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Welcome to the Northeast edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe Now button below. Thanks for reading! -Caitlin Rivers Respiratory diseasesInfluenza-like illnessThe past week has seen a general rise in influenza-like illness (ILI) rates across the Northeast. On average, ILI rates in the region have increased from 2.6% to 2.9%, which is similar to the national average. Multiple states are already near or above 4%, including New Jersey, New York, and Connecticut. New Jersey posted the largest increase at +0.9%, followed by Connecticut at +0.4%, and New York at +0.4%. Nearly all Northeast states experienced rising ILI, except for Rhode Island which saw a small 0.1% decline. Flu season is definitely underway in the region. Covid-19Although the Northeast currently has the highest Covid-19 hospitalization rates in the nation, most states in the region are seeing a decline in activity. The regional weekly admission rate dropped from 5.3 to 4.9 per 100,000. The recent summer peak was 7, for reference. Multiple states saw notable declines, including New York, Massachusetts, and New Jersey. New Hampshire posted the largest decrease. Nearly all Northeast states experienced falling hospitalization rates except for Vermont, which saw a 1.2 increase in hospitalizations per 100,000.
I have something new for you this week! The plot above shows how Covid-19 activity changed for each state from one week to the next. The points at the start and the end of the arrow are the hospitalization rates during each of the weeks. The number given in a percent is the percent change. Love it? Hate it? Let me know in the comments. RSVRSV continues to make rapid gains across the Northeast—activity increased another 2 percentage points in the past week. Test positivity is now 10%, up from 8% last week and 6% two weeks ago. Nearly all states in the region are reporting increases this week. Those trends have been sustained for several weeks now. Massachusetts continues to report the highest case positivity in the region at 15.8%. Pennsylvania has increased to 11.4%, up from 9.4% last week. Maine, New York, Connecticut and New Jersey are all reporting PCR test positivity rates of 6-8%. Vermont continues to stand apart, with a low test positivity of 1.3%; there is insufficient data for Rhode Island. There is no suggestion that RSV has peaked in the region yet; last year test positivity rose to nearly 20% test positivity before declining. As cases continue to rise, remember to wash your hands frequently, clean frequently touched surfaces, and avoid touching your face. Other Respiratory + Stomach BugsI’m keeping an eye on several other respiratory and stomach bugs, but overall things are looking relatively quiet at the moment in the Northeast.
Food recallsThe following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items: New this week:
Previously reported:
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
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THE EPIDEMIOLOGISTS ON AMERICA’S “COVID CASE” SAY THE EPIDEMIC IS COMING BACK 
NORTHEAST COVID EXPECTED TO RISE. WESTCHESTER ON TARGET FOR 2,000 COVID CASES IN NOVEMBER . THE FLU STARTS

GALLERIA “FORUMS” START TO PROMOTE ADVANTAGES GALLERIA PROJECT TO GET WHITE PLAINS “INFLUENCERS” BEHIND THE $3 BILLION PROJECT WESTCHESTER’S LARGEST DEVELOPMENT

INSURANCE KILLING! PREMIUMS FOR MEDICARE SUPPLEMENT COVERAGE BALLOON 9%
WHEN INFLATION IS ONLY 4%. THOUSANDS A YEAR OUT OF SENIOR INCOMES!

COUNTY ADDS 60 TEMPORARY PARKING PLACES TO SUPPLEMENT SHORTAGE OF PARKING FOR THANKSGIVING TRAVELERS. 25 MONTHS LEFT TO START COMPREHENSIVE PLAN BEFORE ADMINISTRATION CHANGES. INADEQUACY OF TERMINAL, PARKING, CAPACITY OBVIOUS.

