations to the second group — just a week after the first distribution of vaccines for the first group — caught many providers off guard.
“It was in response to all of the chatter and angst to ‘Oh my God, they haven’t given all their vaccines out,’ and it’s been five days,” said McCarthy of Memorial Hermann. “I thought we would get all the health care workers done, and then we would move on. I didn’t think we’d be doing them simultaneously.”
Memorial Hermann got its first allocation of 16,000 doses, enough to vaccinate its front line medical staff, on Dec. 15. “It was all queued, it was all slated to be given,” McCarthy said of the first allotment. “We had no idea when we would get our second allocation.”
All of a sudden, “on Christmas Eve we’re drawing up a plan to do patients” because of the state’s announcement, he said.
Seemingly overnight, many Texas hospitals, health centers and pharmacies’ phone lines were clogged. Websites for providers all over the state crashed. Long lines of the people most vulnerable to the virus began to form at vaccine centers.
In a tweet, Gov. Greg Abbott added to the frustration, seemingly suggesting that an excess supply of vaccine was available and criticizing providers for not moving quickly enough to administer it.
At Memorial Hermann, a link was emailed to 50,000 select, qualified patients to schedule their vaccine at one of seven public clinics. But some recipients started forwarding that link to friends and family, and even posting it on Instagram.
Every space was booked within 36 hours. People who weren’t supposed to register had registered. People who weren’t supposed to show up, showed up. Staff had to turn them away if they didn’t meet the state’s criteria for a vaccine, McCarthy said.
Peggy Duncan, 77, center, stands with her daughter Lori McCormick, right, and other Tarrant County residents as they wait to receive a COVID-19 vaccine at the Esports Stadium in Arlington on Tuesday.
Credit: for the Texas Tribune
“That’s a very difficult thing,” McCarthy said. He said the hospital’s tech team resolved the problem with a link that couldn’t be forwarded.
In the Rio Grande Valley and elsewhere on the border, patients responded to vaccination announcements and found themselves in long lines. One line to get the vaccine at a public drive-thru clinic in Laredo extended for miles last weekend, with Texans at high risk of the virus arriving as early as 3:30 a.m. Sunday, according to the Laredo Morning Times.
Across the state, the vaccine providers quickly realized “first come, first served” was not working. Normal scheduling mechanisms would have to be revised.
In Southeast Texas, CHRISTUS Health piloted some walk-in clinics, but those were quickly overwhelmed.
“It’s not feasible to do a walk-in clinic,” said Dr. Sam Bagchi, chief clinical officer at CHRISTUS Health, a health care system with 34 hospitals in the state, many in Southeast Texas. “We ran out very quickly or experienced long delays.”
The system directed its qualified patients to schedule an appointment, as many other providers have now done. Both CHRISTUS Health and Memorial Hermann executives said that starting with their regular patients was the fastest way to begin distributing vaccines because all of their information was already in the system.
Valley residents lined up in the early hours of the morning for the COVID-19 vaccine at the Rio Grande Valley Livestock Show Grounds on Jan. 5, 2020.
Credit: Jason Garza for The Texas Tribune
Smaller providers, too, were bogged down by the huge demand. At Jeffrey Warnken’s 38th Street Pharmacy, a family-owned business in Austin, staff took 500 calls in one hour on the day the state announced group 1B could begin receiving the vaccine.
“Honestly, we couldn’t even fill our prescriptions that day,” due to the enormous call volume, Warnken said. His pharmacy is already out of its allotment; there are thousands on his waiting list. “I’m all in favor of 1B getting it. We just need to get more vaccines.”
Chris Van Deusen, a spokesperson for the state’s health department, said Texas wanted to give providers flexibility to vaccinate priority groups in the best way they can, and that the Expert Vaccine Allocation Panel felt that people in high risk groups should be prioritized as soon as possible.
“We don’t want to have an overly restrictive system that creates barriers to people getting vaccinated,” Van Deusen said.
But limited supplies meant that providers had to make decisions about who should be prioritized within the already prioritized groups.
At Memorial Hermann, the system invited limited pools of people over 65 who are regular patients to schedule — McCarthy said they didn’t want to debate whether or not the patient had a qualifying medical condition.
“It’s not meant to be who is more worthwhile — the fact of the matter is supply and capacity,” he said. “Our intent is to get to everybody … We need a lot of patience to make this work.”
At CHRISTUS Health, a task force mapped out the ethical distribution of vaccines between different groups, particularly emphasizing distribution to communities of color that have historically been marginalized by the U.S. health care system, Bagchi said.
“We had to balance ethical prioritization with the logistics of depleting the inventory as quickly as possible,” Bagchi said.
Some, like CHRISTUS Health, are glad to make those calls: Bagchi said he applauds the state’s move to open vaccination to more people: “Because of the quick move to 1B and broader definition of 1B, I think more people are getting vaccinated faster,” he said.
