Cut thru myths to see facts about COVID-19

Summary: I talk to people who worry about the coronavirus epidemic and so read much about it – but know almost nothing, with facts lost amidst the rumors and misinformation. Here is a clear picture of what is known, so far. We learn more each day.


Important: the WHO has not yet declared COVID-19 (aka coronavirus) to be a pandemic – where the epidemic spreads rapidly across multiple regions simultaneously. The label “pandemic” describes a disease’s extent and speed of spread, not its severity. See the WHO website for details (here and here). The COVID-19 epidemic now might be breaking containment to become a pandemic. This is where the preparation during the past two months will prove its worth – or not.

The current status

From the WHO Situation Report of February 23.

So far there are 29 nations affected (5 new nations since February 3). There are 1769 confirmed cases outside China (367 new), with 17 deaths (6 new). That is 1135 cases plus the 634 guaranteed or tested from the Diamond Princess cruise ship. Reminder: the world’s population outside China is six and one-half billion.

  • South Korea is experiencing the most rapid spread of the disease outside of China – so far with small numbers afflicted and an immensely strong response by its government and people. They have 602 confirmed cases: 1 new case reported on Feb. 18, 20 on Feb. 19, 53 on Feb. 20, and 100 on Feb. 21, 104 on Feb. 22, and 256 on Feb. 23.
  • The other nation experiencing a rapid spread is Italy, so far with tiny numbers: 76 confirmed cases (vs. 3 on WHO’s Feb. 21 report). Again, the government and people are responding strongly and proactively to contain the outbreak (details here).
  • Iran reported its first two cases on Feb 20. There are now 28 cases and 5 deaths, which implies that there are many more than 28 people infected.

People take for granted this accurate, timely, and detailed data (esp. the “government can’t do anything” and “the UN is evil” folks). It did not exist for epidemics until recently. This information is collected according to the International Health Regulations (2005). All Member States are required to immediately report any new confirmed case of COVID-19 and, within 48 hours, provide information related to clinical, epidemiological, and travel history using the WHO standardized case reporting form.

Cases in the US

As of Feb 21, the CDC reports that 414 people have been tests and 14 cases confirmed – with no tests pending results.

As of February 15, the CDC estimates that so far this season (since September 9) there have been at least 29 million flu illnesses, 280,000 hospitalizations, and 16,000 deaths from flu. See their summary page and detail page for current information. But remember America’s new motto: “What, me worry?”

An overview of the epidemic

Excerpt from a speech by Tedros Adhanom, the Director-General of WHO, on February 21. Full text here.

“It’s hard to believe that only 52 days ago {January 1}, WHO’s country office in China was notified of a cluster of cases of pneumonia of unknown cause in Wuhan city. In just seven weeks, this outbreak has captured the world’s attention, and rightly so, because it has the potential to cause severe political, social and economic upheaval.

“As you know, WHO declared a Public Health Emergency of International Concern within a month {on January 30} after the first reported cases, as a result of the signs of human-to-human transmission we saw outside China. And because of the major concerns we had that this virus could spread to countries with weaker health systems such as in our continent. China has now reported 75,569 cases to WHO, including 2239 deaths.

The data from China continue to show a decline in new cases. This is welcome news, but it must be interpreted very cautiously. It’s far too early to make predictions about this outbreak.

“Outside China, there are now 1200 cases in 26 countries, with 8 deaths. As you know, there is one confirmed case on the African continent, in Egypt {reported Feb. 15}. Several African countries have tested suspected cases of COVID-19, but fortunately they have been found negative.

“Although the total number of cases outside China remains relatively small, we are concerned about the number of cases with no clear epidemiological link, such as travel history to China or contact with a confirmed case. We are especially concerned about the increase in cases in the Islamic Republic of Iran, where there are now 18 cases and four deaths in just the past two days.

