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Understating Airborne Covid-19

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My title is slightly misleading but meant to tell you what this essay is about. I want to talk about recent reports that SARS-CoV-2, the virus that causes Covid-19, is airborne.

The concept of airborne in thinking about pathogens is probably the single most misunderstood thing in epidemiology, not by epidemiologists but by regular people. It is also probably the most evocative, and stupifying. Recently, the word “airborne” has been used in discussions of Covid-19, and this led to many extreme reactions. Like this:

Input: Bla bla bla Covid-19 bla bla bla airborne.

Output: All the credible experts have agreed that Covid is airbone! it is no longer spread by contact, but now it is airborne! The Fauci mutation probably made it airborne! And so on!

SARS-CoV-2 is spread by shedding from an infected person’s respiratory system and getting into a new host’s respiratory system via droplets of mucus that go from hand to hand, hand to mouth, mouth to hand, mouth or nose to surface, surface to hand then hand to mouth, etc. Human upper respiratory bodily fluids (snot, etc.) get on stuff and then people touch stuff and then it get into their respiratory system. This is how most cold and flu infections are passed on, generally. That is not airborne spread.

Among all the many viruses that give us colds or the flu — the many strains of influenza, rhinovirus, coronaviruses other than SARS-CoV-2, etc. — this is how infection happens.

Again, this is not airborne spread. It might be airborne in your head, because you imagine someone sneezing, into the air, droplets of virus-containing spittle and snot flying around in the air, and since that stuff flies through the air it must therefore airborne. But that is not what airborne means, and the distinction is important.

There is probably a certain amount of true airborne transmission in any of the above mentioned categories of virus, including the flu and more common colds. But it is rare enough that these diseases are not said to be airborne.

So what is airborne then, if it is not simply flying snot particles?

Airborne spread requires several things to be true often enough that an observable number of cases were spread in this way. First, the virus must be aerosolized. This means that the virus is embedded in a very small gobs of snot, perhaps near 5 microns, droplets that are small enough to be suspended in the air. Larger drops will fall out of the air, these smaller drops will float in the air like they were part of the air. They act like a gas in the air.

The droplets also have to be small enough to get into the parts of the respiratory system that the virus targets, which for SARS-CoV-2 is not too much of a limiting factor since it likes to inhabit the upper respiratory tract. But, since it also can invade the lungs, there would be the possibility that airborne transmission would be more associated with a more serious infection, if and when it happens.

Airborne spread also requires that the virus can live in the air long enough to get to its target. The longer the virus can live in the air, the worse of a problem it is because it can travel farther, through ventilation systems, down hallways, etc. There is no evidence that SARS-CoV-2 does that like, say measles, the king of airborne infection does it. Whatever environmental conditions are experienced by this suspended droplet have to NOT kill the virus. IV light kills SARS-CoV-2, so it is not going to get far during the day, outside, when the sun is out. SARS-CoV-2 might like certain humidity levels. None of this is really known for SARS-CoV-2, but it is a virus of type that we generally know about. Other forms of coronavirus are known to survive a while in the air, so that may pertain here. Be cautious in reacting to what you hear though. Detecting a virus some distance away from a sneeze does not mean that the virus is viable or capable of infection

Also, the virus has to be out there in the air in sufficient numbers to actually cause an infection. One would think that it only takes one single virus to infect someone, but generally it takes a much larger number. There seems to be a threshold for most viruses. The body dispenses of the first N viruses, then after that it gets harder, and eventually the system is overwhelmed. Maybe. The point is, virus experts will tell you that is has to be a large number for most viruses, and this is certainly true for SARS-CoV-2.

Truly aerosolized, viable, in sufficient numbers.

Finally, note that if SARS-CoV-2 was mainly airborne, we would know it by now. You can look at it, epidemiologically, and say, no, the main form of transmission is not airborne. That does not mean that there is not an airborne component, but it means that airborne is not the major way of spread. That has not changed.

What does the new research tell us?

