Leading Countries in Covid-19 Vaccination administration.

 

Daily number of COVID-19 vaccinations administered per 100 people

The following chart shows the daily number of COVID-19 vaccination doses administered per 100 people. This is shown as the rolling seven-day average. Note that this is counted as a single dose, and may not equal the total number of people vaccinated, depending on the specific dose regime (e.g. people receive multiple doses).

Note: Includes countries for which data is available.·Source: Our World in Data

The data on countries with a current vaccination campaign was compiled from government sources by Our World in Data. Many countries, particularly those in the developing world, where governments have struggled to procure vaccines, are not yet vaccinating residents at all.

Most countries are using vaccines from Pfizer-BioNTech or Moderna, both of which require two doses. Two of the countries with among the world’s highest vaccination rates, the United Arab Emirates and Bahrain, are also using a vaccine developed by the Chinese company Sinopharm, which has not been approved for use in the United States or the European Union.

The table below shows which countries have vaccinated their residents at the fastest rates since the start of their immunization campaigns, and which vaccinated the most in the last seven days. It also shows, at current speeds and immunization levels, how long it will take for at least half the residents in each country to receive at least one dose of a vaccine.

Israel, for example, will reach half its population with at least one dose of the vaccine in just four weeks at its current rate, though the vaccination campaign and the vaccinated rate excludes Palestinians in the occupied West Bank and blockaded Gaza Strip, who may have to wait several months for widespread distribution. Most European countries are months away from reaching Israel’s levels of vaccination.

Part of the disparity stems from when vaccines were approved in each country. Health authorities in the European Union approved the Pfizer vaccine 10 days later than their counterparts in the United States and nearly three weeks after U.K. officials.

And distribution lagged in some countries even after the vaccine was approved. The Netherlands, one of Europe’s richest countries, was the last in the European Union to begin its vaccination campaign — on Jan. 6, a week and a half after neighboring Germany and almost a month after the United Kingdom. The Dutch health minister attributed the delay to the need for proper preparations.

Europe’s slow vaccine rollout has been hampered by supply shortages, a lack of nurses, and burdensome paperwork. Criticism of the European Union’s procurement strategy has grown louder as new variants of the virus threaten to take hold on the continent.

Hungarian authorities recently broke with the bloc to approve Russia’s Sputnik V vaccine and the Oxford-AstraZeneca vaccine. Hungary also agreed to purchase China’s Sinopharm vaccine.

If Europe is moving slowly, almost all nations in the developing world are further behind, and in most of them, inoculations have not even begun. Wealthy countries have preordered more than half of the doses that could come to market by the end of the year, in many cases enough to vaccinate their populations several times over. Many poorer nations may be able to vaccinate one in five residents, at most, by then.

Coronavirus vaccine: OC health care worker dies days after receiving second shot

A report from ABC7 news.

IRVINE, Calif. (KABC) -- 

A health care worker has died at UC Irvine Medical Center after receiving his second dose of Pfizer's coronavirus vaccine, the Orange County Register reported Tuesday.

Watch News

Tim Zook, a 60-year-old X-ray technician at South Coast Global Medical Center in Santa Ana, suffered an adverse reaction within hours after the second shot was administered.

He died days later, on Saturday.

Zook's family said he had high blood pressure and was slightly overweight, but he was a proponent of the vaccine.

The Orange County coroner's office said it was investigating the man's death, adding that if there is a correlation to the vaccine it will notify the OC Health Care Agency.

Test for COVID-19 anal swabs, where virus may survive longer: experts

Beijing reported a 9-year-old boy tested positive for COVID-19 last week, and his school conducted a variety of tests including serum antibody tests, nasal, throat, and even anal swabs for all its staff and students, prompting many to wonder if anal swabs could be more accurate in detecting the virus than other measures.

Li Tongzeng, a deputy director in charge of infectious disease at Beijing You'an Hospital, said that studies have shown that the coronavirus survives longer in the anus or excrement than those taken from upper body tracts, and for some silent carriers the virus may be present in their throats for 3 to 5 days, allowing some tests to provide false negative results.

Taking an anal swab could increase accuracy in key groups, Li noted during an interview with the China Central Television. However, given that the method is not as convenient as throat swabs, it will only be applied to key groups at quarantine centers.