JOHN KIRKPATRICK SERVED ON COMMON COUNCIL DEPARTS
A CITIZEN’S CITIZEN. ALWAYS WORKED TO PROMOTE WHITE PLAINS GROWTH

JOHN BAILEY AND THE NEWS
THIS WEEK EVERY WEEK ON WHITE PLAINS WEEK
FOR 22 YEARS
ON THE LEGACY OF THANKSGIVING 2023
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Reservations are NOT accepted over the phone. Customers must reserve via the website at:
https://www.westchestercountyairportparking.com/
This link is found from the County airport website by going to: Airport link at the bottom of “Departments” tab
– Departments
– Westchester County Airport (way bottom)
– Ground Transportation (left side bookmarks)
– Parking Areas (left side bookmarks)
– Only link there under “Airport Overflow Lot”
On-airport parking phone number for customer service (NOT reserving parking):
914-946-0843. Available 4:30am to last arriving flight (with enough time for customers to get through front of terminal).
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Si quiere leer la versión en español, pulse aquí. State of Affairs: November 16RSV activity is high. Covid and flu are increasing.
Well, we are officially in full-on “epidemic” mode for our fall and winter respiratory season. RSV, Covid-19, and flu are increasing across the nation. Here is your State of Affairs. Influenza-like illnessesThe climate of respiratory health in the United States (coined “influenza-like illnesses by CDC) reached the “epidemic” level threshold this week. This year continues to land somewhere between pre-pandemic years and last year. We’ll start with the star of the show… RSV: Very highWe have a bad RSV season. RSV moves through the nation like a wave, starting in the South and spreading outwards nationally. So, on a national level, positive RSV tests are exponentially increasing but not yet as high as last year. In Southern states, hospitalizations are as high (or higher) than last year. For example, Georgia hospitalizations below have exceeded the past two years. It looks like it’s starting to peak in the South. This is surprising. We had such an intense RSV season last year that we thought things would be calmer this year. Mainly because RSV immunity lasts longer than, for example, Covid-19 or flu. Two possible explanations:
Unfortunately, the new RSV vaccines and monoclonal antibodies also aren’t impacting the population-level viral transmission because coverage is poor (see more below). Covid: IncreasingCovid-19 wastewater—the earliest transmission indicator—is slowly creeping up nationwide. ED visits remain plateaued for now.
(Source: Biobot) Covid-19 hospitalizations are decreasing but lag cases by about 3-4 weeks, so this will change soon. Covid-19 hospitalizations today are lower than last year but remain the leader compared to other respiratory viruses. The NYT published some pretty jarring graphs showing an increase in young adults having “serious difficulty” remembering, concentrating, or making decisions. This is undoubtedly long Covid, but I think various other factors, like managing full-time childcare on top of full-time work, could also drive this. It’s worth probing (as some have); this is concerning. Flu: IncreasingFlu is increasing, too. The number of positive tests and the percent positivity rate are increasing exponentially. Hospitalizations remain low for now. Vaccination ratesVaccine uptake for respiratory diseases is not great, to say the least. The latest data shows Covid-19 (among those 18+) and RSV vaccination (among those 60+) remain significantly lower than flu (among those 18+). Rates are tracking last year’s. There are significant sociodemographic disparities—more so than during the pandemic—due to suboptimal access and cost. Data will be coming out very soon. Bottom lineRespiratory season is officially in full throttle. It’s not too late to get your vaccines. I have also started wearing a KN95 mask again in crowded indoor areas, like airports. As a working mom, I just don’t have time to get sick. Risk reduction is the name of the game. Love, YLE “Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH 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: |
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Good morning! I am writing with a quick, mid-week update of Outbreak Outlook to share some important information.
I was not able to include influenza-like illness (ILI) in my update on Monday because of delays due to the Veteran’s Day holiday. Well, ILI data has now been released, and it confirms that we have crossed the threshold that marks the onset of flu season.
As of the week ending November 4, 2.9% of doctor visits nationwide were for symptoms like fever, cough, or sore throat, up from 2.7% the previous week. This is the second earliest start of the flu season in the past six years.
