C.D.C. Testing Guidelines for People Without Covid-19 Symptoms

Posted on September 19, 2020 by admin

“It is critical that science, evidence and data continue to serve as the foundation of every C.D.C. recommendation.” Dr. Mary Pittman, president and chief executive of the nonprofit Public Health Institute

The Centers for Disease Control and Prevention reversed its earlier controversial recommendation suggesting people who have had close contact with a person infected with the coronavirus do not need to get tested if they have no symptoms.

The new guidance recommends that anyone exposed to an infected person for more than 15 minutes needs a test. The change comes after widespread criticism of the earlier guideline.

Those who have been within 6 feet of a person with the coronavirus for at least 15 minutes, and those without symptoms, “need a COVID-19 test”. The Centers for Disease Control and Prevention

The previous phrasing, which suggested asymptomatic people who have had close contact with an infected individual “do not necessarily need a test,” now clearly instructs them: “You need a test.”

Public health experts welcomed the change as consistent with research showing that people without symptoms can spread the virus to others.

References:

America’s Mental Health Epidemic

Posted on September 18, 2020 by admin

“Be sure to give each other a lot of grace and be kind and forgiving to each other. We’re all experiencing heightened levels of uncertainty and anxiety right now. Giving an extra beat of patience to others is critical.” Dani Fallin, chair of the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health

The mental health impact of COVID-19 are real, widespread and growing exponentially. The immense stress and emotional trauma experienced by vulnerable individuals, families and households amid the pandemic has given rise to an unprecedented mental-health crisis. Additionally, there’s strong evidence showing that social isolation and distancing can increase symptoms of mental illnesses like depression and anxiety.

Data is staggering

The latest data reveals some of the most frightening and staggering spikes in anxiety, depression, substance use, drug overdose and suicide rates that behavioral-health experts have ever witnessed, according to Babette Hankey, president/CEO of Aspire Health Partners in Orlando.

A recent survey by the Centers for Disease Control and Prevention on adult mental health found that more than 40% of U.S. adults have reported at least one mental health issue during this pandemic, and more than 1 in 10 adults had seriously considered suicide. During this period, 7 out of 10 young adults (18-24 years old) reported experiencing symptoms of anxiety and depression and more than 25% have seriously considered suicide.

In the wake of the coronavirus COVID-19 outbreak, many people may feel anxiety or stress.

Everyone responses differently

Everyone reacts differently to stressful situations such as the seemingly enduring COVID-19 pandemic infectious disease outbreak. It is normal to experience a wide range of emotions. Yet, it’s important for people to take care of themselves physically, emotionally, and mentally.

According to the CDC study, the rate of substance abuse and/or suicidal thoughts among unpaid caregivers more than tripled between May and the end of June.

Older Americans appear to be more resilient to the strain of the pandemic compared to the young: The study found rates of anxiety, depression, substance abuse and suicidal thoughts were most prevalent among those aged 18 to 24, and the prevalence of these issues “decreased progressively with age.”

Black and Hispanic Americans tended to have higher rates of mental health issues tied to the pandemic than did whites, the study also found.

Of course, unemployment or the threat of it is a major source of anxiety for millions in 2020. So, efforts aimed at “strengthening economic supports to reduce financial strain” should be part of an effort to boost mental health, the researchers said.

According to the CDC, reactions during the outbreak can include:

Fear and worry about your health status and that of your loved ones who may have been exposed to COVID-19.
Increase levels of stress, anxiety, hopelessness and depression.
Changes in sleep or eating patterns.
Difficulty sleeping or concentrating.
Worsening of chronic health problems.
Increased use of alcohol, tobacco, or other drugs.

Learning to cope with anxiety and stress

Figuring out ways to cope with anxiety and stress can help you, your loved ones and your community. If stress begins to interfere with your daily life, reach out to your healthcare provider.

These numbers, although startling, are unsurprising to mental health experts given the emotionally taxing measures local and state governments have taken to reduce the spread of the virus: children and grandchildren have been separated from their parents and grandparents; students are prevented from attending school; and the sick and dying have been denied the embrace of loved ones.

During this unique moment in the nation’s history, American society and economy have slowed down, we’re experiencing unprecedented social unrest and political rancor, and, many have been left feeling powerless and uncertain about their physical health and financial wellbeing as well as that of their loved ones.

https://youtu.be/60kGONUJSRY

The importance of self-care during this challenging time.

