#Workplace Safety for Nurses

[nursingucgconferences]

Submit Your Abstract for the 15th World Healthcare, Nursing & Patient Safety Conference: A Golden Opportunity to Showcase Your Expertise!

The 15th World Healthcare, Nursing & Patient Safety Conference (15NHPSUCG2024), scheduled to take place from May 14–16, 2024, in the vibrant city of San Francisco, USA, is calling for innovative, impactful, and research-driven abstracts. This prestigious gathering brings together healthcare leaders, nursing professionals, researchers, academicians, and policy-makers from around the globe to discuss emerging trends, share knowledge, and set the tone for advancements in healthcare and patient safety.

If you are passionate about transforming healthcare practices and advancing the field of nursing, this conference offers the perfect platform to present your groundbreaking research, evidence-based practices, and transformative solutions. Here’s why you should consider submitting your abstract today.

Key Topics for Abstract Submission

The scientific sessions at 15NHPSUCG2024 encompass a diverse range of healthcare and nursing topics. Here are some of the focal areas:

1. Nursing Specialties and Advanced Practice

Pediatric Nursing: Innovations in child care and advocacy.

Women’s Health Nursing: Advances in maternal and reproductive health.

Geriatric Nursing: Addressing aging-related health challenges.

Psychiatric and Mental Health Nursing: Strategies for mental well-being.

Emergency and Trauma Nursing: Innovations in critical care settings.

2. Patient Safety and Quality Care

Risk management in healthcare settings.

Error prevention and safe medication practices.

Role of technology in enhancing patient safety.

Addressing disparities in patient outcomes.

3. Healthcare Management and Leadership

Leadership development in nursing.

The economics of healthcare: Challenges and solutions.

Effective strategies for managing healthcare teams.

Policy-making for a sustainable healthcare future.

4. Emerging Trends in Nursing Education

Use of simulation and AI in nursing training.

Innovations in curriculum design for nursing programs.

Continuing Professional Development (CPD) for nurses.

5. Public Health and Global Nursing Practices

Community health nursing: Bridging gaps in underserved areas.

Nursing’s role in combating infectious diseases.

Addressing the social determinants of health.

6. Nutrition, Dietetics, and Metabolic Health

Role of nursing in dietary management of chronic diseases.

Managing metabolic syndrome through interprofessional approaches.

Innovations in patient education on nutrition and wellness.

7. Technology in Healthcare

Impact of AI and machine learning on nursing practices.

Telemedicine and its role in modern nursing.

Wearable health technologies and patient monitoring.

Why Submit Your Abstract?

Gain Global Recognition: Present your work to a distinguished audience of healthcare experts from across the world.

Network with Thought Leaders: Build connections with pioneers in healthcare, nursing, and patient safety.

Enhance Your Career: Showcase your expertise, receive constructive feedback, and boost your professional profile.

Awards and Recognition: Compete for awards in oral and poster presentation categories.

How to Submit Your Abstract

Submitting your abstract is easy and streamlined. Visit the official conference website here to explore detailed instructions on submission guidelines and deadlines. Make sure to align your abstract with one of the conference’s scientific tracks for a higher chance of selection.

Abstract Submission Tips

Clearly define your research objective and its relevance to healthcare or nursing.

Provide concise and impactful conclusions.

Highlight the innovation or novelty of your work.

Proofread thoroughly to ensure clarity and professionalism.

Mark Your Calendar

Abstract submission deadline: TBDEarly registration deadline: November 30, 2024

Join us at the 15th World Healthcare, Nursing & Patient Safety Conference and contribute to reshaping the future of global healthcare. Whether you’re a seasoned professional or a budding researcher, your voice matters. Share your insights, inspire others, and help drive impactful change in healthcare practices worldwide.

Submit your abstract today and make your mark in the world of healthcare and nursing!

4o

You said:

Add submit your Abstract here: https://nursing.utilitarianconferences.com/scientific-sessions add topics of 50 nursing topics and hyperlink with the same

ChatGPT said:

ChatGPT

Submit Your Abstract for the 15th World Healthcare, Nursing & Patient Safety ConferenceSubmit Here

The 15th World Healthcare, Nursing & Patient Safety Conference (15NHPSUCG2024) is your platform to share impactful research, innovative practices, and groundbreaking ideas in healthcare and nursing. This event, happening from May 14–16, 2024, in San Francisco, USA, invites you to contribute to its dynamic sessions and collaborate with global thought leaders.

Explore an extensive array of nursing topics, submit your abstract, and be part of this transformative conference.

Key Topics for Abstract Submission

Specialized Nursing Fields

Pediatric Nursing

Neonatal Nursing

Geriatric Nursing

Cardiac Nursing

Orthopedic Nursing

Critical Care Nursing

Oncology Nursing

Psychiatric and Mental Health Nursing

Women’s Health Nursing

Emergency and Trauma Nursing

Patient Safety and Quality Improvement

Safe Medication Practices

Infection Prevention and Control

Healthcare Risk Management

Error Reduction in Clinical Settings

Disparities in Patient Outcomes

Technology in Nursing and Healthcare

Artificial Intelligence in Nursing

Telemedicine in Nursing Practice

Wearable Health Technologies

Robotics in Patient Care

Big Data and Predictive Analytics

Nursing Education and Professional Development

Simulation in Nursing Education

Continuing Professional Development (CPD)

Innovative Curriculum Design

Leadership Training for Nurses

Interdisciplinary Learning

Public Health Nursing and Global Health

Community Health Nursing

Nursing’s Role in Infectious Disease Control

Global Health Disparities

Healthcare for Refugees and Migrants

Nursing’s Contribution to Disaster Relief

Chronic Disease Management

Diabetes Care and Management

Hypertension and Cardiovascular Health

Managing Metabolic Syndrome

Nursing’s Role in Obesity Management

Palliative and End-of-Life Care

Nutrition and Wellness

Nutrition in Chronic Illness

Dietary Counseling for Patients

Nursing’s Role in Promoting Wellness

Nutritional Therapy in Critical Care

Patient Education on Healthy Lifestyles

Other Emerging Topics

Holistic Nursing Approaches

Ethics in Nursing Practice

Cultural Competence in Nursing

Environmental Health Nursing

Healthcare Policy and Advocacy

Innovations in Surgical Nursing

Perioperative Nursing

Workplace Safety for Nurses

Burnout Prevention in Nursing

Future Trends in Nursing

Why Submit Your Abstract?

Gain recognition for your work on a global stage.

Network with leading healthcare professionals and researchers.

Enhance your expertise with valuable feedback.

Compete for prestigious awards for oral and poster presentations.

Don’t miss this opportunity!Submit your abstract today: https://nursing.utilitarianconferences.com/submit-abstract

[heardatmedschool]

“Don’t hold the stitches like that, you’ll get into a sharps accident. You DON’T want a sharps accident.”

A poor resident that has seen too much.

[performancehealthpartners]

Explore practical strategies for improving nurse safety in the workplace with Performance Health. Our detailed guide offers actionable tips, best practices, and innovative solutions to protect nurses from workplace hazards. Learn how to reduce risks, prevent injuries, and enhance the well-being of healthcare professionals. Create a safer, healthier work environment for nurses. Visit our blog for essential insights and expert advice.

[ek-ranjhaan]

She has not just been raped and murdered, she was very much tortured and brutalized like Nirbhaya. It is all over the Bengali news. I don't understand why no one is talking about this.

A 2nd year Respiratory Medicine in a well known government medical college in Kolkata, West Bengal, India is found in a semi-naked state and the college/ hospital called it a suicide.

I'm a MBBS student in second year. After reading about her, what crossed my mind is the amount of times she would have felt this fear, before this worst fear of hers eventually materialized.

"A young resident doctor was found dead in the seminar room of her medical college in Kolkata. Initial autopsy report suggests possible rape and murder."

As all are saying,

She wasn't walking the street at odd hours. She wasn't wearing clothes that were provocative. She wasn't loitering in dangerous neighbourhoods.

She was a resident doctor, looking for a place to rest in her own hospital.

She had been on duty and had gone to rest in the early hours of Friday.

The one place which was supposed to guarantee her safety failed her, miserably.

Someone comes, rapes a female pg who is merely resting in a seminar hall because there is no proper place for her to rest, brutalized her and kills her. How did NO one know? The college and police initially call it a suicide. Excuse me? It is also being said that under pressure from local politicians, the Principal and Dean attempted to alter the post-mortem report. Autopsy confirms sexual assault.

What are the actions taken? One man arrested because his behavior seemed "shady". This is clearly not an act of one man. And this was a very well aware of and a well executed criminal act.

Also, all this happening in WB right when the situation of bangladesh is in turmoil and news of Bangladeshi Hindus being killed and tortured, seems wrong, VERY WRONG. Happening right before NEET-PG, as 24 lakh doctors prepare to write an exam on Sunday to be resident doctors, this news has wrapped us all in agony and rage,

What are they working so hard for? Why should they aspire to be in a system that ignores their basic needs? The minimum requirement of a workplace is safety. That should be non-negotiable.

This profession demands extereme hardwork, a lot of mental strength and Physical Assaults, harassment, low paying jobs with odd working hours with intense humiliation. Now its the worst of all seeing a bright mind losing her life in the most disrespectful state of all. This should never happen to any woman.

I'd also like to question why isn't any big media house covering this news, where are all the international news channels all this time.

What are the students in other medical colleges doing? This talks about their own safety and lives. What are the medical students across the world doing? It's time for us to stand for the most basic Human right, safety.

Yesterday when my roommate, an MBBS final year intern was heading for her night posting, I feared and prayed for her to come back safely. Thinking about it, in a few years I will also have night posting, I'll also return from my hospital duties late at night. I'll also have to go through the same fear, and I'll also have to keep praying that my worst fears don't turn into reality. So many female doctors, nursing staffs, other Healthcare workers, other working women, non-working women go through the same fear, probably multiple times a day.

It is a shame to be born in such a disgusting world and society, it is shame to witness such a brutal crime, and it is a shame to live in this fear daily.

Those RAPISTS need to be hunged infront of the whole natio...if needed burned alive. People should fear the idea of raping, more than getting raped.

[batboyblog]

Things Biden and the Democrats did, this week #25

June 28-July 5 2024

The Department of Labor's Occupational Safety and Health Administration (OSHA). Is putting forward the first ever federal safety regulation to protect worker's from excessive heat in the workplace. As climate change has caused extreme heat events to become more common work place deaths have risen from an average of 32 heat related deaths between 1992 and 2019 to 43 in 2022. The rules if finalized would require employers to provide drinking water and cool break areas at 80 degrees and at 90 degrees have mandatory 15-minute breaks every two hours and be monitored for signs of heat illness. This would effect an estimated 36 million workers.

The Federal Emergency Management Agency announced $1 Billion for 656 projects across the country aimed at helping local communities combat climate change fueled disasters like flooding and extreme heat. Some of the projects include $50 Million to Philadelphia for a stormwater pump station and combating flooding, and a grant to build Shaded bus shelters in Washington, D.C.

The Department of Transportation announced thanks to efforts by the Biden Administration flight cancellations at the lowest they've been in a decade. At just 1.4% for the year so far. Transportation Secretary Pete Buttigieg credited the Department's new rules requiring automatic refunds for any cancellations or undue delays as driving the good numbers as well as the investment of $25 billion in airport infrastructure that was in the Bipartisan Infrastructure Law.

The Department of Transportation announced $600 million in the 3rd round of funding to reconnect communities. Many communities have been divided by highways and other Infrastructure projects over the years. Most often effecting racial minority and poor areas. The Biden Administration is dedicated to addressing these injustices and helping reconnect communities split for decades. This funding round will see Atlanta’s Southside Communities reconnected as well as a redesign for Birmingham’s Black Main Street, reconnecting a community split by Interstate 65 in the 1960s. 

