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Matthew Cortland (they)

@matthewcort.land
34K followers 967 following 6K posts

Chronically ill public health JD writing to make sense of the policy hellscape so you don't have to do it alone. Actionable analysis & trustworthy guidance for people the system wasn't built to protect. Free & paid: ShouldntNeed.com Sr. Fellow DFP. 🏳️‍⚧️nb

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Matthew Cortland (they) @matthewcort.land · 06/10/2026
shouldntneedtobealawyer.com/posts/plague...
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Matthew Cortland (they) @matthewcort.land · 04/10/2026
That is my hand she is using as a pillow- I have been line this for near an hour
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Matthew Cortland (they) @matthewcort.land · 03/10/2026
Including the covid vaccine - basically everyone should get it shouldntneedtobealawyer.com/posts/vaccin...
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Matthew Cortland (they) @matthewcort.land · 02/10/2026
"Medicaid work requirements" are above water with the American electorate (net +18). Calling the same policy "Medicaid eligibility cuts" meaningfully decreases support (net -11). I do not understand the insistence on adopting the framing of those trying to destroy Medicaid
Bar chart of polling data from Data For Progress.
Title: Voters Support the Same Medicaid Rules When Called "Work Requirements" and Oppose Them When Called "Eligibility Cuts".
Description: Under new rules, some adults can get or keep Medicaid only if the state confirms that they meet work, school, or volunteer rules. [Split A n=613] Do you support or oppose these Medicaid work requirements? [Split B n=598] Do you support or oppose these Medicaid eligibility cuts?
[Split A] Medicaid work requirements — Support: 57%, Oppose: 39%
[Split B] Medicaid eligibility cuts — Support: 42%, Oppose: 55%

September 25–28, 2026 survey of 1,211 U.S. likely voters.
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Matthew Cortland (they) @matthewcort.land · 01/10/2026
it is unknown at this time if mystic will be making an appearance
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Matthew Cortland (they) @matthewcort.land · 29/09/2026
This is from a NEJM Voices piece
And think about what was being compared: two infusions, on days 1 and 8, versus weeks of conventional antibiotic therapy. No PICC line. No daily infusions. No home delivery and storage of antibiotics. No vancomycin levels. No weekly laboratory monitoring for drug toxicity.
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Matthew Cortland (they) @matthewcort.land · 29/09/2026
scams all the way down
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Matthew Cortland (they) @matthewcort.land · 24/09/2026
the bad place - we live in the bad place and hell is other people
Per a note to Boston Globe staff today, the lesbian bar story generated 1,000 subscriptions to the paper yesterday. The Globe's managing editor said it was "by far our best performing story of the year," and appears to be
"on pace to shatter all sorts of Globe records."
# The Boston Globe & @BostonGlobe • Sep 22
A lesbian bar in Greenfield eased its stringent mask mandate, a decision that has splintered the queer community in the city and beyond. trib.al/FyZjBWs
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L7 1.8K
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Matthew Cortland (they) @matthewcort.land · 21/09/2026
what's up?
mystic, a black adn white tuxie, in a box, looking directly at you
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Matthew Cortland (they) @matthewcort.land · 19/09/2026

