Measles cases reach 600: Experts warn of contagion risk and vaccine importance

by Matt Sheehan
OSF Healthcare

PEORIA - As measles cases continue to climb across the United States, the long-term implications can’t be ignored.

The respiratory viral infection, although thought eliminated in the U.S. in 2000, has reemerged, especially among unvaccinated individuals. As of early April 2025, the Centers for Disease Control and Prevention (CDC) has reported more than 600 confirmed cases of measles.

Measles is extremely contagious

"The key to measles is how highly infectious it is. Each person that has measles will infect between 12 and 18 people in an unvaccinated situation," says Doug Kasper, MD, an infectious disease specialist with OSF HealthCare. "The key for controlling measles is widespread vaccine use."

Doug Kasper, M.D.
OSF Infectious Disease Specialist


For reference, each influenza patient, on average, will infect one to two others.

The measles vaccine is normally offered once a child has reached one year of age. It's a two-shot series, which came on the market in 1963. Dr. Kasper says this gives medical experts decades of data that show a correlation between people receiving the vaccine, and close to zero circulation of the virus in the United States.

The states with measles outbreaks are in unvaccinated people, and no breakthrough cases (in those who have received the vaccine) have been reported, Dr. Kasper adds.

The long-term risks for unvaccinated measles patients
"There is emerging information that vaccination not only protects an individual from not becoming ill or having less severity of illness with a viral exposure, whether that's measles, chicken pox, influenza or COVID-19, but that there are long-term risks from viral infections that we do not appreciate in the moment," Dr. Kasper says. "Some of these have been associated with memory loss or dementia as somebody ages. Some of these are associated with organ disease like hepatitis or kidney disease."

Subacute Sclerosing Panencephalitis (SSPE)
SSPE is a rare, deadly degenerative disease of the central nervous system that can happen seven to 10 years after a measles infection. Young children, pregnant women and immunocompromised people are the most at-risk for SSPE. One to three out of every 1,000 children who become infected with measles will die from respiratory and neurologic complications, the CDC says.

SSPE symptoms happen over four stages.

  • Stage 1: Personality changes, mood swings or depression. There may also be fever and headaches, this stage can last up to six months
  • Stage 2: Muscle spasms and uncontrolled movement problems. Loss of vision, dementia and seizures can occur
  • Stage 3: Twisting movements and rigidity. Sometimes death
  • Stage 4: Serious brain damage, including areas of the brain that control breathing, heart rate and blood pressure, leading to coma and death

Immune amnesia
Another long-term impact of measles is known as immune amnesia. The American Society for Microbiology (ASM) calls immune amnesia “one of the most unique and most dangerous features of measles pathogenesis.” The extremely rare condition causes people’s immune systems to “forget” how to fight off infections and makes the person more susceptible. The ASM determined it normally takes two to three years after a measles infection for protective immunity to return.

A measles outbreak was declared in Northeast Illinois in early 2024 and declared “over” by the Illinois Department of Public Health (IDPH) in June. The expectation of statewide health experts is that measles will return to Illinois in the coming months. This is mainly due to heavy travel through Chicago airports and summer festivals. County health departments have now been tasked with keeping an eye on their measles vaccine rates and identifying areas where vaccine rates are low.

Peoria County's measles vaccine rate is quite high, around 95%. But outlying communities in central Illinois have lower vaccine rates, normally more rural counties. Health experts at Michigan Medicine call the Great Lake State “ripe for a measles outbreak,” as only 66% of toddlers receive the recommended childhood immunizations.

Measles symptoms
"Measles typically presents with a high fever, typically much higher than what we'd see with seasonal colds or influenza. Fevers can be 104 or 105 degrees Fahrenheit," Dr. Kasper says. "That's followed by a runny nose and a characteristic rash. This typically develops on the head and then spreads down the rest of the body."

“We don’t want to go back”
"Measles at its peak, in the 1950s before the vaccine, led to a significant number of hospitalizations in young children. Around 50,000 hospitalizations were estimated per year and about 500 deaths," Dr. Kasper says. "We don't want to go back to that scenario in any capacity, where we have a large number of unvaccinated people. The outcomes could be too severe."

Immunocompromised people like those who have received an organ transplant, cancer patients or those on long-term therapies that could impact their immune system, are at high risk for measles.

