OUTBREAK OUTLOOK –NORTHEAST –NY COVID STABLE, HOSPITALIZATIONS STABLE

Posted on October 9, 2023 by John Bailey

Outbreak Outlook – Northeast – October 9

OCT 9, 2023

By DR. CAITLIN RIVERS

Welcome to the Northeast edition of Outbreak Outlook, formerly called This Week in Outbreaks! This content is only available to paid subscribers. As I am launching the regional editions, your feedback and support is invaluable. Thanks for reading! -Caitlin

Respiratory diseases

Influenza-like illness

Influenza-like illness (ILI) has increased for several weeks now in the Northeast. It currently ranks as the second-highest region for ILI in the country, with around 2.3% of visits to the doctor for ILI symptoms. This is an increase over last week’s 1.8%, but still far below the national threshold that marks the beginning of flu season, which is 2.5%. Current levels are similar to what the Northeast region saw at this time last year.

While most states in the region fall in the “minimal” or “low” ILI activity categories, New York City was again categorized as “high.” More detailed information on influenza-like illness will become available later this month, when states begin to turn on their ILI surveillance systems and pay closer attention to what is going around.

Once again, it’s the littlest ones who are most heavily affected. For kids aged 0-4, 7.1% of their visits to the doctor were for fever and cough or sore throat, up from 6.8% the week prior. For the 5-24 age group, the rate is lower at 3.3%, while rates for older age groups are below 2%.

Covid-19

Hmm. Covid-19 trends in the Northeast are puzzling. Data from Biobot shows an unexpected rise in wastewater concentration. This surprised me, because other regions in the country are showing improvement. I had anticipated the Northeast to follow a similar trend. I’ll keep an eye on it and update you on the next developments.

In Northern New England, the number of new hospitalizations rose slightly. Interestingly, while hospitalizations increased, the test positivity rate saw a dip from 12.5% to 9.7%. I hope that foreshadows improvements in Covid-19 activity, but again, I’m uncertain.

In New York and New Jersey, the number of new hospitalizations is remaining mostly stable. The test positivity has fallen slightly. It climbed high to 16.2% on September 16, but by September 23, it had calmed down to 13.2%.

Hospitalizations in Pennsylvania are still increasing.

Also, I got my free, at-home Covid-19 tests in the mail last week! One reader pointed out that the tests were not due to arrive until October 2 — and indeed they did, right on time. Order yours today! covid.gov/tests.

RSV

RSV activity but slowly increasing in New England states. PCR test positivity is now 2%, up from a recent low of less than 1%. Still, during the height of RSV season, test positivity can reach 20%, so overall activity is low.

Not much sign of increase in New York, New Jersey or Pennsylvania.

Other Respiratory + Stomach Bugs

All the other respiratory virus that I keep an eye on — seasonal coronavirus, human metapneumovirus, parainfluenza virus, and adenovirus —look good.

Norovirus activity is low.

Food recalls

The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New this week:

Ion and Restore brands Sinus Spray (more info)
Organic Chicken and Beef Broth sold at Costco and Whole Foods (more info)

Previously reported:

Whole cantaloupes sold by Eagle Produce (more info)
Not Fried Chicken sold by Life Raft Treats (more info)
Hillshire Brands smoked sausage (more info)
Banquet Chicken Strips Meal (more info)
Frozen corn and mixed vegetables from Food Lion and Kroger (more info)
If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.

In Other News

New Hampshire has reported the state’s first human case of Jamestown Canyon Virus (JCV) for the year. JCV, which is transmitted by mosquito bites, can lead to symptoms like flu-like illness, fever, and muscle aches It can also cause more severe illness. In addition, two cases of Powassan Virus (POWV) have been identified. POWV is transmitted by the blacklegged tick, the same tick responsible for Lyme Disease. There are no vaccines or treatments for JCV or POWV. Since 2018, New Hampshire has reported a total of 13 human cases of JCV and 8 cases of POWV since its first detection in humans in the state in 2013.