‪brendan 🇵🇸‬
 ‪@ohiolandmarks.bsky.social‬
· 9m
Replied to you
It's a red flag, but it's also loser shit to get upset about. I use Democrat all the time to save characters/trigger the libs, because who cares? I hate Republicans more than any KHive trash on Bluesky, as evidenced by me not conceding a bunch of policies to them like Democrat politicians always do.
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Matthew Cortland (they) @matthewcort.land · 19/09/2026
So aside from everything else, the use of "Democrat" (instead of "Democratic") in this way is a tell. For the last 40 years, GOP operatives have made a concerted effort to use "democrat" as an epithet — this is someone who is drinking the GOP kool-aid
Top Pop @authorjosephduncan.bsky.social • 1d
Sometimes you have to choose the lesser of two evils. Actually, I wouldn't even call it evil. Talarico backpedaling a bit is just him trying to snatch a few more conservative voters from his opponent. These ridiculous Democrat purity tests is what got us here. I suspect agent provocateurs.
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Matthew Cortland (they) @matthewcort.land · 19/09/2026
What a fucking deranged thing to write @healthbeat.org / @chalkbeat.org. Students with disabilities struggle to access the legally mandated ACESSILE EDUCATION they are entitled to under federal disability civil rights law but that NYC fucking refuses to provide.
Chronic absenteeism skyrocketed to 40%, the highest level in decades, during the COVID pandemic when students returned full-time to their classrooms during the 2021-22 school year. And though the rates have decreased since then, the latest figure — 33.5% — released Thursday in the Mayor’s Management Report (a compendium of performance data from city agencies), reveals how challenging it is for schools to move the needle. The hurdles are highest for the neediest students, particularly those who are homeless. Students with disabilities also struggle with attendance, often exacerbated by busing-related issues.
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Matthew Cortland (they) @matthewcort.land · 18/09/2026
I'm genuinely a public health expert and what Trump is saying is nonsensical gibberish
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Matthew Cortland (they) @matthewcort.land · 18/09/2026
oh to be a kitten asleep on fresh laundry
mystic, a tuxie cat, asleep on a pile of laundry in a laundry basked
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Matthew Cortland (they) @matthewcort.land · 17/09/2026
Instead they allowed the dude to harass me without any sort of repercussion — for him. I mean, there were plenty of repercussions for me. Anyway,
bar chart - bluesky, x, threads
showing monthly acctive users, iOS, and Android WORLD Jun 2026, Year over Year Worldwide
"threads, an instagram app" positive ~22%
X (formerly Twitter) negative ~3%
Bluesky negative ~26%
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Matthew Cortland (they) @matthewcort.land · 15/09/2026
I love her so much
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Matthew Cortland (they) @matthewcort.land · 14/09/2026
i guess the answer to both of those was 'no'
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Matthew Cortland (they) @matthewcort.land · 13/09/2026
"Bluesky’s app has lost more than half its monthly active users from its late-2024 high, which means that its app usage continued to shrink even after the initial post-election surge subsided" techcrunch.com/2026/08/11/b...
bar chart - bluesky, x, threads
showing monthly acctive users, iOS, and Android WORLD Jun 2026, Year over Year Worldwide
"threads, an instagram app" positive ~22%
X (formerly Twitter) negative ~3%
Bluesky negative ~26%
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Matthew Cortland (they) @matthewcort.land · 13/09/2026
The people running this site are not trying to build a "public square" 🧵 www.cnbc.com/2026/06/04/b...
Bluesky is built on an open-source AT Protocol, allowing developers to build apps, services, and communities with greater control over their content. Bluesky was initially founded within Twitter in 2019 and backed by Twitter co-founder Jack Dorsey, but it spun off in 2021. After Musk acquired Twitter in 2022, the companies ended their service agreement.

It raised $100 million in Series B funding in April 2025, but at the end of October last year, it had reportedly seen a 40% drop in daily mobile active users over the preceding 12 months.

According to a former engineering lead at Bluesky who posts user statistics on the platform, Bluesky declined from a peak of 1.4 million active daily posters in late 2024 to around 600,000 today.

It had 43 million global users as of March, compared to an estimated 450 million X users worldwide. Threads, the Instagram-linked platform Meta
launched in 2023, surpassed 400 million active monthly users last year, per its executives.“The world is changing rapidly, and we’re not trying to build what social used to be and get to parity,” Wang told CNBC on the sidelines of SXSW in London on Wednesday.

Wang said that Bluesky would move away from the “public square” style of feed of X or Threads, and will instead be “useful” as a discovery mechanism.

“What we’ve learned through this process is that I think the public square is not the direction we want to go in. Essentially, I think it’s useful as a discovery mechanism, but we’re very inspired by companies like Reddit.” she said.