The Biden Administration approved its 9th offshore wind power project. About 9 miles off the coast of New Jersey the planned wind farm will generated 2,800 megawatts of electricity, enough to power almost a million homes with totally clear power. This will bring the total amount of clean wind power generated by projects approved by the Biden Administration to 13 gigawatts. The Administration's climate goal is to generate 30 gigawatts from wind.

The Biden Administration announced funding for 12 new Regional Technology and Innovation Hubs. The $504 million dollars will go to supporting tech hubs in, Colorado, Montana, Indiana, Illinois, Nevada, New York, New Hampshire, South Carolina, Florida, Ohio, Oklahoma, and Wisconsin. These tech hubs together with 31 already announced and funded will support high tech manufacturing jobs, as well as training for 21st century jobs for millions of American workers.

HHS announced over $200 million to support improved care for older Americans, particularly those with Alzheimer’s and related dementias. The money is focused on training primary care physicians, nurse practitioners, and other health care clinicians in best practices in elder and dementia care, as well as seeking to  integrate geriatric training into primary care. It also will support ways that families and other non-medical care givers can be educated to give support to aging people.

HHS announced $176 million to help support the development of a mRNA-based pandemic influenza vaccine. As part of the government's efforts to be ready before the next major pandemic it funds and supports new vaccine's to try to predict the next major pandemic. Moderna is working on an mRNA vaccine, much like the Covid-19, vaccine focused on the H5 and H7 avian influenza viruses, which experts fear could spread to humans and cause a Covid like event.

[my-secret-shame-but-fanfiction]

Stitches

Marc Spector x GN!Reader • Rating: T Masterlist• ao3• want to be tagged? | request info • MK Bingo 2024 Masterlist •

Summary: Marc goes to A & E after you have an accident at work.

🌛For @moonknight-events MK Bingo Spring 2024 Event🌜

A/N: *gestures vaguely*

Warnings: swearing, reader has hair that gets shaved at the back, slimy guy called Luke

Word Count: 941

Marc was going to kill him. Kill everyone. It was a workplace for fuck’s sake, there were rules, regulations, fucking health and safety. They were meant to be in place to stop things like this happening, to stop things from happening to you. 

He marched through the hospital entrance, the automatic doors taking a millisecond too long for his liking and he had been a hair's breadth away from kicking the glass in.

He turned sharply left, heading for A & E, and spotted Luke, fucking Luke, a moment after he spotted him. 

And apparently Luke had a fucking death wish, because Marc’s scowl wasn’t enough to discourage the man from jumping to his feet and making his way over to him. 

Luke swallowed nervously as he came over, brushing his hair back with his right hand. “Steven, mate,” 

Oh, ‘mate’ was it? Marc clenched his jaw. The sudden urge to punch him square in the jaw was blisteringly overwhelming. His hand tensed, tendons trying to curl into a fist. 

Kick him in the dick instead. Steven.

Not in public. Jake. 

The surprisingly, but honestly unsurprisingly, agreement to violence from both of his headmates made Marc pause. Swallow. Try to calm himself. 

“Where are they?” Marc said gruffly, too stressed to bother with even sounding vaguely Steven-like. 

Luke stammered, a little on edge at the vicious tone of his voice. “I… Well…”

Marc glared. 

Luke had been a lot more collected when they’d met a few weeks ago at your work’s Christmas party. Charming and slimy in the way he’d weaselled over and flirted with you right in front of Steven. Despite your blatant rebuttal of his advances. Despite your clear refusal of wanting anything to do with him. No matter how many times you’d showed disinterest at work he still just didn’t get the fucking message. 

“Where are they?” Marc repeated, his voice cold and quiet. 

“They, well, there was an accident…”

Marc bit his tongue, forcing the words ‘I fucking know that’, down. Even if he hadn’t been given the message already, the fact that they were in a fucking hospital should have been enough for Luke to gather that Marc had a vague idea of what was going on.

“They’re with a doctor now, they’re just getting some stitches and-”

Marc didn’t see red. Instead, it was as if everything went sepia, drained of colour to the point where nothing mattered at all. “Stitches?” 

“Yeah, just a few-”

Marc stepped closer and Luke visibly cowered back suddenly realising the danger he was in. 

“Can I help you?” A nurse, a young man with bright eyes who barely seemed old enough to be out of school, moved between them, glancing between Marc and Luke. 

Luke said nothing, eyes wide still watching Marc for any sudden movements. 

Marc spoke your name softly, looking down. “I’m their partner, are they…?” He swallowed, too many words all at once trying to force their way out of his mouth. 

The nurse smiled kindly, “They’re fine, just with the doctor now down the hall. I’ll take you to them, okay?” 

Marc faltered for a moment, his eyebrows pinched together. “Is that okay, is, is that allowed? I don’t want to get in the way of anything.”

The nurse shook his head. “No problem at all, come.” He gently touched Marc’s arm, just enough to get him to turn and walk with him. 

You smile when the door opened and saw a rather ashen-looking Marc being ushered in by a kind-looking nurse. 

“Doctor Ali, is it okay for the patient’s partner to come in?” 

The doctor smiled and nodded her head, “Of course, I’m nearly done anyway.” She was busying herself with the equipment cart. 

Marc rushed in and quickly knelt down next to you, “Baby,” he whispered, taking your hand and pressing his lips to your knuckles. 

“Hey, hey,” you rubbed his back soothingly. “It’s okay, I’m okay.” 

He looked up at you with glassy eyes and a growing lump in the back of his throat. 

Slowly you moved your hand to his cheek and ran your thumb lightly over his skin. Newly growing stubble prickled against your fingers. 

Marc closed his eyes for a second, letting out a long sigh through his nose and allowed himself to press into your touch before he placed a kiss to your wrist and looked back into your eyes. 

“Though,” you smiled, trying to lighten the mood a little, “I might look a bit like a fifteenth century monk for a bit.” You pointed to the back of your head, moving slightly so Marc could see the patch of shaved hair and stitches. 

“Fuck.” He muttered, his voice barely audible. 

“It’s okay,” you smile. “It’ll grow back.” 

Marc gave you a look, “you know I’m talking about the size of the wound.”

“I know.” You lean down and kiss his forehead. 

“How did it happen?”

“I fell down, didn’t I?” 

“Baby-”

You pull him a little closer so you can give him a proper hug, he lets out another sigh when you wrap your arms around him and kiss his temple. “I’ll tell you the whole boring story later, I promise.” 

He nods. He knows, deep down, you’re only waiting until he’s calmed down a little, until the panic and nausea have left his heart and throat. 

“I saw Luke in the waiting area,” Marc mutters, still pressed close. “I nearly punched him.” 

You chuckle a bit at that in spite of yourself. “Amazing self control Spector.” 

Marc’s eyes crease as he smiles. “The day is still young.” 

____________________________________

Thank you for reading!

@pleasurebuttonwrites @raven-rk @campingwiththecharmings @alexxavicry @mystinky-butt @cocodiem @oscarisaacsspit @whatthefishh @mbakubabe @romanarose @pimosworld @jake-g-lockley @saturn-rings-writes @boredzillenial @lonelyisamyw-0love @melodygatesauthor @steven-grants-world  @eyelessfaces @angel-of-the-moons @minigirl87

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[techramonic]

More random info and pictures of the Kerch Polytechnic incident, mainly small details regarding Vlad.

home

His house and room. He grew up in Arshintsevo before moving somewhere else in Kerch, Crimea with his mother after his parents split up. He was living in poverty, since the only direct provider was his mother, who was a nurse and oncologist at a nearby orderly hospital.

ammo and gun training

The ammo he used for the attack. He used birdshot and buckshot pellet bullets. On July 18th 2018, he went to Egida Training Centre to apply for gun training.

Accordining to an interview user Skanderarrent2 posted on reddit, his trainer mentioned that he was skilled in shooting and initially thought that he had experience with firearms:

“Because he spoke very confident, self-collected. I felt that he was more mature in his soul than (an) 18 year old. It felt that he was a young adult, not a teenager, not an 18 year-old because he did everything clearly. Some people are verbose, but he didn’t have extra words, was silent. And he didn’t ask too many questions. I had the impression that he quickly learned, etc. That is, he created the impression of a trained person. The teachers noticed that he shot well, when asked where he learned why he shot so well, the young man replied, ‘I practiced shooting’”

The taining which included 4 hours in theory and 2 hours practice, cost Vlad 4,000 rubles or $62 instead of 6000 or $93. He said he had financial difficulties, and the management gave him a discount. He then subsequently earned a license and bought a gun from Oruzheinik Gun Shop during August of 2018.

purchase history and materials

His purchase history up until the attack and what he had bought and wore during the attack. People speculate that he hand-painted the "ненависть" on his shirt.

handwriting

an assignment he wrote regarding electrical safety. a rough translation of his assignment reads:

“Mapogon or an order defines the boundaries of the workplace, the volume of work performed, the scope of the work, as well as the list of employees who are responsible and perform the work. Unauthorized carrying out of work and white changes in people's permission instructions are strictly prohibited. If the work performed in an electrical installation involves the use of (unintelligible) mechanisms, then 4 technological steps are necessary KAPTAM - according to specially developed software. When performing work on electrical equipment up to 1000 V, the MO should be directly energized. Install fences for nearby live parts to which K work is carried out. accidental contact is possible when performing acidental...”

extra. why he standing like dat?? had to tip a toe

[covid-safer-hotties]

Also preserved on our archive

SARS-CoV-2 is now circulating out of control worldwide. The only major limitation on transmission is the immune environment the virus faces. The disease it causes, COVID-19, is now a risk faced by most people as part of daily life.

While some are better than others, no national or regional government is making serious efforts towards infection prevention and control, and it seems likely this laissez-faire policy will continue for the foreseeable future. The social, political, and economic movements that worked to achieve this mass infection environment can rejoice at their success.

Those schooled in public health, immunology or working on the front line of healthcare provision know we face an uncertain future, and are aware the implications of recent events stretch far beyond SARS-CoV-2. The shifts that have taken place in attitudes and public health policy will likely damage a key pillar that forms the basis of modern civilized society, one that was built over the last two centuries; the expectation of a largely uninterrupted upwards trajectory of ever-improving health and quality of life, largely driven by the reduction and elimination of infectious diseases that plagued humankind for thousands of years. In the last three years, that trajectory has reversed.

The upward trajectory of public health in the last two centuries Control of infectious disease has historically been a priority for all societies. Quarantine has been in common use since at least the Bronze Age and has been the key method for preventing the spread of infectious diseases ever since. The word “quarantine” itself derives from the 40-day isolation period for ships and crews that was implemented in Europe during the late Middle Ages to prevent the introduction of bubonic plague epidemics into cities.

Modern public health traces its roots to the middle of the 19th century thanks to converging scientific developments in early industrial societies:

The germ theory of diseases was firmly established in the mid-19th century, in particular after Louis Pasteur disproved the spontaneous generation hypothesis. If diseases spread through transmission chains between individual humans or from the environment/animals to humans, then it follows that those transmission chains can be interrupted, and the spread stopped. The science of epidemiology appeared, its birth usually associated with the 1854 Broad Street cholera outbreak in London during which the British physician John Snow identified contaminated water as the source of cholera, pointing to improved sanitation as the way to stop cholera epidemics. Vaccination technology began to develop, initially against smallpox, and the first mandatory smallpox vaccination campaigns began, starting in England in the 1850s.

The early industrial era generated horrendous workplace and living conditions for working class populations living in large industrial cities, dramatically reducing life expectancy and quality of life (life expectancy at birth in key industrial cities in the middle of the 19th century was often in the low 30s or even lower). This in turn resulted in a recognition that such environmental factors affect human health and life spans. The long and bitter struggle for workers’ rights in subsequent decades resulted in much improved working conditions, workplace safety regulations, and general sanitation, and brought sharp increases in life expectancy and quality of life, which in turn had positive impacts on productivity and wealth.

