COVID-19

Health, Fitness, Insurance, ...
Frita
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Re: COVID-19

Post by Frita »

7Wannabe5 wrote:
Thu Aug 06, 2020 9:50 am
One thing that I think is very important issue with school openings is the fact that the current number of school nurses is very low and this job has largely been taken on by school clerical staff with virtually no training. Even in a normal situation, in an elementary school with a few hundred students there will be a near constant stream of sick or “playing sick” kids into the office throughout the day. Who is going to take responsibility for determining whether third grader likely has Covid, strep throat, just allergies, or just wants to go home and play video games? I can’t imagine the situation as being anything but a logistical nightmare.
Yep, our state requires a BSN, approximately 1 per 400 students, but it’s still challenging under normal circumstances. High needs special ed. kids, asthma, vision/hearing/dental screening, sex ed., lots of duties before COVID.

RealPerson
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Joined: Thu Nov 22, 2012 4:33 pm

Re: COVID-19

Post by RealPerson »

New Zealand has its first case of community transmission in 102 days. Auckland is being locked down.

https://www.theguardian.com/world/2020/ ... n-102-days

The source of the infection is a mystery since none of the infected people had an overseas trip. The same thing happened in Vietnam recently. COVID 19 has a lot of tricks up its sleeve. I am sorry that New Zealand is facing this, and it reminds me of the Swedish approach. With virtually no herd immunity building, NZ is 100% betting on an effective vaccine, or closing its borders for years to come. COVID 19 may be inevitable, and it could be better to let natural immunity develop at an RO rate that is manageable for the health care system. Like Sweden did on purpose and the US did by accident. It is possible that COVID 19 will die out naturally before we even get a vaccine.

thrifty++
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Re: COVID-19

Post by thrifty++ »

Yes, NZ has turned to shit really fast.

Auckland is being locked down on half a days notice. The rest of the country not locked down - yet- but subject to prohibitions on large gatherings.

If NZ hasnt been able to get rid of it the world is fucked. The virus is everywhere.

Riggerjack
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Joined: Thu Jul 14, 2011 3:09 am

Re: COVID-19

Post by Riggerjack »

COVID 19 may be inevitable, and it could be better to let natural immunity develop at an RO rate that is manageable for the health care system.
Better for who? The stockholders? By comparison to what? I'm a stockholder, I am willing to be convinced.

Myself, I have no spare heart, and lots of anticipated need for the one I am using. C19 and heart health seem to have limited compatability.

So what wonderful benefits to widespread C19 am I missing that will make it better to let c19 run wild at a rate that is "manageable" for the healthcare system?

Because from the way it looks C19 expenditures go up with infection rate, controlling infection rate controls expenditures. Up to a point.

But expenditures for C19 (per case) are still so much cheaper than for heart problems (per case), that my economic concerns for C19 are as much follow up costs as these temporary business closures and refitting we worry about today.

No end in sight, no lights ahead, and the tracks go downhill. Maybe this isn't a tunnel... :shock:

RealPerson
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Re: COVID-19

Post by RealPerson »

Riggerjack wrote:
Tue Aug 11, 2020 2:13 pm
No end in sight, no lights ahead, and the tracks go downhill. Maybe this isn't a tunnel... :shock:
I am not suggesting that we should go out and try to get infected. A covid-19 party is one of the dumbest things I have heard. I propose that, within the envelope of personal responsibility, we should all do what we can to stay uninfected. I am saying that we cannot perennially shut down our economy to bring down disease transmission as low as possible. I wear a mask everywhere, wash my hands all the time, carry a CO2 monitor to make an educated guess of aerosol presence in a public indoor place and avoid unnecessary contact with people, especially indoors. These things alone can immensely reduce our personal risk, the community exposure and keep our economy going. There are very real costs associated with drastic economic shutdowns, for all stakeholders in the economy.

