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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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21 minutes ago, atomheartbevo said:

More like Surly collapses under the weight of underlying conditions.

Just because we bang 10s and wash our asses with bidets powered by coconut water, doesn’t mean we are all within 5 pounds of our ideal weight.  

Yeah definitely meant the old and fat thing 

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47 minutes ago, Hate said:

Can you elaborate on the criteria for making one a “fattie” as opposed to being “big boned” or “husky”?

I realize you're joking, but fuck it, why not. If I remember correctly, more than 20 lbs overweight can considered obese. Morbid obesity is a BMI of 40% or higher. 

Not sure if that's relevant here, but, can't hurt. 

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13 hours ago, justhookit said:

So I’ve posted off and on in this thread about what my mom’s doctor in San Antonio has been doing. he’s been testing anyone showing covid symptoms  since the tests came available and doesn’t ask you to fly to Colorado to get one.

anyway now he is antibody testing ALL of his regular clients. Going in alphabetical order, my mom’s test is tomorrow morning. I don’t know which test he is using and I suspect it’s part of a study but he is seeing a much higher than expected positive result. Generally he emails updates on Fridays so maybe I’ll have some actual numbers soon. Hopefully the results are real and it’s not an issue with testing accuracy but I’m not holding my breath.

So here is what I was referring to. BTW my mom’s test was negative.  This email was sent out April 20-

“While the practice continues to have the capability to perform PCR tests, last week we procured antibody tests for our patients.  In an effort to assess the reliability of the new tests, I screened all 15 of my PCR-positive Covid-19 patients. The good news is that all 15 patients had congruent antibody and PCR test results.  All those patients who had positive PCR tests also were positive antibody IgG (past Covid-19 illness though no longer contagious or symptomatic) and negative antibody IgM (acutely infectious and have Covid-19 currently).  I also re-tested those patients by PCR as well.  While we are still awaiting 3 results, 12 out of 15 indicate no current presence of virus in the nose, and no risk of them being contagious.   

On Friday, by use of antibody testing, I was able to identify a newly infected and early symptomatic patient. We are still awaiting the results of the PCR test.  Because she had not been practicing social distancing as recommended, we used contact tracing to identify other individuals who I tested as well. Unfortunately, we did identify several who tested positive, though they were asymptomatic. The ability to get a rapid result from the antibody test enabled us to stop the spread of that cluster. It is worth noting again that most people are completely asymptomatic for at least 5-7 days after infection. 

A study from Stanford University randomly sampled their county residents using antibody testing.  They extrapolated that 2.49% to 4.16% of their residents had previous Covid-19 exposure. Though the study did not specify if the positive results were from symptomatic or asymptomatic individuals, it reinforces why widespread testing is so important.  In my practice alone, I have had 2 positive antibody tests in people who were experiencing symptoms so mild, they did not believe they had the virus. I intend to use the antibody test as the screening test and will perform PCR testing to confirm the diagnosis. 

To that end, beginning tomorrow (Tuesday April 21), I would like to use the antibody test on every patient in my practice. We have established a protocol to achieve that goal. Each patient will be notified by Cleda of their appointed time to be tested. You will drive into the back-parking lot, where you will get the test by a finger prick. You will not exit your car; one of my team can take the test while you remain in your vehicle. The simple test takes 10 minutes to complete, and you will wait to get your results before you leave.  For my patients, this test is free of charge. We will test patients alphabetically. Please do not attempt to come on a day that you have not been scheduled. On Tuesday we will see patients with last names beginning with A- E, Wednesday F-K, Thursday L-R, and Friday S-Z.  After Tuesday, I will have a better idea of how efficiently we are operating and will adjust accordingly.”

 

i cant wait to see his numbers

 

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1 minute ago, justhookit said:

So here is what I was referring to. BTW my mom’s test was negative.  This email was sent out April 20-

“While the practice continues to have the capability to perform PCR tests, last week we procured antibody tests for our patients.  In an effort to assess the reliability of the new tests, I screened all 15 of my PCR-positive Covid-19 patients. The good news is that all 15 patients had congruent antibody and PCR test results.  All those patients who had positive PCR tests also were positive antibody IgG (past Covid-19 illness though no longer contagious or symptomatic) and negative antibody IgM (acutely infectious and have Covid-19 currently).  I also re-tested those patients by PCR as well.  While we are still awaiting 3 results, 12 out of 15 indicate no current presence of virus in the nose, and no risk of them being contagious.   