As usual, children aged 0-4 are the most affected, with 9.3% of their doctor visits being for ILI symptoms. The next most affected age group is people aged 5-24, with 4.7% of doctor visits for ILI symptoms. For older age groups, the percentage of doctor visits for ILI symptoms is 2.2% or lower.
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Source: CDC
The Southern region is most affected, with multiple states in the Southeast experiencing “high” or “moderate” levels of ILI. In Florida, for example, around 5% of visits to the doctor were for ILI symptoms. In Georgia, it’s 4.3%.
Alaska, Puerto Rico, and New Mexico are also seeing high levels of activity. In fact, Puerto Rico has declared an influenza epidemic following the hospitalization of at least 1,048 people due to flu. Around half of cases (not hospitalizations, but cases) are in children. Puerto Rico has also already recorded 42 deaths, mostly in unvaccinated older adults.
I suspect that other areas in the U.S., currently showing “low” ILI activity, will see an increase in the upcoming weeks. Get your flu vaccine if you are among the 65% of adults who has not done so yet!
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Source: CDC
I also want to highlight a significant recall of cinnamon applesauce pouches. While I’ve mentioned this recall in my recent weekly updates, new information has emerged that underscore the recall’s importance.
Several brands of cinnamon applesauce squeeze pouches are being recalled due to dangerously high levels of lead. So far, at least 22 toddlers across 14 states have suffered from lead poisoning from these pouches. The brands currently known to be affected are WanaBana, Schnucks, and Weis. However, as investigators continue to trace the source of the contamination, more affected products may be identified.
Lead poisoning is not always obvious. If you think your child has eaten an affected product, talk to your pediatrician about a blood lead test.
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Si quiere leer la versión en español, pulse aquí.
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CDC released the latest vaccine exemptions and routine vaccination rates data for last school year. This, coupled with new data on growing acceptance of vaccine misinformation, shows a slow, painful bleed.
Here’s the data story.
A few years ago, rates of routine vaccines (i.e., DTaP, measles, mumps, rubella, and polio) began to decline. Last school year, vaccine coverage among kindergarten students hit a new low—93%.
This seems high. It is high. But we must keep it that way because some diseases, like measles, require 95% coverage to maintain herd immunity.
Unfortunately, concerning trends are developing on a state level. For example, thirty-six states are below the MMR (measles, mumps, rubella) coverage threshold of 95% for kindergarteners. The state with the lowest vaccination rate is Idaho (81%). This means 250,000 kindergartners are at risk for measles infection today.
This provides large pockets of unvaccinated people—a breeding ground for infectious diseases. Take Ohio, for example, which had the 9th lowest coverage in MMR vaccination last year. It’s no coincidence that there was a measles outbreak last year—85 children got sick, and 36 were hospitalized.
School mandatory vaccination is one the biggest drivers of vaccination. Exemptions—parents opting out for medical or non-medical reasons—are low (3%) but rapidly increasing. Non-medical exemptions—for religious or philosophical reasons—are driving the change. Research shows that non-medical exemptions are more common in areas with a higher percentage of a White population and higher income.
Ten states have exemptions exceeding 5% of kindergartners. Idaho has by far the highest exemption rate at 12%.
The states with the fastest-growing rate of vaccine exemptions are Hawaii, Idaho, Oklahoma, Louisiana, and Oregon. This acceleration started in 2020 and hasn’t slowed.
Five states do not allow non-medical exemptions. For example, after the massive Disneyland measles outbreak in 2015, California eliminated non-medical exemptions from school-entry vaccination requirements. While some parents found workarounds, this policy change had an overall direct impact on exemptions. Maine has a similar story.
Misinformation is increasing. Our information landscape has dramatically changed—false news spreads 6 times faster than the truth on social media, and 70% of Americans get health news on social media. Public health has not kept up.
This is directly impacting behaviors like getting vaccinated. A recent Annenberg report asked Americans whether certain statements about vaccines were true. They found a consistent theme: a growing acceptance of vaccine misinformation. For example, 1 in 8 people believe there are toxins, like antifreeze, in vaccines.
