COVID-19 situation: 17 Feb 2020

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Pandemic Threats and Health Emergencies

COVID-19 situation: 17 Feb 2020

Welcome to this special issue of the newsletter where we highlight latest research and policy news and literature on 2019-nCVO situation

Please send your feedback, articles and reports, or questions you would like to share to Dr. Chadia Wannous via email  cwannous@yahoo.com  

Wishing you useful reading!
Chadia

COVID-19 Outbreak Situation

 
Situation updates:
 
WHO situation report no 28 on 17 Feb

  • No new countries reported cases of COVID-19 in the past 24 hours.
  • From today, WHO will be reporting all confirmed cases, including both laboratory-confirmed as previously reported, and those reported as clinically diagnosed (currently only applicable to Hubei province, China). From 13 February through 16 February, we reported only laboratory confirmed cases for Hubei province as mentioned in the situation report published on 13 February. The change in reporting is now shown in the figures. This accounts for the apparent large increase in cases compared to prior situation reports.
  • Based on the evidence currently available about COVID-19, WHO has developed guidance documents for managing public health events at Points of Entry and mass gatherings. These are posted on WHO COVID-19 Points of Entry and Mass Gatherings website. See Technical Focus for more details.
  • WHO Eastern Mediterranean office has updated information on COVID-19 cases.
  • WHO RISK ASSESSMENT

China         Very High
Regional Level       High
Global Level          High

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200217-sitrep-28-covid-19.pdf

 
Novel coronavirus (2019-nCoV) situation as of 17 February 2020, 16:00 (CET)

http://who.maps.arcgis.com/apps/opsdashboard/index.html

 
China’s National Health Commission Feb 17: Daily briefing on novel coronavirus cases in China
On Feb 16, 31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps reported 2,048 new cases of confirmed infections, 1,563 new cases of suspected infections, and 105 deaths (100 in Hubei province, 3 in Henan province, and 2 in Guangdong province). 1,425 patients were released from hospitals after being cured. 28,179 people who had had close contact with infected patients were freed from medical observation. Serious cases decreased by 628.
http://en.nhc.gov.cn/2020-02/17/c_76588.htm

Latest developments in epidemic control on Feb 17 (2)
China has stepped up efforts to curb the spread of the novel coronavirus. Here are the latest developments:
— China reported 2,048 new confirmed cases of novel coronavirus infection and 105 deaths on Feb 16 from 31 provincial-level regions and the Xinjiang Production and Construction Corps.
Among the deaths, 100 were in Hubei province, three in Henan, and two in Guangdong. Another 1,563 new suspected cases were reported on Feb 16.
— A total of 10,844 patients infected with the novel coronavirus had been discharged from hospital after recovery by the end of Feb 16.
By the end of Feb 16, a total of 1,770 people had died of the disease and 70,548 confirmed cases of novel coronavirus infection had been reported in 31 provincial-level regions and the Xinjiang Production and Construction Corps in China.
— China's daily new confirmed cases of the novel coronavirus infection outside Hubei, the epicenter province of the outbreak, have since Feb 3 dropped for 13 consecutive days. A total of 115 new confirmed cases were reported on Feb 16 outside Hubei.
— Hubei province reported 1,933 new confirmed cases and 100 new deaths on Feb 16. The latest report brought the total confirmed cases in the hard-hit province to 58,182. Wuhan, the provincial capital, recorded a total of 41,152 confirmed cases.
— Nearly 4 million workers from China's primary-level medical and health institutions, including both community health service centers in cities and clinics in rural areas, have played an important and unique role in the fight against the coronavirus.
Medical workers at the primary level have engaged in timely detections of fever patients and suspected cases to ensure the implementation of isolation and patient transfer, while they also need to carry out daily diagnosis and treatment for common diseases and the management of chronic diseases.
http://en.nhc.gov.cn/2020-02/17/c_76637.htm
 