New Zealand, while being admirably successful in containing Covid-19 up to now, backed itself into a corner. Unless a very effective vaccine, available and administered on an unprecedented scale happens in short order, NZ will be faced with the choice of keeping their border closed for years to come, ban their own citizens from leaving and enforce draconian shutdowns like the one now implemented in Auckland, or face the reality of a COVID 19 epidemic going through the country. If NZ persists on the current path, it will provide hugely valuable data in the future for biostatisticians and economists. There will be many strategies to compare in retrospective studies.

And I hear you on the heart concerns. The same applies to the lungs, kidneys, brain and some other viral structures (like testes 😳). I am just acknowledging the reality of an extremely contagious virus and wonder how we can deal with that reality. By manageable, I mean that the health care system is able to provide appropriate care to those who need it. If we exceed that capacity, mortality rates will rise very quickly.

jacob
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Re: COVID-19

Post by jacob »

Like other coronaviruses (SARS1, MERS, ...) SARS2 (COVID) might only create immunity for 6-12 months from either having been infected or from having been temporarily vaccinated. If this is so then given the [slow] rate it's spreading, "herd immunity"(*) will not be possible unless society is permanently behaviorally rewired. If not, the virus will present itself it recurring breakouts around the planet.

(*) Whatever the number percentage follows from however people behave. We now know what kind of behavior will take R0 below 1 given the current infection rates. Insofar that behavior becomes the new normal, then herd immunity will be achieved.

Various countries are already going down different tunnels^H^H^H^Hholes.

We keep talking about health vs economy as if we can choose which aspect of normality we can sacrifice for the other. Some propose that they're intertwined (for example, Sweden with its open policy still suffered as much or more economic/GDP damage as the other Scandinavian countries because people stayed at home on their own anyway) and that there's a way to thread the needle. However, it may also be that we have to accept that SARS2 will become endemic and add to the disease burden in a material way.

This is not all that different than how e.g. malaria kills millions of people in areas/countries which for reasons of government, population density, environment, and overall behavior can't control it. For example, Malaria used to be endemic in North America until a mass effort installed window screens and systematically eliminated standing water (drained swamps).

It's similarly conceivable that COVID will become endemic in areas where people can't figure out masks, different behavioral habits, and new business practices. Some existing practices are no longer possible because the world (procreation, living, eating and travel habits) will eventually literally kill the incompatible behavior. While the average human tends to have a fairly narrow and short-sighted outlook ("it hasn't happened to me and anyone I know, so it's not going to happen to me"), it will eventually happen to everybody who didn't protect themselves (whether as a country or an individual) and so lives will change eventually. Either they'll change behaviorally now, or they'll be cut short (die) later because of not having changed behavior. This goes for both humans and businesses.

In that regard, it's really no different than other lifestyle diseases. It's random, but it's not that random. And it kills a significant number of people. Currently, in the US, the COVID kill rate is approximately half of what cancer kills. Figure about a quarter million per year forever in recurring outbreaks here and there as immunity wears out in previously burned out areas.

Change in behavior will influence this a lot. (Like staying home from work when sick. A culture of wearing masks in public. Getting the stink eye if coughing in public.)

Change in behavior could influence the cancer rate too but it hasn't because people enjoy their freedom to live a carcinogenic lifestyle more than they enjoy an additional 5+ years of lifespan. IOW, it's hard to know how acceptable adding this disease will be to Americans (cf. e.g. Europeans, Asians, or Africans) and how willing and/or capable people are to change to avoid it. We won't know until most people have yet to be personally exposed/laid down by it. People often have an epiphany after being personally exposed to a major health scare but not before.

I expect the world to do significant amounts of Kuebler-Ross exercises navigating denial, anger, bargaining, depression, and ultimately acceptance of the "new normal" as their navigate their own emotions, values, and habits to make the transition. It's basically a process.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

Interesting analysis, @Jacob. I pretty much agree with everything you wrote. It's really not unlike influenza, which never really goes away. However, CV-19 is much more deadly than influenza. Long, long term, there will probably be a yearly vaccine to get in order to ensure herd immunity. The vaccines they are working on now don't provide "sterilizing" immunity. That is, they don't prevent covid. The current criteria is to merely reduce the severity of illness in 50% of cases. That might help save lives, but it's going to require sterilizing immunity to stop the spread.

