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COVID-19 Timeline

This timeline is an aid to decision-making during the recovery from the pandemic and how to better prepare for outbreaks in the post-COVID-19 pandemic policy environment.

2015

2016

Domestic Resource Mobilization in
Global Health Security

This session will explore the issue of major infectious disease outbreaks as a threat to economic and human security, and the need for domestic resource mobilization for pandemic preparedness. Emphasis will be placed on the situations within lower-middle and low-income countries, which often lack the financial, human, and physical resources required to strengthen their global health security infrastructure. This includes but is not limited to emergency response, health workforce, surveillance, procurement of countermeasures, cold and supply chain management, and adequate health systems.”

2019

October

Event 201: The Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation hosted Event 201, a high-level pandemic exercise on October 18, 2019, in New York, NY.

“The exercise illustrated areas where public/private partnerships will be necessary during the response to a severe pandemic in order to diminish large-scale economic and societal consequences.

Statement about nCoV and our pandemic exercise

In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes “Event 201,” would require reliable cooperation among several industries, national governments, and key international institutions.”

Human Extinction and the Pandemic Imaginary by Christos Lynteris is published on 8 October 2019 in London (ISBN 9780429322051).

“This book develops an examination and critique of human extinction as a result of the ‘next #pandemic’ and turns attention towards the role of pandemic catastrophe in the renegotiation of what it means to be human.”

The Times: En suite loos, wi-fi and showers . . . but our trains can’t keep up with China’s

“Anyone with a real interest in business and global trade will have been in London last week. To look on as the government tried to enact Brexit legislation? No — to attend the World Chinese Entrepreneurs Convention.”

“… It is 30 years old, but came to Europe for the first time only last week. …

3,000 delegates from Chinese-owned businesses representing a large part of world trade were at the ExCel centre in Docklands for three days.

“What’s a girl to do when she gets an invitation to the key dinner for this event?.”

November

Johns Hopkins University: Pandemic simulation exercise spotlights massive preparedness gap: Event 201, hosted by the Johns Hopkins Center for Health Security, envisions a fast-spreading coronavirus with a devastating impact

“ONCE YOU’RE IN THE MIDST OF A SEVERE PANDEMIC, YOUR OPTIONS ARE VERY LIMITED. THE GREATEST GOOD CAN HAPPEN WITH PRE-PLANNING.”Eric Toner, Senior scholar, Johns Hopkins Center for Health Security

2020

Nature: Two decades of pandemic war games failed to account for Donald Trump

The scenarios foresaw leaky travel bans, a scramble for vaccines and disputes between state and federal leaders, but none could anticipate the current levels of dysfunction in the United States.

January

On January 20, 2020, CDC received a clinical specimen collected from the first reported U.S. patient infected with SARS-CoV-2. CDC immediately placed the specimen into cell culture to grow a sufficient amount of virus for study.

February

December

Reuters: Fact check: The virus that causes COVID-19 has been isolated, and is the basis for the vaccines currently in development

2021

Bulletin of the Atomic Scientists: The origin of COVID: Did people or nature open Pandora’s box at Wuhan?

Further Reading:

Global health and the new world order: Historical and anthropological approaches to a changing regime of governance Edited by Jean-Paul Gaudillière, Claire Beaudevin, Christoph Gradmann, Anne M. Lovell and Laurent Pordié

“The phrase ‘global health’ appears ubiquitously in contemporary medical spheres, from academic research programs to websites of pharmaceutical companies. In its most visible manifestation, global health refers to strategies addressing major epidemics and endemic conditions through philanthropy, and multilateral, private-public partnerships. This book explores the origins of global health, a new regime of health intervention in countries of the global South born around 1990, examining its assemblages of knowledge, practices and policies.

The volume proposes an encompassing view of the transition from international public health to global health, bringing together historians and anthropologists to analyse why new modes of “interventions on the life of others” recently appeared and how they blur the classical divides between North and South. The contributors argue that not only does the global health enterprise signal a significant departure from the postwar targets and modes of operations typical of international public health, but that new configurations of action have moved global health beyond concerns with infectious diseases and state-based programs.