Hong Kong Ministry of Health reports that two residents living on different floors of the same apartment building contracted the virus, recalling a superspreading event in an apartment building during the 2003 SARS outbreak that was later linked to faulty plumbing. The Hong Kong government has successfully is following up with other households within the building and has found no additional cases.
https://www.info.gov.hk/gia/general/202002/11/P2020021100768.htm
 
The first case of the new coronavirus has been reported in Africa — in a person in Egypt. The case was detected as a result of the country’s programme to trace visitors who had come from affected countries. Researchers have been concerned about the virus arriving in African countries that are vulnerable because of their economic status or political instability.
(Nature | continuously updated)

Singapore: Five More Cases Discharged; Two New Cases of COVID-19 Infection Confirmed
https://www.moh.gov.sg/news-highlights/details/five-more-cases-discharged-two-new-cases-of-covid-19-infection-confirmed
 
Countries with confirmed cases
China: 70635 Cases
International conveyance (Japan): 454 Cases
Singapore: 77 Cases
Japan: 59 Cases
Thailand: 35 Cases
Republic of Korea: 30 Cases
Malaysia: 22 Cases
Germany: 16 Cases
Viet Nam: 16 Cases
Australia: 15 Cases
United States of America: 15 Cases
France: 12 Cases
United Arab Emirates: 9 Cases
United Kingdom: 9 Cases
Canada: 8 Cases
India: 3 Cases
Italy: 3 Cases
Philippines: 3 Cases
Russian Federation: 2 Cases
Spain: 2 Cases
Belgium: 1 Cases
Cambodia: 1 Cases
Egypt: 1 Cases
Finland: 1 Cases
Nepal: 1 Cases
Sri Lanka: 1 Cases
Sweden: 1 Cases
 
The MRC Centre for Global Infectious Disease Analysis at Imperial College London published their fifth modeling report relating to the COVID-19 outbreak.
Their findings suggest that the virus undergoes greater genetic diversity in its subsequent generations, that the crossover event that introduced the virus to humans occurred in the beginning of December, and that the epidemic doubling size is around 7 days.
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College---COVID-19---genetic-analysis-FINAL.pdf
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Consequences of the Outbreak on Economy

China's monetary authorities to keep bank credits on tap to help companies survive the business slump caused by the coronavirus outbreak
https://finance.yahoo.com/news/chinas-monetary-authorities-keep-bank-093000669.html

How China’s coronavirus epidemic could hurt the world economy
Covid-19 brings many unquantifiable risks
https://www.economist.com/leaders/2020/02/13/how-chinas-coronavirus-epidemic-could-hurt-the-world-economy

Coronavirus and business: ‘Panic spreads much faster than any pandemic’
Continuity planning is a vital tool when a sudden crisis hits
https://www.ft.com/content/49e8c034-48fe-11ea-aeb3-955839e06441

Apple cut its sales forecast because of the coronavirus, as production and demand for its products have been slowed in China by the outbreak.

Apple is one of the first to publicly disclose what is likely to be a difficult chain effect from China and the virus on the business world. Many global companies rely on factories in China to manufacture everything from socks to laptop computers. And Chinese consumers, who had ridden a wave of rising wealth, had snapped up luxury goods, iPhones and many other items.
Read the latest
 
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Control Measures

Do not violate the International Health Regulations during the COVID-19 outbreak
Article 43 of this legally binding instrument restricts the measures countries can implement when addressing public health risks to those measures that are supported by science, commensurate with the risks involved, and anchored in human rights. The intention of the IHR is that countries should not take needless measures that harm people or that disincentivize countries from reporting new risks to international public health authorities.
In imposing travel restrictions against China during the current outbreak of 2019 novel coronavirus disease (COVID-19), many countries are violating the IHR.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30373-1/fulltext
 
UN health agency developing COVID-19 virus treatment master plan
The World Health Organization (WHO) is developing a master plan for coordinating clinical trials that could lead to potential therapies for patients infected with the COVID-19 virus, the agency’s chief, Tedros Adhanom Ghebreyesus, announced on Wednesday.
https://news.un.org/en/story/2020/02/1057281

Surprise Case Prompts Quarantine Rethinking 
COVID-19’s spread on cruise ships is raising tough questions about how to track the disease and what’s the best approach to quarantines.
An American cruise ship passenger—who had passed the presumed 14-day incubation period—tested positive for COVID-19 in Malaysia, leaving authorities scrambling to track passengers after they disembarked in Cambodia.
Reuters reports.