Humanity and disease (infectious or otherwise) have a long and interesting history. There's any number of diseases that can be prevented through behavior (washing hands, not eating sugar, draining standing water, etc), and yet, there's a profound history of humans not changing our behavior and instead merely accepting the disease burden.

I do think the perception of CV-19 being an "old person disease" is materially influencing the response. For example, malaria largely kills children, but CV-19 largely kills the 50+ older crowd.

I do think we're in for a long and strange period of readjustment as the world figures this out.

tonyedgecombe
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Re: COVID-19

Post by tonyedgecombe »

The Spanish flu mutated to become less lethal, by 1920 it was all but gone. We already have evidence CV-19 is mutating, perhaps it's only a matter of time before it becomes less lethal.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

I wouldn't put too much stock in covid mutating. While it is an RNA virus, it has special error checking proteins that make it less prone to mutation than other RNA viruses. Also, when exposed to a large population of completely susceptible and densely packed hosts, many diseases can evolve to become more virulent, not less. The 1918 flu also evolved to be more deadly before it went away (the first wave was minor; the second wave was extremely deadly.) Many diseases have existed for millions of years, yet never evolved lower virulence (smallpox, diphtheria). This isn't to say that covid will or will not mutate. It's just that "the virus will mutate" is more a science fiction movie plot point than it is something that is guaranteed to happen.

J_
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Re: COVID-19

Post by J_ »

@Jacob thanks for your analysis.
It is up to each of us to maintain/develop (or not) a way of life to avoid contamination and/or to be or to become more robust if we are hit by this virus.
It requires some more attention in our daily life: e.g.what will I avoid when shopping, if it is too busy in the shop I come again later. Shall I go by plane or take the car for my visit to my other home and so on.
And for people who have a job it requires even more daily considerations.

jacob
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Re: COVID-19

Post by jacob »

SARS1 faded away as well. While virulence tends to decrease as infectious agents evolve, I'm not sure its a rule or an expression of survivor bias. For example, social distancing might favor more virulent or resilient strains in order to survive. I'm not aware of any detailed models(*) for virulence although surely it's co-evolving according to the various environments, we (humans) are setting it up for.

(*) My paygrade for this is pretty low though.

As it is it's certainly occupying the Goldilocks zone of infectious agents in terms of lethality, reach, force, ... and primarily messing with the ACE2 receptors, which are found in very many human cell types (hence all the "COVID19 could damage X-organ"-papers) and regulate important systems like blood pressure, it's also more "creatively destructive" (H/T Schumpeter) than H?N?-type flues (hooking up to other cell receptors) which mainly get into the lungs and kills via secondary pneumonia in the weak as the damaged lung tissues get infected by bacteria which then go on into the blood stream and eventually terminate some critical organs.

In some bizarre sense, that is, from its own perspective, it's a brilliant disease. Because Goldilocks, I'm not sure, we (humanity as a whole) can defeat it, so hopefully it will defeat itself.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

Do Pathogens Gain Virulence as Hosts Become More Resistant?
Traditional selective breeding, genetic engineering, and immunization can all be used to make animals more resistant to infections. If pathogens in nature respond to increases in host resistance by evolving greater virulence, however, is it possible that such efforts will unintentionally select for the same response in pathogens infecting farm animals?

Nothing will happen if hosts are made completely resistant: stop onward transmission, and evolution will cease as well. But artificially enhanced resistance is often imperfect. Many vaccines used on farms do not render hosts impervious to infection, and animal breeders have yet to produce animals completely resistant to a number of different infections. In those situations, pathogens will evolve in newly resistant hosts, just as MYXV, RHDV, WNV, and MG did. Given what we now know about pathogen-host arms races, we think we have to take seriously the possibility that by creating resistant hosts, humans might trigger the evolution of more-virulent animal pathogens.