But at Austin Regional Clinic, Chief Medical Information Officer Dr. Manish Naik said the quick pivot to 1B caught them by surprise.
“(The state) opened up a very large group,” said Naik. “That’s a huge number of people, and there’s a bit of a disconnect versus the amount (of vaccine) we actually have to administer. It’s created a lot of anxiety among patients.”
“We made our best guess”
Before vaccines even arrived, much of the preparation was a guessing game for providers. They didn’t know whether they’d get the Moderna or Pfizer vaccine, which have different thaw times and storage temperatures. They didn’t even know the size of the vaccine boxes and whether they would fit in their freezers.
“We made our best guess,” said Naik of the Austin Regional Clinic, which has 29 locations throughout the Austin metro area. “There was a lot of energy and cost put into preparation before we even got a dose of vaccine.”
Providers stocked up on syringes, Band-Aids and masks, months in advance. IT teams started designing scheduling websites. Still, most of the decisions were being made in the dark. Some decided to invest in ultra-low-temperature freezers to store the Pfizer vaccine. Centro San Vicente, a community health center in El Paso, coordinated with a local university to get access to more freezer space. Others just hoped they’d get the Moderna vaccine.
Once the vaccines arrived, logistical hurdles emerged. Providers had trouble syncing their computer systems with the state’s COVID-19 immunization registry, which the state uses to compile data on vaccinations.
Many had to input the data by hand. It took four Tarrytown Pharmacy staffers six hours to input around 500 patients’ data into the state’s registry, Ching estimated.
“That’s 24 hours they could be vaccinating people — if they had doses,” Ching said. “It creates a huge bottleneck.”
A row of syringes for the COVID-19 vaccine at Doctors Hospital at Renaissance in Edinburg on Dec. 19, 2020.
Credit: Jason Garza for The Texas Tribune
In a statement, Van Deusen of DSHS said that the state is continuously working with providers to help them report vaccination data as smoothly as possible.
Less than half of the vaccine doses sent across Texas have been given out, according to state data, although the estimates lag behind real time due to reporting delays. Several providers said their vaccines have already been earmarked for patients. Others have run out and aren’t sure when more will arrive.
H-E-B, for example, wrote in a press release Jan. 3 that it has either already distributed its first allotment of vaccines or has scheduled them to be administered.
Some providers expect a second allotment will arrive soon, but they don’t know when. During the first allotment, many only got a day or a few hours of notice.
“We haven’t gotten a lot of lead time on this,” Naik said. “Within a day we have to scramble to figure out: Where are we going to allot these, and do we have the staff, or do we need to set up a separate site?”
Any vaccine still on shelves could be a result of scheduling patients to receive the vaccine and needing the staff, information and time to get them all done, providers said. Vials must be properly thawed. Vaccinations must be scheduled. Patient consent forms acquired. Reports written for the state. The logistics are unending.
“It’s a very daunting process, so I think the perception of what’s being ‘held on the shelf’ is us trying to organize and prepare,” said Dr. Celina Beltran, chief medical officer at Centro San Vicente, which began administering vaccines to group 1B on Wednesday.
“Giving the patients the vaccine is the easy part,” Beltran said. “We’ve spent a majority of the time on rolling out the process.”
Disclosure: Christus Health and H-E-B have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.
I’m in some level of shock at the attempted insurrection in Washington this week.
Clearly, Trump’s goal was to have the rioters seize the boxes containing the state reports of electoral votes, thus preventing the process of ordaining President-Elect Biden from reaching it’s conclusion. That goal failed when alert Congressmen grabbed the boxes and carried them to safety before the rioters could achieve entry to the chambers. That also explains the rifling of desks — the insurgents couldn’t find what they wanted.
In doing that, Trump violated his oath of office and should be impeached and perhaps charged with treason. In fact, he will fly to Florida before the inauguration to avoid arrest by police on behalf of the State of New York when his term as president ends. The governor of Florida has sworn to prevent extradition to New York. That’s why Trump won’t be at the Inauguration. He’s…
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Hold on for a while and catch a little breath
Let your effervescence not restrained
From getting entwined with the moment
Do perceive and reflect
As much as you can
Soak the warmth of the sun
Feel the texture of the sand
Go lost in the colors of the sky
The prized laughter of your beings
Just take a moment to cherish
As the time is slithering and will soon perish
Don’t await for tomorrow to relish
The essence once gone never replenish
Don’t tie up your inner butterflies
Let them flutter
For if you save them for later
Nothing will you ever cater
Man never settles until their doom
With those twinkling eye drops
Smiling and laughing you can only reminisce
You can’t perceive and live them again
Neither will you be the same
Neither will be those who loved you so
You will see a long…
View original post 95 more words