“A public square, where there’s only a stage, and there’s posters, like people on a stage and people who are watching, that is not social... we’re in the medieval stages of the online world.”
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Matthew Cortland (they) @matthewcort.land · 12/09/2026
Mystic, a  tuxedo cat, curled up tight on a pale blanket with her head tucked down and two white-mitted front paws folded in front of her face, long white whiskers fanning out against the black fur.
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Matthew Cortland (they) @matthewcort.land · 11/09/2026
CDC has declared the cyclospora lettuce outbreak to be over. If you've altered your behavior to mitigate the risk from this outbreak, and my guidance is helpful, I would wait at least another week before easing those mitigating measures.
nvestigation of Multistate Outbreak of Cyclospora Illnesses: Iceberg Lettuce
CDC declares outbreak over. FDA's outbreak investigation is ongoing. 

September 11, 2026

As of September 11, 2026, CDC has declared this outbreak over. While the outbreak is over, FDA continues the outbreak investigation of Cyclospora infections linked to iceberg lettuce sourced from central Mexico and recalled by Taylor Farms de Mexico. FDA will continue to collaborate with CDC as well as state and local partners as necessary.

Since the last update on August 27, 2026, state and local health officials have continued to interview additional sick people with cyclosporiasis and CDC has added them to this multistate outbreak. The outbreak includes people who reported exposure to processed iceberg lettuce from Taylor Farms de Mexico served or purchased at various locations, including people who previously reported eating at Taco Bell. Most of these illnesses began before the Taylor Farms de Mexico iceberg lettuce recall on July 17, 2026. The total case count associated with this multistate outbreak is now 12,883 illnesses reported from 21 states. Since the last update, one additional state has been added: Virginia.

FDA’s onsite inspections and sample collection at iceberg lettuce growers and the processing facility in Mexico, in coordination with Mexican officials, have ended. Samples from the onsite inspections are pending analysis.

FDA remains confident that all recalled iceberg lettuce related to this specific Cyclospora outbreak is off the market. Although the outbreak is over, FDA’s outbreak investigation remains ongoing. FDA will continue to work with federal, state, and international partners to complete its investigation and will provide updates as they become available. In addition, FDA will provide updates on Cyclospora prevention efforts on a new page: Post-Outbreak Response Activities: Multistate Outbreaks of Cyclospora Illnesses.
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Matthew Cortland (they) @matthewcort.land · 09/09/2026
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Matthew Cortland (they) @matthewcort.land · 08/09/2026
mystic would like me to work less and pet more
mystic, laying on her side
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Matthew Cortland (they) @matthewcort.land · 08/09/2026
There is a thing where some people just aren't good at readying 🤷
ohnoerik! @ohnoerik.com • 5h
if you're a loser trying to hawk subscriptions to a substack, everything is a conspiracy.
it couldn't possibly be that, generally, the CDC was, generally, written about as a reliable source for decades.
* Matthew Cortland (they) @matthewcort.land • 13h
D Elf
Cleric
ChatGPT refuses to recognize the reality of the situation we are in relative to public health. It routinely refuses to believe what's actually happening, e.g. CDC covering up measles deaths. It insists on the explanations most favorable to the trump regime.
The systematic bias is intense.
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Matthew Cortland (they) @matthewcort.land · 08/09/2026
Trying to figure out what sort of guidance to give folks when we're seeing patients being targeted by ads like this is... everything is awful
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Matthew Cortland (they) @matthewcort.land · 05/09/2026
One of the professional 'mistakes' I've made has been trying to do too much — by which I mean, I thought other players broadly on our side* would prioritize efficacy. And I acted as if that was true. But they just ... didn't.
mystic, loafing
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Matthew Cortland (they) @matthewcort.land · 04/09/2026
According to surgeon, I'm supposed to be healed by now. I am not 🫠
clinic selfie
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Matthew Cortland (they) @matthewcort.land · 03/09/2026
The Roman Catholic Church engaged in the wholesale rape of children and now my medical care sucks Just no way to run a society
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Matthew Cortland (they) @matthewcort.land · 03/09/2026
mystic, a black and white cat, laying on a cardboard scratcher.
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Matthew Cortland (they) @matthewcort.land · 03/09/2026
From "Here's How To Reduce 🦠 Risk During Holiday Travel Season" 12-21-2025
Virus Replicates Exponentially — Act Quickly 

Here's something I very much want you to understand about how viruses work, because it explains why timing matters so much with antivirals:

When a virus gets into your body, it hijacks your cells to make copies of itself. Those copies infect more cells, which make more copies. To oversimplify slightly: one virus becomes ten, ten become a hundred, a hundred become ten thousand. The viral load in your body doubles, then doubles again, then doubles again. In other words, viral load grows exponentially.