On Friday, by use of antibody testing, I was able to identify a newly infected and early symptomatic patient. We are still awaiting the results of the PCR test.  Because she had not been practicing social distancing as recommended, we used contact tracing to identify other individuals who I tested as well. Unfortunately, we did identify several who tested positive, though they were asymptomatic. The ability to get a rapid result from the antibody test enabled us to stop the spread of that cluster. It is worth noting again that most people are completely asymptomatic for at least 5-7 days after infection. 

A study from Stanford University randomly sampled their county residents using antibody testing.  They extrapolated that 2.49% to 4.16% of their residents had previous Covid-19 exposure. Though the study did not specify if the positive results were from symptomatic or asymptomatic individuals, it reinforces why widespread testing is so important.  In my practice alone, I have had 2 positive antibody tests in people who were experiencing symptoms so mild, they did not believe they had the virus. I intend to use the antibody test as the screening test and will perform PCR testing to confirm the diagnosis. 

To that end, beginning tomorrow (Tuesday April 21), I would like to use the antibody test on every patient in my practice. We have established a protocol to achieve that goal. Each patient will be notified by Cleda of their appointed time to be tested. You will drive into the back-parking lot, where you will get the test by a finger prick. You will not exit your car; one of my team can take the test while you remain in your vehicle. The simple test takes 10 minutes to complete, and you will wait to get your results before you leave.  For my patients, this test is free of charge. We will test patients alphabetically. Please do not attempt to come on a day that you have not been scheduled. On Tuesday we will see patients with last names beginning with A- E, Wednesday F-K, Thursday L-R, and Friday S-Z.  After Tuesday, I will have a better idea of how efficiently we are operating and will adjust accordingly.”

 

i cant wait to see his numbers

 

Awesome.  IMO these tests are most important.  You can get a covid test, negative today and get covid the next day.  With antibody, It is best to see how widespread this is and per Stanford study it is 50 to 80% greater than projections. 

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2 hours ago, ChiTownDoc said:

And Remdesivir flops on first real trial.  I called that about 200 pages ago.  No magic drug, people.  Period. 

I thought with Remdesivir the hope was more for early intervention [pre ventilator]. Not sure that aspect has been proven or not at this point. 

And since WHO is apparently the propaganda arm of China, color me skeptical of their motives in front running the actual release. 

Still, not great. Hopefully not terrible either. 

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33 minutes ago, Onboard 2.0 said:

None at all. I was making  a comment about the economic state of affairs at the time, how the housing industry and real estate were both solid and expanding.  And how I felt if they were able to weather the storm would help lead us out of the pandemic, and back near  the economy we've been experiencing the last 24-36 months. 

How was that meaningless ? lulz....??  And in reality, how Meaningful is anything being said here EVER ?  It's so much blather by a bunch of bored posters

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23 minutes ago, dcar00 said:

NY state is a hot zone so 14% isn't realistic.  lets say overall country is at 8% with 330M pop you get 26M

I would buy that kind of number. Not herd immunity by any means but certainly significant. And since people under 18 are largely unaffected I would think you are really looking for 70% of the 80% above 18. Now you are about 200mm people. 

Still going to need a vaccine. 

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50 minutes ago, NaTeWHO said:

So, let's do some math.

NY state population 19,450,000
NY state antibodies 13.9%
NY state infected 2,703,550
NY state deaths 15,302
Mortality rate .57%

This sort of data is definitely important, because it can help us make better, more informed decisions.  The IFR for the flu is usually around .1%, occasionally pushing towards .2% (so, one to two people per thousand who are infected die).

If the IFR for COVID is in the .5%-.6% range, then the IFR is around 3-6 times that of the seasonal flu (5 or 6 people per thousand who are infected will die).  That's plenty bad....but could we live with a year or two of the seasonal flu being 3-6 times as bad, if we could get a handle on things after a year or two?  I don't know, but maybe.

The wildcard, though, is the infection rate.  If COVID is twice as infectious, meaning twice as many people catch it as usually catch the flu, then you're not just looking at 3-6 times the number of deaths we see with the flu - you're looking at 6-12X the deaths.  That's a bit more daunting.  And we saw how fast this thing moved when we had open transmission in the wild the last couple of months -- left unchecked (like we do with the flu), it would burn hot and fast.

And on top of that, there's the hospitalization and "long term effects" rate (how many of the infected need to be hospitalized, and how many of them experience long term harmful effects of the infection).