Well, by the standards of peer reviewed scientific research, pretty much nothing, because that research is still in its infancy. But here is what happened. Several cases of infection have been reported that can be best explained by airborne infection. How many? So few that some would interpret that as potentially useless data. These may be cases that are simply misreported. Somebody licked someone else’s tongue and refuses to admit it. Does that really happen? Well, ask any expert on the epidemiology of sexually transmitted diseases about it. Of course it can. Most rare cases can be explained away or ignored.

But in this case, a large number of experts have settled on a provisional consensus: They see enough cases of possible airborne transmission of SARS-CoV-2 to ask the overarching institutional authorities like the CDC to seriously consider it and look into it. Yeah, that is it. Important, concerning, should shape policy modestly for now, requires more consideration. The smart money is on SARS-CoV-2 being transmittable via aerosol, though that will probably not be the main modality of transmission in most settings. That is my bet. Airborne transmission can happen, and will happen in some cases. More on that below. But, this is provisional.

What this does not mean.

This does not mean that there is a new mutation. Repeat: this is not a new mutation. This has been there all along, and the fact that it has not been obvious since the beginning means, as stated, this is not the new mode of transmission. This does not mean that the virus has changed. Probably.

This also has no impact on mask wearing. Airborne transmission will go right around the masks most people wear, but we already know that if airborne transmission is happening, it is not the main way the virus is spread. This is NOT AN ARGUMENT TO NOT WEAR MASKS so don’t go making that argument or you are a full-on jerk. Ignorant jerk. I know you won’t, but if you see that argument being made by others, that is what you are seeing. That argument is so stupid, you can expect Trump to make it soon.

What this might mean.

This is the important part of all this, worthy of careful consideration. Assume that normal near-distance non airborne transmission is the normal and most common form of transmission by a large margin. We assume that if people are kept a minimum of 6 feet away from each other (or 10 if you like) and do not share objects with their hands and faces, i.e, social distancing, that transmission will be minimized. This works for social gatherings, according to some, especially if masks are worn.

However, over longer term, while people are avoiding infecting each other by keeping their mucus to themselves, a low level background transmission via the air could be happening at a small level.

It would be rare. Say one hour of exposure within a single medium size room with modest air circulation has a one in a thousand chance of one infected person giving the disease to one other person in the room. (I am totally making up all these numbers, but just bear with me.)

But now, we take that room and put between zero and three infected people in it, and 30 target non infected people. But we put then in that room for 8 hours, and do that for 185 days. This configuration of people might sound familiar to you.

This is a classroom full of students social distancing. But wait, you say, if they are social distancing, they can’t fit 30 people in the room. But you would be wrong in some cases. Elementary schools with the pod system have four classes of 30 (including teachers) in the room. They will get their social distancing by spreading out into larger rooms in closed high schools or other places (gyms, etc.), so the main class of about 30 is still in one room. Maybe not. The point is, in the worst case scenario, we divide 1,000 by 8 (hours) then again by 185 (days) to get a baseline on transmission probability (though the math is slightly more complex than that) to arrive at this conclusion: Transmission within the classroom where there are one or two virus shedding individuals on any given day is nearly inevitable if there is a low probability of airborne transmission. Most classrooms may have zero infected people most of the time, but in a given school there would be several classes. In a given school system, maybe dozens and dozens.

If the air circulation does not remove the viruses, maybe they are being spread across the school. Students passing in halls, or any classes where the kids are reshuffled add to the dynamic, families with multiple kids (or both kids and staff) in the same school, etc. add to the dynamic.

You can do a similar calculation for restaurants and bars. Regular inside dining and bar hopping even with social distancing and mask wearing is probably not recommended if there is a low level of airborne transmission. More limitations on how retail shopping happens may be recommended. Certainly, unnecessary retail shopping maybe an unnecessary danger.

The final meaning of it all: When it comes to basic day to day life, under the current conditions of caution and distancing, this airborne problem would not have that much of an effect because it has to be rare. We know it is rare (if it is real) because if it was common we would see it. But, under school or large workplace reopening conditions, or reopening of indoor dining and shopping, etc., it may be a factor that causes two really bad problems.