LEAGUE OF WOMEN VOTERS OF WHITE PLAINS ANNOUNCES CANDIDATES FORUM FOR COMMON COUNCIL ELECTION

Posted on October 8, 2023 by John Bailey

View this email in your browser

Wednesday, October 25
7-9 p.m.
White Plains Public Library Auditorium

The League of Womens Voters of White Plains will be holding a Candidate Forum for the White Plains Common Council Candidates running in this November’s election. The five candidates running for the three contested seats include:

Jeremiah Frei-Pearson (D)
Enrique Jinite (R)
Charles Lederman (R)
Victoria Presser* (D)
Jennifer Puja* (D)

*Incumbent

NO QUESTIONS WILL BE TAKEN FROM THE FLOOR
How You can Submit Questions for the candidates:

Email your question(s) to Alan Cass, alancass3@gmail.com
Write Forum Question in the subject line
While we will not share your name and contact information at the Forum,we ask that you include the following information to ensure that White Plains Residents have their questions heard:

-Your Name
-Your Address
-Your Question

Questions should be applicable to all candidates and center on White Plains issues rather than personalities. The League will review questions and consolidate similar ones that will reflect a wide range of issues.

Video: The forum will be recorded by White Plains Community Media for rebroadcasting on Optimum Channel 75 and Verizon Channel 47 (schedule to be announced).
Please note that the League of Women Voters policy does not allow personal video or audio recording of the forum. The only recording permissible will be by White Plains Community Cable.

The League is pleased to be working with AKA and the NAACP on this event.

Headlines Editor: Libby Hollahan

GOVERNOR HOCHUL ANNOUNCES 18,000 POTENTIAL JOB OPENINGS FOR MIGRANTS IN NEW YORK

Posted on October 7, 2023 by John Bailey

Hospitality and food service companies were the biggest group of employers to enroll in the state program.

Gov. Kathy Hochul announces 18,000 jobs available to asylum-seekers and migrants as part of statewide initiative to move individuals out of shelters. SUSAN WATTS/OFFICE OF GOVERNOR KATHY HOCHUL

OCTOBER 7, 2023

As both New York City and state officials continue to try and discourage more migrants from coming to New York, Gov. Kathy Hochul said on Monday that employers in the state are ready to hire asylum-seekers once they receive work permits.

During a press conference in Manhattan, Hochul announced that nearly 400 employers from across the state had signed up to participate in a state Department of Labor program meant to connect migrants authorized to work with jobs. According to her, that translated to roughly 18,000 jobs.

“That can help solve our problems, at least a start towards reducing the number of people who need shelter in our city,” Hochul said. Venezuelans who arrived in the country by July 31 will be eligible to apply for Temporary Protected Status beginning on Tuesday, meaning that some would be eligible to receive work authorization and can begin filling those jobs.

According to data released by Hochul’s office, over half of the jobs would be in New York City, with the rest scattered across the rest of the state. After the city, the Hudson Valley, Western New York and Long Island would have the most jobs among employers who have signed up. The 379 employers also represented a range of industries, with the most – 24% – from the hospitality and food service industries.

“When I think about all the folks that have come to New York City seeking asylum … they want to work hard, they want opportunity,” said Andrew Rigie, executive director of the New York City Hospitality Alliance. “And we know our city’s restaurant industry represents that opportunity.” Rigie was one of three representatives of the food and hospitality industries to speak at the Monday press conference.

Health care and social assistance were 79 of the employers, or 21% of the program’s participants. That made it the second-largest industry to sign up to connect with migrants, but no representatives from the field spoke at the press conference hosted by the governor.

Asked for a list of the largest participating employers, particularly in health care, a spokesperson for the state Department of Labor said they did not have a full list, but added that Premier Home Health Care Services is one of the larger health care employers participating in the program.

The company has offices in Manhattan, Long Island, Westchester County and Staten Island. And a spokesperson for the Greater New York Hospital Association told City & State that it is currently trying to determine if any of its members are participating. A spokesperson for the New York Health Plan Association also did not immediately have information regarding which, if any, of its members signed up.

Other industries made up smaller percentages of participating employers. The third-largest number of employers came from manufacturing, from which 38 companies signed up, or 10% of all employers so far. After that was 8% in administrative support, 7% categorized as “other,” and 5% each for construction and retail. No representatives from any of these other fields spoke at the Monday press conference.