Loss of trust in institutions also drives misinformation and behaviors. This isn’t unique to public health but will surely have dire consequences to communities.
Disruption in care. During the pandemic, many children missed their regular doctor visits and thus missed their vaccines. Routine vaccination is rebounding, but specific demographics, like those living in poverty or rural areas, remain lower than pre-pandemic rates.
Depending on where you live, measles, polio, and other outbreaks may start popping up around you and in the news, like the measles outbreak in Ohio or the polio outbreak in New York that prompted a state of emergency.
If your child is fully vaccinated, there isn’t cause for concern. But, many children <12 months cannot be fully vaccinated because they aren’t eligible yet.
We are moving backwards, which means we will likely see the resurgence of infectious diseases once considered 19th-century problems. It’s hard to watch this slow bleed because it is preventable.
Love, YLE
In case you missed it:
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH Ph.D.—an epidemiologist, wife. During the day, she is a senior scientific consultant to several organizations, including the CDC. 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:
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TOURING BATTLE HILL (ON FOOT) SHOWING SITE OF ONE OF THE BATTLE OF WHITE PLANS WITH 3-wall feature with map of where YOU ARE IN WHITE PLAINS (Top of screen) at The OPTIMUM IGLOO THIS MORNING.
HOME OF BEYOND HUMAN INTELLIGENCE on 2nd floor of the library
WPCNR TOMORROW AND BEYOND. By John F. Bailey. November 13, 2023:
Forget about whatever you read about artificial intelligence.
There is nothing artificial about it.
It is reality, beyond imagination.
Never did I ever think a machine could write for me!
This can!

APPROACHING CHATTERTON HILL CLIMATIC BATTLE OF WHITE PLAINS SITE
I saw the Optimum Igloo artificial intelligence three-wall wraparound studio this morning demonstrated by Austin Olney, Digital Media Specialist of White Plains Public Library.
I saw a miracle performing with everything I saw.
Mr. Olney swept away any skepticism I have about “artificial” intelligence being something to fear.
It is a miracle.
The new is always feared.
Because it is a threat to power and the status quo.
The OPTIMUM makes research, writing, design, art, engineering, medicine diagnosis, faster, saving time and money LOTS OF IT.

Story about checkers created by Chatbot by the Igloo “BRAIN IN THE ROOM”
“Beyond Human Intelliegence,” as I call it, has the infinite possibility to stretch the envelope of creative genius in all fields far beyond where man and woman have ever gone before. It will enable the mind to do more with this computer assistant, a superbrain to test,try,invent, faster and more often.
I would call it “Beyond Human Intellgence” for the way it is stirring the blowing of winds of change, progress, possibilities of ultimate creative, research and discovery accelerating at warp speed.
It uses Chatbot, the fastest growing internet product ever, (Mr. Olney said) grew in a month faster than any internet launch. Midjourney is the other program that teams with Chatbot for graphics. Mr. Olney describes the two programs as “top of the line.”
Olney showed how chatbot creates a definition of one word such as a checkers, and comes up with a definition in a second or two.
I remember the hour or so I used to spend coming up with short punchy headlines when I was in advertising. My tongue was hanging out seeing this.
The “beyond human brain” can build on rough advertisng copy or news article if asked to “enhance it.”
In less than 20 seconds it fleshes out a new article in punchy easy flowing copy that weeds out the sometimes awkward phrasing written in the heat of a deadline.
The awesome brain in a room makes every creative person able to create faster in any field.
Mr. Olney then showed how I could instruct chatbot to create a story and then and then…a short play with dialogue, based on the rough story the machine had created out of a rough story there– it appeared.
And there it was in seconds…better than Brenda Starr!
I cannot tell you how hard writing is, the revising, the agonizing over words.
The miracle in a room can take your rough idea and give you a start, load in facts and background, then cut it for you.
The Optimum Igloo is being demonstrated monthly and it is worth seeing.