Quarantining passengers on a cruise ship has backfired, and we must learn lessons
https://www.theglobeandmail.com/canada/article-quarantining-coronavirus-patients-on-a-cruise-ship-has-backfired-and

Unmasked: Experts explain necessary respiratory protection for COVID-19
Ideally, experts say, anyone coming into the room with a COVID-19 patient should wear a tight-fitting respirator, not a looser-fitting surgical mask.
More »
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China:

New party boss of China's Hubei pledges to contain coronavirus - state media
http://news.trust.org/item/20200213111248-r9yx1
 
China CDC published updated guidance on the use of ventilation and air-conditioning systems in offices and public spaces during the COVID-19 epidemic.
The updated guidance emphasizes the circulation of fresh air from outside, rather than the recirculation of air from inside the structure. For systems that are unable to draw fresh air directly from outdoors (eg, window air-conditioning units), the guidance instructs users to open other windows and doors to allow fresh air to circulate inside the structure. For shopping malls, office buildings, and other locations with large numbers of people, ventilation should run continuously, even if air-conditioning is not used, and the ventilation should run for at least 1 hour after the building is empty. Doors and windows should be opened in densely populated areas to increase ventilation, and workers should wear masks for increased protection. If suspect or confirmed cases of COVID-19 are detected, the ventilation should be secured/stopped, and the system should be cleaned and inspected before resuming operation.
http://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_11815/202002/t20200213_212605.html
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Other Countries

Joint Statement by U.S. Department of State and U.S. Department of Health and Human Services on Repatriation of American Passengers from the Diamond Princess Cruise Ship
https://www.state.gov/joint-statement-by-u-s-department-of-state-and-u-s-department-of-health-and-human-services-on-repatriation-of-american-passengers-from-the-diamond-princess-cruise-ship/
 

CDC: Flu surveillance system enlisted in hunt for COVID-19 cases
Officials will use the nation's flu surveillance system to detect the new coronavirus.
More »

The coronavirus outbreak exposes the U.S.’s pharma supply chain vulnerability
https://www.statnews.com/2020/02/14/coronavirus-outbreak-exposes-weak-link-us-drug-supply-chain
 
The coronavirus outbreak: 3 ways the United States was (and is) unprepared
Science and Security Board member Asha George, a biosecurity expert and executive director of the Bipartisan Commission on Biodefense, details for the Bulletin where she thinks the US government is falling short in its response to the coronavirus and other biological threats.
Read more.
 
Japan issues guidelines to prevent rush on hospitals as COVID-19 cases surge
The health ministry on Monday released guidelines for people who fear they have been infected with COVID-19 as officials said 99 more aboard the Diamond Princess cruise ship, including 43 Japanese citizens, had tested positive.
https://www.japantimes.co.jp/news/2020/02/17/national/japan-covid19-guidelines
 
The Singapore Ministry of Manpower announced it would implement a mandatory 14-day stay home notice to all work pass holders entering or returning to Singapore with travel history to mainland China within the past 14 days. Additionally, the country is extending the Leave of Absence Support program to provide financial support to businesses affected by people under Stay-Home Notices. 
https://www.mom.gov.sg/newsroom/press-releases/2020/0214-mandatory-shn-for-wph-with-travel-history-to-china

Coronavirus: home testing pilot launched in London to cut hospital visits and ambulance use
The home testing initiative was started by Laurence John from the infectious diseases department at Northwick Park Hospital. He told The BMJ that the need for community testing became clear after 25 London ambulances had to be taken out of service in one afternoon to be decontaminated after carrying potential cases to hospital for testing. Decontamination can take an ambulance out of service for up to eight hours.
https://www.bmj.com/content/368/bmj.m621
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Scientific publications and reports and news
 