The announcement came on the heels of comments that Hochul made over the weekend on CBS’ “Face the Nation” calling on the federal government to impose “a limit on who can come across the border.” She said that the border is “too open right now” and that many people asking for asylum are “ending up in the streets of New York.” A top adviser for New York City Mayor Eric Adams also called on federal officials to “close the border” on Sunday.

Asked by reporters whether the statement went too far as Republicans seized on it, Hochul demurred. “I’ve been in the business long enough to know that no matter what I say … they will interpret it and misinterpret it and lie about it in any way that suits their political interest,” Hochul said.

WHITE PLAINS WEEK TONIGHT AT 7 PM , THE OCT 6 REPORT ON CH 45 FIOS COUNTYWIDE, CH76 WPTV OPTIMUM AND www.wpcommunitymedia.org

Posted on October 6, 2023 by John Bailey

COVID CASES IN COUNTY DOWN 42% AFTER 14 INCREASING WEEKS

BEYOND PLASTICS WEBINAR EXPOSED THE PLASTIC PLAGUE OF ENDOCRINE-INTERRUPTERS CHEMICALS. DR. PETER MEYERS OF ENVIRONMENTAL HEALTH NETWORK EXPLAINS IN KEY VIDEO

STATE SENATOR PETER HARCKHAM SPONSORS NY PLASTIC PACKAGING LAW THAT WOULD MAKE PLASTIC PACKAGING HAVE TO RECYCLABLE IN 12 YEARS

AFTER CITIZENS COMPLAIN, COUNCIL REVISES BAN ON COMBUSTION-FUELED LEAF BLOWERS ALLOWING THE USE OF THE PREVIOUS BANNED IN WHITE PLAINS BLOWERS IN FALL.

CAITLIN RIVERS DEBUTS ON WPCNR “THIS WEEK IN OUTBREAKS–THE NORTHEAST”

FREE ANTIGEN TESTS FROM WASHINGTON ARE GOING OUT ACROSS AMERICA ORDER YOURS FREE

KEEP LOWERING COVID INFECTIONS BY MAKING SURE YOU ARE NOT POSITIVE

JOHN BAILEY AND THE NEWS THAT AFFECTS YOU MR. AND MRS AND MS. WHITE PLAINS

REPORTING EVERY WEEK ON WHITE PLAINS WEEK FOR 22 YEARS

THE GEORGE LATIMER WEEKLY BRIEFING NEWS COMPLETE ON WPCNR.COM: FLOOD UPDATE AND INTRODUCTION OF WEEKLY HERO. COMPLETE

Posted on October 6, 2023 by John Bailey

https://www.youtube.com/watch?v=i2uA0KvXKXM

TONIGHT AT 8 ON “PEOPLE TO BE HEARD” FIOS CH 45. WP OPTIMUM CH 76 AND www.wpcommunitymedia.org : JOHN IORIS AND STEPHEN FERRI OF WHITE PLAINS PERFORMING ARTS CENTER ON THEIR 20TH ANNIVERSARY SEASON AND GALA COMING UP

Posted on October 5, 2023 by John Bailey

THE NEW SEASON

HOW THE WPPAC HAS GROWN IN 20 YEARS

THE GALA IN NOVEMBER

PREVIEWS OF THE NEW SEASON.

WESTCHESTER COUNTY NEW COVID CASES DROP 42% LAST WEEK OF SEPT. FIRST DECLINE IN 14 WEEKS

Posted on October 5, 2023 by John Bailey

White Plains Hospital Continues seeing 60% of Patients Admitted positive for covid.

WPCNR COVID SURVEILLANCE. Data from New York State Covid Tracker. Observation & Analysis by John F. Bailey. October 4, 2023 UPDATED WITH FREE ANTIGEN TESTS ORDERING INFO:

Westchester County new covid cases dropped the first week in 14 weeks (dating back to the last week in June, sEPT 24-30 last week, recording 1,081 persons testing positive for covid, down from 1,242 the week of Sept 17-23.

In the last week, the prevalence of covid in the area is evidenced by White Plains Hospital official admissions figures reported to the New York State Board of Health.

White Plains Hospital reported September 22- Oct 2, 73 persons were admitted to beds, and after being admitted 43 or 59%, were found positive with Covid. This continues the trend at White Plains hospital established the last 9 months with half to 60% of admissions found with covid after admission.