In fact, this may have already happened. Marek’s disease virus (MDV) is a highly contagious cancer-causing herpesvirus of poultry. Fenner-style common garden experiments clearly show that MDV has become more virulent over the last 50 years.10 When the poultry industry began to ramp up in the 1950s, MDV caused mild disease and had little economic impact. Currently, MDV strains that kill all unvaccinated birds in just 10 days are common in the US and Europe. Birds have to be vaccinated or the losses are devastating. Critically, and for reasons not fully understood, MDV vaccines protect against disease but they do not generate so-called sterilizing immunity: vaccinated hosts can become infected and transmit viruses to other chickens.
The critical thing to understand here is that under what conditions viruses evolve more virulence is not always well understood. With 8 billion humans on the planet, and CV-19 circulating widely, it's entirely possible for it to infect a particularly susceptible population, evolve to be more virulent, then emerge to infect everyone else with the more deadly version, as has happened in many animal populations.

Viruses can also paradoxically evolve higher virulence in immuno-compromised hosts. Because higher virulence often translates to higher viral loads faster, infecting hosts who are likely to die anyway (immuno-compromised) can put selective pressures on spreading the virus ASAP into the infection, which favors faster reproduction of the virus, which favors higher virulence. It's always been a concern about novel pandemic diseases that they will get into a high HIV+ population, evolve higher virulence there, then go on to infect everyone else with the now more virulent strain.

Is any of this stuff guaranteed to happen? Definitely not. There's a lot of uncertainty about the direction this disease will evolve in. But whether the disease evolves more or less virulence is basically a crapshoot at this point.

(My entirely armchair guess is it will stay about the same level of virulence, as this disease is pretty well suited to spread in a lot of conditions. That's just speculation on my part though.)

nomadscientist
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Re: COVID-19

Post by nomadscientist »

jacob wrote:
Wed Aug 12, 2020 7:32 am
It's similarly conceivable that COVID will become endemic in areas where people can't figure out masks, different behavioral habits, and new business practices. Some existing practices are no longer possible because the world (procreation, living, eating and travel habits) will eventually literally kill the incompatible behavior. While the average human tends to have a fairly narrow and short-sighted outlook ("it hasn't happened to me and anyone I know, so it's not going to happen to me"), it will eventually happen to everybody who didn't protect themselves (whether as a country or an individual) and so lives will change eventually. Either they'll change behaviorally now, or they'll be cut short (die) later because of not having changed behavior. This goes for both humans and businesses.
It's not Ebola, it doesn't kill healthy fertile age people in any significant numbers, we've lived with endemic diseases much more deadly than this; really society (or at least some societies) are just freaking out at returning to the distant normality of all settled human life before the 1960s, where cancer (as one example) isn't the only improbable but not-vanishingly-improbable cause of death before general systems collapse from age.

Speaking from strictly species level functional view, the current social restrictions must be suppressing birth rates far more than the virus would by killing 25-35yos without restrictions. Already some large number of women will never have children who otherwise would have done because corona restrictions killed their social options as their fertility window was closing, almost certainly more women than people who have died (so far) of the disease.

Riggerjack
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Re: COVID-19

Post by Riggerjack »

https://advances.sciencemag.org/content ... dv.abd3083

Basically, they used a laser and a cell phone camera to track numbers of droplets released during speach, through various masks.

Surprise, some masks are worse by this measure than no mask. But please remember masks work both ways, and this is not the personally important direction. And most masks are an improvement on no mask.