The Epidemiological Characteristics of an Outbreak of 2019 NovelCoronavirus Diseases (COVID-19) — China, 2020
A total of 72,314 patient records—44,672(61.8%) confirmed cases, 16,186 (22.4%) suspected cases, 10,567 (14.6%) clinically diagnosed cases (Hubei Province only), and 889 asymptomatic cases(1.2%)—contributed data for the analysis. Among confirmed cases, most were aged 30–79 years (86.6%), diagnosed in Hubei (74.7%), and considered mild (80.9%). A total of 1,023 deaths occurred among confirmed cases for an overall case fatality rate of 2.3%. The COVID-19 spread outward from Hubei Province sometime after December 2019, and by February 11,2020, 1,386 counties across all 31 provinces were affected. The epidemic curve of onset of symptoms peaked around January 23–26, then began to decline leading up to February 11. A total of 1,716 health workers have become infected and 5 have died (0.3%).
Conclusions: COVID-19 epidemic has spread veryquickly taking only 30 days to expand from Hubei tothe rest of Mainland China. With many peoplereturning from a long holiday, China needs to preparefor the possible rebound of the epidemic.
http://weekly.chinacdc.cn/fileCCDCW/journal/article/ccdcw/newcreate/COVID-19.pdf

Time Course of Lung Changes on Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia
The study identified 4 distinct phases of disease, with peak in Phase 3. Descriptions and timeline of the phases are included in the article.
https://pubs.rsna.org/doi/10.1148/radiol.2020200370

Management of ill travellers at Points of Entry – international airports, seaports and ground crossings – in the context of COVID-19 outbreak
This document aims to provide advice on the detection and management of ill travellers suspected of COVID-19 infection, at international airports, ports and ground crossings. It includes the following measures; 1)Detection of ill travellers; 2) Interview of ill travellers for COVID-19; 3) Reporting of alerts of ill travellers with suspected COVID-19 infection and 4) Isolation, initial case management and referral of ill travellers with suspected COVID-19 infection.
 Access the publication

Key planning recommendations for Mass Gatherings in the context of the current COVID-19 outbreak (Interim guidance)
The purpose of this document is to outline key planning considerations for organizers of mass gatherings in the context of the COVID-19 outbreak. It should be read in conjunction with WHO’s Public Health for Mass Gatherings: Key Considerationswhich provides general advice on the public health aspects of mass gathering events. It is also adapted from WHO’s interim planning considerations previously released for mass gatherings in the context of pandemic (H1N1) 2009 influenza, and International meetings attended by individuals from Ebola virus disease-affected countries.
Access the course

Facebook, Amazon, Google and more met with WHO to figure out how to stop coronavirus misinformation
 https://www.cnbc.com/2020/02/14/facebook-google-amazon-met-with-who-to-talk-coronavirus-misinformation.html

Coronavirus’ Assault on Wuhan Mental Hospital Alarms Experts
Experts are for calling for more stringent measures to protect people with psychological conditions after at least 80 patients and staff at a mental health facility in Wuhan contracted the coronavirus that has now killed more than 1,300 people in China and infected over 60,000 worldwide.
http://www.sixthtone.com/news/1005191/coronavirus-assault-on-wuhan-mental-hospital-alarms-experts

The Best Defense Against Disturbing New Diseases
The global fight against coronavirus depends on the health systems of the world’s most vulnerable communities.
https://www.theatlantic.com/ideas/archive/2020/02/poor-countries-are-front-line-against-coronavirus/606283/

Opinion: Sustainable development must account for pandemic risk
https://www.pnas.org/content/early/2020/02/12/2001655117

More than 80 clinical trials are running in China to test coronavirus treatments.
As HIV drugs, stem cells and traditional Chinese medicines vie for a chance to prove their worth, the World Health Organization is working to ensure that studies follow strict standards for parameters such as control groups, randomization and measures of clinical outcomes.
(Nature | 6 min read)
 