“With every day that passes, we know a little bit more about this virus, and the disease it causes. We know that more than 80% of patients have mild disease and will recover. But the other 20% of patients have severe or critical diseases, ranging from shortness of breath to septic shock and multi-organ failure. These patients require intensive care, using equipment such as respiratory support machines that are, as you know, in short supply in many African countries. And that’s a cause for concern. In 2% of reported cases, the virus is fatal, and the risk of death increases the older a patient is, and with underlying health conditions. We see relatively few cases among children. More research, of course, is needed to understand why.

“Our biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems. …we’re working hard to prepare countries in Africa for the potential arrival of the virus. …We’ve also published a Strategic Preparedness and Response Plan, with a call for US$675 million to support countries, especially those which are most vulnerable.

“WHO has identified 13 priority countries in Africa because of their direct links to China or their high volume of travel with China. …an increasing number of African countries are now able to test for COVID-19 with laboratory test kits supplied by WHO, compared with only one just a couple of weeks ago. Some countries in Africa, including DRC, are also leveraging the capacity they have built up to test for Ebola, to test for COVID-19. This is a great example of how investing in health systems can pay dividends for health security.

“We have also shipped more than 30,000 sets of personal protective equipment to several countries in Africa, and we’re ready to ship almost 60,000 more sets to 19 countries in the coming weeks. We’re working with manufacturers of personal protective equipment to address the severe disruption in the market for masks, gloves, gowns and other PPE, to ensure we can protect health workers.

“During the past month about 11,000 African health workers have been trained using WHO’s online courses on COVID-19, which are available free of charge in English, French and other languages at OpenWHO. We’re also providing advice to countries on how to do screening, testing, contact tracing and treatment.

“Last week we brought the international research community together to identify research priorities, especially in the areas of diagnostics, therapeutics, and vaccines. …

The increasing signs of transmission outside China show that the window of opportunity we have for containing this virus is narrowing. We are calling on all countries to invest urgently in preparedness. We have to take advantage of the window of opportunity we have, to attack  the virus outbreak with a sense of urgency.

The numbers for COVID-19

From WHO’s February 19 Situation Report. Footnotes omitted. See the report for footnotes with links to research. Links and red emphasis added.

“WHO has been working with an international network of statisticians and mathematical modelers to estimate key epidemiologic parameters of COVID-19, such as the incubation period (the time between infection and symptom onset), case fatality ratio (CFR, the proportion of cases who die), infection fatality ratio (IFR, the portion of all of those infected who die), and the serial interval (the time between symptom onset of a primary and secondary case).

“To calculate these parameters, statisticians and modelers use case-based data from COVID-19 surveillance activities, and data captured from early investigations, such as those studies which evaluate transmission within clusters of cases in households or other closed settings. Preliminary estimates of median incubation period are 5-6 days (ranging from 0-14 days) and estimates for the serial interval range from 4.4 to 7.5 days. …

“The confirmed case fatality ratio, or CFR, is the total number of deaths divided by the total number of confirmed cases at one point in time. Within China, the confirmed CFR, as reported by the Chinese Center for Disease Control and Prevention is 2.3%. This is based on 1023 deaths amongst 44,415 laboratory-confirmed cases as of 11 February. This CFR does not include the number of more mild infections that may be missed from current surveillance, which has largely focused on patients with pneumonia requiring hospitalization; nor does it account for the fact that recently confirmed cases may yet develop severe disease, and some may die. As the outbreak continues, the confirmed CFR may change.

“Outside of China, CFR estimates among confirmed cases reported is lower than reported from within China. However, it is too early to draw conclusions as to whether there are real differences in the CFR inside and outside of China, as final outcome data (that is, who will recover and who will die) for the majority of cases reported from outside China are not yet known.”

That last paragraph is important and often ignored. The fatality rate in developed nations is as yet unknown, but probably far lower than China’s due to availablilty of more advanced tools for treatment – especially for respiratory problems.

About transmission of covid-19

From WHO’s February 21 Situation Report.