What I take from this is that people are not testing themselves when a procedure is scheduled. Or not testing in a timely manner. Like 3 days before they go in for what every procedure they have scheduled.

However in two weeks since mid-September the spread of the disease has dropped significantly.

As of September 22 Covid disease was spreading in the boroughs of New York City at the rate of 1,537 new covid cases a day. As of October 4, the New York city cases were down to 683 a drop of 56%!

Nassau and Suffolk were spreading at the rate of 700 new cases a day on September 22,.

On October 4, Nassau and Suffolk Counties reported 297 covid positives, also down 50%

The Mid-Hudson Region two weeks ago September 22 saw Westchester leading infections with 161, Orange and Rockland with 78, Dutchess, 48, and Sullivan, with 11 and Putnam 7 for a total of 383 cases a day.

In my opinion, Orange, Rockland and Dutchess had been gaining in cases in midweek up to about a week ago, now those counties seemed to have stabilized their spread, somewhat

October 4 Westchester dropped to 93 cases from 161 – a 42% DECREASE in cases!

The other 6 Mid-Hudsons showed Orange at 45, Rockland, 34, Dutchess, 24, Ulster, 11, Sullivan 11 and Putmam 5

The number of antigen (home test positives) lab verified is running 33% of new covid cases in New York City.

In Westchester, 38 of Westchester’s 93 positives October 4, were as a result of lab tested antigen tests. Indicating that persons who are experience cold or slight fever, should take this as a reason to take a home test to see if they might be positive and go for treatmemt if you test positive.

In Westchester the antigen test verified cases of the 161 Westchester total is 32%. In Nassau and Suffolk County people are getting covid at the highest rate of all 7 counties and New York City. Of 700 total covid positives in Nassau and Suffolk Counties, 52% of the case, 361 were verified antigen positives. That says to me people are getting sick, and going for antigen tests, testing positive with the ominous “+” sign and going for treatment.

This seems to indicate that Westchester residents are taking having antigen tests at home is a good idea to test if they seem sick or have heard of persons infected they have seen recently.

A reminder: The U.S. Government is supplying antigen tests free. The tests are free and you receive them within a week by mail. If you have none you might want to get some and mingle with confidence, rather than infect friends and relatives, buddies or significant others.

They are available online direct from the United States Postal Service and they are FREE.

Only go to COVIDtests.gov to order your free test kits from the federal government. When you click to order, you’ll be redirected to special.usps.com/testkits. If you’re following a link from a news story, double-check the URL that shows in your browser’s address bar.

BEWARE of any one calling you at home offering Antigen tests, and wanting a credit card number. It is a scam.

BLOWING OF LEAVES WITH INTERNAL COMBUSTION LEAF BLOWERS BAN LIFTED STARTING OCT 15 THROUGH DECEMBER 15

Posted on October 3, 2023 by John Bailey

The White Plains Common Council voted 4-3 Monday evening, to modify the city’s ban on gas-powered leaf blowers all year long, the original leaf blower law.

Beginning October 15 residents and businesses will be allowed through the fall season through the end of November to use gas powered leaf blowers. Previously, they were banned throughout the year, which according to residents’ observations of violations was widely ignored by groundskeeping businesses servicing neighbors, residents themselves themselves and even the White Plains DPW using gas blowers to clean up the July fireworks night with authorization, the Mayor said. The school district has also been alleged to use gas leaf blowers

As a result of numerous videos and pictures submitted by residents to the Mayor’s office and councilpersons documating violations, the Common Council discussed the situation among themselves and Councilperson John Martin “crafted” a compromise ordinance, eliminating the ban of gas-powered leaf blowers beginning October 15 THROUGH DECEMBER 15,

in the video replay of Monday’s meeting, Councilpersons Martin, Jennifer Puja, Nadine Hunt-Robinson,and robert Paine voted to amend and allow the the fall use of gas blowers. Mayor Roach, Councilperson Brasch, Councilperson Victoria Presser voted against weakening the law.

All 7 councilpersons had extensive comments and those may be viewed on the city website at

http://whiteplainsny.swagit.com/play/10032023-520

and select item 4 on the program

Mayor Roach speaks for 20 minutes on why he voted against the law.