Why vaccines are so important right now
Summer travel along with large crowds at places like airports and theme parks, will likely bring more measles cases to the United States.

"This time, as good as any time, is to make sure somebody is updated on their vaccinations. If somebody isn't sure if they were vaccinated as a child, they should talk to their primary care provider about testing or receiving the vaccine. If someone is immunocompromised and they might be at a higher risk for measles through travel in areas that have exposure, they should talk to their primary care provider about the vaccine," Dr. Kasper says. "If someone has young children or is at an age where vaccine is recommended, we wholly recommend for them to discuss with their provider to remain up to date on their vaccine series."

Vaccine hesitancy continues to be a topic of discussion, one that Dr. Kasper recommends patients openly discuss with their medical provider.

Natural immunity is not a viable option with measles. The highly infectious nature of the virus, along with the severity of symptoms and potential for long-term complications, make it an illness people need to try and avoid entirely.


Few states are tracking dairy farmer worker health protections amid current Bird Flu outbreak

Records from 15 states with confirmed cases of bird flu in dairy cattle in the USA. Nearly 700 dairy cattle have been found infected.
Photo: Kylee Alons/Unsplash

by John McCracken
Investigate Midwest

In May, the Centers for Disease Control recommended that state public health departments, veterinarians and epidemiologists provide personal protective equipment, or PPE, for workers in direct contact with animals and their fluids, such as raw milk, that could be exposed to bird flu.

As of early December, almost 60 people have been infected with the virus, with the majority of cases stemming from human contact with dairy cattle. Nearly 700 dairy cattle herds have been infected.

The most effective way to protect workers is with face shields, latex gloves and respirators, the CDC advised.

However, records from 15 states with confirmed cases of bird flu in dairy cattle reveal inconsistent responses by agencies when it comes to providing farmworkers with personal protective equipment. Most state health agencies, which are often responsible for the human impacts of communicable diseases, have left PPE distribution to local county health officials.

The documents, which Investigate Midwest obtained through multiple public records requests, found:

  • At least a third of state health departments in states with confirmed dairy cattle outbreaks do not track the distribution of PPE.
  • Ohio, Wyoming and New Mexico, which have had active bird flu cases in dairy cattle, have either not tracked requests for farmworker PPE or are currently not accepting requests.
  • Only one dairy farm in Wisconsin, a major dairy state that has not had a confirmed cattle outbreak, has requested PPE from the state’s health department.
  • Minnesota has had few cases of bird flu in dairy cattle, but more than 200 agriculture businesses have received PPE from the state.
  • Michigan and North Carolina, which are also major dairy-producing states, have provided PPE to less than a dozen farms.

“It looks like a failure in how we’re communicating on the public health side to producers,” said Bethany Alcauter, director of research and public health for the National Center for Farmworker Health, a Texas-based nonprofit that provides resources and training to farmworkers and advocacy groups across the country.

Alcauter said farm operators and processors don’t have the same knowledge and outlook as public health officials because sick workers and animals are often part of the job.

“It’s not to say that they’re not getting sick, but because it’s maybe not that different from what they experience normally, it’s not going to change their perception of the risk just because it’s a different pathogen,” she said.


How dairy-producing states differ in providing PPE to workers during bird flu outbreaks

When dairy workers are milking cows, raw milk can come into contact with their hands, faces and bodies, increasing the risk of infection. The CDC advises that dairy workers wear PPE, including gloves, rubber overalls and face shields, to minimize the spread of the virus.

The Occupational Safety and Health Administration, OSHA, states that employers of workplaces where exposure to bird flu viruses could occur are responsible for providing PPE to workers and keeping records on infected animals and employees.

However, OSHA cannot enforce its standards on farms with less than 11 employees, an exemption that has harmed dairy workers in the past when dairy worker deaths and injuries went unreported. This makes the enforcement and responsibility of safety measures hard to pin down, Alcauter said.

“Workers are on their own in terms of actually enforcing anything,” she said.

Michigan and Colorado Workers Aren’t Using or Getting PPE

In a recent CDC study, the agency said that the prevention of human infections is critical to mitigating changes in the bird flu virus that could lead to a pandemic.

Employers can best reduce the risk of infection by providing and educating workers on the use of PPE, as well as monitoring and testing animals and workers for the virus, the study said.