“Currently, there are investigations conducted to evaluate the viability and survival time of SARS-CoV-2. In general, coronaviruses are very stable in a frozen state according to studies of other coronaviruses, which have shown survival for up to two years at -20°C. Studies conducted on SARS-CoV ad MERS-CoV indicate that these viruses can persist on different surfaces for up to a few days depending on a combination of parameters such as temperature, humidity, and light. For example, at refrigeration temperature (4°C), MERS-CoV can remain viable for up to 72 hours.

“Current evidence on other coronavirus strains shows that while coronaviruses appear to be stable at low and freezing temperatures for a certain period, food hygiene and good food safety practices can prevent their transmission through food. Specifically, coronaviruses are thermolabile, which means that they are susceptible to normal cooking temperatures (70°C). Therefore, as a general rule, the consumption of raw or undercooked animal products should be avoided. Raw meat, raw milk or raw animal organs should be handled with care to avoid cross-contamination with uncooked foods.

“SARS-CoV and MERS-CoV are susceptible to the most common cleaning and disinfection protocols and there is no indication so far that SARS-Cov-2 behaves differently.”


The combination of good global organization by the national public health organizations (coordinated by WHO) and high technology have contained the epidemic for 52 days. This time allowed implementation of screening and quarantine mechanisms, creation of diagnostic tools (based on decoding its genome), development of protocols for treatment, dissemination of equipment, and starting research about the diseases’ nature and cure.

The next few weeks might show what difference all that has made. Future historians might see COVID-19 as a new age of public health, with the first effective response to a pandemic. Time will tell.

It’s easy to follow the coronavirus story

The World Health Organization provides daily information, from highly technical information to news for the general public.

Posts about the coronavirus epidemic.

For More Information

Ideas! For some shopping ideas, see my recommended books and films at Amazon. Also, see a story about our future: Ultra Violence: Tales from Venus.

Please like us on Facebook and follow us on Twitter. Also, see these posts about epidemics…

  1. See the ugly cost of the next big flu pandemic. We can do more to prepare.
  2. Stratfor: The superbugs are coming. We have time to prepare.
  3. Posts debunking the hysteria about the 2009 swine flu in America.
  4. Posts debunking the hysteria about the 2015 ebola epidemic in America.
  5. Important: A vaccine against the fears that make us weak.

Films about scientists responding to global threats

In these films, we see scientists behaving according to their and our highest ideals.

When Worlds Collide (1959) – The world will end. Scientists band together to warn the world and build an ark to carry humanity to another home.

Contagion (2011). – This shows the progress of a pandemic from its start with Patient Zero, through the global devastation, to an eventual victory by the world’s scientists.

When Worlds Collide (1951)
Available at Amazon.
Contagion (2011)
Available at Amazon.


22 thoughts on “Cut thru myths to see facts about COVID-19”

  1. The mortality rate for CoV-19 is around 2%, whereas the CDC data indicates that for the flu it is about 0.05%.
    So a 40x higher mortality rate for a comparably infectious disease. Plus it is spreading exponentially despite intensive containment efforts.
    Add to this the reality that most hospital supplies and drug precursors are made in China, with domestic supply now so tight that the FBI had to order masks directly from 3M.
    Sounds plenty alarming to me.

    1. etudiant,

      “Plus it is spreading exponentially despite intensive containment efforts.”

      “Exponentially” is a way of expressing a number; it does not mean the number is large. In fact, it is spreading quite slowly outside China – as the containment procedures have been remarkably successful. That might be changing.

      “The mortality rate for CoV-19 is around 2%, whereas the CDC data indicates that for the flu it is about 0.05%.”

      Also false. That mortality rate fro COVID-19 is for cases in China; the rate for the flu is for cases in the US. It’s clear that advanced treatment, esp. for respiratory symptoms, lowers the fatality rate. There are insufficient cases so far in developed nations to determine a number for comparison to the flu.

      “So a 40x higher mortality rate for a comparably infectious disease.”

      Also false. The R0 for COVID-19 is not known for a developed nation. I’ve not seen the R0 for the flu in China. R0 is not a universal constant, like the speed of light.

      “Sounds plenty alarming to me.”