Meanwhile, the testing method has been controversial among experts. Yang Zhanqiu, a deputy director of the pathogen biology department at Wuhan University, told the Global Times that since the virus has proven to be contracted via the upper respiratory tract rather than the digestive system, the most efficient tests are still nasal and throat swabs.

"There have been cases concerning the coronavirus testing positive in a patient's excrement, but no evidence has suggested it had been transmitted through one's digestive system," Yang added.

Beijing will also conduct serum antibody tests for all inbound overseas travelers who have entered the Chinese capital city since December 10 in an effort to find the chain of transmission in the latest cluster infections in the capital's Daxing district, the Beijing government said on Friday.

Chinese health experts said antibody tests for inbound travelers revealed that the outbreak in Daxing district began a month before the first case was reported on Sunday, and nucleic acid testing won't be able to find the first patient.

COVID-19 Symptoms That Won’t Seem to go easily

The World Health Organization says that typically a person suffering from COVID-19 recovers in two weeks, but there are people who can't shake the disease. As per a new study published in the medical journal, The Lancet, people are suffering from 5 signs long after recovering from the Coronavirus. The study says the first few signs start to show up in the first week of recovery itself and COVID-19 recovered patients will need post COVID care.

5 Long COVID Symptoms You Should be Aware of 

1- Severe Fatigue: 

After recovering from any illness or viral infection, our body tends to take time to heal and people often get tired easily but COVID recovered patients suffer from fatigue and exhaustion but it can last for up to six months. The severity and duration of your fatigue can help determine Long COVID. The study says that around 63% of patients have reported suffering from fatigue, weakness, muscle pain for almost six months even after the first symptoms start to show up.

2- Myalgia or Inflammation

The Long-haulers or long-term patients also suffered from muscle pain or myalgia after recovery from the virus. Myalgia attacks the healthy tissues which are present across the body which results in soreness, muscle pain, inflammation, and weakness. Because of this symptom people have reported back pain and joint ache.

3- Insomnia

COVID-19 recovered patients get difficulty in getting proper sleep or rest. The research states that sleep deprivation, insomnia is also part of the problem and hampers the recovery process.

4- Mental health issues

COVID-19 recovered patients have been diagnosed with depression or have complained about mental health issues, according to a study by Italian researchers. People suffer from depression, Post Traumatic Stress Disorder (PTSD), cognitive decline, memory loss, and mood disorders.

5- Anxiety

The Lancet study says that 15% of people have reported anxiety or palpitations. The lockdown and the pandemic have added fuel to it.

It is important that COVID-19 recovered patients should give their body ample time to recover as healing is an important aspect. in severe conditions of post-recovery symptoms along with medical consultation, patients should seek psychiatric consultation to improve their mental status of anxiety and can get rid of depression-like issues.

Coronavirus: 'COVID Tongue' Has Been Identified As A New Coronavirus Symptom, As Per Experts

01/5'COVID tongue' has been identified as a new coronavirus symptom

The number of COVID-19 symptoms have expanded and continued to increase since the outbreak of the deadly virus over 9 months ago. While the bid to contain the spread of the virus continues to rage on, new and unusual symptoms have come to the surface and wreak havoc in the public domain. Although, fever, fatigue and dry cough are some of the most predominant signs of SARs-COV-02, a rare and 'strange symptom' has been established amongst COVID-19 patients in the recent past, which causes infection inside the mouth.

02/5What is this new and rare symptom of COVID-19?

According to an epidemiologist at King’s College London, Professor Tim Spector, one of the unusual warning signs of COVID-19 may be developing in the mouth. He claims to be seeing an increase in the number of COVID patients suffering with uncomfortable symptoms in their mouth, such as coated tongue or 'COVID tongue' as he calls it.

Professor Spector, also a lead scientist on the Zoe Covid Symptom Study App, tweeted about the 'strange symptom' saying, "One in five people with Covid still present with less common symptoms that don't get on the official PHE list - such as skin rashes."

Apart from that, he also claims observing increasing numbers of Covid tongues and strange mouth ulcers in COVID-19 patients.

That said, Spector also included an image of a patient with Covid tongue, showing white patches all over the tongue.

03/5​COVID tongue

COVID tongue can cause patches and ulcers all across your mouth. Though the tongue gets back to normal in a week's time. But if you notice patches on your tongue, you must consult your doctor and get yourself tested.