The book will appeal to academics, students and health professionals interested in new discussions about the transnational circulation of drugs, bugs, therapies, biomedical technologies and people in the context of the “neo-liberal turn” in development practices.”

Global health and the new world order: Historical and anthropological approaches to a changing regime of governance Edited by Jean-Paul Gaudillière, Claire Beaudevin, Christoph Gradmann, Anne M. Lovell and Laurent Pordié

My background:

CASE STUDY 7: UNOSSC + UNDP | 2007 – 2016

CASE STUDY 5: GOSH/ICH Child Health Portal | 2001 – 2003

CASE STUDY 4: UN + UNDP Mongolia | 1997 – 1999

Hannah Institute For The History Of Medicine | 1992 – 1994

Lamas Against AIDS

Mongolian AIDS Bulletin

Philippine Conference Tackles Asia’s AIDS Crisis

Taking Medicine To The People: Four Innovators In Community Health

Take Two Big Doses Of Humanity And Call Me In The Morning

Women scientists prove potency of Mongolian beverage

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Study Says Jetliner Air Quality Poses Health Risks: CUPE Takes On Airline Industry With Findings Of Survey

By David South

Now Magazine (Toronto, Canada), March 11-17, 1993

Canada’s troubled airline industry is about to face some more turbulence, as the union representing more than 6,000 flight attendents presses its concern that many of its members’ health problems are related to poor air quality in jets.

The Canadian Union of Public Employees (CUPE) says its locals have compiled data that paints a fairly stale profile of in-flight air quality and its relationship to altitude, passenger load and length of flight. As part of the survey, the union recorded flight crews’ complaints of chest pains and lack of oxygen, as well as other work-related problems like back injuries, hearing loss and high incidence of colds and flu.

Of more interest to frequent fliers might be the opinion of some experts that even the more common jet lag may be caused by excess carbon dioxide, ozone and radiation. More than half the air in many aircraft is recirculated, “stale” air that is high in carbon dioxide and may be carrying bacteria and viruses, according to some experts.

CUPE health and safety chair Tracy Angles says the union now has enough evidence to at least pressure the carriers to undertake more comprehensive air quality studies. CUPE represents workers at Air Canada, Canadian, Nationair, Air Transat and some smaller feeder carriers.

While the union’s study is the first of its kind in Canada, a survey by the US department of industrial relations found, among other things, that flight attendents had 20 times the expected frequency of respiratory illness.

Flying mines

“Flight attendants have been equated with coal miners in terms of the bad air they have to breathe,” says Angles. “But this is not something the companies want to study.”

However, spokespeople for Air Canada and Canadian Airlines say they have not heard of such health problems. Jerry Goodrich of Canadian simply says, “It’s not an issue.”

However, while earlier-model jets supplied the cabin with 100 per cent fresh air, increasing fuel costs led to some modification. Modern jets mix fresh air – expensive to produce – with stale air from inside the cabin, which is passed through filters. The percentage of recirculated air in some aircraft, such as the popular Boeing 747-400, could be as high as 52 per cent, Boeing’s figures show.

Boeing’s Tom Cole says air circulation in Boeing’s jets is better than in an average office building, and that the passengers are “washed” with air to eliminate carbon dioxide and other hazards.

Critics like Georgia doctor William Campbell Douglass, publisher of the health newsletter Second Opinion, charge that the high rates of recirculated air, and the reliance on passengers’ own breath and perspiration to humidify the dry air, provide a perfect environment for bacteria and viruses. Douglass even speculates that planes could transmit serious diseases like tuberculosis. He suggests jet leg could be “nothing more than CO2 intoxification and oxygen starvation.”

“There is no doubt if you are in a confined space, you are at greater risk,” says University of Toronto microbiologist Eleanor Fish. “Aircraft filter systems aren’t sophisticated enough to filter out all the bacteria and viruses. But I’d be hard pressed to believe that you are at greater risk traveling on airplanes than on elevators.”