Biologists rush to re-create the China coronavirus from its DNA code
The world is watching with alarm as China struggles to contain a dangerous new virus, now being called SARS-CoV-2. It has quarantined entire cities, and the US has put a blanket ban on travellers who’ve been there. Health officials are scrambling to understand how the virus is transmitted and how to treat patients. But in one University of North Carolina lab, there’s a different race. Researchers are trying to create a copy of the virus. From scratch.
 https://www.technologyreview.com/s/615231/biologists-rush-to-re-create-the-china-coronavirus-from-its-dna-code/
 
The Proximal Origin of SARS-CoV-2
Since the first reports of a novel pneumonia (COVID-19) in Wuhan city, Hubei province, China there has been considerable discussion and uncertainty over the origin of the causative virus, SARS-CoV-2. Infections with SARS-CoV-2 are now widespread in China, with cases in every province. 
 http://virological.org/t/the-proximal-origin-of-sars-cov-2/398
 
A Coronavirus Quarantine in America Could Be a Giant Legal Mess
For observers in the United States, it was shocking enough when, in January, the Chinese government effectively sealed off Wuhan, larger in population than New York City. Officials shut down public transportation and blocked highways, confining residents and visitors alike in an attempt to stop the spread of the new coronavirus.
https://www.theatlantic.com/ideas/archive/2020/02/coronavirus-quarantine-america-could-be-giant-legal-mess/606595/
 
US Emergency Legal Responses to Novel Coronavirus - Balancing Public Health and Civil Liberties
With increasing numbers of cases of coronavirus disease 2019 (COVID-19) globally and in the United States, Health and Human Services (HHS) Secretary Alex Azar declared a national public health emergency on January 31.1 The emergency declaration of the HHS authorizes additional resources, enhanced federal powers, interjurisdictional coordination, and waivers of specific regulations.
https://jamanetwork.com/journals/jama/fullarticle/2761556
 
Risk for Transportation of 2019 Novel Coronavirus Disease from Wuhan to Other Cities in China  
On January 23, 2020, China quarantined Wuhan to contain 2019 novel coronavirus disease (COVID-19). We estimated the probability of transportation of COVID-19 from Wuhan to 369 other cities in China before the quarantine. Expected COVID-19 risk is >50% in 130 (95% CI 89–190) cities and >99% in the 4 largest metropolitan areas.
https://wwwnc.cdc.gov/eid/article/26/5/20-0146_article
 
Are European laboratories ready to detect COVID-19?
A first assessment looking at the preparedness of EU/EEA laboratories to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) demonstrates a fast implementation of molecular diagnostics by the European specialised laboratory networks. It also shows a good geographical coverage for testing.
https://www.ecdc.europa.eu/en/news-events/are-european-laboratories-ready-detect-covid-19
 
Why do we wait until emergency vaccines are necessary before recognising we need them?
As the outbreak of this new coronavirus continues to escalate, efforts to develop a vaccine against 2019-nCoV are intensifying. 
https://blogs.bmj.com/bmj/2020/02/07/why-do-we-wait-until-emergency-vaccines-are-necessary-before-recognising-we-need-them/

COVID-19 Coronavirus And Complex Supply Chains
Supply chain disruptions and access to critical commodities such as personal protective equipment continues to be a primary concern during the ongoing COVID-19 outbreak. The challenge rests not only in the manufacturing of final product goods, but in the access to raw materials needed for manufacturing.
https://www.forbes.com/sites/billconerly/2020/02/15/covid-19-coronavirus-and-complex-supply-chains
 
The role of absolute humidity on transmission rates ofthe COVID-19 outbreak
The study suggests that changes in temperature and humidity may not reduce transmission of COVID-19. Previous studies not specific to COVID-19 have suggested that warmer and more humid temperatures may reduce transmission of viruses, like influenza in comparison to cooler drier environments. However, this evidence does not yet exist for COVID-19 and implementation of public health control measures may be needed to reduce transmission of the virus. 
http://www.people.fas.harvard.edu/~msantill/Mauricio_Santillana/Publications_files/Luo_et_al_2020_Absolute_Humidity_R0_COVID-19.pdf
 