04/5When should you be alarmed?

COVID tongue' can cause serious infection inside the mouth and also form patches all over the tongue. This may seem alarming initially, it's a harmless condition, which will resolve itself in a few days or weeks.

However, if in case you develop 'COVID tongue' along with other signs of coronavirus, it is important to get yourself diagnosed and confirm whether you have contracted the virus or not. In the meantime, you must self-isolate yourself and take every precautionary measures, so as to contain the spread of the virus.

05/5Other symptoms of COVID-19

While new and unusual symptoms of COVID-19 continue to expand and increase, it is also important to be aware of the most common and classic symptoms. The novel coronavirus brings along wide ranges of medical conditions that can go from mild to severe symptoms. Some of the most common signs of COVID-19 are as follows.

- Fever

- Dry cough

- Sore throat

- Runny and stuffy nose

- Chest pain and shortness of breath

- Fatigue

- Gastrointestinal infection

- Loss of sense of smell and taste

Vitamin D Deficiency in COVID-19 Quadrupled Death Rate

 

Vitamin D deficiency on admission to hospital was associated with a 3.7-fold increase in the odds of dying from COVID-19, according to an observational study looking back at data from the first wave of the pandemic.

Nearly 60% of patients with COVID-19 were vitamin D deficient upon hospitalization, with men in the advanced stages of COVID-19 pneumonia showing the greatest deficit.  

Importantly, the results were independent of comorbidities known to be affected by vitamin D deficiency, say the authors, led by Dieter De Smet, MD, from AZ Delta General Hospital, Roeselare, Belgium.

"[The findings] highlight the need for randomized controlled trials specifically targeting vitamin D–deficient patients at intake, and make a call for a general avoidance of vitamin D deficiency as a safe and inexpensive possible mitigation of the SARS-CoV-2 pandemic," said De Smet and colleagues in their article, published online November 25 in the American Journal of Clinical Pathology.

A search of ClinicalTrials.gov reveals there are currently close to 40 ongoing intervention trials with vitamin D in COVID-19 around the world for varying purposes, including prevention, and varying forms of treatment.

Consider Vitamin D to Prevent COVID-19 Infection

With regard to the potential role in prevention, "Numerous observational studies have shown that low vitamin D levels are a major predictor for poor COVID outcomes," notes Jacob Teitelbaum, MD, an internist who specializes in treating chronic fatigue syndrome and fibromyalgia who also has an interest in COVID-19.

"This study shows how severe a problem this is," Teitelbaum told Medscape Medical News. "A 3.7-fold increase in death rate if someone's vitamin D level was below 20 [ng/mL] is staggering. It is arguably one of the most important risk factors to consider."

"What is not clear is whether vitamin D levels are acting as an acute-phase reactant, dropping because of the infection, with larger drops indicating more severe disease, or whether vitamin D deficiency is causing worse outcomes," added Teitelbaum, who is director of the Center for Effective CFIDS/Fibromyalgia Therapies, Kailua-Kona, Hawaii.

Also asked to comment, Andrea Giustina, MD, president of the European Society of Endocrinology, said: "The paper by De Smet et al confirms what we already hypothesized in BMJ last March: that patients with low vitamin D levels are at high risk of hospitalization for COVID-19 and developing severe and lethal disease."

"This is likely due to the loss in the protective action of vitamin D on the immune system and against the SARS-CoV-2-induced cytokine storm."

He said it is particularly interesting that the authors of the new study had reported more prevalent vitamin D deficiency among men than women, most likely because women are more often treated with vitamin D for osteoporosis.

The new study should prompt all clinicians and health authorities to seriously consider vitamin D supplementation as an additional tool in the fight against COVID-19, particularly for the prevention of infection in those at high risk of both COVID-19 and hypovitaminosis D, such as the elderly, urged Giustina, of San Raffaele Vita-Salute University, Milan, Italy.

Results Adjusted for Multiple Confounders

De Smet and colleagues looked at serum 25-hydroxyvitamin D (25(OH)D) levels in 186 patients hospitalized for severe COVID-19 infection as a function of radiologic stage of COVID-19 pneumonia as well as the association between vitamin D status on admission and COVID-19 mortality.

Cognizant of the potential for confounding by multiple factors, they adjusted for age, sex, and known vitamin D–affected comorbidities such as diabetes, chronic lung disease, and coronary artery disease.