1) More outbreaks, and some insidious ones. The school children, some getting very sick and maybe dying, others never becoming ill, passing the disease on to their families. Ignoring the airborne problem may involve asking our children to kill their grandparents, then live with that for the rest of their lives. You might get sick because you needed to shop for a new comic book or try out the headphones at the electronic store instead of ordering on line.

2) Not discussed anywhere else as far as I know, but I would think obvious: if we set up a situation where the rare airborne transmission has a better chance of actually transmitting the disease, we may also be setting up a positive selective environment for that. In other words, we may help make SARS-CoV-2 more airborne by giving it this chance. That is pure speculation on my part, but speculation based on some damn powerful theory (Darwinian evolution). It is not a chance I’d like to take.


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The Art of Melania Trump’s Deal

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When I first heard of this book I assumed it would be a prurient one-off by some hack reporter. Turns out it is a well researched and important contribution to the story of the metastasizing Trump “Presidency.”

“Based on interviews with more than one hundred people in five countries, The Art of Her Deal: The Untold Story of Melania Trump draws an unprecedented portrait of the first lady. While her public image is of an aloof woman floating above the political gamesmanship of Washington, behind the scenes Melania Trump is not only part of President Trump’s inner circle, but for some key decisions she has been his single most influential adviser.”

The Art of Her Deal: The Untold Story of Melania Trump by Mary Jordan, Washington Post reporter.


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The argument for a police officer killing a citizen

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Among the many arguments for a cop to kill a citizen, my favorite is the argument of reasonable fear. This is an actual legal doctrine, and it may even make sense. A cop is really really scared so he kills some dude. Gee, sorry.

The problem, of course, is that racists cops are automatically, by definition, mostly afraid of people of color, especially men, so that allows cops to kill black men and only rarely get in trouble.

My question is, does the reverse apply? Right now every person I know is more afraid of the police than ever before. I am afraid of what any particular random cop would do to a member of my family, especially family members that currently live or work right in the middle of the hot zone for protests and police brutality.

Is there an argument that citizens should start killing cops, to keep them in line?

That sounds like an ironic, or sarcastic, statement. A month ago maybe it was. But today? I’m not so sure.

Anyway, on this and related issues, The Daily has an interesting podcast in which Shaila Dewan of the New York Times outlines the reasons that the police usually don’t get in trouble when they murder or mutilate citizens. She covers the fear excuse, but many other aspects as well. Click here to hear.


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Minnesota Republicans Reject Science, Call For Increasing Death Toll

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In Minnesota, we have a Democratic Governor, a Democratic House, and a Republican Senate. We have what is recognized nationwide as one of the best responses to COVID-19 by any US State. Within Minnesota, we find the highest level epidemiology and immunology talent, with one of the top in a small handful of leading scientists in each of those field in the world, and they are directly advising Governor Tim Walz.

But, the Republicans are now holding us hostage. They will not proceed, until the shutdown ends, with what we call the “bonding bill” (the bill that comes out every two years that deals with funding but not policy, and covers a lot of the work done in infrastructure, including roads and bridges (which fall down when properly maintained), educational facilities, all of that. Their reasoning?

“Waaa waaa! We’ve done that for weeks now. Waaa waaa! It should be done by now. Mommy I don’t wanna any more.”

Typical Republican BS.

If you are in my neighborhood, vote for, or donate money to, Ann Johnson Stewart? or Adam Jennings? for State Senate, and, actually, ThrowTheBumsOut! The Democrats will take the Senate if both of these candidates win, and with enough support, then can win.

(Please forgive the question marks in the above links. That is an as yet unexplained bug in the latest version of WordPress, one that I find very troubling. With luck they have gone away by the time you see this!)