Riggerjack
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Re: COVID-19

Post by Riggerjack »

It's not Ebola, it doesn't kill healthy fertile age people in any significant numbers, we've lived with endemic diseases much more deadly than this; really society (or at least some societies) are just freaking out at returning to the distant normality of all settled human life before the 1960s, where cancer (as one example) isn't the only improbable but not-vanishingly-improbable cause of death before general systems collapse from age.
Yeah, if it was Ebola, we wouldn't have to listen to people desperate to pretend C19 is no big deal.

Now I agree with everything you said, C19 has been far less deadly than initial reports suggested.

And if one's concern is that young folks are still breeding, no worries, that's showing no signs of slowing down.

On the other hand, if one is concerned about the society we will age into, a disease that seems to kill the grandparents, and give heart issues to the rest is going to have serious degrading effects.

What do we collectively learn from our aged? What do we lose with them?

Many here in one form or another has complained about balance of grasshoppers and ants (of Aesop's fables) in our society.

How does increased mortality at all ages, but increasing with age affect that balance in the future? Does anyone think this is a good thing? Or even an insignificant change?

How does heart problems for a significant portion of the population change society? How does it change the economy? Surely there will be positive changes, but I can't think of any that come close to balancing the harm.

But sure. People have outbred disease burdens in the past. Economies have grown despite disease burdens. And even when most of us die, many will fill in the places freed up by our passing. But don't think they will thank us for dropping this ball, or live better for having one more burden to carry.

At some point, I would love to hear someone try to compare the costs of prevention with the costs of incubation. When I look at it, prevention looks cheap and easy by comparison to carrying this burden into the future.

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

Riggerjack wrote:
Wed Aug 12, 2020 5:54 pm
and give heart issues to the rest is going to have serious degrading effects.

How does heart problems for a significant portion of the population change society?
This is pure speculation at this point. There may be some deleterious cardiac effects a few weeks post infection. Based on the study provided upthread. Those effects may or may not be similar to any serious viral infectious disease, because we don't normally run these tests on people who have been very sick from a virus. They may or may not last longer than a few weeks post infection resolution defined by negative PCR tests.

What we know for sure is that lifestyle issues in the US have direct causative evidence of serious cardiovascular diseases. Yet that evidence is still not enough to encourage lifestyle change in a majority of the population. So, even if COVID proves to have some long term cardiac effects to some people, how much lifestyle change do you think people will tolerate to prevent it? How do you think it'll change society? Well, we already have an analogous situation, so I'm guessing not too much.

nomadscientist
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Re: COVID-19

Post by nomadscientist »

The ship has sailed on prevention. Maybe China can prevent it forever, at the cost(?) of isolating their country from the dunderhead West. The only ways out would be herd immunity and vaccination, both of which depend on lengthy immunity periods. Without lengthy immunity periods, coronavirus will be around forever.

Assuming coronavirus will remain around forever (the argument of the passage I quoted, but not yet certain) eternal restrictions to reduce its impact are just yet more conspicuous consumption by an unpragmatic society.

Evolution really does not care if grandparents live to 80 or 82; historically, most did neither. It does care that restrictions are social sterilisation for the young.

At least we've established by a peer review that Black Lives Matter protests never spread coronavirus, so maybe they'll replace church, the office, and finally tinder as the main place families are formed. Since they'll be the only place. :lol:

Historically, lots of diseases were just around forever, diseases like smallpox, polio, and tuberculosis (which is surely coming back as well).

shemp
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Re: COVID-19

Post by shemp »

I'm convinced covid-19 will eventually be remembered more as a social than health phenomenon.

Technological changes have long been making it easier for elites to control masses. Surveillance technologies, in particular. At a subconscious level, elites everywhere simultaneously realized that this year was the right time to consolidate power tightly in their hands, or lose power forever in favor of other elites with less scruples. Of course, there are usually divisions among the elite and infighting among elite subgroups, so the process isn't clearcut, nor is the process coordinated between countries, and a few countries may even be temporarily moving in the opposite direction. Final result is that most countries will be much more unequal than prior to covid, with power more tightly consolidated at the top, and all sorts of new surveillance and security apparatus in place to eliminate possibility of future resistance by the masses. Covid as a bodily disease no more significant than a particularly bad strain of flu. Real significance of covid is as an excuse to speed up power consolidation process that was already underway.