THE SCIENCE STORY BEHIND THE COVID 19 VACCINE AND KARIKO’ AND WEISSMAN’S NOBEL PRIZE

Posted on October 3, 2023 by John Bailey

Karikó and Weissman’s Nobel Prize

Your “translated” version of their scientific discovery

By Dr. KATELYN JETELINA

AND

EDWARD NIRENBERG

OCT 3, 2023

Yesterday, the 2023 Nobel Prize Winners for Physiology or Medicine went to Drew Weissman and Katalin Karikó for their discoveries in the biotechnology behind our Covid-19 mRNA vaccines.

Behind the amazing story of perseverance and collaborative spirit (it’s a fascinating story) is an absolutely revolutionary scientific discovery.

Here is the problem they solved, how we leveraged it for the pandemic, and the far-reaching implications.

The problem

In 1961, we discovered RNA in living things. RNA is a string of letters that gives our cells instructions on how to function.

At first, scientists explored how synthetic messenger RNA (mRNA) could be leveraged in gene therapy. This was attractive because it meant we didn’t actually have to change our DNA. There would be no risk of accidentally introducing mutations that could affect how healthy genes work or, worst case, cause cancer.

But, every time mRNA was introduced to cells for gene replacement, it caused a profound immune response. In other words, our immune system was doing its job: recognizing a foreign agent and trying to get rid of it.

This caused scientists to pivot as there is an obvious application for a situation where you want an immune response: vaccination. In 1993, an mRNA influenza test showed successful induction of anti-influenza T cells in mice. This was incredibly exciting.

But there was a major challenge: the mRNA vaccines activated the immune system too early. This resulted in a mediocre antibody response and diverted T cells from a pathway that supported antibody production.

Hou et al., Lipid nanoparticles for mRNA delivery. Nat Rev Mater (2021).

The solution

Enter Karikó, an RNA biochemist, and Weismann, an immunologist.

Karikó was confident she could fashion a vaccine from mRNA but encountered the same stubborn problem: the mice had trouble coping with the immune response after the mRNA vaccine. The quality of the immune response wasn’t as good as she’d hoped for either. Why did Karikó’s synthetic RNA do this when our cells constantly made mRNA with no such problem? Karikó’s RNA had to differ from the RNA our cells made, but how?

In 2005, Karikó and Weissman found the secret sauce: a group of RNA letter changes (i.e. modifications). A particular modification stood out: the change of U (uridine) to Ψ (pseudouridine, a common modification in our own RNA) prevented the immune system from recognizing the mRNA as foreign. They published these findings in Immunity, one of the top journals in the field of immunology.

As the 2010s progressed, mRNA vaccines trickled into early-phase clinical trials. However, another matter still limited confidence in the approach: mRNA is so fragile that it is very difficult to work with and requires very cold storage conditions.

The pandemic

Then the pandemic came. While we had a key puzzle piece above, there were also other things that needed to come together:

Carrier: Needed to find an efficient way to deliver the mRNA to our cells before it degraded (we used fat bubbles, which also had a long history; see timeline above).
Cell instructions: Needed to stabilize the SARS-CoV-2 spike antigen.
Storage: Needed to supply special freezers to store the vaccine.

All of these were accomplished; the perfect storm that brought together scientific discovery, extensive investment, and global teamwork.

The implications

It is not an understatement to say that their discovery totally transformed our approach to vaccines. You would have a hard time naming a virus of public health importance for which an mRNA vaccine isn’t being attempted, but there are uses beyond that:

Vaccines against tick-borne infections that target proteins in tick saliva.
Vaccines to stop or reduce autoimmune diseases, like multiple sclerosis.

Bottom line

Your mRNA Covid-19 vaccine is Nobel Prize-worthy. And an excellent example of our gains from the decades-long road of scientific discovery.

Congratulations to Karikó and Weissman! Their work has saved millions of lives already and will continue to save millions more in the decades to come.