“Seek out ways to have social and professional engagement while adhering to social distancing…can help people feel connected socially with their colleagues, family, and friends, and maintain a sense of belonging.” Dani Fallin, chair of the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health

Avoid excessive exposure to media coverage of COVID-19. Be aware and conscious of your news and media intake. The more time you spend consuming news about the pandemic, the more likely you are to feel anxious and concerned. That’s especially true at home, when you’re able to access news media 24/7.
Take care of your body. Take deep breaths, stretch or meditate. Eat healthy, well-balanced meals, exercise regularly, get plenty of sleep and avoid alcohol, smoking and drugs.
Make time to unwind and remind yourself that strong feelings will fade. Take breaks from watching, reading, or listening to news stories. It can be upsetting to hear about the crisis and see images repeatedly. Try to do some other activities you enjoy to return to your healthy life.
Learn a new hobby or skill like gardening, a foreign language or a musical instrument. Devote yourself to learning and growing everyday.
Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships.
Maintain a sense of hope that “this too shall pass” and maintain positive outlook and thinking. Have faith in your inherent resilience to persevere and overcome life’s extraordinary challenges brought on by the pandemic.

Take care of your mental health

Mental health is an important part of overall physical health and emotional wellbeing. It affects how we think, feel, and act. It may also affect how we handle stress, relate to others, and make choices during uncertain situations or an emergency.

Again, we stress to contact your healthcare provider if you think you have new or worsening mental health symptoms or stress (or anxiety) gets in the way of your daily activities for consecutive days.

References:

Vitamin D: The supplement Dr. Fauci takes to help keep his immune system healthy | CNBC

Posted on September 17, 2020 by admin

HEALTH AND WELLNESS | CNBC
Date Tue, Sep 15 20208:00 PM EDT

“Vitamin D is a key nutrient for your immune system.” Dr. Anthony Fauci

According to Dr. Anthony Fauci, most “so-called immune boosting supplements” actually do “nothing.” However, there are two vitamins Fauci does recommend to help keep your immune system healthy.

“If you are deficient in vitamin D, that does have an impact on your susceptibility to infection. So I would not mind recommending, and I do it myself taking vitamin D supplements,” Fauci said during an Instagram Live on Thursday, when actress Jennifer Garner asked Fauci about immune-boosting supplements.

“COVID-19 infection is more prevalent among African Americans, older adults, nursing home residents and health care workers—populations who all have increased risk of vitamin D deficiency.” University of Chicago Medicine

Researchers at the University of Chicago Medicine recently found a link between vitamin D deficiency and the likelihood of being infected with COVID-19. Those with an untreated deficiency were more likely to test positive. Half of Americans are thought to be deficient in vitamin D, with much higher rates seen in African Americans, Hispanics and individuals living in areas where it is difficult to get enough sun exposure in winter.

“Vitamin D is important to the function of the immune system and vitamin D supplements have previously been shown to lower the risk of viral respiratory tract infections,” said David Meltzer, Chief of Hospital Medicine at UChicago Medicine and lead author of the study. “Our statistical analysis suggests this may be true for the COVID-19 infection.”

The research team looked at 489 patients at UChicago Medicine whose vitamin D level had been measured within a year before being tested for COVID-19. Patients who had vitamin D deficiency (defined as less than 20 nanograms per milliliter of blood) that was not treated were almost twice as likely to test positive for COVID-19 compared to patients who had sufficient levels of the vitamin.

In addition to vitamin D, Fauci said that vitamin C is “a good antioxidant.” “So if people want to take a gram or two at the most [of] vitamin C, that would be fine,” he said.

Vitamin C “contributes to immune defense by supporting various cellular functions” of the body’s immune systems, according to 2017 study published by The National Institutes of Health, and vitamin C also appears to prevent and treat “respiratory and systemic infections.” according to researchers.

But “any of the other concoctions and herbs I would not do,” Fauci said.

During another interview with actress Tiffany Haddish released on Sept 4., Fauci said in clinical studies most “so-called” immune-boosting supplements didn’t really help people unless they had some sort of a deficiency. If fact, a lot of these herbs “either do nothing, or, if you take too much of them, they harm you,” Fauci told Haddish.