This miracle thing I saw today is so good The New York Times is suing it over copyright.
Chatbot and Midjourney collect content and store it and add to the store of knowledge billions and billions of facts, pictures, that can be incorporated faster than you can say “Jack Robinson.” You pick and choose.
This Giant Brain in a room will shake copyright law up. I have often thought that if you disseminate copyrighted material on a website for example it is fair use to copy portions of it. The Times for example makes you pay for access to their website. So if you pay for access to the material on their website or by their paper you should be able to copy it because it has already been disseminated to you for pay.
Chatbot prohibits political material, discussion or dissemination of violence, and sexually oriented content from being created. Something many platforms refuse to do effectively.
Olney pointed out that Chatbot does not verify facts. So if you include them you need to do your own checking.
The Midjourney graphics creates wraparound three-dimensional sequences. Mr. Olney is currently creating scenic tours of The Battle of White Plains with it. Which brings the terrain of that epic battle alive.
I no longer fear artificial intelligence.
Neither should you.
It is great for training, I can see it being used for aviation, the military, police training

MR. OLNEY DRIVING A ROUTE IN WHITE PLAINS DRAMATICALLY GIVING A REALITY WRAP AROUND VIEW
It will dramatically enhance the way children learn in schools that will adapt to it. It is adaptible to cellphone technology, I think, at-home learning, etc.
It will teach good writing by example.
It will demonstrate math by graphics and ultimately throw out those geometric formulas on regents by demonstrating with graphics.
It will teach English grammar faster.
It will revolutionize entertainment, bring stars of the past who have now passed away back to life in new movies, scripts, sitcoms and concerts of artists touring the world. Humphrey Bogart will be back in his glory. Barbara Stanwyck, John Wayne.
Chatbot is now free.
I have got to try this and so should you.
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Outbreak Outlook – Northeast – November 13
Welcome to the Northeast edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe Now button below. Thanks for reading! -Caitlin BY DR. CAITLIN RIVERS (REPRINTED WITH PERMISSION)
Respiratory diseasesInfluenza-like illnessNo new data was released this week due to the Veteran’s Day holiday. Covid-19Covid-19 trends look pretty good in the Northeast. New Hampshire saw the only increase in hospitalization incidence in the Northeast, rising 0.4 admissions per 100,000 people over the past week. The rest of the region experienced declines or remained relatively flat. Wastewater concentration is also pretty flat. Vermont posted the steepest drop at 1.8 fewer admissions per 100,000. New Jersey and New York also saw substantial decreases of 0.7 and 0.6 per 100,000, respectively. More moderate declines between 0.1-0.2 per 100,000 were seen in Maine, Massachusetts, Connecticut, and Rhode Island. Pennsylvania changed very little week-over-week. One note of caution: I’m seeing some early indicators of increase in other areas of the country, so I am (tentatively) concerned that the Northeast may see the same in the weeks to come. (EDITOR’S NOTE: COVID