Love, YLE and EN

“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, M.P.H. Ph.D.—an epidemiologist, wife. During the day, she is a senior scientific consultant to several organizations. At night, she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below:

NEW! INTRODUCING “THIS WEEK IN OUTBREAKS: THE NORTHEAST EDITION” FROM DR. CAITLIN RIVERS

Posted on October 2, 2023 by John Bailey

Editor’s Note from John Bailey, The White Plains CitizeNetReporter: Good morning! Today introduces a new timely addition to White Plains CitizeNetReporter. Dr. Caitlin Rivers of Johns Hopkins University, who publishes Force of Infection, is introducing a new regional edition of her newsletter which zeros in on the numbers up close and personal in the northeast. WPCNR is a paid subscriber of this new source of clarity on covid as the New York metropolitan area is matching last September covid cases and enters the fall season when last year new infections lead to thousands of infections last January. This Week in Outbreaks is published for the first time today and is reprinted with permission.

NORTHEAST

Outbreak Outlook – Northeast – October 2

By Dr. CAITLIN RIVERS

OCT 2, 2023

Respiratory diseases

Influenza-like illness

Influenza-like illness (ILI) has increased for several weeks now in the Northeast. Around 2.3% of visits to the doctor were for ILI symptoms, which include fever and cough or sore throat. This is a significant increase over last week’s 1.8%. Current levels are similar to what the Northeast region saw at this time last year.

While most states in the region fall in the “minimal” or “low” ILI activity categories, New York City stands out, currently categorized as “high.”

Since it’s still the off-season, I was not able to find additional details about what is going on in NYC. More detailed information on influenza-like illness will become available later this month, when states begin to turn on their ILI surveillance systems and pay closer attention to what is going around.

At the national level, the littlest kiddos are still the most affected by ILI. Nearly 7% of visits to the doctor’s office were for ILI symptoms among kids ages 0-4, up from a recent low of 4%. Older kids, ages 5-24, are faring better at 3.2%. All adult age groups report rates below 2%.

Covid-19

Covid-19 activity has not yet peaked in the Northeast, but the number of new hospitalizations has begun to level off. Wastewater concentration has also plateaued, according to data from Biobot. Taken together, I think the summer Covid-19 wave is currently at peak in the Northeast and should begin dropping soon. The other three regions have already started seeing a decline. It’s reassuring that hospitalizations in the Northeast are still significantly lower than last summer’s uptick.

Don’t forget that the new Covid-19 vaccine is now widely available, and you can get four free at-home tests from covid.gov/tests. I ordered my tests last week, and they haven’t arrived yet; delivery may be delayed.

In Other News

A Covid-19 outbreak at a hospital in Plattsburgh, New York, near the Vermont border, has led to the reinstatement of a mask mandate. The hospital reported 50 Covid-19 infections among its staff and 20 patient admissions due to the virus this week.
Officials have now mandated that all patients and visitors wear surgical masks. The hospital is part of the University of Vermont’s health network, but no other hospitals in this network have reintroduced mask mandates. At least five hospitals in New Jersey have also reinstituted mask mandates.

RSV

RSV activity is low in the Northeastern region. As a reminder, new shots are available for infants, older adults, and now pregnant women.

Others

All the other respiratory virus that I keep an eye on — seasonal coronavirus, human metapneumovirus, parainfluenza virus, and adenovirus —look good for the Northeast.

Stomach bugs

Norovirus activity increased for several weeks during the summer but is now on the decline in the Northeast. PCR test positivity was 5.8% at last report, a decrease from the recent peak of 9%. Despite the decline, these figures still highlight a moderate level of ILI activity. Norovirus rates are usually lowest in summer, then rise through autumn and winter before peaking in springtime.

Food recalls

The following foods were sold and are now being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New this week:

Not Fried Chicken sold by Life Raft Treats (more info)

Previously reported:

Hillshire Brands smoked sausage (more info)
Banquet Chicken Strips Meal (more info)
Frozen corn and mixed vegetables from Food Lion and Kroger (more info)
Dehumidifiers, dozens of models sold by major retailers, including Home Depot, Lowe’s, and Walmart. The recalled units were manufactured between 2011 and 2014 (more info — check this list carefully, it’s extensive)
If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.

Genevieve McCracken

19 mins ago

Thank you so much for this! I was so excited to see your newsletter, for the north east region, in my inbox this morning. Your work is so valuable. So thankful for you.

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AUG 17 •

CAITLIN RIVERS

AND

KATELYN JETELINA