Overall, the best way to boost your immune system is to get good sleep and exercise, Fauci said. “Those are the things that are so much better than a bunch of herbs that really have never really been shown to do that,” Fauci told Haddish.

References:

Family Gatherings and House Parties Account for Majority of COVID-19 Transmissions

Posted on September 13, 2020 by admin

In Maryland’s Prince George’s County, family gatherings and house parties have accounted for sixty-seven percent (67%) of COVID-19 transmissions, according to county officials. County officials say that contact tracers have determined that 44 percent of people who contracted COVID-19 reportedly attended family gatherings and 23 percent reportedly attended a house party.

Maryland Governor confirms that the trend is the same across the state of Maryland, saying that the number one cause of virus transmission in the state is family gatherings, followed by house parties, and then outdoor events.

Additionally, the Texas Medical Association released a chart breaking down the risk of contracting COVID-19 from certain activities ranging from grocery shopping, having parties at some else’s house and swimming in a public pool. Activities such as going to a hair salon or barbershop, traveling by plane, attending family gatherings like weddings and funerals, and going to a bar are considered moderate-high to high risk even for those wearing masks, maintaining six-feet of distance when out and washing hands thoroughly.

Texas Medical Association “Know Your Risk”

Currently, those at greatest risk of infection are individuals who have had prolonged, close contact with symptomatic or asymptomatic individuals infected with COVID-19 and those who live in or have recently been to areas with sustained transmission, according to Texas Medical Association and CDC. Keep in mind that many Americans have not been tested and studies suggest that people can be infected and not feel sick.

According to recent scientific findings, age is a strong risk factor for severe illness, complications, and death. Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.

References:

COVID-19 Lung and Heart Damage

Posted on September 12, 2020 by admin

“Your immune system in response to COVID-19 infection can become overzealous and go rogue – attacking and killing healthy cells in the body“.

COVID-19 patients suffer lung and heart damage, but there’s encouraging news for many “long-haulers” — COVID-19 patients who have continued showing symptoms for months after the initial infection — report neurological problems including confusion, difficulty concentrating, heart and lung issues, fatigue, insomnia, plus loss of taste and/or smell.

Cytokines are inflammatory immunologic protein

The immune system is there to help us fight infection, but sometimes it wreaks more havoc than the disease itself.

“There is evidence now that the virus can directly attack heart muscle cells, and there’s also evidence that the cytokine storm that the virus triggers in the body not only damages the lungs, but can damage the heart,” according to John Swartzberg, a clinical professor emeritus of infectious diseases and vaccinology in the the UC Berkeley-UCSF Joint Medical Program.

Inflammatory proteins, also known as cytokines, serve as molecular messengers between cells. Cytokines are proteins that are produced by cells and play a crucial role in the immune response. Cytokines interact with cells of the immune system in order to regulate the body’s response to disease and infection, as well as mediate normal cellular processes in the body.

If this immune response is too strong, a phenomenon known as “cytokine storm” can cause harm to the patient. It has been thought that a cytokine storm contributes to disease severity in patients with COVID-19.

“Cytokine storm”…your body may not know how to handle the presence of the coronavirus and overreact.” Reynold Panettieri, M.D., a lung specialist and vice chancellor for translational medicine and science at Rutgers University

With viral infections like COVID-19, our immune system can become overzealous and go rogue – attacking and killing everything in sight, including healthy cells in the body. When “cytokine storm” happens, it may kill severe COVID-19 patients.

“Cytokines are inflammatory immunologic proteins that are there to fight off infections and ward off cancers,” says Randy Cron, M.D., Ph.D, at the University of Alabama at Birmingham, “But when they are out of control, they can make you very ill.”

While some research has found an elevated presence of cytokines in coronavirus patients, there isn’t enough data to say all rapidly-declining cases of COVID-19 are a result of a cytokine storm–the immune system gone rogue.

References:

COVID-19 Prevention: Avoid Touching Your Face

Posted on September 11, 2020 by admin

According to one infectious disease doctor, if you want to stay coronavirus-free there is one single thing you should avoid touching at all costs: YOUR FACE.