It is difficult for public health authorities to pin down the health risks of airplane travel because passengers disperse immediately after a flight. However, medical journals have documented two cases where virus transmission could be established because the passengers were easily traceable.

In 1977, 38 of the 54 passengers on a plane grounded in Alaska for a four and a half hours came down with the same strain of flu.

“We consistently hear complaints about certain aircraft,” says Angles. “The Airbus 320 is one of the worst.”

Angles says many airlines exacerbate the problem by over-crowding planes and flying them longer and farther than they were designed for.

Cut corners

“With deregulation, they have more people in there than was ever planned on. Nationair is a good example. A normal class Air Canada 747 carries about 420 people. In the all-economy configuration the load is upwards of 496.”

Angles also says airlines have been known to cut corners by turning down air flow to save money. In their 1990 book The Aircraft Cabin: Managing the Human Factors, Mary and Elwin Edwards cite a study indicating a 1 per cent saving on a fuel bill can be achieved by reducing the ventilation rate in a McDonnel-Douglas DC-10.

More resources: 

April 2021

Airqualitynews.com Terror at 20,000 feet

A new global campaign and film asks whether the air we breathe on commercial flights is as safe as we think it is.

Another issue, which frequently gets overlooked, is the quality of the air passengers breathe onboard

In February, a global campaign was launched by the Global Cabin Air QualityExecutive (GCAQE), which called for the mandatory introduction of effective filtration and warning systems, to be installed on all commercial passenger jet aircraft.

According to the GCAQE, there have been 50 recommendations and findings made by 12 air accident departments globally over the last 20 years, directly related to contaminated air exposures on passenger jet aircraft.

However, commercial aircraft continue to fly, with no contaminated air warning systems to inform passengers and crews when the air they are breathing is contaminated.”

Jetliner Cabins Are Quickly Cleared of Virus, Pentagon Says

“Particles the size of the new coronavirus are quickly purged from a commercial aircraft cabin, according to a U.S. Defense Department study touted by United Airlines Holdings Inc. in its effort to reassure wary travelers.

Filtration systems and rapid air-exchange rates mean that only about 0.003% of infected particles entered a masked passenger’s breathing zone, said the report, released Thursday.”

Aircraft Air Quality – Protecting Against Contaminants, Association of Flight Attendants

“On October 5, 2018, a 5-year FAA bill became law. Included in the bill is a study on technologies to combat contaminated bleed air. This is significant progress!”

‘Contaminated air’ on planes linked to health problems, 21 June 2017

AEROTOXIC SYNDROME: A NEW OCCUPATIONAL DISEASE?, Public Health Panorama, Volume 3, Issue 2, June 2017

Influenza Air Transmission, Influenza A (H1N1) Blog, September 28, 2009

“What does this tell us? Aerosols, very small particles of saliva containing the virus we exhale when we sneeze or even when we breathe if we have the flu, probably have an important role in the transmission of influenza. In addition to that we have public transportation, with a great number of people circulating in a place that may be closed and badly ventilated at times and we may have a notion of the importance of public campaigns that promote education and awareness of contaminated people to avoid leaving their homes when they have the flu and that they cover their mouth and nose with a disposable tissue when they sneeze and discard it right after that.”

2006

Tuberculosis and Air Travel: Guidelines for Prevention and Control

“The revised International Health Regulations, adopted in 2005, provide a legal framework for a more effective coordinated international response to emergencies caused by outbreaks of infectious diseases. A number of provisions are relevant to the detection and control of TB during air travel, strengthening the authority of WHO and of national public health authorities in this domain. Because of these important developments since the original guidelines were issued in 1998, WHO has prepared this revised version to take account of current public health risks that may arise during air travel and new approaches to international collaboration in dealing with them. The guidelines were developed with the collaboration of international experts in air travel medicine and other authorities. Implementing the recommendations will help to reduce the spread of dangerous pathogens across the globe and decrease the risk of infection among individual travellers.