I can’t easily give a link to this story, but it is the Star Tribune (front page) May 3rd. In brief:

GOP says no bond deal amid stay-home

Kurt “Science Doubter” Daudt, Minnesota House Speaker. Photo from a 2016 story on how he can’t balance his checkbook.
By CHRISTOPHER SNOWBECK and TOREY VAN OOT Star Tribune staff

After a brutal April that saw more than 300 deaths and hundreds of COVID-19 hospitalizations, Minnesota health officials say the new month promises more sickness and loss but also a health care system better equipped to handle the pandemic.

House Minority Leader Kurt Daudt, R-Crown, said his caucus will block passage of a public infrastructure borrowing package until the peacetime state of emergency Walz has used to enact the stay-at-home order and other coronavirus response measures comes to an end.

“We feel that this has gone on for basically two months now where we’ve had unilateral decisionmaking by the executive,” Daudt said.


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A Coronavirus (Covid-19) Vaccine

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There are no current vaccines for any coronavirus. I’m not comfortable explaining why that is the case, but I’m usually told that the actual killer coronaviruses (there are not many, most viruses of this kind are not big problems for humans) came and went too fast to “need” a vaccine.

This is not really true, since at least one such virus is endemic to a region, a continuous threat, but found mostly in domestic camels. There was a vaccine developed to address that virus, but testing was never completed, and deployment never happened, so we don’t know if it was really effective.

The question of “can there be a vaccine” and “do we develop an immunity to this virus” are related, and we still see the occasional panicked revelation that maybe humans don’t actually develop an immunity to this virus. Don’t worry, we do. If we didn’t the situation would look very different than it does now.

However, we don’t know everything we need to know about that immunity. We know that for this kind of virus, it is possible that a partial immunity develops in most but not all people, and that some people have a much stronger immune response than others. It is quite possible that we develop an immunity that lasts only a few years (for most people), and it is also possible that repeated exposures and/or vaccinations will build up a longer term immunity. These are all important questions, but they do not raise the possibility that we can’t be or won’t be immune to SARS-CoV-2 (the virus that causes Covid-19). Rather, they frame the issue of how a vaccine is actually deployed. We may see a world, in two years from now, where a Covid-stick is an annual event, but one that people take more seriously than they currently take the annual flu shot, and quite possibly, one that works better (SARS-CoV-2 and influenza are very different things).

There are several vaccines in development. In my experience tracking disease and epidemiology (I’m an immunologists or an epidemiologists, but both my wife and I play these roles in the classroom and she is actually a fellow in an immunology program for teachers), the assertion that “we’re close to a vaccine” is one of the Great Lies, which are “the check is in the mail” and two other ones.

But, there is hope, and it might be real hope, that there will be a vaccine, and there is even the possibility that it will take less time than the several years. It may even take less than the oft-cited but pretty much made up “18 month” time span.

A few takes current, add to comments your newer information if you have some:

April 14: Microneedle coronavirus vaccine triggers immune response in mice

Researchers led by Drs. Louis Falo, Jr. and Andrea Gambotto from the University of Pittsburgh have been working to develop vaccines for other coronaviruses… They adapted the system they had been developing to produce a candidate MERS vaccine to rapidly produce an experimental vaccine using the SARS-CoV-2 spike protein.

…a method for delivering their MERS vaccine into mice using a microneedle patch. Such patches resemble a piece of Velcro, with hundreds of tiny microneedles made of sugar. The needles prick just into the skin and quickly dissolve, releasing the vaccine. Since the immune system is highly active in the skin, delivering vaccines this way may produce a more rapid and robust immune response than standard injections under the skin.

When delivered by microneedle patch to mice, three different experimental MERS vaccines induced the production of antibodies against the virus. These responses were stronger than the responses generated by regular injection of one of the vaccines along with a powerful immune stimulant (an adjuvant). Antibody levels continued to increase over time in mice vaccinated by microneedle patch—up to 55 weeks, when the experiments ended….

April 14th: Johnson and Johnson claim a vaccine is imminent

Johnson & Johnson (JNJ) said on Tuesday it plans to begin imminent production of its trial COVID-19 vaccine on an “at risk” basis, as the coronavirus pandemic infects nearly 2 million people around the world.