I think that any way you cut it, this is a serious-ass communicable disease that indeed does merit significant social changes.  BUT, if 1) those changes can lower the transmission rate meaningfully (say, get it down to the rate of the flu - talking about things like wearing masks and avoiding large, close crowds - sorry, music festivals - and testing and contact tracing), and 2) we can develop therapies that can reduce the IFR and the serious injury rate (no magic bullet yet, maybe never, but perhaps some that help enough to lower deaths and injuries), then 3) we can make it to the point where we get an effective and available vaccine.

Data makes for better decisions.  I know it seems like this has gone on forever, but we've really only been dealing with this as a serious problem in the US for 6-8 weeks.  AND, we should piggyback on what other countries know and are doing -- if they're ahead of us, let's learn.

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2 minutes ago, bullzak said:

I thought with Remdesivir the hope was more for early intervention [pre ventilator]. Not sure that aspect has been proven or not at this point. 

And since WHO is apparently the propaganda arm of China, color me skeptical of their motives in front running the actual release. 

Still, not great. Hopefully not terrible either. 

Yep - very likely in the middle.  Not a magic drug and not totally worthless.  

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8 minutes ago, justhookit said:

On Friday, by use of antibody testing, I was able to identify a newly infected and early symptomatic patient. We are still awaiting the results of the PCR test.  Because she had not been practicing social distancing as recommended, we used contact tracing to identify other individuals who I tested as well. Unfortunately, we did identify several who tested positive, though they were asymptomatic. The ability to get a rapid result from the antibody test enabled us to stop the spread of that cluster. It is worth noting again that most people are completely asymptomatic for at least 5-7 days after infection. 

Bolded the whole damned para, because it's that important.

Frequent and easily available antibody testing.  Helps spot and isolate spreaders.  Then, contact tracing to stop additional spreaders.  You put out the fire when it's .2 acres instead of 200 acres, meaning you end up with a lot less scorched land.  

If you are curious about what the SINGLE most effective way to get us somewhat out of this mess until we get a vaccine, I think it's "lots of antibody testing and tracing."

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3 minutes ago, Brisketexan said:

This sort of data is definitely important, because it can help us make better, more informed decisions.  The IFR for the flu is usually around .1%, occasionally pushing towards .2% (so, one to two people per thousand who are infected die).

If the IFR for COVID is in the .5%-.6% range, then the IFR is around 3-6 times that of the seasonal flu (5 or 6 people per thousand who are infected will die).  That's plenty bad....but could we live with a year or two of the seasonal flu being 3-6 times as bad, if we could get a handle on things after a year or two?  I don't know, but maybe.

The wildcard, though, is the infection rate.  If COVID is twice as infectious, meaning twice as many people catch it as usually catch the flu, then you're not just looking at 3-6 times the number of deaths we see with the flu - you're looking at 6-12X the deaths.  That's a bit more daunting.  And we saw how fast this thing moved when we had open transmission in the wild the last couple of months -- left unchecked (like we do with the flu), it would burn hot and fast.

And on top of that, there's the hospitalization and "long term effects" rate (how many of the infected need to be hospitalized, and how many of them experience long term harmful effects of the infection).

I think that any way you cut it, this is a serious-ass communicable disease that indeed does merit significant social changes.  BUT, if 1) those changes can lower the transmission rate meaningfully (say, get it down to the rate of the flu - talking about things like wearing masks and avoiding large, close crowds - sorry, music festivals - and testing and contact tracing), and 2) we can develop therapies that can reduce the IFR and the serious injury rate (no magic bullet yet, maybe never, but perhaps some that help enough to lower deaths and injuries), then 3) we can make it to the point where we get an effective and available vaccine.

Data makes for better decisions.  I know it seems like this has gone on forever, but we've really only been dealing with this as a serious problem in the US for 6-8 weeks.  AND, we should piggyback on what other countries know and are doing -- if they're ahead of us, let's learn.

I don't believe the country is near .5 or .6.  This is closer to .2 maybe  to .3.  NYC has a subway system and a ton of older people living on top of each other ,1.2M over 65.  if it is highly transmissable than even more people likely have it than we think and it has been around for longer than just early Feb.

your points about some social changes are necessary near term are correct.

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6 minutes ago, dcar00 said:

I don't believe the country is near .5 or .6.  This is closer to .2 maybe  to .3.  NYC has a subway system and a ton of older people living on top of each other ,1.2M over 65.  if it is highly transmissable than even more people likely have it than we think and it has been around for longer than just early Feb.