Coronavirus or antibiotic resistance: Our appetite for animals (wild and domestic) poses big disease risks
The wildlife trade in China may have played a part in spreading the new coronavirus. But at the moment, it's industrial meat production that actually poses a more deadly threat. Antibiotics fed to livestock are contributing to the growing problem of drug-resistant infections in animals and humans. 
Read more.
 
Clinical diagnosis of 8274 samples with 2019-novel coronavirus in Wuhan
Clinical testing methods for 2019-nCoV require improvement. Importantly, 5.8% of 2019-nCoV infected and 18.4% of non-2019-nCoV-infected patients had other pathogen infections. It is important to treat combined infections and perform rapid screening to avoid cross-contamination of patients. A test that quickly and simultaneously screens as many pathogens as possible is needed.
https://www.medrxiv.org/content/10.1101/2020.02.12.20022327v1.full.pdf
 

Notes from the Field: Isolation of 2019-nCoV from a Stool Specimen of a Laboratory-Confirmed Case of the Coronavirus Disease 2019 (COVID-19)
http://weekly.chinacdc.cn/en/article/id/ffa97a96-db2a-4715-9dfb-ef662660e89d
 
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Updated WHO Myth buster
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters
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WHO Technical guidance
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
 

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Lancet Coronavirus Resource Centre
This resource brings together new 2019 novel coronavirus (2019-nCoV) content from across The Lancet journals as it is published. All content listed on this page is free to access.

https://www.thelancet.com/coronavirus

Elsevier’s free health and medical research on novel coronavirus (2019-nCoV)
https://www.elsevier.com/connect/coronavirus-information-center

CABI makes more than 17,000 records open access
to help fight coronavirus outbreak

You can access the free content by following this link: www.cabdirect.org/globalhealth
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Training courses:
 
1. WHO Critical Care Severe Acute Respiratory Infection Training
This course is intended for clinicians who are working in intensive care units (ICUs) in low and middle-income countries and managing adult and pediatric patients with severe forms of acute respiratory infection (SARI), including severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis and septic shock. It is a hands-on practical guide to be used by health care professionals involved in critical care management during outbreaks of influenza virus (seasonal) human infection due avian influenza virus (H5N1, H7N9), MERS-CoV, nCoV or other emerging respiratory viral epidemics.
https://openwho.org/courses/severe-acute-respiratory-infection
 

2. “ePROTECT respiratory occupational health and safety” now available
This course provides a general introduction to Acute Respiratory Infections (ARIs) and basic hygiene measures to protect against infection.
By the end of this course, participants should understand:

  • the basic principles of acute respiratory infections;
  • how to assess the risk of infection; and
  • basic hygiene measures to protect against infection.

There are 4 modules, as follows:

  • Module 1: Acute Respiratory Infections (ARIs) of public health concern - Introduction
  • Module 2: How to protect yourself against Acute Respiratory Infections (ARIs)
  • Module 3: Basic hygiene measures
  • Module 4: Wearing a medical mask

The course will take approximately 2 hours to finish. There is no certificate available at this time. Access Web: https://openwho.org
 

3. Online course for public health preparedness for mass gathering events
This project aims to support host nations in delivering a safe and successful event, as part of WHO’s ongoing support to countries in strengthening the International Health Regulations capacities for prevention, detection and response to the public health events in the context of hosting mass gathering events.
To create a user account, future members need to click on “Register” from the homepage of the Health Security Learning Platform:
Access the course
 
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Knowledge Sharing

Thank you for reading. If you have thoughts, feedback, story ideas, or questions you would like to share or interested in partnering with us on a special event coverage, please send a note to Chadia Wannous via email cwannous@yahoo.com  

 

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