Patients were hospitalized from March 1 to April 7, 2020 (the peak of the first wave of the pandemic) at their institution, AZ Delta General Hospital, a tertiary network hospital.

The mean age of patients was 69 years, 41% were women, and 59% had coronary artery disease. Upon admission to hospital, median vitamin D level was 18 ng/mL (women, 20.7 ng/mL; men, 17.6 ng/mL).

A remarkably high percentage (59%, 109/186) of patients with COVID-19 were vitamin D deficient (25(OH)D < 20 ng/mL) when admitted (47% of women and 67% of men), write the authors.

"What surprises me," said Teitelbaum, is that almost 60% "of these patients had 25(OH)D under 20 ng/mL but most clinicians consider under 50 to below."

All patients had a chest CT scan to determine the radiologic stage of COVID-19 pneumonia and serum vitamin D measurement on admission. The radiologic stage of pneumonia was used as a proxy for the immunologic phase of COVID-19.

Vitamin D Deficiency Correlated With Worsening Pneumonia

Among men, rates of vitamin D deficiency increased with advancing disease, with rates of 55% in stage 1, 67% in stage 2, and up to 74% in stage 3 pneumonia.

There is therefore "a clear correlation between 25(OH)D level and temporal stages of viral pneumonia, particularly in male patients," write the authors.

"Vitamin D dampens excessive inflammation," said Teitelbaum. "In these patients with acute respiratory distress syndrome, the immune system has gone wild."

"The study was carried out in Belgium, so there's less sunlight there than some other places, but even here in Hawaii, with plenty of sunshine, we have vitamin D deficiency," he added.

"More studies are needed, but I think there are enough data to suggest a multivitamin should be used to aid prophylaxis, and this is reflected in [some] infectious disease recommendations," he noted.

 

 

Medscape Medical News © 2020 WebMD, LLC

After COVID Infection, Antibodies Highly Protective for Months

 After infection with SARS-CoV-2, antibodies protect most healthcare workers from reinfection for up to 6 months, results of the first prospective study of the subject reveal.

Dr David Eyre

The main message for healthcare workers is, "if you've had COVID, at least in the short term, you are unlikely to get it again," David Eyre, senior author, associate professor at the Big Data Institute and infectious diseases clinician at the University of Oxford, Oxford, United Kingdom, told Medscape Medical News.

Eyre and colleagues assessed for the presence of two antibodies to SARS-CoV-2 among 12,541 healthcare workers in the United Kingdom, including about 10% who had a history of polymerase chain reaction (PCR)–confirmed infection. Of those, 223 who did not have antibodies tested positive on PCR for the virus during 31 weeks of follow-up; two participants who did not have antibodies at baseline tested positive.

The study was published online today in The New England Journal of Medicine.

Dr Mark Slifka

"It's great news because there have been so many questions regarding whether or not you can be protected against reinfection, and this healthcare worker study is really an elegant way to address that question," Mark Slifka, PhD, told Medscape Medical News when asked to comment on the findings.

Although "there are millions of people in the US who have been infected with COVID, we don't know how common reinfection is," said Slifka, a researcher at the Oregon National Primate Research Center and professor at Oregon Health Sciences University School of Medicine, Portland, Oregon.

The likelihood of a subsequent positive PCR test result was 1.09 per 10,000 days at risk among those without antibodies, compared with 0.13 per 10,000 days among those with anti-spike antibodies.

The investigators also assessed for the presence of anti–nucleocapsid IgG antibody titers. They found a significant trend for increasing PCR-positive test results with increasing antibody levels. Similar to the anti-spike antibody findings, 226 of 11,543 healthcare providers who did not have anti–nucleocapsid IgG antibodies subsequently tested positive on PCR; by contrast, two of 1172 participants who did not have antibodies tested positive. Adjusted for age, sex, and calendar time, this finding translates to a 0.11 incidence rate ratio (0.13 per 10,000 days at risk; 95% CI, 0.03 – 0.45; P = .002).

"This is a study a number of us have been trying to do," said Christopher L. King, MD, PhD, professor of pathology and associate professor of medicine at Case Western Reserve University School of Medicine, Cleveland, Ohio.

"To really follow a group like this longitudinally like they've done, with a large population, and to see such a big difference ― it really confirms our suspicion that those who do become infected and develop an antibody response are significantly protected from reinfection.