While PPE is a needed tool to prevent the spread, the practical application can be hard for workers who are working long hours and completing repetitive motion tasks in tight corners and hot environments.

Every worker who contracted the virus has been tasked with cleaning and working in milking parlors, according to the study.

After surveying the predominantly Spanish-speaking workers at Michigan and Colorado dairies, the agency found that none of the workers who were infected with the virus reported using PPE. In fact, the use of PPE was low among all workers.

“This investigation identified low PPE adherence among dairy workers, which has been an ongoing challenge in hot, tight spaces where visibility around large animals is important and the use of eye protection can be challenging,” the study states.

Records obtained by Investigate Midwest show inconsistent PPE distribution processes in both Michigan and Colorado, where dairy industries have been wrestling with the virus since early this year.

From January 2023 to late September 2024, records show only 11 dairy farms requested PPE for farmworkers in Michigan. Only 16 other operations requested PPE from the state during this time.

Farms that have requested PPE from the state have had an average of nine farmworkers per dairy farm, according to the self-reported request forms, which Investigate Midwest received through its records requests.

Conversely, the handful of poultry farms that have requested PPE have an average of 60 farmworkers per operation.

In Colorado, 40 dairy farms have requested PPE from the state agency between the beginning of 2023 and September 2024, according to documents and interviews with the agency.

Most requests came over the summer when Colorado started seeing repeated outbreaks of bird flu at dairy operations. As of early December, the state has had 64 confirmed cases in dairy herds.

The average number of dairy farmworkers operating on Colorado dairy farms that have requested PPE was roughly 40 people per farm.

“Some farms also reported that they had already purchased PPE and therefore didn’t need to make a request,” David Ellenberger, a spokesperson for the Colorado Department of Public Health and Environment, CDPHE, wrote in an email to Investigate Midwest.

“Additionally, CDPHE has sent bulk orders of PPE to an agricultural workers outreach group, who has relationships with individual workers, and was able to further distribute PPE on an individual level,” Ellenberger added.

Texas, California Take Different Approaches

Earlier this year, Texas was the first state in the country to have a confirmed case of bird flu in dairy cattle and, soon after, became the second site of mammal-to-human transmission of the virus in the country.

Since then, Texas has had nearly 30 cases of bird flu in cattle.

The state’s department of health has eight regional offices and it instructs farmers to contact their local office to request PPE.

“Each region fills them as they come in,” Texas spokesperson Douglas Loveday told Investigate Midwest.

In California, which now leads the country in the number of confirmed dairy cattle cases, the health and agriculture departments do not track or manage the distribution of PPE to farms and affected facilities. This task is left to the state’s 58 local health agencies.

In an email, a California Department of Public Health spokesperson said the state supported a one-time distribution of PPE to dairy farms earlier this year. When local requests can’t be fulfilled, the state agency fulfills the request.

As of early December, the agency has fulfilled or is currently fulfilling 43 PPE requests from dairy farms, six from poultry farms and 11 from farmworker organizations.

A similar system is used in Iowa and Idaho, which have also had numerous cases of bird flu in dairy cattle.

Ken Gordon, Ohio Department of Health spokesperson, told Investigate Midwest that when bird flu was detected in northwest Ohio earlier this year, the state made PPE available as the USDA investigated the outbreak. The state received two requests for PPE from agricultural operations during that time.

Now that the farm is no longer being investigated, the state is no longer offering PPE to farmworkers upon request.

“The state-level Ohio Department of Health made PPE available, via the survey, to farms and agricultural businesses on a temporary basis as the situation was new and evolving,” Gordon said.

Other states have received few requests or do not track disbursements:

  • As of early December, only one Oklahoma farm had requested PPE from the state’s health department to manage bird flu. The state agency used to have a formal request process for PPE, but it has since closed. “The purpose of this program was to support farms as part of the immediate response until these farms were able to ascertain PPE on their own,” an Oklahoma State Department of Health spokesperson wrote in an email to Investigate Midwest. 
  • Idaho Department of Public Health spokesperson AJ McWhorter said the agency worked with the industry group Idaho Dairymen’s Association and local public health districts to identify dairy worker needs for equipment and filled a one-time request for PPE for dairy workers in June.
  • An Iowa health department spokesperson told Investigate Midwest they direct people to local agencies or to the U.S. Department of Agriculture. 
  • In Wyoming, a state with one confirmed affected dairy herd, the health department said it did not track PPE requests or make a request form available to producers. Wyoming Department of Health spokesperson Kim Deti said the state’s poultry and dairy industries are small and PPE requests have been taken on a case-by-case basis.
Few Farms in North Carolina, New Mexico and Wisconsin Request PPE

North Carolina has one confirmed case of dairy cattle infected with bird flu. The state has also seen numerous cases of infected poultry, which is a major industry in the state.