Well, what you and I believe are both worth the same -- jack shit.

Data.  Data is what we need.  We are seeing data that indicates that the IFR is certainly lower than the 2-3% number that was out there in the early days of this pandemic.  Let's do real-deal statistically valid sampling and find out what it is.  That can help drive our decisionmaking.

And it sure seems to me like the single most important thing we can be doing as a country right now is cranking out reliable antibody tests like they were Kardashian TV appearances -- a shitload of them, available everywhere.

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4 minutes ago, Brisketexan said:

Well, what you and I believe are both worth the same -- jack shit.

Data.  Data is what we need.  We are seeing data that indicates that the IFR is certainly lower than the 2-3% number that was out there in the early days of this pandemic.  Let's do real-deal statistically valid sampling and find out what it is.  That can help drive our decisionmaking.

And it sure seems to me like the single most important thing we can be doing as a country right now is cranking out reliable antibody tests like they were Kardashian TV appearances -- a shitload of them, available everywhere.

We can agree on the first line.  we are certainly well below 1%.  another 4 weeks for full scale antibody tests in my opinion, see first line

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I think this is going to cause the CDC to rethink how they estimate flu cases and deaths with flu complications.  last decade is approx 30M on average cases.  I think it is higher, even with the vaccine.

It’s really such a lazy way to approximate data. Don’t they just take a certain number, times it by 60 and that’s it?
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44 minutes ago, bullzak said:

ChiTown, do you have an opinion or any scuttlebutt on plasma treatments? 

That road seems to make some sense and would assume we could scale in short run. 

If it was 1/1 then great, but you need several plasma donations, like 20+ to treat one patient...that severely limits how much we can use it. 

Edit: I don't do these, it's what I was told as someone donating.  

Edited by ChiTownDoc
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9 minutes ago, MNLonghornFUKM said:


It’s really such a lazy way to approximate data. Don’t they just take a certain number, times it by 60 and that’s it?

well yeah but there's lots of nice charts and graphs and equations before you get there...

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16 minutes ago, ChiTownDoc said:

If it was 1/1 then great, but you need several plasma donations, like 20+ to treat one patient...that severely limits how much we can use it. 

Edit: I don't do these, it's what I was told as someone donating.  

I believe that if we asked Americans to donate plasma for this cause, they'd line up to do it.

Which, ironically, would spread the disease. 

Ball game.

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10 minutes ago, Cheeseweasel said:

I believe that if we asked Americans to donate plasma for this cause, they'd line up to do it.

Which, ironically, would spread the disease. 

Ball game.

Don't you know? Americans are greedy, and hate having to help others 

Edited by workswithseed
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4 minutes ago, Shaddie said:

Was CA on the quarantine list? About to board CA-TX flight and got handed a form to fill out about where I will be quarantined. 
 

I thought it was NY, FL and LA? I honestly don’t remember CA being on the list. 
 

 

Just write Surly DT thread. 

I don't remember CA being on the list. FL wasn't on the list a few weeks ago when I flew back. 

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6 minutes ago, Shaddie said:

Was CA on the quarantine list? About to board CA-TX flight and got handed a form to fill out about where I will be quarantined. 
 

I thought it was NY, FL and LA? I honestly don’t remember CA being on the list. 
 

 

Yes, but only to keep migration down. 

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8 minutes ago, Shaddie said:

Was CA on the quarantine list? About to board CA-TX flight and got handed a form to fill out about where I will be quarantined. 
 

I thought it was NY, FL and LA? I honestly don’t remember CA being on the list. 
 

 

w9jfC6G.jpg

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3 hours ago, ChiTownDoc said:

And Remdesivir flops on first real trial.  I called that about 200 pages ago.  No magic drug, people.  Period. 

What's up with the quick spike on this?  How many times are they going to announce the Chinese trials were no good? I figured you, out of everyone here, would actually wait to see the data and details.

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6 minutes ago, babysdaddy said:

What's up with the quick spike on this?  How many times are they going to announce the Chinese trials were no good? I figured you, out of everyone here, would actually wait to see the data and details.

Huh?  I maintain what I said the whole time.  When the first study came out and when this one came out.  It may help with severity or length of illness...may being the key word.  It's no fucking magic drug.  I don't give a shit what this study or the prior one says.  I've personally seen it used hundreds of times and have eyes.  Where have I ever waffled on that stance? 