      Every one of the many articles I’ve run about epidemics in the past decade has produced similar comments by terrified people, based on equally bogus information.

      1. Yes. You could also have said that the numbers which Etudiant bases his alarm on are not robust.

        We can be sure that the number of cases in China is seriously understated, because the number counted is limited by the capacity for diagnosing. They have widened the criteria, from those diagnosed by testing to those diagnosing by either tests or x-ray, but this must still be missing a great many cases that never come to any kind of diagnosis.

        We know there are many relatively mild cases which are not being counted. There are probably also substantial numbers of more serious ones which are also not being counted.

        This would lead to the death rate being much lower than Etudiant’s estimates. You also say “The R0 for COVID-19 is not known for a developed nation”. Yes, given the other uncertainties, the R0 must be very uncertain indeed.

        Etudiant might reply that the deaths are also being underestimated, with many being classified as simple pneumonia and maybe many not being reported at all. That may be too, but the question is how it balances against the uncertainties in the incidence estimates.

        We will know more in the next couple of weeks as we see both trends in Europe and the US. Now that its a known thing and public awareness is high there is much more chance of catching a higher proportion of cases by screening and tracking, and we are starting the process with a small enough number of cases for more complete tracking to be possible and likely.

        We should also get a lot of information from what happens in China in the next few weeks.

        Agreed that so far cautious optimism on the efficacy of the global response is justified. But there are some disturbing indications – Iran and Korea for instance, and the basically unknown situation in the African continent. Its not time to panic, but it is time to be wary.

      2. Henrik,

        “We can be sure that the number of cases in China is seriously understated”

        Since this post makes no mention of China, that’s irrelevant. This is about the spread of the disease outside China. So your entire comment is irrelevant.

        Please read the post before commenting.

      3. henrik,

        Whoops – my mistake. I misunderstood the post you were replying to.

        “We can be sure that the number of cases in China is seriously understated”

        I congratulate your belief in your super-duper knowledge, but I’ll stick with the people who have actual data.

      4. Expert opinion I’ve read is precisely that the Chinese reported numbers are understatements.

        No-one seems to think that they have tested every case. The universal view is that they do not have capacity of testing, and that not all cases are presenting to them anyway. The reports are that they are overwhelmed by sheer numbers.

        Its an argument that makes Etudiant’s number of 2% likely to be a lot on the high side. You say:

        That mortality rate fro COVID-19 is for cases in China; the rate for the flu is for cases in the US. It’s clear that advanced treatment, esp. for respiratory symptoms, lowers the fatality rate. There are insufficient cases so far in developed nations to determine a number for comparison to the flu.

        This is true. But what is also true is that the mortality rate in China is only for the cases confirmed according to their criteria, and my take on expert opinion is that there are likely to be many more than that, and so a lower death rate.

        I agree that mortality rates for flu in China would be an important check point. You would expect that given smoking an air pollution it might be much higher than in the US or Europe.

    2. Here’s my simple and basic concern. I am a U.S. citizen. In a country of roughly 330 million people how is it that 3 months into this outbreak, having received tens of thousands of travelers from China over this period, we have only tested 414 people to date. I am aware that the initial testing kits sent out were found to be faulty. Has this situation been corrected? How can we have tested so few people? Something here doesn’t add up.

      1. Stacy,

        It “doesn’t add up” because you don’t understand what’s happening. There is no reason you should, after all. It’s a complex situation!

        (1) You appear to be assuming that all of China has been affected for 2 months. For the first month the epidemic was almost entirely in Hubei Province (Wuhan is a city in it) – and it is still the core area affected. As of February 20, about 78% of the confirmed cases have been from Hubei Province (source).

        That’s why the mandatory quarantines Trump ordered eff Feb. 2 affected only Americans coming from Hubie (it also barred Chinese citizens from entry into the US, with few exceptions).

        Most of the traffic with the US is with Hebei Province (Beijing), Shanghai, Guangdong Province, and Hong Kong.

        (2) “I am aware that the initial testing kits sent out were found to be faulty.”