One farm and four farmworkers requested PPE from the state during the ongoing outbreak. The majority of the state’s requests for PPE have come from farmworker organizations and advocacy groups.

The Association of Mexicans in North Carolina requested 2,000 face shields for dairy workers, stating that the association will make PPE available through health fairs aimed at farmworkers and contractors and their families held across the state.

In New Mexico, a state with nine confirmed outbreaks in dairy cattle, only two farms have requested PPE, according to state health department spokesperson David Morgan.

Some major agricultural states are preparing for outbreaks, even if a confirmed case hasn’t been reported.

When dairy workers are milking cows, raw milk can come into contact with their hands, faces and bodies, increasing the risk of infection. The CDC advises that dairy workers wear PPE, including gloves, rubber overalls and face shields, to minimize the spread of the virus. graphic provided by the CDC

In Wisconsin, a major dairy-producing state, the state health agency has received 11 requests for PPE from the beginning of 2023 to September of this year. The state has yet to have a confirmed case of bird flu in dairy cattle or humans.

Only one Wisconsin dairy farm and one egg production company have requested protective equipment for employees.

Most of the state’s requests have come from cheese or dairy product manufacturers in the state, as well as veterinary offices.

In addition to workers on farms with dairy cattle, employees who work in dairy processing plants are at risk of exposure to the virus. The CDC states that employees on dairy and poultry farms, dairy processing plants and poultry slaughter plants, should receive PPE to prevent the spread.  The virus is destroyed when raw milk is pasteurized at a processing plant.

A spokesperson for Dairy Farmers of America, the country’s largest milk co-op and owner of nearly 50 dairy processing plants nationwide, told Investigate Midwest that the company has a safety protocol to provide PPE for workers at their plants.

DFA was not listed as a PPE recipient in the state of Wisconsin, where the company has three plants.

“PPE is (and was) standard protocol at our plants, prior to the bird flu, as many of our employees work around cleaning chemicals, “ a DFA spokesperson told Investigate Midwest in an email. “To date, we’ve had no requests for extra PPE.”

Wisconsin Department of Health Services spokesperson Elizabeth Goodsitt, said the agency has worked alongside the state’s agriculture department to provide updates about bird flu to producers, including information on how producers and industry groups can receive PPE.

“We know from our experience across public health that getting resources to agencies, organizations, and individuals who are most trusted by specific populations is the best way to share important information,” she said.

“Producers should continue to enhance their biosecurity efforts and monitor and control disease in their herds and flocks,” she said in an email to Investigate Midwest.

Minnesota Stands from the Rest

Minnesota’s Department of Public Health has fulfilled more than 200 requests for PPE since May despite the state having far fewer confirmed outbreaks in dairy cattle compared to its peers.

As of December, Minnesota has had 9 outbreaks in dairy cattle herds.

The majority of the state’s requests came from dairy producers, with 138 farms requesting. Twenty poultry farms requested PPE and nearly a dozen processing facilities, either dairy or poultry, requested equipment.


This story was originally published on Investigate Midwest. This article originally appeared in Sentient at https://sentientmedia.org/ppe-dairy-farm-workers-bird-flu/.

Investigate Midwest is an independent, nonprofit newsroom. Our mission is to serve the public interest by exposing dangerous and costly practices of influential agricultural corporations and institutions through in-depth and data-driven investigative journalism. Visit us online at www.investigatemidwest.org

Yesterday's class, today's reality

About six and half years ago, back in October of 2013, I wrote a commentary addressing the lashing that St. Joseph-Ogden High School was taking from news outlets that week after a story broke that teachers were holding "death panels". Most of the attention was quite negative and tabloid speculation.

Who could have remotely imagine that the critical hypothetical event discussed in a sociology class would one day be a very real issue for governments around the globe and the doctors feverishly battling a pandemic.