The Centers for Disease Control and Prevention (CDC) states that COVID-19 is mainly spread from person-to-person, either between close contact or through respiratory droplets produced when an infected person coughs, sneezes or talks. If those respiratory droplets land on your hand and make contact with any open skin, or the mucous membranes of your mouth, nose or eyes, you may be at risk.

To help control the spread of the coronavirus disease (COVID-19), health officials say it’s very important for you to avoid touching your face. Touching your face (i.e., your mouth, nose, and eyes) allows the virus on your hands to reach moist, porous surface tissue, mucous membranes, where the coronavirus can enter your body and cause infection.

Not touching your facial mucous membranes, an area known as the “T-zone,” is perhaps the most important step you can take to prevent an infection, said William Sawyer, a family doctor in Sharonville, Ohio, and founder of Henry the Hand, a nonprofit organization that promotes hand hygiene.

“It’s the one behavior that would be better than any vaccine ever created,” Sawyer said. “Just stop this simple behavior. Stop picking, licking, biting, rubbing — it’s the most effective way to prevent a pandemic.”

On average, people touch their faces up to 23 times per hour, and once you’ve been told not to touch your face, it’s suddenly all you want to do.

Sometimes, it’s impossible to avoid touching your face. And since the virus can also live on surfaces for several days. if you touch a table that someone with the virus sneezed on earlier, then rub your eye, you could give yourself the virus. That’s why experts stress hand-washing as a key infection control measure. Wash before and after any hand-face contact, using soap and water for at least 20 seconds. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.

https://youtu.be/d914EnpU4Fo

Washing your hands, along with stopping as many other instances of face-touching as you can, is one of your best defenses in helping you avoid getting infected by the coronavirus.

If you touch your face unconsciously throughout the day, think of physically touching something else without upping your risk of bacteria exposure like your elbow or leg.

It’s not enough to simply instruct people to stop touching their face, said Elliot Berkman, a psychology professor at the University of Oregon who studies habits and behaviors; people must be able to “outsmart their habit” or form a different one. One way to do that quickly is to change something in your environment, Berkman said. Wear something on your hands or face that can serve as a cue, an interruption to an automatic action.

References:

Mental Health Impact of COVID-19 Pandemic

Posted on September 6, 2020 by admin

“Many experts believe there’s going to be a second curve, which is the mental health impact of COVID.” Alison Malmon, founder and executive director of the nonprofit organization Active Minds

The pandemic has stressed the mental health and well-being of millions of Americans

During this unprecedented time of uncertainty and fear, it is likely that mental health issues and substance use disorders among Americans will be exacerbated. Since epidemics in the past have been shown to induce general stress and anxiety across a population and may lead to new mental health and substance use issues, according to The Pan American Health Organization (PAHO).

Experts warn of an upcoming wave of mental disorders because of coronavirus. In the past, unprecedented times like a pandemic are almost always accompanied by increases in depression, posttraumatic stress disorder (PTSD), substance use disorder, a broad range of other mental and behavioral disorders, domestic violence, and child abuse, according to a recent opinion piece published in the Journal of the American Medical Association, Sandro Galea, MD, MPH, DrPH, a professor at the Boston University School of Public Health.

“If the country continues to ignore the collateral damage — specifically our nation’s mental health — we will not come out of this stronger.” Benjamin F. Miller, PsyD, chief strategy officer at Well Being Trust.

Preliminary data shows the pandemic has already negatively affected people’s mental health and well-being, particularly college students, according to Catherine Grus, the American Psychological Association’s chief education officer. More than one in three adults in the U.S. have reported symptoms of anxiety or depressive disorder during the COVID-19 pandemic. The negative implications on mental health and well-being of social distancing practices and job loss related to the economic recession on mental health is significant and growing

According to a recent Kaiser Family Foundation poll, more than half of Americans — 56% –reported that worry or stress related to the outbreak has led to at least one negative mental health effect.

Those negative mental health and well-being effects include trouble with eating or sleeping, drinking alcohol more, frequent headaches or stomachaches, shorter tempers, and other health problems. Among frontline health care workers and their families, 64% reported worsened mental health, as did 65% of those who had lost income.

Another recent report, released Friday from the Well Being Trust, said the pandemic could lead to 75,000 additional “deaths of despair” from drug and alcohol misuse and suicide due to unemployment, social isolation, and fears about the virus.