Florence Nightingale reemphasized the role of ventilation in healing and preventing illness, ‘The very first canon of nursing… : keep the air he breathes as pure as the external air, without chilling him,’ a maxim that influenced building design at the time.

These trends continued in the 20th century, greatly helped by further technological and scientific advances. Many diseases – diphtheria, pertussis, hepatitis B, polio, measles, mumps, rubella, etc. – became things of the past thanks to near-universal highly effective vaccinations, while others that used to be common are no longer of such concern for highly developed countries in temperate climates – malaria, typhus, typhoid, leprosy, cholera, tuberculosis, and many others – primarily thanks to improvements in hygiene and the implementation of non-pharmaceutical measures for their containment.

Furthermore, the idea that infectious diseases should not just be reduced, but permanently eliminated altogether began to be put into practice in the second half of the 20th century on a global level, and much earlier locally. These programs were based on the obvious consideration that if an infectious agent is driven to extinction, the incalculable damage to people’s health and the overall economy by a persisting and indefinite disease burden will also be eliminated.

The ambition of local elimination grew into one of global eradication for smallpox, which was successfully eliminated from the human population in the 1970s (this had already been achieved locally in the late 19th century by some countries), after a heroic effort to find and contain the last remaining infectious individuals. The other complete success was rinderpest in cattle9,10, globally eradicated in the early 21st century.

When the COVID-19 pandemic started, global eradication programs were very close to succeeding for two other diseases – polio and dracunculiasis. Eradication is also globally pursued for other diseases, such as yaws, and regionally for many others, e.g. lymphatic filariasis, onchocerciasis, measles and rubella. The most challenging diseases are those that have an external reservoir outside the human population, especially if they are insect borne, and in particular those carried by mosquitos. Malaria is the primary example, but despite these difficulties, eradication of malaria has been a long-standing global public health goal and elimination has been achieved in temperate regions of the globe, even though it involved the ecologically destructive widespread application of polluting chemical pesticides to reduce the populations of the vectors. Elimination is also a public goal for other insect borne diseases such as trypanosomiasis.

In parallel with pursuing maximal reduction and eventual eradication of the burden of existing endemic infectious diseases, humanity has also had to battle novel infectious diseases40, which have been appearing at an increased rate over recent decades. Most of these diseases are of zoonotic origin, and the rate at which they are making the jump from wildlife to humans is accelerating, because of the increased encroachment on wildlife due to expanding human populations and physical infrastructure associated with human activity, the continued destruction of wild ecosystems that forces wild animals towards closer human contact, the booming wildlife trade, and other such trends.

Because it is much easier to stop an outbreak when it is still in its early stages of spreading through the population than to eradicate an endemic pathogen, the governing principle has been that no emerging infectious disease should be allowed to become endemic. This goal has been pursued reasonably successfully and without controversy for many decades.

The most famous newly emerging pathogens were the filoviruses (Ebola, Marburg), the SARS and MERS coronaviruses, and paramyxoviruses like Nipah. These gained fame because of their high lethality and potential for human-to-human spread, but they were merely the most notable of many examples.

Such epidemics were almost always aggressively suppressed. Usually, these were small outbreaks, and because highly pathogenic viruses such as Ebola cause very serious sickness in practically all infected people, finding and isolating the contagious individuals is a manageable task. The largest such epidemic was the 2013-16 Ebola outbreak in West Africa, when a filovirus spread widely in major urban centers for the first time. Containment required a wartime-level mobilization, but that was nevertheless achieved, even though there were nearly 30,000 infections and more than 11,000 deaths.

SARS was also contained and eradicated from the human population back in 2003-04, and the same happened every time MERS made the jump from camels to humans, as well as when there were Nipah outbreaks in Asia.

The major counterexample of a successful establishment in the human population of a novel highly pathogenic virus is HIV. HIV is a retrovirus, and as such it integrates into the host genome and is thus nearly impossible to eliminate from the body and to eradicate from the population (unless all infected individuals are identified and prevented from infecting others for the rest of their lives). However, HIV is not an example of the containment principle being voluntarily abandoned as the virus had made its zoonotic jump and established itself many decades before its eventual discovery and recognition, and long before the molecular tools that could have detected and potentially fully contained it existed.

Still, despite all these containment success stories, the emergence of a new pathogen with pandemic potential was a well understood and frequently discussed threat, although influenza viruses rather than coronaviruses were often seen as the most likely culprit. The eventual appearance of SARS-CoV-2 should therefore not have been a huge surprise, and should have been met with a full mobilization of the technical tools and fundamental public health principles developed over the previous decades.

The ecological context One striking property of many emerging pathogens is how many of them come from bats. While the question of whether bats truly harbor more viruses than other mammals in proportion to their own species diversity (which is the second highest within mammals after rodents) is not fully settled yet, many novel viruses do indeed originate from bats, and the ecological and physiological characteristics of bats are highly relevant for understanding the situation that Homo sapiens finds itself in right now.

Another startling property of bats and their viruses is how highly pathogenic to humans (and other mammals) many bat viruses are, while bats themselves are not much affected (only rabies is well established to cause serious harm to bats). Why bats seem to carry so many such pathogens, and how they have adapted so well to coexisting with them, has been a long-standing puzzle and although we do not have a definitive answer, some general trends have become clear.

Bats are the only truly flying mammals and have been so for many millions of years. Flying has resulted in a number of specific adaptations, one of them being the tolerance towards a very high body temperature (often on the order of 42-43ºC). Bats often live in huge colonies, literally touching each other, and, again, have lived in conditions of very high density for millions of years. Such densities are rare among mammals and are certainly not the native condition of humans (human civilization and our large dense cities are a very recent phenomenon on evolutionary time scales). Bats are also quite long-lived for such small mammals – some fruit bats can live more than 35 years and even small cave dwelling species can live about a decade.

These are characteristics that might have on one hand facilitated the evolution of a considerable set of viruses associated with bat populations. In order for a non-latent respiratory virus to maintain itself, a minimal population size is necessary. For example, it is hypothesized that measles requires a minimum population size of 250-300,000 individuals. And bats have existed in a state of high population densities for a very long time, which might explain the high diversity of viruses that they carry. In addition, the long lifespan of many bat species means that their viruses may have to evolve strategies to overcome adaptive immunity and frequently reinfect previously infected individuals as opposed to the situation in short-lived species in which populations turn over quickly (with immunologically naive individuals replacing the ones that die out).

On the other hand, the selective pressure that these viruses have exerted on bats may have resulted in the evolution of various resistance and/or tolerance mechanisms in bats themselves, which in turn have driven the evolution of counter strategies in their viruses, leading them to be highly virulent for other species. Bats certainly appear to be physiologically more tolerant towards viruses that are otherwise highly virulent to other mammals. Several explanations for this adaptation have been proposed, chief among them a much more powerful innate immunity and a tolerance towards infections that does not lead to the development of the kind of hyperinflammatory reactions observed in humans, the high body temperature of bats in flight, and others.

The notable strength of bat innate immunity is often explained by the constitutively active interferon response that has been reported for some bat species. It is possible that this is not a universal characteristic of all bats – only a few species have been studied – but it provides a very attractive mechanism for explaining both how bats prevent the development of severe systemic viral infections in their bodies and how their viruses in turn would have evolved powerful mechanisms to silence the interferon response, making them highly pathogenic for other mammals.

The tolerance towards infection is possibly rooted in the absence of some components of the signaling cascades leading to hyperinflammatory reactions and the dampened activity of others.

An obvious ecological parallel can be drawn between bats and humans – just as bats live in dense colonies, so now do modern humans. And we may now be at a critical point in the history of our species, in which our ever-increasing ecological footprint has brought us in close contact with bats in a way that was much rarer in the past. Our population is connected in ways that were previously unimaginable. A novel virus can make the zoonotic jump somewhere in Southeast Asia and a carrier of it can then be on the other side of the globe a mere 24-hours later, having encountered thousands of people in airports and other mass transit systems. As a result, bat pathogens are now being transferred from bat populations to the human population in what might prove to be the second major zoonotic spillover event after the one associated with domestication of livestock and pets a few thousand years ago.

Unfortunately for us, our physiology is not suited to tolerate these new viruses. Bats have adapted to live with them over many millions of years. Humans have not undergone the same kind of adaptation and cannot do so on any timescale that will be of use to those living now, nor to our immediate descendants.

Simply put, humans are not bats, and the continuous existence and improvement of what we now call “civilization” depends on the same basic public health and infectious disease control that saw life expectancy in high-income countries more than double to 85 years. This is a challenge that will only increase in the coming years, because the trends that are accelerating the rate of zoonotic transfer of pathogens are certain to persist.

Given this context, it is as important now to maintain the public health principle that no new dangerous pathogens should be allowed to become endemic and that all novel infectious disease outbreaks must be suppressed as it ever was.

The death of public health and the end of epidemiological comfort It is also in this context that the real gravity of what has happened in the last three years emerges.

After HIV, SARS-CoV-2 is now the second most dangerous infectious disease agent that is 'endemic' to the human population on a global scale. And yet not only was it allowed to become endemic, but mass infection was outright encouraged, including by official public health bodies in numerous countries.

The implications of what has just happened have been missed by most, so let’s spell them out explicitly.

We need to be clear why containment of SARS-CoV-2 was actively sabotaged and eventually abandoned. It has absolutely nothing to do with the “impossibility” of achieving it. In fact, the technical problem of containing even a stealthily spreading virus such as SARS-CoV-2 is fully solved, and that solution was successfully applied in practice for years during the pandemic.

The list of countries that completely snuffed out outbreaks, often multiple times, includes Australia, New Zealand, Singapore, Taiwan, Vietnam, Thailand, Bhutan, Cuba, China, and a few others, with China having successfully contained hundreds of separate outbreaks, before finally giving up in late 2022.

The algorithm for containment is well established – passively break transmission chains through the implementation of nonpharmaceutical interventions (NPIs) such as limiting human contacts, high quality respirator masks, indoor air filtration and ventilation, and others, while aggressively hunting down active remaining transmission chains through traditional contact tracing and isolation methods combined with the powerful new tool of population-scale testing.

Understanding of airborne transmission and institution of mitigation measures, which have heretofore not been utilized in any country, will facilitate elimination, even with the newer, more transmissible variants. Any country that has the necessary resources (or is provided with them) can achieve full containment within a few months. In fact, currently this would be easier than ever before because of the accumulated widespread multiple recent exposures to the virus in the population suppressing the effective reproduction number (Re). For the last 18 months or so we have been seeing a constant high plateau of cases with undulating waves, but not the major explosions of infections with Re reaching 3-4 that were associated with the original introduction of the virus in 2020 and with the appearance of the first Omicron variants in late 2021.

It would be much easier to use NPIs to drive Re to much below 1 and keep it there until elimination when starting from Re around 1.2-1.3 than when it was over 3, and this moment should be used, before another radically new serotype appears and takes us back to those even more unpleasant situations. This is not a technical problem, but one of political and social will. As long as leadership misunderstands or pretends to misunderstand the link between increased mortality, morbidity and poorer economic performance and the free transmission of SARS-CoV-2, the impetus will be lacking to take the necessary steps to contain this damaging virus.