Sociology Class At SJO Exposes Biases Beyond The Classroom

I remember an assignment in high school, probably as many adults my age, based on the crash of Uruguayan Flight 571 back in 1972. The story of the survivors was later recounted in the book Alive: The Story of the Andes Survivors and brought to cinematic life in 1976, my freshman year of high school.

As part of our assignment, we had to choose, as did the survivors of the crash, to become cannibals to survive or perish from malnutrition and exposure in a similar crash. As the source for food became scarce we had to decide who among the survivors would be sacrificed with dignity and heartbreaking regret to provide protein for the next several days worth of meals.

"The local hospital has enough machines to support six people. That means four people are not going to live. You must decide from the information below which six will survive."
After the initial joking and comical outbursts typical of high school juniors and seniors, the conversation turned serious. Our teacher guided the class through a conversation where each student eventually examined their moral beliefs, will to survive and sacrifice, and the emotional toll it could and likely would take years after rescue.

In 1978, it was our Kobayashi Maru and from other accounts, high school students around the country are given similar no-win or not-everyone wins situations. How many of you completed a similar assignment?

According to several comments posted to a local television station’s Facebook wall, previous classes at St. Joseph-Ogden High School (SJO), have pondered similar dilemmas over decades. Recently, the classroom lesson has gain overnight national attention. However, contrary to reports on other websites, the students are not making actual life or death decisions.

Hats off to The Leader, the community’s weekly newspaper, who simply headlined their story: "School Assignment Cause Controversy". Other news agencies were not so benign.

Nudged into the spotlight by championnews.net after the parent of one student reportedly posted her objections to the classroom lesson on social network page, Fox News and even former presidential candidate Sarah Palin chimed in on what has been dubbed the "Death Panel", a term originating back in 2009 while the Affordable Care Act was in its infancy. Nearly every media outlet reporting on the assignment for the Sociology class could not resist assigning a sensational, gutter press headline to their stories or blog posts.

"Teacher Makes Students Decide Who Lives, Who Dies"

"Ghastly: Students Decide Who Lives, Who Dies In Death Panel Discussion"

"Illinois High School Students Given Death Panel Assignment"

"Death Panel Assignment In IL High School"

First of all, calling it a "Death Panel" by the reporting outlets is illogical. But, those outlets reporting on the issue were more interested in sensationalizing than reporting.

Those who penning the headlines obviously did not graduate from SJO, a school with a Prairie State Achievement Exam score of 66.7, second highest within a 20-mile radius of Champaign-Urbana, or Mahomet-Seymour topping the list at 71.1%. The word panel, by definition, is a group of people.

The assignment was for each individual student, not a party of two or more students working together, to complete the survey handed out by the teacher.

The assignment read:

"The following ten people have a problem. They are all in desperate need of kidney dialysis. Unless they receive this procedure they will die. The local hospital has enough machines to support six people. That means four people are not going to live. You must decide from the information below which six will survive. Next to each person’s short biography there is a line where you place a score. Put the people in order using 1-10, 1 being the person you want to save first and 10 being the person you would save last. You are only to use the information provided."

In the bio section, students learn about the ten individual in need of medical attention, six men and four women, ages 9 to 65 and their background, which included ethnicity and profession (even someone in the oldest of them all). Four of the individuals were married with children and one was a single-mom with a 3-year-old. After students completed their ranking, the teacher, whose has not been identified, and the class normally discussed the choices that were made.

And no, the results are not tabulated and shipped off to Washington D.C., Mr. Obama at the White House or any government agency using abbreviations such as NSA, CIA or DIA to be used to form public policy, the next great purge or as data for some ultra-secret, right/left wing extremist group.

Brian Brooks, principal at the high school, explained the assignment for the class for juniors and seniors, to Lennie Jarratt, author of the post on championnews.net:

"The purpose of the assignment is to educate students about social values and how people in our society unfortunately create biases based off of professions, race, gender, etc. The teacher’s goal is to educate students in the fact that these social value biases exist ..."

Among sporadic criticism, there has been overwhelming support in the more than 360 comments about the assignment in the comment section on the Facebook post by WCIA Channel 3 earlier yesterday.


Tracy Wright wrote: "I see the irony of this situation being that it is being referred to as the "death penalty" assignment. Nowhere in the assignment is anyone assigning death, as the circumstances of the assignment assume death was inevitable without the use of medical treatment... the assignment is to determine whom gets medical treatment to save the individual- not the same ... what a great assignment and I applaud the teacher's effort at making today's students think."