An outbreak of influenza aboard a commercial airliner, American Journal of Epidemiology, Volume 110, Issue 1, July 1979

“A Jet airliner with 54 persons aboard was delayed on the ground for three hours because of engine failure during a takeoff attempt. Most passengers stayed on the airplane during the delay. Within 72 hours, 72 per cent of the passengers became III with symptoms of cough, fever, fatigue, headache, sore throat and myalgia. One passenger, the apparent Index case, was III on the airplane, and the clinical attack rate among the others varied with the amount of time spent aboard. Virus antigenlcally similar to A/Texas/1/ (H3N2) was Isolated from 8 of 31 passengers cultured, and 20 of 22 ill persons tested had serologic evidence of infection with this virus. The airplane ventilation system was inoperative during the delay and this may account for the high attack rate.”

The Airliner Cabin Environment and the Health of Passengers and Crew.

“At the end of its review of health data in the 1986 report The Airliner Cabin Environment: Air Quality and Safety, the National Research Council (NRC) committee concluded that “available information on the health of crews and passengers stems largely from ad hoc epidemiologic studies or case reports of specific health outcomes [and] conclusions that can be drawn from the available data are limited to a great extent by self-selection…and lack of exposure information” (NRC 1986). This chapter reviews data on possible health effects of exposure to aircraft cabin air that have emerged since the 1986 report and the emergence of data resources (e.g., surveillance systems) and studies that have particular relevance for the evaluation of potential health effects related to aircraft cabin air quality. Selected earlier sources are also reviewed. The decision to ban tobacco-smoking on domestic airline flights in 1987 and on flights into and out of the United States in 1999 reduces the relevance of some studies of exposures and reported signs and symptoms that clearly could have been related to the products of tobacco smoke.” 

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

By David South

Today’s Seniors (Canada), July 1993

HIV-tainted blood transfusions given in the early 1980s have left some seniors with AIDS, but it is feared many are unaware of their HIV-positive status. 

Between 1979 and 1985 – before testing of blood products for HIV became mandatory – 266 transfusion recipients and over 677 hemophiliacs are known to have been infected in Canada, according to the Centre for AIDS Statistics. 

But the final numbers are unkown – estimates range from 400 to 1,000 cases of HIV transmission among the 1.5 million Canadians given blood products during this time. 

This uncertainty is fueling public concern. With such a serious public health danger, many are shocked by the confusing messages being sent by governments, the Canadian Red Cross Society and hospitals. 

But it took the report of an all-party Parliamentary subcommittee on health, released at the end of May, to shock the federal government into calling for a public inquiry into the blood system. The report is highly critical of the decision-making process involved in blood collection and distribution. 

“We have members of our group who are seniors,” says Jerry Freise, spokesperson for advocacy organization HIV-BT (Blood Transfusion) Group, whose wife was infected with HIV due to a blood transfusion. “And many of them went for years being misdiagnosed and treated for something other than HIV. Others have gotten sick, and one died without knowing it because nobody told him. 

“A classic case is Kenneth Pittman who was infected in 1984. The Red Cross found out in 1985 and they allegedly took two years to tell The Toronto Hospital. The hospital took two years to tell his doctor, and his doctor decided not to tell anybody. 

Infected

“Another couple, a lady of 59 and a man of 64, called us April 1. She found she was infected, and the reason she took a test is because her husband turned out to be HIV-positive three weeks before a transfusion in 1983. He had gone for years without a diagnosis from doctors.” 

This runs counter to the Red Cross’s story. 

“Whenever a blood donor tests positive for HIV antibodies, we go back and trace the prior donations,” says spokesperson Angela Prokoptak at the Society’s national office. “The Red Cross supplies blood to hospitals, so we know which units went to which hospital. But the hospital must go through their records to find who they transfused. 

“After identifying the recipient, the hospital contacts the recipient’s physician, and then they have them tested. There are of course limitations.

“Since 1987, the Red Cross has been advising people who may be concerned to consult their physician for counselling and advice.”