Political will is in short supply because powerful economic and corporate interests have been pushing policymakers to let the virus spread largely unchecked through the population since the very beginning of the pandemic. The reasons are simple. First, NPIs hurt general economic activity, even if only in the short term, resulting in losses on balance sheets. Second, large-scale containment efforts of the kind we only saw briefly in the first few months of the pandemic require substantial governmental support for all the people who need to pause their economic activity for the duration of effort. Such an effort also requires large-scale financial investment in, for example, contact tracing and mass testing infrastructure and providing high-quality masks. In an era dominated by laissez-faire economic dogma, this level of state investment and organization would have set too many unacceptable precedents, so in many jurisdictions it was fiercely resisted, regardless of the consequences for humanity and the economy.

None of these social and economic predicaments have been resolved. The unofficial alliance between big business and dangerous pathogens that was forged in early 2020 has emerged victorious and greatly strengthened from its battle against public health, and is poised to steamroll whatever meager opposition remains for the remainder of this, and future pandemics.

The long-established principles governing how we respond to new infectious diseases have now completely changed – the precedent has been established that dangerous emerging pathogens will no longer be contained, but instead permitted to ‘ease’ into widespread circulation. The intent to “let it rip” in the future is now being openly communicated. With this change in policy comes uncertainty about acceptable lethality. Just how bad will an infectious disease have to be to convince any government to mobilize a meaningful global public health response?

We have some clues regarding that issue from what happened during the initial appearance of the Omicron “variant” (which was really a new serotype) of SARS-CoV-2. Despite some experts warning that a vaccine-only approach would be doomed to fail, governments gambled everything on it. They were then faced with the brute fact of viral evolution destroying their strategy when a new serotype emerged against which existing vaccines had little effect in terms of blocking transmission. The reaction was not to bring back NPIs but to give up, seemingly regardless of the consequences.

Critically, those consequences were unknown when the policy of no intervention was adopted within days of the appearance of Omicron. All previous new SARS-CoV-2 variants had been deadlier than the original Wuhan strain, with the eventually globally dominant Delta variant perhaps as much as 4× as deadly. Omicron turned out to be the exception, but again, that was not known with any certainty when it was allowed to run wild through populations. What would have happened if it had followed the same pattern as Delta?

In the USA, for example, the worst COVID-19 wave was the one in the winter of 2020-21, at the peak of which at least 3,500 people were dying daily (the real number was certainly higher because of undercounting due to lack of testing and improper reporting). The first Omicron BA.1 wave saw the second-highest death tolls, with at least 2,800 dying per day at its peak. Had Omicron been as intrinsically lethal as Delta, we could have easily seen a 4-5× higher peak than January 2021, i.e. as many as 12–15,000 people dying a day. Given that we only had real data on Omicron’s intrinsic lethality after the gigantic wave of infections was unleashed onto the population, we have to conclude that 12–15,000 dead a day is now a threshold that will not force the implementation of serious NPIs for the next problematic COVID-19 serotype.

Logically, it follows that it is also a threshold that will not result in the implementation of NPIs for any other emerging pathogens either. Because why should SARS-CoV-2 be special?

We can only hope that we will never see the day when such an epidemic hits us but experience tells us such optimism is unfounded. The current level of suffering caused by COVID-19 has been completely normalized even though such a thing was unthinkable back in 2019. Populations are largely unaware of the long-term harms the virus is causing to those infected, of the burden on healthcare, increased disability, mortality and reduced life expectancy. Once a few even deadlier outbreaks have been shrugged off by governments worldwide, the baseline of what is considered “acceptable” will just gradually move up and even more unimaginable losses will eventually enter the “acceptable” category. There can be no doubt, from a public health perspective, we are regressing.

We had a second, even more worrying real-life example of what the future holds with the global spread of the MPX virus (formerly known as “monkeypox” and now called “Mpox”) in 2022. MPX is a close relative to the smallpox VARV virus and is endemic to Central and Western Africa, where its natural hosts are mostly various rodent species, but on occasions it infects humans too, with the rate of zoonotic transfer increasing over recent decades. It has usually been characterized by fairly high mortality – the CFR (Case Fatality Rate) has been ∼3.6% for the strain that circulates in Nigeria and ∼10% for the one in the Congo region, i.e. much worse than SARS-CoV-2. In 2022, an unexpected global MPX outbreak developed, with tens of thousands of confirmed cases in dozens of countries. Normally, this would be a huge cause for alarm, for several reasons.

First, MPX itself is a very dangerous disease. Second, universal smallpox vaccination ended many decades ago with the success of the eradication program, leaving the population born after that completely unprotected. Third, lethality in orthopoxviruses is, in fact, highly variable – VARV itself had a variola major strain, with as much as ∼30% CFR, and a less deadly variola minor variety with CFR ∼1%, and there was considerable variation within variola major too. It also appears that high pathogenicity often evolves from less pathogenic strains through reductive evolution - the loss of certain genes something that can happen fairly easily, may well have happened repeatedly in the past, and may happen again in the future, a scenario that has been repeatedly warned about for decades. For these reasons, it was unthinkable that anyone would just shrug off a massive MPX outbreak – it is already bad enough as it is, but allowing it to become endemic means it can one day evolve towards something functionally equivalent to smallpox in its impact.

And yet that is exactly what happened in 2022 – barely any measures were taken to contain the outbreak, and countries simply reclassified MPX out of the “high consequence infectious disease” category in order to push the problem away, out of sight and out of mind. By chance, it turned out that this particular outbreak did not spark a global pandemic, and it was also characterized, for poorly understood reasons, by an unusually low CFR, with very few people dying. But again, that is not the information that was available at the start of the outbreak, when in a previous, interventionist age of public health, resources would have been mobilized to stamp it out in its infancy, but, in the age of laissez-faire, were not. MPX is now circulating around the world and represents a future threat of uncontrolled transmission resulting in viral adaptation to highly efficient human-to-human spread combined with much greater disease severity.

While some are better than others, no national or regional government is making serious efforts towards infection prevention and control, and it seems likely this laissez-faire policy will continue for the foreseeable future. The social, political, and economic movements that worked to achieve this mass infection environment can rejoice at their success.

Those schooled in public health, immunology or working on the front line of healthcare provision know we face an uncertain future, and are aware the implications of recent events stretch far beyond SARS-CoV-2. The shifts that have taken place in attitudes and public health policy will likely damage a key pillar that forms the basis of modern civilized society, one that was built over the last two centuries; the expectation of a largely uninterrupted upwards trajectory of ever-improving health and quality of life, largely driven by the reduction and elimination of infectious diseases that plagued humankind for thousands of years. In the last three years, that trajectory has reversed.

The upward trajectory of public health in the last two centuries Control of infectious disease has historically been a priority for all societies. Quarantine has been in common use since at least the Bronze Age and has been the key method for preventing the spread of infectious diseases ever since. The word “quarantine” itself derives from the 40-day isolation period for ships and crews that was implemented in Europe during the late Middle Ages to prevent the introduction of bubonic plague epidemics into cities1.

Rat climbing a ship's rigging. Modern public health traces its roots to the middle of the 19th century thanks to converging scientific developments in early industrial societies:

The germ theory of diseases was firmly established in the mid-19th century, in particular after Louis Pasteur disproved the spontaneous generation hypothesis. If diseases spread through transmission chains between individual humans or from the environment/animals to humans, then it follows that those transmission chains can be interrupted, and the spread stopped. The science of epidemiology appeared, its birth usually associated with the 1854 Broad Street cholera outbreak in London during which the British physician John Snow identified contaminated water as the source of cholera, pointing to improved sanitation as the way to stop cholera epidemics. Vaccination technology began to develop, initially against smallpox, and the first mandatory smallpox vaccination campaigns began, starting in England in the 1850s. The early industrial era generated horrendous workplace and living conditions for working class populations living in large industrial cities, dramatically reducing life expectancy and quality of life (life expectancy at birth in key industrial cities in the middle of the 19th century was often in the low 30s or even lower2). This in turn resulted in a recognition that such environmental factors affect human health and life spans. The long and bitter struggle for workers’ rights in subsequent decades resulted in much improved working conditions, workplace safety regulations, and general sanitation, and brought sharp increases in life expectancy and quality of life, which in turn had positive impacts on productivity and wealth. Florence Nightingale reemphasized the role of ventilation in healing and preventing illness, ‘The very first canon of nursing… : keep the air he breathes as pure as the external air, without chilling him,’ a maxim that influenced building design at the time. These trends continued in the 20th century, greatly helped by further technological and scientific advances. Many diseases – diphtheria, pertussis, hepatitis B, polio, measles, mumps, rubella, etc. – became things of the past thanks to near-universal highly effective vaccinations, while others that used to be common are no longer of such concern for highly developed countries in temperate climates – malaria, typhus, typhoid, leprosy, cholera, tuberculosis, and many others – primarily thanks to improvements in hygiene and the implementation of non-pharmaceutical measures for their containment.

Furthermore, the idea that infectious diseases should not just be reduced, but permanently eliminated altogether began to be put into practice in the second half of the 20th century3-5 on a global level, and much earlier locally. These programs were based on the obvious consideration that if an infectious agent is driven to extinction, the incalculable damage to people’s health and the overall economy by a persisting and indefinite disease burden will also be eliminated.

The ambition of local elimination grew into one of global eradication for smallpox, which was successfully eliminated from the human population in the 1970s6 (this had already been achieved locally in the late 19th century by some countries), after a heroic effort to find and contain the last remaining infectious individuals7,8. The other complete success was rinderpest in cattle9,10, globally eradicated in the early 21st century.

When the COVID-19 pandemic started, global eradication programs were very close to succeeding for two other diseases – polio11,12 and dracunculiasis13. Eradication is also globally pursued for other diseases, such as yaws14,15, and regionally for many others, e.g. lymphatic filariasis16,17, onchocerciasis18,19, measles and rubella20-30. The most challenging diseases are those that have an external reservoir outside the human population, especially if they are insect borne, and in particular those carried by mosquitos. Malaria is the primary example, but despite these difficulties, eradication of malaria has been a long-standing global public health goal31-33 and elimination has been achieved in temperate regions of the globe34,35, even though it involved the ecologically destructive widespread application of polluting chemical pesticides36,37 to reduce the populations of the vectors. Elimination is also a public goal for other insect borne diseases such as trypanosomiasis38,39.

In parallel with pursuing maximal reduction and eventual eradication of the burden of existing endemic infectious diseases, humanity has also had to battle novel infectious diseases40, which have been appearing at an increased rate over recent decades41-43. Most of these diseases are of zoonotic origin, and the rate at which they are making the jump from wildlife to humans is accelerating, because of the increased encroachment on wildlife due to expanding human populations and physical infrastructure associated with human activity, the continued destruction of wild ecosystems that forces wild animals towards closer human contact, the booming wildlife trade, and other such trends.

Because it is much easier to stop an outbreak when it is still in its early stages of spreading through the population than to eradicate an endemic pathogen, the governing principle has been that no emerging infectious disease should be allowed to become endemic. This goal has been pursued reasonably successfully and without controversy for many decades.

The most famous newly emerging pathogens were the filoviruses (Ebola44-46, Marburg47,48), the SARS and MERS coronaviruses, and paramyxoviruses like Nipah49,50. These gained fame because of their high lethality and potential for human-to-human spread, but they were merely the most notable of many examples.

Pigs in close proximity to humans. Such epidemics were almost always aggressively suppressed. Usually, these were small outbreaks, and because highly pathogenic viruses such as Ebola cause very serious sickness in practically all infected people, finding and isolating the contagious individuals is a manageable task. The largest such epidemic was the 2013-16 Ebola outbreak in West Africa, when a filovirus spread widely in major urban centers for the first time. Containment required a wartime-level mobilization, but that was nevertheless achieved, even though there were nearly 30,000 infections and more than 11,000 deaths51.

SARS was also contained and eradicated from the human population back in 2003-04, and the same happened every time MERS made the jump from camels to humans, as well as when there were Nipah outbreaks in Asia.