Disproportionate impact on African Americans and people of color

Additionally, it’s important to address the fact that the pandemic and the economic fallout has disproportionately affected Black Americans and people of color who have experienced higher mortality rates due to the coronavirus, as well as higher rates of unemployment.

Patrice Harris, MD, immediate past president of the American Medical Association, says COVID-19 worsened the mental and physical health problems that African Americans were already having.

“Pre-COVID-19, in the last 8 to 10 years, we have seen an increase in the number of suicide attempts in our African American youth, increased reports of stress and anxiety in African Americans in general and, unfortunately, we have also seen an increase in a [lack of] access to mental health care,” she says. “That is the foundation from which we have entered … [the] COVID-19 pandemic.”

Since the pandemic came to the United States, Harris says, much of the country has shown signs of more anxiety, stress, and worry. “If you add that to the foundation that we have pre-existing conditions around health and equity, then it just adds to the level of stress, anxiety, and trauma felt by the [African American] community.”

Access to needed health care services was a concern prior to the pandemic

It is imperative that our society focus efforts to educate Americans, especially students and people of color, on issues such as stress, depression and anxiety, and provide ways to cope with these maladies. Many Americans will likely require mental health and substance use services. Consequently, the pandemic spotlights both existing and new barriers to accessing mental health and substance use disorder services.

Among households that report skipping or delaying health care during the pandemic, 4% state that as a result, their or a family member’s mental health condition worsened. For people with insurance coverage, an increasingly common barrier to accessing mental health care is a lack of in-network options for mental health and substance use care.

Limited access to mental health care and substance use treatment is in part due to a current shortage of mental health professionals, which will likely be exacerbated by the COVID-19 pandemic.

“People look at the pandemic and they tend to be drawn to the negative. If we can help shift people to look at the positive, it really helps because we know that neurons that fire together wire together.” Heather Aston, Program Manager, San Diego Access and Crisis Line

It’s helpful to learn about “distress tolerance” skills, which involve accepting that some problems are beyond one’s control. Instead of becoming mired in feelings of unfairness and anger, people can learn healthier ways of thinking and coping when they can’t escape painful situations like a pandemic and economic recession.

Even with the looming epidemic of mental health issues, experts say that people are resilient and can strive to protect their emotional well-being. People can develop their own psychological tools. Experts offer:

Try to to eat healthy, exercise daily and sleep well.
Try to stay socially connected with friends and families, even if you can’t see others in person.
Limit negative news and social media.

How Americans are coping during COVID-19

References:

Myocarditis, Inflammation of the Heart Muscle

Posted on September 4, 2020 by admin

Penn State doctor says 30-35% of Big Ten athletes testing positive for COVID-19 had myocarditis symptoms.

Cardiac MRI scans revealed that roughly a third of all athletes who have tested positive for the coronavirus appear to have myocarditis, an inflammation of the heart muscle, said Penn State’s director of athletic medicine.

Myocarditis is an inflammation of the heart muscle that can lead to arrhythmia, cardiac arrest and death, especially in a person who doesn’t know they have it and performs rigorous exercise. The risk of myocarditis was a prime reason behind the Big Ten Conference’s decision to postpone the upcoming football season.

According to the Mayo Clinic, “In many cases, myocarditis improves on its own or with treatment, leading to a complete recovery.”

Even in mild cases of myocarditis, however, the clinic suggests that “persons should avoid competitive sports for at least three to six months.”

The cause of COVID-19 myocarditis is unclear. Some researchers speculate that the coronavirus may sometimes directly infect the heart.

Another possible culprit is the immune system’s response against the virus. When it fires out of control — a severe inflammatory reaction known as a cytokine storm — it can damage organs throughout the body, including the heart.

References:

COVID-19 Frequently Asked Questions | New York Times

Posted on September 3, 2020 by admin

Updated September 1, 2020

Why is it safer to spend time together outside?

Pandemic life is safer outdoors. Outdoor gatherings lower risk because wind disperses viral droplets, and sunlight can kill some of the virus. Open spaces prevent the virus from building up in concentrated amounts and being inhaled, which can happen when infected people exhale in a confined space for long stretches of time, said Dr. Julian W. Tang, a virologist at the University of Leicester. Thus, while the risk of outdoor transmission is low, it can happen.