Antivirals work by interfering with that replication process. They gum up the machinery the virus uses to copy itself. But antivirals don't kill virus that's already been made. They only slow down the production of new virus. If you take an antiviral when you have 100 viral particles, you're slowing replication from a small base. If you wait until you have 10 million viral particles, you're trying to slow replication from a massive base and your immune system has a much bigger job ahead of it.
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Matthew Cortland (they) @matthewcort.land · 31/08/2026
Building 18 will reopen tomorrow. The grad student's residence hall has also been decon'd (it sounds like he was in a newer building than the one I stayed in. Oh, and he probably didn't make dimethylmercury
Building 18 - update— Aug. 29, 2026, 3:36 p.m.
Offices across campus have been responding to a reported hazardous material incident involving a single individual in a chemistry laboratory. The Institute became aware of the matter after the individual, a graduate student, self-reported to a local emergency room and claimed to have synthesized dimethyl mercury, a compound that is not authorized as part of their research program. Emerging information calls into question whether this compound was in fact synthesized. We are also able to disclose, with the student’s permission, that while the student remains under medical supervision, their initial blood test result, which was received today, shows no sign of exposure to mercury.
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Matthew Cortland (they) @matthewcort.land · 30/08/2026
m
Mystic, on her back
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Matthew Cortland (they) @matthewcort.land · 26/08/2026
i can't stand or even sit up to play with her, so we've been laying on the floor together
Mystic, a tuxedo cat, lying on her side on a cardboard scratcher, black with a white chest and white front paws, eyes half-open and long white whiskers fanned out. Matthew's hand, wearing a patterned silver ring, is under the cat's cheek. The scratcher sits on a dark wood floor
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Matthew Cortland (they) @matthewcort.land · 25/08/2026
A lot of people quote posting this without reading the piece _or even reading the teaser_ which plainly says "Dolly Parton donated $1M USD to Vanderbilt University Medical Center in 2020 to fund the research that resulted in the Moderna mRNA vaccine"
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Matthew Cortland (they) @matthewcort.land · 25/08/2026
If you're logging in via an alt to see why I blocked you — it's because you saw me doing this via alt-text and went and fucking snitched anyway, fuck you
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Matthew Cortland (they) @matthewcort.land · 25/08/2026
I have never appeared as a friendly guest on authoritarian ultra-nationalist, white supremacist "GB News" to defend AI datacenters, slop, etc in response to a Chinese robot running.
screenshot of GBNews live on TikTok. anchor, nem leo(?) on the left. T@ayl0r L0renz on the right.
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Matthew Cortland (they) @matthewcort.land · 25/08/2026
Mystic, a black and white tuxie, on a bright orange case
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Matthew Cortland (they) @matthewcort.land · 22/08/2026
Mystic, a tuxedo cat with green eyes, lies on a cardboard scratcher, licking her nose, tongue curled mid-lick, with a pink feather toy in the foreground.
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Matthew Cortland (they) @matthewcort.land · 22/08/2026
anyway, it's selling AI shit - that's what the x dot com account is doing, it's selling AI shit
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Matthew Cortland (they) @matthewcort.land · 22/08/2026
Since 11AM yesterday, the same Facebook post from someone called Nicholas Stewart, a post of a screenshot of an X dot post from an account called "Will Revieu" has been posted by people I know into my feed about 6 or 7* times. The thing is, Will Revieu is fake. It's engagement rage bait.
Nicholas Stewart
Yesterday at 10:19 AM • 6
Someone ask Grok "How can it be wrong if the Al did it?"
Will Revieu
@Seeing_Redlines
I just had a deeply alarming 45 minute sync with our Talent Acquisition team regarding their new Al-driven resume screening tool.
They reported that the software's reduced our time-to-hire by 60% over the last month.
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Matthew Cortland (they) @matthewcort.land · 21/08/2026
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Matthew Cortland (they) @matthewcort.land · 20/08/2026
Perhaps I'm being unfair – after all, this is a favorite argument of some of the parents of some disabled children. It'll be instantly recognizable to anyone familiar with autism parent groups that aren't moderated by actually autistics. So is it the most fucked up arg I've read recently? Yeah.
@professor-dave.bsky.social • 17h
ADHD is very, very real. It is also a spectrum. Some people simply cannot function, and I don't mean in a slightly distracted or mischievous kind of way, I mean absolutely cannot function, without 1:1 personal support and medical intervention. Others have very mild symptoms indeed.
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professor-dave.bsky.social @professor-dave.bsky.social • 17h
There has to be some differentiation in how patients are diagnosed, treated, and most importantly labelled. The same applies to autism, which has hugely varied impacts, from mild social impairment, to non-verbal and requiring full-time care.
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professor-dave.bsky.social @professor-dave.bsky.social • 17h
If we do not start to differentiate properly, many profoundly disabled people with ADHD (and/or autism) are going to be thrown under the bus as the backlash grows against these labels, in part as a result of them including so many relatively mild cases.
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Matthew Cortland (they) @matthewcort.land · 20/08/2026
www.wgbh.org/news/health/...
Hannah Reale
August 13, 2026
A new rule from the Trump administration this week means the federal government will stop covering gender-affirming treatments for transgender children who rely on public health insurance like Medicaid.