Later, Sherri Morgan added: "Great assignment in critical thinking. Real life scenarios. He is not passing along his opinions. He is opening up their minds."

"I believe if the teacher was trying to convey to his students the potentially serious consequences social bias can have on individuals, this could be an excellant excercise [sic] to guide young minds to ponder this issue," wrote William Marshall.

Ignoring posts about Palin’s comments, Obamacare and those likening the list to the future of the Affordable Care Act, most detractors took issue with the age group required to complete the assignment. Most, either for lack of knowledge or desire to add a little sensationalism of their own, incorrectly assumed the students are younger than 15 years of age. The class is an elective for juniors and seniors, making the actual ages of the students between 15 or older.

Heather Lian stated: "This assignment was for 14 year olds...and to teach a 14 year old that it is okay to put a number value on someone's life based on race, age, and occupation is wrong, no matter what political party you're affiliated with."

"Disgusting!!!!" Jamie Denham posted in opposition to the assignment. "We dont [sic] want our young people to think in those terms!!! If you condone this then they will think that mindset is the norm!!!"

"Is it okay to put a number value on someone’s life at the age of 14 -- or at any age?"

Like it or not, our lives are simply a numbered value. There are a select group of mathematicians called actuaries who earn a comfortable living assigning every human life a numerical value that in the case of health care has determined who lives and who dies. They decide how credit worthy a citizen is, interest rate for loan note or mortgage and premiums for automobile insurance.

As Ms. Lian is apparently unaware of, there is an entire, vibrant industry that puts a number value based on not only age, race and occupation, but also the street someone lives on, the number of miles they drive a year and how many times they make a late credit card payment.

The greater lesson for the students of the sociology class comes not from the assignment, but bias held by those who are critical of the classroom task. With their own prejudices rampant and unchecked, their incoherent posts on message boards around the web, broadcast the fear of their generation as well as represents the unbridled insecurity representative of their social class.

They fear, armed with knowledge and fewer prejudices as baggage, students who are taught to think and reason will some day live long and prosper on their voyages through life. They fear you will go where no one has gone before. But most of all, deep down inside, they fear that possibly in the future, you will choose a 23-year-old single mom who earns a living from prostitution over them for the last spot on a dialysis list.

Clark Brooks, Publisher
PhotoNews

Yesterday, President Donald Trump, no doubt taking heat from business leaders and investors who are watching profits tumble in to an abyss and losing loyal followers in the face of his seemingly lack of leadership while clawing desperately for public approval,indicated that he wants end the self-isolation protocol he was pushing a little more than a week ago as soon as possible.

A CNN article said, "While the guidelines on self-isolating may still be extended, Trump said Monday he was eager to lift them so businesses could begin operating again and employees can return to work. The mitigation measures would not last into the summer, he said.

"I'm not looking at months, I'll tell you right now," Trump said, according to the CNN article. "We're going to open up our country.""

Meanwhile in Texas Gov. Greg Abbott has made it clear, despite having more than 700 confirmed cases of the Coronavirus in his state, is resisting issuing a shelter-in-place order as Illinois, California and other states have done to mitigate the spread of the COVID-19 virus and control the infection rate so hospitals will be able treat severe cases of the infection.

Experts in epidemiology, infectious diseases, microbiologist, virologists and behavior biologists for weeks have recommended that Europe and USA observe self-isolation to avoid the spread of this particularly nasty strain that attacks the upper respiratory system. Italy, who ignored the advice until it was too late, now has more than 69,000 confirmed cases and has lost 6,820 of its citizens to the disease. Their number of deaths is nearly twice that of China where the virus originated.

Yet, in 180º turn from more than a week ago, President Trump now wants America to get back to work. Regardless of the number of lives the coronavirus could leave in its wake, a number estimated close to one million American lives by most predictive models, he want to kickstart the economy which has taken a severe hit with unemployment rising and thousands of people in the service industry scrambling to make ends meet. The human cost is real as demonstrated in China, Italy, Spain and potentially the UK, who is looking equally devastating losses.

Like it or not, as I wrote then and clearly evident in the news today, our lives are simply a number value, insignificant to the wealthy and easily subtracted. Easily sacrificed.

Looks like class isn't out just yet.


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