“The virus load is important,” said Eugene Chudnovsky, a physicist at Lehman College and the City University of New York’s Graduate Center. “A single virus will not make anyone sick; it will be immediately destroyed by the immune system. The belief is that one needs a few hundred to a few thousand of SARS-CoV-2 viruses to overwhelm the immune response.”

What are the symptoms of coronavirus?

In the beginning, the coronavirus seemed like it was primarily a respiratory illness — many patients had fever and chills, were weak and tired, and coughed a lot, though some people don’t show many symptoms at all. Those who seemed sickest had pneumonia or acute respiratory distress syndrome and received supplemental oxygen. By now, doctors have identified many more symptoms and syndromes. In April, the C.D.C. added to the list of early signs sore throat, fever, chills and muscle aches. Gastrointestinal upset, such as diarrhea and nausea, has also been observed. Another telltale sign of infection may be a sudden, profound diminution of one’s sense of smell and taste. Teenagers and young adults in some cases have developed painful red and purple lesions on their fingers and toes — nicknamed “Covid toe” — but few other serious symptoms.

Why does standing six feet away from others help?

The coronavirus spreads primarily through droplets from your mouth and nose, especially when you cough or sneeze. The C.D.C., one of the organizations using that measure, bases its recommendation of six feet on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet. But six feet has never been a magic number that guarantees complete protection. Sneezes, for instance, can launch droplets a lot farther than six feet, according to a recent study. It’s a rule of thumb: You should be safest standing six feet apart outside, especially when it’s windy. But keep a mask on at all times, even when you think you’re far enough apart.

COVID-19 risk factors for severe disease

Based on currently available information and clinical expertise, older adults and people with underlying medical conditions are at higher risk for severe illness from COVID-19. According to the CDC, “…6% of the deaths, COVID-19 was the only cause mentioned.” Essentially, 94 percent of Americans who have died from coronavirus from the week ending February 1, 2020 to the week ending August 22, 2020 had, on average, almost three comorbidities that played a role in their death.
According to CDC’s report, the leading comorbidities among COVID-19 deaths were respiratory diseases, circulatory diseases, sepsis, malignant neoplasms, diabetes, obesity and Alzheimer’s disease, respectively.
“Anecdotally, there are several stories of cases in which people with COVID-19 had deadly heart attacks, yet these cases were coded as COVID-19 deaths. In one extreme case, a Florida man who died in a motorcycle crash happened to also have COVID-19 at the time, yet was coded as having died from COVID-19, not because of the motorcycle accident.” Many clinicians are putting COVID-19 on death certificates when it might not be entirely accurate because they died infected with coronavirus and not because of coronavirus.

Sources:

Sorrento Therapeutic’s COVID-19 Test

Posted on September 2, 2020 by admin

Sorrento’s COVID-19 test appears to be superior to competing diagnostics, and it just made a good acquisition, while its overall strategy is sound.

Sorrento has produced a coronavirus test which is expected to be approved and then become widely used in the U.S. and potentially around the world. The company requested emergency use authorization (EUA) from the Food and Drug Administration for its COVI-TRACK diagnostic test, which detects novel coronavirus antibodies. It also plans to file for an EUA for COVI-TRACE, a rapid salivary diagnostic test licensed from Columbia University.

Sorrento has been even more active in developing potential treatments for COVID-19. The biotech filed for FDA approval earlier this month to begin a phase 1 study of antibody therapy STI-1499 (COVI-GUARD) in treating hospitalized COVID-19 patients. It hopes to quickly advance the candidate through clinical testing and perhaps even receive an EUA for STI-1499 as soon as the end of 2020.

a number of test tubes and capsules are pictured under a cool blue light

Source: Shutterstock

Sorrento’s coronavirus test yields results in just 30 minutes, does not require lab equipment and doesn’t have to be sent to labs. As a result, it, unlike other tests, could be used by hospitals, stadiums, hotels, office buildings and other organizations to allow people to safely enter their facilities on the same day that the test is taken.

References:

From Gratitude to Greatness: Brownlee Global's Path to a Purposeful Life

Guide and Educate Individuals How to Build Long-Term Wealth, Better Manage Their Money, and Achieve Financial Freedom

Tag Archives: COVID-19

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