HOSPITALIZATIONS AT WHITE PLAINS HOSPITAL: FROM NOVEMBER 1 THROUGH FRIDAY NOVEMBER 10, WHITE PLAINS HOSPITAL ADMITTED 93 PERSONS TO BEDS AND OF THE 93, 46 (49%) WERE FOUND TO HAVE COVID AFTER ADMISSION. FROM NOVEMBER 5 THROUGH THURSDAY, NOVEMBER 9 396 PERSONS IN WESTCHESTER COUNTY, 79 A DAY, TESTED POSITIVE FOR COVID. LAST WEEK FROM OCTOBER 29 TO NOV 4, 574 PERSONS TEST POSITIVE FOR COVID. IN THE 5 DAYS SUNDAY NOV 5 THROUGH THURSDAY NOV 9, 396,79 A DAY HAVE TESTED POSITIVE FOR COVID. FIGURES ON COVID CASES IN OCTOBER THIS YEAR ARE HALF THE POSITIVE CASES OF COVID IN OCTOBER LAST YEAR. IF WESTCHESTER CONTAINS COVID AT THE RATE OF UNDER 1,000 IN NOVEMBER CASES IN DECEMBER COULD PROJECT TO LESS THAN HALF THE SPREAD OF LAST DECEMBER, UNDER 6,000.) RSVRSV is making rapid gains across the Northeast. PCR test positivity is up to 8.4% in the region, up from 3.9% just two weeks ago. Massachusetts (13% PCR test positivity) and Maine (~10% for the past two weeks) have the highest PCR test positivity in the region, increasing to 13% and 9.6%. Pennsylvania, New York, New Hampshire, and Connecticut have all seen increases in the past two weeks from the 3-4% range to roughly 6.5%. New Jersey has increased from 2.2% two weeks ago to 4.9% test positivity. Vermont still has relatively low RSV activity, with positivity below 1%. (There is insufficient data for Rhode Island.) Other Respiratory + Stomach Bugs
Food recallsThe following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items: New this week:
Previously reported:
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
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THE COLORS ARE RAISED BY THE WHITE PLAINS COLOR GUARD OF POLICE AND FIREMEN,. ISABEL HOCH SANG A MEASURED, STATELY “STAR SPANGLED BANNER” THAT PRODUCED JUST THE RIGHT NOTE OF HONOR, REMEMBRANCE, PRIDE AND APPRECIATION– FRANCIS SCOTT KEY WOULD HAVE BEEN PLEASED. MS. HOCH SET THE TONE OF WHAT AMERICA’S VETERANS WHO SAVED THIS COUNTRY SO THAT BANNER MAY “WAVE OVER THE LAND OF THE FREE AND THE HOME OF THE BRAVE.”

MAYOR TOM ROACH HONORED WHAT SERVICE TO AMERICA IN THE ARMED FORCES MEANT TO VETERANS, REMINISCING ABOUT HIS FATHER WHO SERVED ON A PBY RESCUE PLANE IN WORLD WAR II, AS A NOSE GUNNER, THAT HIS FATHER “ALWAYS TREASURED HIS SERVICE. HE SAID HE HAD RECEIVED A LETTER FROM A VETERAN WHO SERVED ON THE U.S.S. WHITE PLAINS, AND HOW THE NAVY VETERAN WAS PROUD AND SHARED WITH THE MAYOR WHAT HIS SERVICE ON THE SHIP HAD MEANT TO HIM AND STILL DOES MEAN TO HIM.
MITCHEL STOGEL, FIRST LIEUTENANT, U.S. ARMY STANDING AT LEFT, WHO SERVED IN IRAQ, AFGHANISTAN AND SOMALIA IN ADDRESSING THE AUDIENCE, SHARED THE FEELING OF SATISFACTION FROM HIS 13 YEARS OF SERVICE AND RECALLED HOW MANY MEMBERS OF HIS FAMILY HAD SERVED WHICH CONVINCED HIM TO GO INTO THE ARMY. OF HIS EXPERERIENCE, HE SAID “I WOULD TRADE IT FOR ANYTHINNG ELSE.”

WHEN THE SERVICE ENDED, THE SILVER BELL WAS RUNG 11 TIMES TO COMMEMORATE THE 11TH HOUR OF THE 11TH DAY OF THE 11TH MONTH WHEN THE ARMISTICE WAS SIGNED IN A RAILROAD CAR OUTSIDE PARIS
AS THE SOLEMN RINGING ENDED, OLD GLORY, SLACK ON THE FLAG POLE ABOVE CITY HALL WHEN THE CEREMONY BEGAN , WAS WHIPSNAPPING UNFURLING RIPPLING IN THE WIND. IT WAS FITTING THE FLAG, WHICH IS A LIVING THING, APPEARED TO BE FILLING WITH ROBUST PRIDE AND SALUTING THE VETERANS OF THE PAST FOR THEIR VALOR AND NEVER TO BE FORGOTTEN DEBT AMERICA OWES THEM.