But subcommitte member Chris Axworthy, an NDP MP, found that hospitals and the Red Cross hesitated to notify former patients for fear of lawsuits. He says the federal government should show some leadership and stop passing the buck to other agencies and departments. 

Only two hospitals in Ontario – Toronto’s Hospital for Sick Children and Princess Margaret Hospital – have tried systematically to contact former patients. 

Ontario health ministry spokesperson Layne Verbeek says it is a laborious and costly task for hospitals to notify former patients. “We’ve always informed people if they are thought to be at risk, but many hospitals aren’t in the position to trace. If people are at risk or have doubts, they should be tested.”

Verbeek says recent media coverage has caused an increase in the number of people seeking HIV blood tests – requests for the test doubled after the Sick Kids hospital went public. The provincial government’s lab went from 700 tests per day to 1,300, but Verbeek says that has started to taper off. 

The ministry of health is happy with the number of people coming forward to be tested, says Verbeek. 

But Friese says the different players are more concerned about lawsuits than informing the public. He is especially upset at the Red Cross for not taking a leadership role in disseminating information. 

“The Red Cross and the medical system have failed miserably to contact people. Even today they are reticent to tell people they were part of a risk group and should get treated.” Friese feels the various governments and the Red Cross are leaving the job of informing the public to his group and the Canadian Hemophiliacs Society. 

Beat the drums

“It’s my job to beat the drums for the media while I’m dealing with my wife being infected? That’s my job, when these are the ministers of health?”, Friese says with anger.

The effect of AIDS on seniors isn’t new to US-based National Institute on Aging researcher Marcia Ory. She and colleagues helped sound the alarm back in 1989 with the book “AIDS In An Aging Society: What We Need To Know.” In the US, over 10 per cent of AIDS cases have occurred in people over 50. 

“Surprisingly, people have ignored older people and the AIDS issue,” says Ory. “You had older people in hospitals who might have complained about fatigue which was thought to be age-related. Older people aren’t as likely to be diagnosed as early because of the assumption that they are not at risk from AIDS.

“We don’t want older people in general to be overly fearful, but we want them to acknowledge the possibility, and to engage in good preventative practices if they are at risk.” 

Ron deBurger, director of AIDS prevention for the Canadian Public Health Association, would like assurances that the security of the blood supply has improved. 

“The subcommittee came to the right conclusion asking for a public inquiry,” says deBurger. “I would hope the terms of reference are broad enough to take a look at the whole issue of the safety of the blood supply, not only in terms of what happened in the past, but, more importantly, what’s happening today.”

Other than hemophiliacs, who require large quantities of blood, deBurger believes anybody who received one transfusion has a small risk. “If you had blood once, I think the odds are pretty long that you are going to end up with tainted blood. But AIDS does take eight to 10 years to manifest itself, and we might still be picking up pieces for the next four to five years that we don’t know about yet.” 

Friese recommends that anybody who received blood or blood products between 1979 and 1985 get an HIV test. If their doctor says it isn’t necessary, they should call the AIDS Hotline about anonymous testing. 

Anybody who has tested positive for HIV and would like support and counselling can call Robert St-Pierre of the Canadian Hemophilia Society at 1-800-668-2686.

For information on anonymous testing call the Ontario government’s AIDS Hotline in Toronto at 416-392-2437. For support write HIV-BT Group, 257 Eglinton Avenue W., Suite 206, Toronto, Ont., M4R 1B1. 

Read more of David South’s 1990s health and medical journalism here: Taking Medicine To The People: Four Innovators In Community Health

More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Philippine Conference Tackles Asia’s AIDS Crisis

Mongolians attend for first time

By David South

UB Post (Ulaanbaatar, Mongolia), October 28, 1997

Manila, Philippines – More than 2,500 delegates have gathered in the steamy hot Philippine capital to renew the fight against HIV and AIDS.

Working up a sweat alongside other participants at the Fourth International Congress on AIDS in Asia and the Pacific are nine Mongolians – a first that isn’t going unnoticed.

The Congress opened Saturday (October 25) to the pounding beat of a theme song performed by teenagers, championing defiance of death and celebration of life.