Those who support this power consolidation process (cheering for lockdowns and masks at all times, for example) are the usual lickspittles and toadies trying to go on record as being "team players", in case of future reprisals, and otherwise get on good terms with the elites and their security apparatus underlings. During early AIDS, when there was no treatment for HIV, these same lickspittles and toadies who cheer for lockdowns reacted with fury to the idea of closing gay bathhouses. Putting entire society under indefinite house arrest is okay, but quarantining a tiny group of people with HIV is a monstrous attack on human rights. Testing at borders for covid is okay, but not testing for HIV. Churches are hotbeds of covid transmission, but not BLM protests. Etc, etc.

Those who resist the power consolidation process are doomed to fail: time for resistance has long since passed.

Middle classes in the developed world are likely to face a severe reduction in their standard of living in the years ahead, as the elite see less and less need to appease the middle class with high living standards. It's not so much that the elite will want to consume more themselves, as that they will focus society's resources on strengthing their grip on power versus economic activity that benefits the masses. Alternatively, we could say the elite do want to increase their share of the consumption pie, but that what elites most want to consume is security, versus traditional consumption goods and services. Lockdowns are a fine example of this kind of thinking: so what if GDP drops 30% and there is mass unemployment and mass bankruptcy of small business and perhaps even mass starvation in Africa and India? As long as elites and their security underlings feel more secure than ever, there is no problem.

Those living the ERE lifestyle will do better than those with a high consumption lifestyle, since they have less distance to fall. Having children will be more expensive than ever, as the elites increasingly see large populations as more threat than asset. Plus robots replace many workers in the future and essential workers (sociopathic security underlings, in particular) can be imported. Financial Investments will do poorly, as the elites will increasingly siphon off corporate profits into their own hands rather than allowing it to reach the non-elite via dividends or bond interest. This siphoning will be accomplished by a combination of inflation, tax code changes, controls on capital, lax attitude towards fraud and other forms of management theft, etc.

Hristo Botev
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Re: COVID-19

Post by Hristo Botev »

@Shemp, I think I'd enjoy grabbing a beer with you.
shemp wrote:
Wed Aug 12, 2020 11:22 pm
Real significance of covid is as an excuse to speed up power consolidation process that was already underway.
Was listening to the most recent Argument podcast on the walk into work this morning (https://www.nytimes.com/2020/08/13/opin ... covid.html), where they had the EXACT SAME left (Frank and Jeneen) vs. right (Ross) argument about COVID--what should we do, what should we have done, how much has the US "failed" in fighting COVID, who/what is to blame--that we've been listening to since April; nothing has changed. And this discussion ALWAYS seems to boil down to: (a) the right having to remind the left that the US, unlike almost every other Western democracy, still pretends to have a federalist system of government, where subsidiarity is supposed to be the default; and (b) the left faulting their despised Trump for not being authoritarian enough, for not grabbing more power in the form of patent overrides, the defense production act, using local county and municipal health officials as if they are defacto employees of the CDC, etc. It's exhausting. That said, while Trump no doubt could have done more to battle this thing without overreaching into power properly held by state and local officials, I shiver to think about how a technocratic elite like a Bloomberg would have used this disease to consolidate more power in the hands of the federal level, in the way FDR did with the Great Depression, or the way LBJ did with his ineffectual war on poverty.

7Wannabe5
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Re: COVID-19

Post by 7Wannabe5 »

So, if you are affluent and well-educated, but you like beer and football and dislike masks then you aren’t a member of the elite? :roll:

I agree that there are some disturbing second order effects of global meritocracy, but it seems to me that the mix of factors that are promoting relatively fast spread of Covid in the U.S. are both red and blue. This also holds for human population issues in general.

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