Manufacturing “at risk” allows the world’s third largest pharmaceutical company to produce a product before its ultimate design is finalized and released to the public. The company plans to produce its COVID-19 vaccine in the Netherlands, and a facility it is updating in the United States.

“We’re manufacturing at risk to ensure that should the clinical development and the trials be successful, we are in a position to kind of flip the switch and ready to go, to create great access across the globe,” J&J CFO Joe Wolk told Yahoo Finance in an interview.

J&J began developing its vaccine for COVID-19 in early January with its European subsidiary Janssen Vaccines & Prevention B.V. It’s using the same biological platform Janssen uses in developmental vaccines for Ebola, Zika and Influenza.

During J&J’s first quarter earnings call, Chief Scientific Officer Paul Stoffels said the company is also negotiating with partners in Europe and Asia to produce the vaccine, and partnerships will be announced in the coming weeks.

“Our goal is to enable the supply of more than 1 billion doses of the vaccine globally,” Stoffels said.

April 14th: Two Pharmaceutical Giants Collaborating To Develop One. GlaxoSmithKline and Sanofi are joining up …

” in an unprecedented collaboration. It brings together two of the world’s biggest vaccine companies with proven pandemic technologies and significant scale, all with the aim of developing an adjuvanted COVID-19 vaccine.”

An adjuvanted vaccine is one that includes a compound known as an adjuvant that enhances someone’s immune response to a vaccine. In the partnership, GSK will be providing the adjuvant and Sanofi will provide the specific protein component of the coronavirus that will generate the appropriate antibody response.

“… we’re planning to start trials in the next few months,” Walmsley said. “And if we’re successful, subject to regulatory considerations, we aim to complete the development required to make the vaccine available in the second half of 2021.”

There is an earlier reported vaccine in development at Johns Hopkins.


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Enormous footprints found on cave ceiling

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This is not something you see every day. Footprints measuring up to 1.25 meters in length, were found on the ceiling of a cave in a karstic cave in southern France, on the Causse Méjean plateau. It is suspected that they were left by a kind of Titanosaur. Artists reconstruction of a Titanosaur walking on the ceiling is to the right.

This prints date to the Bathonian age (ca. 168–166 Ma), which is near the middle of the Jurassic. Some of the tracks, found in three different trackways, are very detailed. And yes, it is possible (and not terribly uncommon) to erect a new species on the basis of footprints. In this case, the new species is Occitanopodus gandi, igen. et isp. nov.

The environment at the time is reconstructed to have been a lake, near the shore. I’ve only read the summaries, so I’m not sure of the exact context and orientation, but limestones from the middle Jurassic in Southern France are sometimes very tilted, so I suppose this could be an upside down (or at least, tilted over 90 degrees) layer. The find is some 500 meters below the surface, which counts as deep in a cave.

Moreau, Jean-David et al. 2020.
Middle Jurassic tracks of sauropod dinosaurs in a deep karst cave in France. Journal of Vertebrate Paleontology. Article: e1728286 | Received 29 Oct 2018, Accepted 13 Dec 2019, Published online: 25 Mar 2020.


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Sara Gideon Vs The Pearl Cluther

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Everyone in the world is annoyed with Maine Senator Susan Collins. She is constantly pausing to grab the nearest string of pearls, to clutch vibrantly in front of whatever media outlet is watching. Then when push comes to shove, or as they say in Maine, it’s time to cut bait or fish, she’s back in the lobster boat pulling traps for Mitch or Donnie.

A recent poll shows that one of the handful of challengers that have emerged to replace Collins, Sara Gideon, has pulled neck and neck. Or, as they say in Maine, this race has become tighter than bark on a tree. Collins is in a gaum at 42% and Sara Gideon is happier than a clam at high tide with 43%. That difference is just a dite, but considering Collins’ last election, it feels a like christly big gap.

In 2014, Collins left her opponent, Shenna Bellows, in the culch with a 36% margin. Being neck and neck with Collins in this most recent poll is a wicked pissah.