That tone was echoed by Dr Peter Piot, executive director of UNAIDS, the Joint United Nations Programme on HIV/AIDS. He said the epidemic can be slowed down with the right public health measures – a positive message for Mongolia as it grapples with an STD crisis that many believe leaves the country at risk of an HIV/AIDS epidemic.

The magnitude of that epidemic outside Mongolia is startling. Around the world, 23 million people are infected with HIV, the virus that causes AIDS. Between 5 and 7 million of them live in the Asia/Pacific region.

“The point is that prevention is feasible,” Piot told the Congress. “The results can be seen in those countries in the Asia-Pacific region where the epidemic has stalled or is in retreat.

“A good indicator for unsafe sexual behaviour is the STD rate. I am impressed at the sustained decline in STD rates in Australia, Hong Kong, Singapore and Thailand over the past decade.

“But I am concerned actual declines in HIV in this region have occurred only in Australia, New Zealand and Thailand.”

The countries to Mongolia’s immediate south and north are experiencing exploding health crises. In China, HIV/AIDS is increasing at a rapid rate due to factors including growing prostitution, drug use and travel – all by-products of a booming economy. The infected population is estimated at 400,000 and is expected to reach 1.2 million by the year 2000, according to China’s national AIDS committee.

To the north in Russia, a complete collapse in the public health system has dramatically slashed life expectancy and led to an upsurge in many diseases, including tuberculosis and HIV/AIDS.

With many Mongolians doing business in both these countries, there are numerous opportunities for AIDS to enter the country.

A wide range of topics is under discussion at the gathering, with women, youth and STD-control measures of particular interest to the Mongolian delegates.

For the Mongolians, the Congress is an opportunity to learn from other countries’ successes and failures in the fight against AIDS.

Mongolia’s nine-member delegation includes four doctors – Dr K. Davaajav, head of the AIDS/STD Department of the Research Centre for Infectious Diseases, Health Ministry representative Dr S. Enkhbat. Medical University director Dr Lkhagvasuren and Dr Darisuren from the United Nations Population Fund.

Also in the team are Democrat MPs B. Delgermaa and Saikhanbileg, UNICEF’s B. Bayarmaa and two representatives from women’s NGOs: S. Tsengelmaa from the Women’s Information and Research Centre and N. Chinchuluun, executive director of the Mongolian Women Lawyers Association.

On Sunday, several presentations focused on the difficulties of getting people to use condoms.

In Fiji, studies found the majority of the population was aware of AIDS and had access to condoms, but still chose not to use them.

Lisa Enriquez, a Filipino woman who is HIV-positive, gave a sobering speech on the epidemic.

“One of the most important things I’ve learned from the epidemic is human nature. AIDS is such a humanizing disease. It reminds us of being human, complete with all the weaknesses and imperfections of being human.

“Let us not kid ourselves: changing behaviour is not easy. One doesn’t change because somebody tells him or her to do so.

“We will need to get our act together, institutionalize our efforts and continue working harder with passion and perserverance.”

The Congress continues until October 30.

More on the Congress here: Fourth International Congress on AIDS in Asia and the Pacific

“The Fourth International Congress on AIDS and Asia in the Pacific convened 3,000 scientists, people working in the communities, and people living with HIV/AIDS to discuss the state of AIDS in Asia and the Pacific and how the problem is being addressed now and into the future. The following topics addressed at the Congress are explored: the extent of the HIV epidemic, HIV risk behaviors, women and HIV, clinical manifestations of HIV infection, antiretroviral therapy, and perinatal HIV transmission. HIV is spread differently among these countries and a nation’s wealth largely determines its ability to execute prevention programs and patient access to therapy. Most patients in Asia pay for their own medications. It is hoped that more prosperous and technologically advanced nations will demonstrate stronger leadership and commitment in the fight against AIDS in the region.” Phanuphak P. Fourth International Congress on AIDS in Asia and the Pacific. J Int Assoc Physicians AIDS Care. 1998 Feb;4(2):22-5. PMID: 11365085.

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