The major counterexample of a successful establishment in the human population of a novel highly pathogenic virus is HIV. HIV is a retrovirus, and as such it integrates into the host genome and is thus nearly impossible to eliminate from the body and to eradicate from the population52 (unless all infected individuals are identified and prevented from infecting others for the rest of their lives). However, HIV is not an example of the containment principle being voluntarily abandoned as the virus had made its zoonotic jump and established itself many decades before its eventual discovery53 and recognition54-56, and long before the molecular tools that could have detected and potentially fully contained it existed.

Still, despite all these containment success stories, the emergence of a new pathogen with pandemic potential was a well understood and frequently discussed threat57-60, although influenza viruses rather than coronaviruses were often seen as the most likely culprit61-65. The eventual appearance of SARS-CoV-2 should therefore not have been a huge surprise, and should have been met with a full mobilization of the technical tools and fundamental public health principles developed over the previous decades.

The ecological context One striking property of many emerging pathogens is how many of them come from bats. While the question of whether bats truly harbor more viruses than other mammals in proportion to their own species diversity (which is the second highest within mammals after rodents) is not fully settled yet66-69, many novel viruses do indeed originate from bats, and the ecological and physiological characteristics of bats are highly relevant for understanding the situation that Homo sapiens finds itself in right now.

Group of bats roosting in a cave. Another startling property of bats and their viruses is how highly pathogenic to humans (and other mammals) many bat viruses are, while bats themselves are not much affected (only rabies is well established to cause serious harm to bats68). Why bats seem to carry so many such pathogens, and how they have adapted so well to coexisting with them, has been a long-standing puzzle and although we do not have a definitive answer, some general trends have become clear.

Bats are the only truly flying mammals and have been so for many millions of years. Flying has resulted in a number of specific adaptations, one of them being the tolerance towards a very high body temperature (often on the order of 42-43ºC). Bats often live in huge colonies, literally touching each other, and, again, have lived in conditions of very high density for millions of years. Such densities are rare among mammals and are certainly not the native condition of humans (human civilization and our large dense cities are a very recent phenomenon on evolutionary time scales). Bats are also quite long-lived for such small mammals70-71 – some fruit bats can live more than 35 years and even small cave dwelling species can live about a decade. These are characteristics that might have on one hand facilitated the evolution of a considerable set of viruses associated with bat populations. In order for a non-latent respiratory virus to maintain itself, a minimal population size is necessary. For example, it is hypothesized that measles requires a minimum population size of 250-300,000 individuals72. And bats have existed in a state of high population densities for a very long time, which might explain the high diversity of viruses that they carry. In addition, the long lifespan of many bat species means that their viruses may have to evolve strategies to overcome adaptive immunity and frequently reinfect previously infected individuals as opposed to the situation in short-lived species in which populations turn over quickly (with immunologically naive individuals replacing the ones that die out).

On the other hand, the selective pressure that these viruses have exerted on bats may have resulted in the evolution of various resistance and/or tolerance mechanisms in bats themselves, which in turn have driven the evolution of counter strategies in their viruses, leading them to be highly virulent for other species. Bats certainly appear to be physiologically more tolerant towards viruses that are otherwise highly virulent to other mammals. Several explanations for this adaptation have been proposed, chief among them a much more powerful innate immunity and a tolerance towards infections that does not lead to the development of the kind of hyperinflammatory reactions observed in humans73-75, the high body temperature of bats in flight, and others.

The notable strength of bat innate immunity is often explained by the constitutively active interferon response that has been reported for some bat species76-78. It is possible that this is not a universal characteristic of all bats79 – only a few species have been studied – but it provides a very attractive mechanism for explaining both how bats prevent the development of severe systemic viral infections in their bodies and how their viruses in turn would have evolved powerful mechanisms to silence the interferon response, making them highly pathogenic for other mammals.

The tolerance towards infection is possibly rooted in the absence of some components of the signaling cascades leading to hyperinflammatory reactions and the dampened activity of others80.

Map of scheduled airline traffic around the world, circa June 2009 Map of scheduled airline traffic around the world. Credit: Jpatokal An obvious ecological parallel can be drawn between bats and humans – just as bats live in dense colonies, so now do modern humans. And we may now be at a critical point in the history of our species, in which our ever-increasing ecological footprint has brought us in close contact with bats in a way that was much rarer in the past. Our population is connected in ways that were previously unimaginable. A novel virus can make the zoonotic jump somewhere in Southeast Asia and a carrier of it can then be on the other side of the globe a mere 24-hours later, having encountered thousands of people in airports and other mass transit systems. As a result, bat pathogens are now being transferred from bat populations to the human population in what might prove to be the second major zoonotic spillover event after the one associated with domestication of livestock and pets a few thousand years ago.

Unfortunately for us, our physiology is not suited to tolerate these new viruses. Bats have adapted to live with them over many millions of years. Humans have not undergone the same kind of adaptation and cannot do so on any timescale that will be of use to those living now, nor to our immediate descendants.

Simply put, humans are not bats, and the continuous existence and improvement of what we now call “civilization” depends on the same basic public health and infectious disease control that saw life expectancy in high-income countries more than double to 85 years. This is a challenge that will only increase in the coming years, because the trends that are accelerating the rate of zoonotic transfer of pathogens are certain to persist.

Given this context, it is as important now to maintain the public health principle that no new dangerous pathogens should be allowed to become endemic and that all novel infectious disease outbreaks must be suppressed as it ever was.

The death of public health and the end of epidemiological comfort It is also in this context that the real gravity of what has happened in the last three years emerges.

After HIV, SARS-CoV-2 is now the second most dangerous infectious disease agent that is 'endemic' to the human population on a global scale. And yet not only was it allowed to become endemic, but mass infection was outright encouraged, including by official public health bodies in numerous countries81-83.

The implications of what has just happened have been missed by most, so let’s spell them out explicitly.

We need to be clear why containment of SARS-CoV-2 was actively sabotaged and eventually abandoned. It has absolutely nothing to do with the “impossibility” of achieving it. In fact, the technical problem of containing even a stealthily spreading virus such as SARS-CoV-2 is fully solved, and that solution was successfully applied in practice for years during the pandemic.

The list of countries that completely snuffed out outbreaks, often multiple times, includes Australia, New Zealand, Singapore, Taiwan, Vietnam, Thailand, Bhutan, Cuba, China, and a few others, with China having successfully contained hundreds of separate outbreaks, before finally giving up in late 2022.

The algorithm for containment is well established – passively break transmission chains through the implementation of nonpharmaceutical interventions (NPIs) such as limiting human contacts, high quality respirator masks, indoor air filtration and ventilation, and others, while aggressively hunting down active remaining transmission chains through traditional contact tracing and isolation methods combined with the powerful new tool of population-scale testing.

Oklahoma’s Strategic National Stockpile. Credit: DVIDS Understanding of airborne transmission and institution of mitigation measures, which have heretofore not been utilized in any country, will facilitate elimination, even with the newer, more transmissible variants. Any country that has the necessary resources (or is provided with them) can achieve full containment within a few months. In fact, currently this would be easier than ever before because of the accumulated widespread multiple recent exposures to the virus in the population suppressing the effective reproduction number (Re). For the last 18 months or so we have been seeing a constant high plateau of cases with undulating waves, but not the major explosions of infections with Re reaching 3-4 that were associated with the original introduction of the virus in 2020 and with the appearance of the first Omicron variants in late 2021.

It would be much easier to use NPIs to drive Re to much below 1 and keep it there until elimination when starting from Re around 1.2-1.3 than when it was over 3, and this moment should be used, before another radically new serotype appears and takes us back to those even more unpleasant situations. This is not a technical problem, but one of political and social will. As long as leadership misunderstands or pretends to misunderstand the link between increased mortality, morbidity and poorer economic performance and the free transmission of SARS-CoV-2, the impetus will be lacking to take the necessary steps to contain this damaging virus.

Political will is in short supply because powerful economic and corporate interests have been pushing policymakers to let the virus spread largely unchecked through the population since the very beginning of the pandemic. The reasons are simple. First, NPIs hurt general economic activity, even if only in the short term, resulting in losses on balance sheets. Second, large-scale containment efforts of the kind we only saw briefly in the first few months of the pandemic require substantial governmental support for all the people who need to pause their economic activity for the duration of effort. Such an effort also requires large-scale financial investment in, for example, contact tracing and mass testing infrastructure and providing high-quality masks. In an era dominated by laissez-faire economic dogma, this level of state investment and organization would have set too many unacceptable precedents, so in many jurisdictions it was fiercely resisted, regardless of the consequences for humanity and the economy.

None of these social and economic predicaments have been resolved. The unofficial alliance between big business and dangerous pathogens that was forged in early 2020 has emerged victorious and greatly strengthened from its battle against public health, and is poised to steamroll whatever meager opposition remains for the remainder of this, and future pandemics.

The long-established principles governing how we respond to new infectious diseases have now completely changed – the precedent has been established that dangerous emerging pathogens will no longer be contained, but instead permitted to ‘ease’ into widespread circulation. The intent to “let it rip” in the future is now being openly communicated84. With this change in policy comes uncertainty about acceptable lethality. Just how bad will an infectious disease have to be to convince any government to mobilize a meaningful global public health response?

We have some clues regarding that issue from what happened during the initial appearance of the Omicron “variant” (which was really a new serotype85,86) of SARS-CoV-2. Despite some experts warning that a vaccine-only approach would be doomed to fail, governments gambled everything on it. They were then faced with the brute fact of viral evolution destroying their strategy when a new serotype emerged against which existing vaccines had little effect in terms of blocking transmission. The reaction was not to bring back NPIs but to give up, seemingly regardless of the consequences.

Critically, those consequences were unknown when the policy of no intervention was adopted within days of the appearance of Omicron. All previous new SARS-CoV-2 variants had been deadlier than the original Wuhan strain, with the eventually globally dominant Delta variant perhaps as much as 4× as deadly87. Omicron turned out to be the exception, but again, that was not known with any certainty when it was allowed to run wild through populations. What would have happened if it had followed the same pattern as Delta?

In the USA, for example, the worst COVID-19 wave was the one in the winter of 2020-21, at the peak of which at least 3,500 people were dying daily (the real number was certainly higher because of undercounting due to lack of testing and improper reporting). The first Omicron BA.1 wave saw the second-highest death tolls, with at least 2,800 dying per day at its peak. Had Omicron been as intrinsically lethal as Delta, we could have easily seen a 4-5× higher peak than January 2021, i.e. as many as 12–15,000 people dying a day. Given that we only had real data on Omicron’s intrinsic lethality after the gigantic wave of infections was unleashed onto the population, we have to conclude that 12–15,000 dead a day is now a threshold that will not force the implementation of serious NPIs for the next problematic COVID-19 serotype.

UK National Covid Memorial Wall. Credit: Dominic Alves Logically, it follows that it is also a threshold that will not result in the implementation of NPIs for any other emerging pathogens either. Because why should SARS-CoV-2 be special?

We can only hope that we will never see the day when such an epidemic hits us but experience tells us such optimism is unfounded. The current level of suffering caused by COVID-19 has been completely normalized even though such a thing was unthinkable back in 2019. Populations are largely unaware of the long-term harms the virus is causing to those infected, of the burden on healthcare, increased disability, mortality and reduced life expectancy. Once a few even deadlier outbreaks have been shrugged off by governments worldwide, the baseline of what is considered “acceptable” will just gradually move up and even more unimaginable losses will eventually enter the “acceptable” category. There can be no doubt, from a public health perspective, we are regressing.