But in what appears to be a first-in-the-nation policy, Massachusetts officials with MassHealth say the state will keep covering the costs of treatments like hormone therapy.

The Centers for Medicare and Medicaid Services finalized a rule Tuesday blocking the use of Medicaid money for transgender care for anyone younger than 18. The rule is set to take effect this fall.
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Matthew Cortland (they) @matthewcort.land · 20/08/2026
Trump's WH Comms Director says stuff like 'lying sack of shit with a peanut sized brain' all the goddamn time. I do NOT understand why — especially given the traction Ossoff has gotten — colleagues are clutching their pearls.
Answering a request for comment on the stories, Cheung replied: “Michael Wolff is a lying sack of s--t and has been proven to be a fraud.

“He routinely fabricates stories originating from his sick and warped imagination, only possible because he has a severe and debilitating case of Trump Derangement Syndrome that has rotted his peanut-sized brain.”
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Matthew Cortland (they) @matthewcort.land · 19/08/2026
i love her tiny little paws mso much
mystic's paws
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Matthew Cortland (they) @matthewcort.land · 18/08/2026
I think if you label your food product with "Milk supply, meet your new breast friend" and it turns out your granola has Salmonella, your customers should get to....
"A pink stand-up pouch of Lacnola brand lactation granola from The Hampton Grocer, 8 oz (227g). Text across the top reads 'Milk supply, meet your new breast friend.' Lower text reads 'Nutrient dense ingredients + moringa,' 'Supports + promotes healthy lactation,' and 'Small batch lactation granola.' Two half-circle images of clustered oat granola with nuts sit on the front, each topped with a small white heart. A blue circular badge reads 'Nourish your baby, good source of key minerals, fuel your day.' Small seals at the bottom indicate non-GMO, gluten-free, and no GMOs."
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Matthew Cortland (they) @matthewcort.land · 18/08/2026
a "just eat more fiber" and "oh no you have to take meds forever" normie has found this post
Cole Hanson
Or, you know... could add fiber. Check and see if you're getting that fresh 30g/day.
I feel like exhausting all of your other options should come before adding
GLP-1's - this is as someone who is not an off the cuff skeptic.

I'm actually quite interested in the entire class of meds. My concern really boils down to how they aren't like many other treatments, and the likelihood of needing them *forever* should be taken seriously and in conversation with your healthcare providers.
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Matthew Cortland (they) @matthewcort.land · 17/08/2026
all hat, no cat here
A black and white cat wearing a teal baseball cap, curled up on gray fabric.
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Matthew Cortland (they) @matthewcort.land · 16/08/2026
Mystic would like you to sub to ShouldntNeedToBeALawyer.com
mystic, paws over eyes
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Matthew Cortland (they) @matthewcort.land · 15/08/2026
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