"What's great about this study is it's nearly a 10-fold reduction in risk if you've recovered from COVID and have antibodies," said King, who was not involved with the research. "That's what a lot of us have been wanting to know."

Unanswered Questions Remain

"How long this immunity lasts, we don't know," King said. He predicted that antibody protection could last a year to a year and a half. The duration of protection could vary. "We know some people lose their antibodies pretty quickly, and other people don't," he said.

Slifka said the suggestion of "a substantially reduced risk for at least 6 months...is great news, and the timing couldn't be better, because we're rolling out the vaccines."

Interestingly, not all antibody responses are alike. For example, data indicate that antibody levels following immunization with the Pfizer/BioNTech or Moderna vaccines are higher on average than those of people who've had a natural infection, King said. He added that initial data on the AstraZeneca COVID-19 vaccine in development showed lower antibody levels compared with natural immunity.

The Centers for Disease Control and Prevention recommends immunization for those with a history of infection. "People who have gotten sick with COVID-19 may still benefit from getting vaccinated," the CDC notes on its Facts About COVID-19 Vaccines website. "Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, people may be advised to get a COVID-19 vaccine even if they have been sick with COVID-19 before," the CDC states.

The agency also notes that people appear to become susceptible to reinfection approximately 90 days after onset of infection. However, the new evidence from the UK study that persons have up to 6 months of immune protection might lead to a modification of recommendations, especially at a time when vaccine supplies are limited, Slifka said.

Another unanswered question is why the two study participants with antibodies subsequently tested positive for reinfection. "There are a lot of things that could have made these people more susceptible," King said. For example, they could have been heavily exposed to SARS-CoV-2 or been immunocompromised for another reason.

Furthermore, the immune response involves more than antibody levels, King noted. Research in rhesus monkeys suggests that T cells play a role, but not as prominent a part as antibodies. "What I think is protecting us from infection is primarily the antibodies, although the T cells are probably important. Once you get infected, the T cells are probably playing a more important role in terms of whether you get very sick or not," he said.

Multiplication + Addition = More Protected?

The 90% natural immunity protection in the study approaches the 95% efficacy associated with the Pfizer and Moderna vaccines, Slifka noted. Even without immunization, this could mean a portion of the US population is already protected against future infection.

Furthermore, the CDC estimates that there are about 7.7 cases of COVID-19 for every case reported.

As of September 30, the CDC reported that there were 6,891,764 confirmed cases. The agency estimated that overall, approximately 53 million people in the United States have been infected. More recent numbers from Johns Hopkins University School of Medicine's Coronavirus Resource Center indicate that there were 18.2 million cases in the United States as of December 22. If that tally is multiplied by 7.7, the total number protected could approach 140 million, Slifka said.

"That could really be a boost in terms of knocking this pandemic down in the next couple of months," Slifka said.

"Now, if we were to modify the current recommendations and briefly defer vaccination of people with confirmed cases of COVID-19 until later on, we could start reaching herd immunity pretty quickly," he added.

Real-Life Implications

"There is no such thing as 100% protection, even from the infection itself. So when you're dealing with someone with possible exposure to COVID-19, you still need to follow the proper precautions," Slifka said.

Nonetheless, he said, "This is great news for those on the front lines who are wondering whether or not they would have any protection if they had COVID-19 before. And the answer is yes ― there is a very good chance they will have protection, based on this quite large study."

One limitation of the study is that the population consisted predominantly of healthy adult healthcare workers aged 65 years or younger. "Further studies are needed to assess post-infection immunity in other populations, including children, older adults and persons with coexisting conditions, including immunosuppression," the researchers note.

Eyre plans to continue following the healthcare workers in the study, some of whom have been vaccinated for COVID-19. This ongoing research will allow him and coinvestigators to "confirm the protection offered by vaccination and investigate how post-vaccine antibody responses vary by whether you have had COVID-19 before or not. We also want to understand more about how long postinfection immunity lasts."

Eyre has received grants as a Robinson Foundation Fellow and NIHR Oxford BRC senior fellow during the conduct of the study. Slifka and King report no relevant financial relationships.

N Engl J Med. Published online December 23, 2020.

Medscape Medical News

Future coronavirus vaccines may cheap, safe and effective.