We had a second, even more worrying real-life example of what the future holds with the global spread of the MPX virus (formerly known as “monkeypox” and now called “Mpox”) in 2022. MPX is a close relative to the smallpox VARV virus and is endemic to Central and Western Africa, where its natural hosts are mostly various rodent species, but on occasions it infects humans too, with the rate of zoonotic transfer increasing over recent decades88. It has usually been characterized by fairly high mortality – the CFR (Case Fatality Rate) has been ∼3.6% for the strain that circulates in Nigeria and ∼10% for the one in the Congo region, i.e. much worse than SARS-CoV-2. In 2022, an unexpected global MPX outbreak developed, with tens of thousands of confirmed cases in dozens of countries89,90. Normally, this would be a huge cause for alarm, for several reasons.

First, MPX itself is a very dangerous disease. Second, universal smallpox vaccination ended many decades ago with the success of the eradication program, leaving the population born after that completely unprotected. Third, lethality in orthopoxviruses is, in fact, highly variable – VARV itself had a variola major strain, with as much as ∼30% CFR, and a less deadly variola minor variety with CFR ∼1%, and there was considerable variation within variola major too. It also appears that high pathogenicity often evolves from less pathogenic strains through reductive evolution - the loss of certain genes something that can happen fairly easily, may well have happened repeatedly in the past, and may happen again in the future, a scenario that has been repeatedly warned about for decades91,92. For these reasons, it was unthinkable that anyone would just shrug off a massive MPX outbreak – it is already bad enough as it is, but allowing it to become endemic means it can one day evolve towards something functionally equivalent to smallpox in its impact.

Colorized transmission electron micrograph of Mpox virus particles. Credit: NIAID And yet that is exactly what happened in 2022 – barely any measures were taken to contain the outbreak, and countries simply reclassified MPX out of the “high consequence infectious disease” category93 in order to push the problem away, out of sight and out of mind. By chance, it turned out that this particular outbreak did not spark a global pandemic, and it was also characterized, for poorly understood reasons, by an unusually low CFR, with very few people dying94,95. But again, that is not the information that was available at the start of the outbreak, when in a previous, interventionist age of public health, resources would have been mobilized to stamp it out in its infancy, but, in the age of laissez-faire, were not. MPX is now circulating around the world and represents a future threat of uncontrolled transmission resulting in viral adaptation to highly efficient human-to-human spread combined with much greater disease severity.

This is the previously unthinkable future we will live in from now on in terms of our approach to infectious disease.

What may be controlled instead is information. Another lesson of the pandemic is that if there is no testing and reporting of cases and deaths, a huge amount of real human suffering can be very successfully swept under the rug. Early in 2020, such practices – blatant denial that there was any virus in certain territories, outright faking of COVID-19 statistics, and even resorting to NPIs out of sheer desperation but under false pretense that it is not because of COVID-19 – were the domain of failed states and less developed dictatorships. But in 2023 most of the world has adopted such practices – testing is limited, reporting is infrequent, or even abandoned altogether – and there is no reason to expect this to change. Information control has replaced infection control.

After a while it will not even be possible to assess the impact of what is happening by evaluating excess mortality, which has been the one true measure not susceptible to various data manipulation tricks. As we get increasingly removed from the pre-COVID-19 baselines and the initial pandemic years are subsumed into the baseline for calculating excess mortality, excess deaths will simply disappear by the power of statistical magic. Interestingly, countries such as the UK, which has already incorporated two pandemic years in its five-year average, are still seeing excess deaths, which suggests the virus is an ongoing and growing problem.

It should also be stressed that this radical shift in our approach to emerging infectious diseases is probably only the beginning of wiping out the hard-fought public health gains of the last 150+ years. This should be gravely concerning to any individuals and institutions concerned with workers and citizens rights.

This shift is likely to impact existing eradication and elimination efforts. Will the final pushes be made to complete the various global eradication campaigns listed above? That may necessitate some serious effort involving NPIs and active public health measures, but how much appetite is there for such things after they have been now taken out of the toolkit for SARS-CoV-2?

We can also expect previously forgotten diseases to return where they have successfully been locally eradicated. We have to always remember that the diseases that we now control with universal childhood vaccinations have not been globally eradicated – they have disappeared from our lives because vaccination rates are high enough to maintain society as a whole above the disease elimination threshold, but were vaccination rates to slip, those diseases, such as measles, will return with a vengeance.

The anti-vaccine movement was already a serious problem prior to COVID-19, but it was given a gigantic boost with the ill-advised vaccine-only COVID-19 strategy. Governments and their nominal expert advisers oversold the effectiveness of imperfect first generation COVID-vaccines, and simultaneously minimized the harms of SARS-CoV-2, creating a reality gap which gave anti-vaccine rhetoric space to thrive. This is a huge topic to be explored separately. Here it will suffice to say that while anti-vaxxers were a fringe movement prior to the pandemic, “vaccination” in general is now a toxic idea in the minds of truly significant portions of the population. A logical consequence of that shift has been a significant decrease in vaccination coverage for other diseases as well as for COVID-19.

This is even more likely given the shift in attitudes towards children. Child labour, lack of education and large families were the hallmarks of earlier eras of poor public health, which were characterized by high birth-rates and high infant mortality. Attitudes changed dramatically over the course of the 20th century and wherever health and wealth increased, child mortality fell, and the transition was made to small families. Rarity increased perceived value and children’s wellbeing became a central concern for parents and carers. The arrival of COVID-19 changed that, with some governments, advisers, advocacy groups and parents insisting that children should be exposed freely to a Severe Acute Respiratory Syndrome virus to ‘train’ their immune systems.

Infection, rather than vaccination, was the preferred route for many in public health in 2020, and still is in 2023, despite all that is known about this virus’s propensity to cause damage to all internal organs, the immune system, and the brain, and the unknowns of postinfectious sequelae. This is especially egregious in infants, whose naive immune status may be one of the reasons they have a relatively high hospitalization rate. Some commentators seek to justify the lack of protection for the elderly and vulnerable on a cost basis. We wonder what rationale can justify a lack of protection for newborns and infants, particularly in a healthcare setting, when experience of other viruses tells us children have better outcomes the later they are exposed to disease? If we are not prepared to protect children against a highly virulent SARS virus, why should we protect against others? We should expect a shift in public health attitudes, since ‘endemicity’ means there is no reason to see SARS-CoV-2 as something unique and exceptional.

We can also expect a general degradation of workplace safety protocols and standards, again reversing many decades of hard-fought gains. During COVID-19, aside from a few privileged groups who worked from home, people were herded back into their workplaces without minimal safety precautions such as providing respirators, and improving ventilation and indoor air quality, when a dangerous airborne pathogen was spreading.

Can we realistically expect existing safety precautions and regulations to survive after that precedent has been set? Can we expect public health bodies and regulatory agencies, whose job it is to enforce these standards, to fight for workplace safety given what they did during the pandemic? It is highly doubtful. After all, they stubbornly refused to admit that SARS-CoV-2 is airborne (even to this very day in fact – the World Health Organization’s infamous “FACT: #COVID19 is NOT airborne” Tweet from March 28 2020 is still up in its original form), and it is not hard to see why – implementing airborne precautions in workplaces, schools, and other public spaces would have resulted in a cost to employers and governments; a cost they could avoid if they simply denied they needed to take such precautions. But short-term thinking has resulted in long-term costs to those same organizations, through the staffing crisis, and the still-rising disability tsunami. The same principle applies to all other existing safety measures.

Worse, we have now entered the phase of abandoning respiratory precautions even in hospitals. The natural consequence of unmasked staff and patients, even those known to be SARS-CoV-2 positive, freely mixing in overcrowded hospitals is the rampant spread of hospital-acquired infections, often among some of the most vulnerable demographics. This was previously thought to be a bad thing. And what of the future? If nobody is taking any measures to stop one particular highly dangerous nosocomial infection, why would anyone care about all the others, which are often no easier to prevent? And if standards of care have slipped to such a low point with respect to COVID-19, why would anyone bother providing the best care possible for other conditions? This is a one-way feed-forward healthcare system degradation that will only continue.

Finally, the very intellectual foundations of the achievements of the last century and a half are eroding. Chief among these is the germ theory of infectious disease, by which transmission chains can be isolated and broken. The alternative theory, of spontaneous generation of pathogens, means there are no chains to be broken. Today, we are told that it is impossible to contain SARS-CoV-2 and we have to "just live with it,” as if germ theory no longer holds. The argument that the spread of SARS-CoV-2 to wildlife means that containment is impossible illustrates these contradictions further – SARS-CoV-2 came from wildlife, as did all other zoonotic infections, so how does the virus spilling back to wildlife change anything in terms of public health protocol? But if one has decided that from here on there will be no effort to break transmission chains because it is too costly for the privileged few in society, then excuses for that laissez-faire attitude will always be found.

And that does not bode well for the near- and medium-term future of the human species on planet Earth.

(Follow the link for more than 100 references and sources)

[rafecameronsmistress]

Heartless

[description] fem reader x heartless rafe cameron

[summary] to you he’s everything you’ve ever wanted and more, to him you’re just another girl in his bed

[cw + tw] 18+ content minors do not interact, smut, alcohol, language, being used for male pleasure, angst, embarrassment, heartache, sadness

[authors note] let’s be honest.. this is the REAL Rafe Cameron.. no matter how much it hurts

ADULT CONTENT AHEAD

Enjoy 🖤

_____________________________________________

it made you sick

a retched knot in your stomach every time

but he didn’t care, it’s what he did

he didn’t belong to anybody, but you belonged to him wether he knew it or not

Rafe Cameron

gorgeous, sensual, desirable

kook, ladies man, douchebag

you’ve loved him from the day you met him, your heart skipped a beat every time he’d look in your direction, butterflies in your stomach when he’d simply notice your existence

the past few months he’s taken a liking to you, at first it was harmless small talk, little gestures like holding to door open for you, and inviting you to his house parties

he did all the right things to wrap you around his finger in order to show his true intentions - and that was to fuck you, any time any where he pleased

you tried so hard not to give in but when the guy who makes your heart throb wants to bend you over in the bathroom of your workplace it’s hard to say no

your mind and your heart have become tangled in this web of emotions, you love him and he almost loves you.. when you give him what he wants

you want to be with him, but he couldn’t care less, you were just another piece of ass

your stomach flips when you see him kiss her, his large hands gripping her waist and pulling her into him as close as possible, the way her hands clasp around the back of his neck and her hips move against his

you wished for a moment you were her, being shown off by Rafe at a party, not a care in the world for who he’s making cry at the end of the night

you nurse the cocktail in your hands and sit by yourself on the couch, you’re in your own head thinking about him and how it feels like your being stabbed in the chest everytime his attention is on someone else

why do you even come to these parties? you end up with your feelings hurt every. single. time.

why does he invite you? probably because he knows you’ll put out if no other girl does, you’re always on the back burner waiting for your chance with him

you walk outside and join a group of people on the patio and get into a mindless conversation, trying to ignore that fact that your heart was just ripped into a million pieces for the hundredth time

about an hour or so later the party dies down and everyone begins to head out, you fish your phone and keys out of your purse ready to leave when you get a text

Rafe:

“my room 5 minutes”

your chest flutters and your cheeks flush, you want to ignore him and go home, but you’ve been waiting for his attention all night, you know he only wants to have sex and then he’ll send you home but it’s worth it, you crave him

you head back inside and dispose of your empty cup and grab a water bottle from the fridge, you quickly go into the bathroom to pee and use mouthwash

after 5 minutes the entire party is cleared out and you head upstairs, your heart thumps with every step

you open his bedroom door, he’s standing at his bed flipping through tv channels, wearing only gray sweatpants and clearly nothing underneath

“hey” he says keeping his attention on the tv

“hi” you set your purse down on the chair next to the door

“shut the door” you do as he says

he gets in bed and sits on top of the covers with his legs outstretched, he pats the empty space next to him

you kick your sandals off and walk over climbing into the bed next to him, you keep your distance and zone in on the tv