The poll is here.

Gideon’s campaign site is here.

A dictionary of Maine terms that will help you translate this post is heah, heah, heah, and heah.


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Activists: Two books you should read

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All Politics Is Local: Why Progressives Must Fight for the States by Meaghan Winter.

Democrats have largely ceded control of state governments to the GOP, allowing them to rig our political system and undermine democracy itself.

After the 2016 election, Republicans had their largest majority in the states since 1928, controlling legislative chambers in thirty-two states and governor offices in thirty-three. They also held both chambers of Congress and the presidency despite losing the popular vote. What happened?

Meaghan Winter shows how the Democratic Party and left-leaning political establishment have spent the past several decades betting it all on the very risky and increasingly foolhardy strategy of abandoning the states to focus on federal races.

For the American public, the fallout has been catastrophic. At the behest of their corporate patrons, Republican lawmakers have diminished employee protections and healthcare access and thwarted action on climate change. Voting rights are being dismantled, and even the mildest gun safety measures are being blocked.

Taking us to three key battlegrounds–in Missouri, Florida, and Colorado–Winter reveals that robust state and local politics are the lifeblood of democracy and the only lasting building block of political power.

American Resistance: From the Women’s March to the Blue Wave by Dana Fisher.

Since Donald Trump’s first day in office, a large and energetic grassroots “Resistance” has taken to the streets to protest his administration’s plans for the United States. Millions marched in pussy hats on the day after the inauguration; outraged citizens flocked to airports to declare that America must be open to immigrants; masses of demonstrators circled the White House to demand action on climate change; and that was only the beginning. Who are the millions of people marching against the Trump administration, how are they connected to the Blue Wave that washed over the U.S. Congress in 2018?and what does it all mean for the future of American democracy?

American Resistance traces activists from the streets back to the communities and congressional districts around the country where they live, work, and vote. Using innovative survey data and interviews with key players, Dana R. Fisher analyzes how Resistance groups have channeled outrage into activism, using distributed organizing to make activism possible by anyone from anywhere, whenever and wherever it is needed most. Beginning with the first Women’s March and following the movement through the 2018 midterms, Fisher demonstrates how the energy and enthusiasm of the Resistance paid off in a wave of Democratic victories. She reveals how the Left rebounded from the devastating 2016 election, the lessons for turning grassroots passion into electoral gains, and what comes next. American Resistance explains the organizing that is revitalizing democracy to counter Trump’s presidency.


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Climate Change Science Resources

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Books about climate change science and policy

Dire Predictions: The Visual Guide to the Findings of the IPCC by Michael Mann is a visually rich, detailed, but very accessible retelling of the IPCC scientific basis report. I recommend this volume (get the most current one) for use in classrooms as well as for general reading. Continue reading Climate Change Science Resources


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Do Recycle. Don’t Relax

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I have two quick things to say about recycling, and these are narrowly focused comments, but please feel free to discuss the issue more broadly in the comments, because I’m writing something more detailed and you can possibly influence that.

1) Do recycle. We have seen a handful of recent reports on authoritative (supposedly) media (like public radio) explaining how the entire recycling industry has collapsed and all the recycling goes into the trash, so YOU should therefore put your recycling in the trash as well. This is INCORRECT at several levels. More on that later. The short version: Let the recycling company decide what gets put in the trash. Your information will never be accurate or up to date compared to theirs.

2) Don’t feel too good about recycling, even if you do it all the time. It isn’t enough to save the planet. Do more. Now. More than that even.


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Language: The mysterious magical murmuring that we do

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Karen Stolznow is a well studied linguist and a spectacularly famous podcasting skeptic, who has published the following items:

God Bless America: Strange and Unusual Religious Beliefs and Practices in the United States

Haunting America

Would You Believe It?: Mysterious Tales From People You’d Least Expect (in which I have a chapter!)

Language Myths, Mysteries and Magic (see my review here)

Hits & Mrs.

Karen was our most recent guest on Ikonokast Podcast. CHECK IT OUT


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