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1 hour ago, dcar00 said:

I think this is going to cause the CDC to rethink how they estimate flu cases and deaths with flu complications.  last decade is approx 30M on average cases.  I think it is higher, even with the vaccine.

Not sure how far off they are on deaths but actual cases are underreported by a metric shitton. 

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41 minutes ago, Shaddie said:

Was CA on the quarantine list? About to board CA-TX flight and got handed a form to fill out about where I will be quarantined. 
 

I thought it was NY, FL and LA? I honestly don’t remember CA being on the list. 
 

 

"At your mom's"

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8 hours ago, Cheeseweasel said:

I've worked in manufacturing all of my adult life. I've yet to see a company that could switch from producing soda to "tests" overnight. 

People who have a naive view of manufacturing make me surly.

And I want a Test WITHOUT High Fructose Corn Syrup.  Maybe a diet Test or Test Zero?

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3 hours ago, NaTeWHO said:

So, let's do some math.

NY state population 19,450,000
NY state antibodies 13.9%
NY state infected 2,703,550
NY state deaths 15,302
Mortality rate .57%

Even better.  NYC, antibodies were 21.2%, so 1.78M due to a population of 8.399M

https://www.bloomberg.com/news/articles/2020-04-23/new-york-finds-virus-marker-in-13-9-suggesting-wide-spread?srnd=premium

Edited by PenelopeWitherspoon
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At one point the axis of "deaths from CV19" vs "economic ruination" point will cross over and economics will win. Especially if the people dying continue to be people that are older, fatter or those who smoke/vape.
It will be a ethics debate for the ages.

Nope. When this virus is hot or bubbling up, people will retreat and lose confidence. The virus leads to economic ruination directly without government intervention. Left unchecked, government intervention pops up too late. We’ll need 2-3 waves before a “healthy people” economy organically develops.

Organized community efforts are the best ways to mitigate economic ruination. We need disciplined communications and cooperation. And a massive testing and tracing program.

Right now, we’re in the part of the movie Jaws where the mayor tells the councilmember to get his fat ass and family in the water because the coroner ruled the girl’s death as a boating accident. Then the Kintner boy gets eaten.

The next phase will be the scene where they catch the Tiger Shark and think the coast is clear. But the great white shark is still out there. $10,000 for Quint? Fuck no! Let’s have amateurs hunt for the shark. Forget that Quint fought off sharks in WWII after they dropped the bomb.

Do you think in the long-term, Amity Island fared better or worse by temporarily opening the beaches up for commerce? Was the Mayor or Brody right? Would people keep swimming in the oceans if 1/1000 swimmers were being eaten each week?
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2 minutes ago, Eskimohorn said:


Nope. When this virus is hot or bubbling up, people will retreat and lose confidence. The virus leads to economic ruination directly without government intervention. Left unchecked, government intervention pops up too late. We’ll need 2-3 waves before a “healthy people” economy organically develops.

Organized community efforts are the best ways to mitigate economic ruination. We need disciplined communications and cooperation. And a massive testing and tracing program.

Right now, we’re in the part of the movie Jaws where the mayor tells the councilmember to get his fat ass and family in the water because the coroner ruled the girl’s death as a boating accident. Then the Kintner boy gets eaten.

The next phase will be the scene where they catch the Tiger Shark and think the coast is clear. But the great white shark is still out there. $10,000 for Quint? Fuck no! Let’s have amateurs hunt for the shark. Forget that Quint fought off sharks in WWII after they dropped the bomb.

Do you think in the long-term, Amity Island fared better or worse by temporarily opening the beaches up for commerce? Was the Mayor or Brody right? Would people keep swimming in the oceans if 1/1000 swimmers were being eaten each week?

To use the shark analogy from Jaws the 1/1000 in your model assumes that the shark is as likely to eat one swimmer as another. In terms of CV19 it has been proven fairly consistently that the virus "eats" those that are fat or old at dramatically different rates than the younger and/or fitter.

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1 minute ago, BrazilHorn said:

To use the shark analogy from Jaws the 1/1000 in your model assumes that the shark is as likely to eat one swimmer as another. In terms of CV19 it has been proven fairly consistently that the virus "eats" those that are fat or old at dramatically different rates than the younger and/or fitter.

Young and fit swim faster.

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9 hours ago, Dahobbs said:

I think you're saying R0 but actually referring to doubling period. R0 is the number of people that each infected person infects. It affects the doubling period, but doesn't define it. 

You're right.  Obviously I'm not a doctor, never played one on tv and am generally a surly dumbass

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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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