“come over here” he stretches his arm out inviting you to lay on his chest

he’s warm, the clean scent of his cologne lingering, the familiar feeling of safety and comfort washing over you

his hand rests at your hip, fidgeting with the waistband, he never allows you to soak in the moment without making you aware he wants to fuck you

you both ‘watch’ the tv anticipating the events that are about to unfold

his fingers slip into your shorts grabbing the thin band of your g string “take these off yeah?” he says tugging at your underwear

you lift off his chest and slip your shorts off, you lift to your knees and turn to face him

“this too” Rafe motions toward your tank top

you slip the straps down your arms then pull the shirt over your head exposing your bare breasts

“c’mere” he nods his head as an invitation, you climb on top of him straddling his waist

his hands immediately explore your tits, he rolls your nipples between his fingers earning a small whimper, your head falls back slightly and your jaw slack when his mouth encases a nipple, licking and sucking on the sensitive bud

you involuntarily grind your hips into his, the feeling of your nipples being tended to sends waves of electricity to your heat

he pushes his hips upward meeting his hardening bulge to your clit, his mouth still latched onto your nipple, this alone could make you cum

you grind into him harder, this time bringing you closer to the edge, you whine in pleasure, he knows you’re about to cum from him doing the bare minimum

Rafe shows mercy on your breasts and unlatches his mouth with a ‘pop’ sound, he grabs your waist and brings you to a halt “i’ve barely touched you and look at the mess you’ve made” he laughs proudly

you look down and realize you’ve soaked through your panties and onto his gray sweatpants, leaving a trail of desperation

“i’m sorry” you climb off his lap embarrassed that you’ve showed just how much of a choke hold he has you in

he laughs again and pulls the pants just past his crotch, his cock springing out and smacking his stomach

your cheeks turn pink and your stomach flutters, you could drool at the sight of his cock

“suck my dick” he says taking it into his hands and standing it upright for you

without hesitation you replace his hand for yours and bring your lips to his tip tasting his leaking pre-cum

swirling your tongue around the head you look up at him in admiration, his head resting back on his pillow, his mouth slightly open, and his closed eyes fluttering in pleasure

your sink your mouth lower onto his shaft taking in what you can before gagging “fuck” Rafe lets out breathlessly, you bob your head up and down slowly while flicking your tongue around

he wraps his hand through your hair at the back of your head and helps you suck him off, his hips meeting your mouth half way causing your eyes to well with tears “shit” he groans

he thrusts his hips faster into the back of your throat without mercy, gagging repeatedly and unable to see through your sobbing eyes “ah- fuck” his hips cease movement, warm ropes of cum filling your throat and spilling out the sides of your mouth onto his thighs

you pull your head up wiping away your tears and the sides of your mouth and attempting to catch your breath

“turn around, get on all fours” he instructs, you comply

your head and chest meet the bed, your hips and ass in the air waiting for his cock

Rafe pulls his sweatpants completely off and gets on his knees behind you, he takes the head of his dick and runs it through your slick folds before pushing himself inside you, completely filling you

“oh god” you cry out, you’ve been craving his cock for weeks and each time felt like the first, your eyes filling with tears once again

Rafe picks up the pace and lands a hard smack to your ass, pumping into you harder with each stroke

the room is filled with the sounds of his hips crashing into your ass and his balls slapping your clit from the back

inaudible sounds pour from your mouth while you become dumb from his cock

he takes your hips moving your body back and forth to match his rhythm “fuck” he lets out through gritted teeth smacking your ass harder this time leaving a large handprint

you yelp in pain, you turn your head looking back at him wanting to see how pleased he is with your pussy “don’t fuckin’ look at me” he says breathlessly pushing your head back down into the sheets

you let the tears flow, his words slicing you open

you grip the sheets beside you when you feel the knot building in your stomach, pornographic moans escaping your lips when euphoria washes over your body, your walls clenching him tightly over and over again

your body becoming weak, drunk off his sex

your pussy pulsates around him milking an orgasm out of him, “ah- fuck” Rafe quickly pulls out and shoots his cum all over your ass, your legs give out beneath you, you lay flat on your stomach in defeat once again

“shit” he laughs wiping his forehead, he hops off his bed and grabs a towel from his laundry basket, he wipes himself off then throws the towel on top of you

you wished so badly he didn’t see you as a toy and would at least clean himself off of you, but once again you find yourself being used

Rafe puts on a clean pair of sweatpants then gathers your clothes handing them to you “i’m goin’ to bed” he says, insinuating that you need to get dressed and go home

“okay” you say softly, dressing yourself and grabbing your belongings, you head toward the bedroom door holding back tears “shut the light off” he points in your direction, you flick the switch and exit the room closing the door behind you

your heart sinks to the floor, you can physically feel the pain in your chest, your face becoming soaked with heartache as you walk out of the house

the man you’re obsessed with

the man you’re in love with

will never think anything more of you than just a quick fuck

and every time you give into him it hurts a little more

and for Rafe Cameron, it’s just another weekend

[i-havenothingelsetopost]

I just love it when people give Danny different jobs. Chemistry teacher. Florist. School nurse. Butler. Workplace safety inspector. Whatever burger chain employees are called. I'm having an incredible time reading these, thank you everyone

[justplainwhump]

Change of Hands

Thank you all for enjoying my last piece [Pet Safety]. This one is a lot slower, but for all those of you wondering about the Chewtoy's fate. Mostly for @whumppsychology who nudged me into this direction. Might a bridge, towards expanding more on their story.

[masterlist]

Adrian makes a deal.

Content/ warnings: BBU, WRU as a workplace :), BBU romantic, dubcon mentioned (offered, but not acted upon), explicit language, brief suicidal ideation (to escape), brief emeto mention.

Adrian had brought the Chewtoy to the WRU clinic in the business district downtown, hidden away in a room with restricted access; just him, Izzy and one of the nurses, who they knew wouldn't ask any questions.

They'd do their best to stabilise her, while Adrian went on working on the upper floors of the same building as he would on any other day.

He did check in on her every lunch break. The first few days, she was sleeping constantly, or barely awake, her eye glazed over, just staring into the void, sometimes whining softly. She looked small in the bed, vulnerable, in a flowered hospital gown, black plastic collar loosely around her neck. Adrian didn't say anything to her, just checked that she was there, her bandages changed, her medication taken care of.

On the fifth day, she looked at him. Even with half her gaze hidden under the eyepatch, Adrian flinched under the intensity of it. Her eye was of a light gray, like metal, maybe. Stainless steel. Indestructible. He hoped she was.

"Who are you?", she asked.

Adrian raised his eyebrows. Pets weren't supposed to ask questions, he thought. Pets were to address strangers as Sir or Madam. Pets were meant to cast down their gaze, and maybe- maybe- look up submissively through their lashes.

400168 just stared.

"I'm Adrian Delgado," he replied. "WRU pet safety inspector."

She slowly placed a hand on her collar, a soft and sensual motion. This, he recognised, standard romantic protocol. Pets weren't meant to touch their collars, though. "This isn't a shock collar," she stated plainly. "Why not?"

"Because you're here to heal."

"So that you can fuck me later?"

"I..." Adrian took in a sharp breath and shook his head. "No. No, I'm not here to fuck you. I'm here to help you."

"Help me get a better pet?" She smiled wistfully and tilted her head. "Usually that includes fucking, Adrian." The way she said his name sent a thrill down his spine. Soft, a little teasing, a little promising. She was strange, in her behaviour. Didn't mean she couldn't cause just the reactions the company wanted her to.

"No. You... you've been through a lot."

She frowned. "You don't want me, because of the scar. Like... like Jack."

Jack? He hadn't seemed like that type.

"Jack Donnell isn't your owner any longer."

She seemed to ponder on that for a moment. "Good," she said then. "I didn't like him."

"Neither did I," Adrian said.

She grinned a little at that.

"Who owns me now, then? You..." She frowned. "I remember you. You... Did you steal me?"

"I got you back for WRU. Your - Jack... He would have killed you."

"I know." She swallowed, cleared her throat, before she turned away. "I was waiting for it."

Adrian shivered. "You... you wanted to die?"

"I don't know," she whispered. "But I didn't want to live any longer." She looked back at him and he flinched under the despair in her gaze. "Please. Adrian Delgado. I... I don't want to go back."

He nodded, swallowed against the lump in his throat. "Yeah," he whispered. "Yeah, I know. I... I'll do what I can. I'll... Let me make a call."

He all but fled the room.

*

"Give me a sec", Izzy said on the phone, their private lines, untraceable SIM cars. He heard her step out of a room and walk down a corridor. When she spoke again, her voice was lower, dampened in a small room. "Listen, Adrian. Something happened. I can't do that for you any longer. It's not like they're onto us, I hope, I really hope, but there... There was a change in protocol. That second signature I'd need to confirm her death... I have no influence on who gives it any longer. Can't be you any more. And I don't know who it'll be. I... I'm with you in this, I really am, this is the good fight, but there have been irregularities in my cases before and I can't... I can't help you any more. It's stealing. Stealing from the company."

Adrian cast a quick gaze back at the Chewtoy's door. This couldn't be. He'd made a promise. "She can't go back," he said into the phone. "Neither to her owner, nor to the company. She won't make it. Please, Iz."

"I can't help you, Adrian. I have to report her healthy. I..." Izzy sighed. "I know this isn't much solace but... Remember, you're not responsible for her bad decisions, right? She signed up for this."

It took a lot, to hold his breath, keep his teeth clenched, push back the 'Fuck You' that was raging in his chest. Sometimes he thought he'd have made a good Guard Dog himself. There was so much fury simmering inside him, all the time, ready to be tapped into nudged toward a target. All they'd need to do was to make him drop the facade.

He wondered if it would feel good, actually. To attack, instead of holding back.

If that was what the Guard Dogs felt, that he inspected on the daily.

He shook off the thought.

"Okay, Iz," he said instead, his words clipped short. "Yeah. See you later. Bye."

He hung up before she could say another thing.

*

His boss called him into her office less than an hour later.

168 had been asleep when he glanced into her room after the call with Izzy. He hadn't woken her up. He couldn't get her out without help. WRU's buildings were designed to be safe. Once in, it was all but impossible to get out. He hated himself, knowing he'd been the one to take the pet here. He'd relied on their system to work.

He shouldn't have. He should've just driven her to a pet lib safehouse, filed her as a runaway, trusting nobody would look for a scarred, half dead Chewtoy. But then again, they wouldn't have taken her in either. Pet lib were careful, they had to be.

No. Keeping his promise was on him, on Adrian alone. And right now, his boss was about to test him.

"Izzy from the clinic has updated me on the Romantic you've brought in. 400168. She seems to be back on her feet." Kelly waved a manila folder at him. "Why isn't she in a crate back into the arms of the company?"

Adrian fought the urge to close his eyes for a second. He had prepared for that question, at least. He managed to call up an easy smile and give a half shrug. "There've been some inconsistencies in her owner's story. I wanted to talk to her about them, before finishing the report."

"Yeah, about that." She smirked. "We're not going to do this. Jack is a good client. He pulled back that complaint he filed against you, but that's still shed some bad light on us. I've already filed the results. He passed the inspection."

"Why-"

"Because I'm your boss, Adrian. You're a good PSI, one of our best, and I highly appreciate your work. But as a WRU manager, I need to think a step further. And that is, balance the interest of clients and company." Her perfectly manicured fingers drummed on the cover of the the folder. Bright red nail polish. Kelly didn't even try not to be threatening. "That Romantic you brought in, I appreciate the notion. The concept of a Chewtoy is unacceptable. But you should've looked at her file before jumping to action. She's a mess. Runaway Romantic, refurbished, but it didn't go well. Memory problems, periods of being nonverbal, sometimes even catatonic. Seems they wiped out some of that nicely programmed conditioning, too. Company shipped her out anyway, because she was a gift, and Jack Donnell noted, quote, I don't mind a little fight, end quote." Kelly sighed as she slid the folder to him over her desk. "Most customers do mind, actually. And now, with that scar in her face, half blind? She's a liability for the company. If we're lucky, very lucky, she'll at least bring in the treatment costs the clinic charged. But that doesn't cover any of the necessary reprogramming."