• A nanoparticle-based COVID-19 vaccine may be cheap, safe, and effective.
• The preclinical study suggests that a single dose of a nanoparticle-based vaccine could provide robust immunity.
• It may be easier to store and transport than currently available vaccines.

To bring the COVID-19 pandemic under control will depend not only on safe and effective vaccines but also on the deployment of billions of relatively cheap doses.

While vaccines based on mRNA, such as those developed by Pfizer and Moderna, are highly effective and quick to develop, they are expensive to make and must be stored at very low temperatures.

For the Pfizer vaccine, this entails storage in a special freezer at a temperature between –80 and –60°C (-112 and -76°F).

Pfizer and Moderna also recommend that their respective vaccines are injected in two doses several weeks apart to maximize their efficacy.

These factors present challenges for low and middle-income countries.

Conventional vaccines that are based on inactivated, weakened, or genetically modified viruses can be highly effective and are easier to store and transport.

However, they take a long time to develop and are more likely to cause side effects.

Biochemists at Stanford University, CA, have created a prototype of a nanoparticle-based COVID-19 vaccine that they believe would not only be cheap, safe, and effective but also remain stable at room temperature.

They are even hopeful that their vaccine could be shipped and stored as a freeze-dried powder.

The scientists recently published the results of a preclinical study of the nanoparticle vaccine in the journal ACS Central Science.

“Our goal is to make a single-shot vaccine that does not require a cold-chain for storage or transport,” says senior author Dr. Peter S. Kim, Virginia and D. K. Ludwig Professor of Biochemistry at Stanford. “The target population for our vaccine is low and middle-income countries.”

Iron-containing protein

The Stanford vaccine candidate is based on nanoparticles of an iron-containing protein called ferritin. Each ferritin nanoparticle is studded with several of the spike proteins that the virus uses to penetrate its host cells.

Before the pandemic, Dr. Kim’s lab had been developing a ferritin-based vaccine against the Ebola virus.

Previous research suggests that vaccinating laboratory animals with nanoparticles decorated with viral proteins — which effectively mimic whole viruses — elicits a stronger immune response than injecting them with the isolated viral proteins.

When the pandemic struck, the biochemists rapidly adapted this approach to target SARS-CoV-2, the virus that causes COVID-19.

First, they formulated a shortened version of the virus’ spike that is easier to synthesize and use. They bonded these shortened spikes to nanoparticles of ferritin, then used electron microscopy to confirm that they had the correct structure.

In mice, they compared the performance of this nanoparticle vaccine against four other vaccines:

• nanoparticles studded with full-length spikes
• full-length spikes alone
• shortened spikes alone
• the part of the spike that binds to host cells, known as the receptor-binding domain

Neutralizing antibodies

A single dose of either nanoparticle vaccine provoked the animals’ immune system to produce “neutralizing” antibodies. These are the most effective type of antibodies because they block the virus from entering its host cells.

After a single dose, levels of these antibodies were roughly twice as high as the average levels found in the blood of patients who had recently recovered from COVID-19.

The same dose of the other vaccines, however, elicited little or no neutralizing antibodies in the mice.

All the vaccines elicited neutralizing antibodies after a second dose, but the nanoparticles with shortened spikes performed better than all the other vaccines, after either one or two doses.

The researchers caution that their nanoparticle-based COVID-19 vaccine is still a work in progress, however.

“This is really early stage, and there is still lots of work to be done,” says Abigail Powell, a former postdoctoral student in Dr. Kim’s lab and lead author of the paper. “But we think it is a solid starting point for what could be a single-dose vaccine regimen that does not rely on using a virus to generate protective antibodies following vaccination.”

The scientists are fine-tuning their vaccine candidate with a view to starting clinical trials in humans.

Crucially, they have shown that in an emergency, it is possible to develop a nanoparticle-based vaccine against a novel pathogen extremely quickly.

“It normally takes a decade to make a vaccine, if you are even successful,” says Dr. Kim. “This is unprecedented.”

Powell estimates that it took only 4 weeks from inception to the first tests in mice.

“Everybody had a lot of time and energy to devote to the same scientific problem,” she says. “It is a very unique scenario. I do not really expect I will ever encounter that in my career again.”

Written by James Kingsland on January 13, 2021 — Fact checked by Alexandra Sanfins, Ph.D.