Another deep sigh, this one even more dramatic than the last one. "I'll have to consider that lack of business acumen in your upcoming evaluation."

"I understand," Adrian said.

Fuck them, he thought. Fuck the company and their disregard of the least shred of humanity. Fuck the company who'd have just let that woman die, to spare them the hassle.

Still, a dangerously stupid idea started to shape in his mind. He swallowed. "Um, maybe I... Maybe I could offer a solution."

"How?"

The words were out before he could think them through. "I buy her. I've collected enough bonus over the years for a product discount, right? That should be what, 50k by now? Covers her clinic bill, doesn't it?"

"She'll still need another refurb."

"What if I take her without it?"

Kelly chuckled. "Oh Adrian, I had clearly underestimated you. You'll spend your 50k bonus on a disfigured, broken Romantic with runaway tendencies, just to protect your career opportunities?"

That was the only thing that made sense to her. Adrian felt sick to the bone as he forced himself to grin at her. "Depends. Would it work?"

Kelly pursed her lips, and he could almost see the calculations running through her head. "Hm. It would," she said finally. "And you know what, I think we could throw in some refreshers on her discipline still. No Drip, that stuff is insanely pricey. But some bedroom specifications that cater to your liking will sure be on the table."

Adrian grinned over the disgust knotting in his stomach. "Perfect. Let me take her home first, see how she behaves. And then I'll come back to that."

Kelly tilted her head, fingernails hitting into the keys. "I'll prepare the transaction. Appreciate the move, Delgado, really. Maybe you actually do have a future in this company."

"I certainly hope so." Adrian smiled, and kept the smile up until they'd shaken hands and he'd left her office, strolled down the corridor, taken a sharp right turn, locked a bathroom stall behind him.

Then he threw up.

[transgenderteensurvivalguide]

Pls help this is very urgent, I don't feel comfortable nor feel safe going to either women or men's lockeroom can I like find some way around that like use the nurses bathroom or aomwthing??

Lee says:

When I was in high school, I brought my clothes with me and changed in the regular bathrooms instead of the open changing area in the gym locker room.

You may have to keep your PE clothing and sneakers in your locker room locker if you don’t have room for them in your normal hallway locker or backpack, which would mean you’d have to enter the locker room, get your items, and then leave.

So if you don’t think it’ll get you in trouble, just get your clothes from wherever they’re stored and then change in the nearest bathroom without even asking the teacher.

If your school has a gender neutral bathroom, you might have better luck changing in there, even if it’s a bit further away than the nearest gendered bathroom is.

But if you’re out as trans, you could explain that you’ll need privacy to your gym teacher, and ask them to be allowed to change elsewhere, like in the nurse’s office bathroom, and that way you can get informal permission to not change in the locker room and won’t be marked as late.

If you don’t want to out yourself, you can tell your teacher that you have anxiety about changing in the gendered locker rooms and not mention the trans thing at all.

If you don’t think your teacher would be open to making informal accommodations for you, or you asked your teacher and they said no, speak to the guidance councilor or whatever school official is in charge of creating formal accommodation plans and see if you’re able to persuade them.

Whether you reach out to a trusted teacher, school counselor, or administrator, explain your concerns about using the gender-specific locker rooms and express your need for a safe alternative. Make sure you explain why you feel unsafe in detail and provide any examples of incidents that would support your concerns. They're more likely to respond if it's presented as a safety issue (and you said it was!) instead of just a personal preference.

If you do go to the top and ask a school official, you an also ask if there are any single-occupancy staff restrooms that you could use. That isn't ideal for you or the school but you can always ask!

Sometimes, having a written request can make the process more formal and may be taken more seriously. It also provides a record of your request, so if you are talking to school officials get everything on paper or in email.

If your parents are supportive, they can back you up and write a note to help excuse you. When you speak with them about this issue, be clear about why the current situation is not working for you and what would make you feel safer because they might not realize how important it is to you.

If even a parent's note doesn't help, familiarize yourself with any non-discrimination policies your school or workplace may have. Many institutions in liberal-leaning have policies in place to accommodate individuals who do not feel comfortable in gender-specific spaces, so you may be able to point at a policy and get backup that way.

And depending on your location, there may be laws that protect your right to safe and comfortable accommodations. Knowing these can help when discussing your needs with officials.

It's also important to know if a law isn't in your favor because then you will have more success just doing it instead of asking because if the school gives you permission they may get in trouble so they might be trying to avoid that. Organizations like the ACLU or local LGBTQ+ advocacy groups can sometimes provide guidance or intervene in situations where individuals are being denied reasonable accommodations, but that can be hard to do if you have unsupportive parents.

Remember, your comfort and safety are paramount, and you have the right to access facilities where you feel secure. Don't hesitate to advocate for yourself, and seek out allies like other trans people at your school or members of the GSA club who can support you through this process. They may have experience with similar situations and can offer advice or advocate on your behalf.

If you have a supportive friend who will stand up for you and come to the bathroom with you or change together with you in the locker room, that can be a great way to plan for your safety until you're able to access alternative facilities. I would honestly consider that to be your first step to help you stay safe while you work everything out.

Finally, it's clear that situations like these can be stressful! Consider speaking with a school counselor (keeping in mind the requirements of mandated reporting) or a therapist for support.

Followers, any tips for anon?

[reneewalkersbiceps]

some things i feel like i should share today as another unelected, money hoarding, tax-dodging, out of touch parasite takes his place as the ‘leader’ of the country:

• i have always been and will always be anti-monarchy. end of.

• today, peaceful protestors on the streets of london are being arrested before they have even started their protests. signs are being confiscated and the public arrested.

• this coronation comes at a time when nurses, junior doctors, teachers and countless others are striking for better working conditions, safety for those they look after and fair pay for the life saving work they do.

• this country has never had more food banks open and overwhelmed. we are drowning in a cost of living crisis that affects everyone but the rich. people have no food and yet east midlands railway is handing out free scones exclusively to it’s first class passengers to celebrate the coronation.

• over 270,000 people in the uk are unhoused (as of jan 2023), living on the streets or in temporary accommodation, meanwhile monarchists have been camping out on the streets for days - uninterrupted by the met police - to catch a fleeting glimpse of a man in a golden carriage driving past.

• speaking of the met police, a recent report found them ‘institutionally racist, misogynistic and homophobic’. just saying.

there’s so much more i could say but i just wanted to illustrate the absolute state of this country at the moment for anyone abroad. we should be ashamed that we as a country are celebrating this day when so many are starving to death, dying on the streets and dying pre/in hospital due to unsafe workplace conditions.

fuck the monarchy. fuck the tories. fuck the police. fuck the coronation. fuck this country and it’s warped sense of what’s right and what’s wrong.

[allthecanadianpolitics]

Nurses in British Columbia officially have a new deal with their provincial government employers.

The ratified collective agreement, shared Thursday, includes key commitments to more than 13 per cent in wage increases over three years, and in a Canadian first, minimum nurse-to-patient staffing ratios.

The deal is retroactive to April 1, 2022, and will expire March 31, 2025.

“The agreement also includes significant improvements in job flexibility and access to leaves, as well as investments in workplace health and safety,” reads a news release from the BC Nurses’ Union (BCNU).

“New contract language will also advance the principles of diversity, equity and inclusivity to ensure all BCNU members are welcome in their workplace.” [...]

Continue Reading.

Tagging: @politicsofcanada

[sapporo-division]

Relationship: Family - Yoichi Shujo

.｡.:*･FAMILY TREE･*:.｡.

==========================================================================

Nobuo Shujo † — Yoichi’s father. He was once a star baseball player before retiring to become a coach where he introduced Yoichi to the sport, sparking his interest. Yoichi fondly remembers his father as a free-spirited and confident man and the bond they shared grew strong as they spent time playing baseball together. His father often looked after him, knowing Yoichi was timid and anxious, and offered emotional support to help him overcome his fears. At that time, Yoichi admired his dad deeply, aspiring to be as cool and brave as him. Tragically, Nobuo died a hero when he was stabbed by a thief while defending an innocent bystander. An event that occurred when Yoichi was around 11 years old. Though he lost his father, Yoichi holds onto the memories they shared, cherishing them deeply.

Kiyoko Shujo (41 years old) — Yoichi’s mother. She is a kind and level-headed widow who works as a nurse and tirelessly dedicates herself to a full-time job to support her family financially. Although she often makes light of her hard work with bad jokes, it sometimes takes a toll on her health which worries Yoichi and motivates him to find a job to help support her. She adores her children and is always there for them but at times, she becomes overly anxious and protective of Yoichi, fearing for their safety. Especially after the tragic loss of her late husband. This sense of responsibility as a mother has led to some unhealthy habits. Despite her worries, she remains mostly calm and collected within the family although she can't shake her fear of Scourger's recent return.

Jun Shujo (29 years old) — Yoichi’s older sister. She works as a senior photojournalist at Snowflake Sentinel News and is the one who helped Yoichi secure a job at her workplace. Jun is a strong and assertive woman more than capable of handling herself with a quiet passion for capturing interesting events to find the best stories for the news. However, whenever she's at home, Jun transforms into a caring older sister who loves her family and often worries about Yoichi's fragile mindset. Yoichi is grateful for her support and strives to do his best to avoid being a burden to her or their mother. Outside of her work, she has been deeply engrossed in investigating The Scourge cases, conducting her own quiet inquiries for the past five years in hopes of uncovering their identities. Unbeknownst to her, Yoichi has an alter ego and is involved with Scourger.

Ayane Shujo (22 years old) — Yoichi’s second older sister. She works as a waitress at a nightclub and is also a social media influencer in her spare time. Ayane is a sociable and undeniably attractive woman. Many of her customers are drawn in by her looks and flirtatious banter, making it easy for her to connect and gossip with them. She loves partying all night and spending quality time with friends, earning her the nickname the sexy waitress. However, her charm is primarily a means to earn easy cash to support her family's finances, and remains grounded despite her work reputation. At home, she is simply a loving big sister who prioritizes her family and is genuinely sweet. Although Yoichi feels overwhelmed by Ayane's affectionate teasing, especially around their siblings, her playful remarks reveal just how much she cares for them. Regarding the Scourger, she has heard the urban legend and feels conflicted about the vigilante. A few years ago, her ex-boyfriend was attacked by Scourger but she later discovered that he was actually an illegal smuggler. She is thankful for the revelation of his crimes despite the confusion surrounding her feelings about the vigilante.

Miyata Shujo (13 years old) — Yoichi’s younger sister and a middle schooler. Many people at her school refer to Miyata as the voiceless doll because of her cute face and blank expression which reflects her silence and reluctance to engage in conversation. She prefers wearing headphones and listening to music, seemingly indifferent to the world around her. All she wants is to mind her own business and spend time on her computer without getting involved in others' affairs. Although she may appear distant, she does care for her family and makes an effort to bond with them whenever she wants to. While Yoichi and Miyata don’t often talk—mostly because she prefers it that way—he loves his sister and wants to look out for her. Fortunately, they share a common interest in video games which provides a way for them to connect as siblings. Miyata has never encountered or heard of Scourger and as a result, she remains indifferent to the vigilante's existence.

[bitethetablet]

anya mouthwashing wearing open toed shoes as a nurse kinda hinting at the company not worrying about workplace safety and the fact that sandals are cheaper than close toed shoes but idk she could just find them comfy