        They were faulty in the sense of sometimes producing “inconclusive” results, requiring re-testing. That does not affect the count of people tested or imply that any cases incorrectly went through. Details here.

        The maximum incubation period is considered to be 14 days. So quarantines of that length are as good or better than using the diagnostic kits. Also, if large numbers of infected arrived here before screening and quarantine protocols were established, they would be symptomatic long before now – and almost certainly detected by health care workers.

  2. Good stuff and good to know. It is sobering to think that a certain number of cases of this thing may end up just being digested by people’s immune systems and they might never know they had it, or just thought it was the flu.

    The one thing that seems a little unclear to me is the method of transmission.

    Do you think the people halfways-cheering-on an epidemic – something I have been seeing in various forms over the last couple of decades – are an example of your “Clown World” hypothesis?

    1. SF,

      “something I have been seeing in various forms over the last couple of decades – are an example of your “Clown World” hypothesis?”

      I think so (I’m guessing, of course). People see the news as entertainment, and form opinions that suit their biases and make a world that they find exciting.

      Also, the collapse of trust in our institutions promotes fear. These posts get the frequent response – “but they’re lying to us.” Saying that makes people feel knowledgable, even wise – although it’s just an expression of bias or cynicism. Ignorance in motion, rather than rational skepticism.

      #ClownWorld. There is no way to handle this, so far as I know. It’s a disease without either a known cure or vaccine. It’s like living in a zombie movie, watching everyone around you get infected.

  3. The spread rate is pretty impressive in ‘civilized’ places such as Italy or Japan. I think doubling every week is an indication that things are out of control and we are not doing that well.
    Seen that the sicker CoV victims monopolize ICU facilities for at least 10 days, there is very limited capacity to treat victims, even if clothing and drug supply is not an issue, which however it is. If the front line doctors and nurses can’t be protected, patient care will take a beating.
    Add to this the medical products supply chain disruption, we are looking at interesting times.
    Fortunately, the worst case is a drastically increased mortality at the high end of the curve. For all I know, some government actuary is currently rejoicing at the reduction in longer term liabilities of the social security system.

    1. etudiant,

      Every single thing you say is wrong. I’m moderating further comments. There is no point to posting information, only to have someone post gibberish contracting it in the comments. It’s a waste of time to reply.

      “The spread rate is pretty impressive in ‘civilized’ places such as Italy or Japan.”

      Total bonkers nonsense. First, that’s innumeracy. “Doubling” means nothing without specifying a time period (ie, making it a statement of rate, not quantity). Second, “doubling” from such small numbers is easy. As in Japan, that doubled in a week to 105 cases – not a big deal.

      “I think doubling every week is an indication that things are out of control and we are not doing that well.”

      Total bonkers nonsense. It would take divine intervention to stop infection clusters of such small numbers. One person can start a cluster in a city. Effective containment mechanisms can (with luck and fast action) prevent the spread from that point.

      “Seen that the sicker CoV victims monopolize ICU facilities for at least 10 days, there is very limited capacity to treat victims”

      Can’t you state anything clearly? A sick patient “fills’ or “occupies” a hospital bed – for some period of time. As mentioned in this post, 80% of the infected in China have mild cases. Most of the other 20% require intensive case. Again, that is from China. We don’t know those numbers for developed states. New York State has aprox 200 hospitals with ICU units, a rough average of 15 beds each – 3,000 beds. That can be increased in an emergency, such as during an epidemic.

      “For all I know, some government actuary is currently rejoicing at the reduction in longer term liabilities of the social security system.”

      You don’t know much, so on that note I’ll end this.

      1. How prepared is the US?

        The US has roughly 80 thousand ICU beds.

        The bottleneck is the number of intensive care beds. Japan has an unusually low number of ICU beds per capita among the developed nations, for a total of roughly 6 thousand beds. They can increase that, to some extent. On the other hand, they also have by far the largest number of hospital beds per capita.

        Belgium and Germany have even more ICU beds per capita than does the US.

        What if a US city or region is overwhelmed with a demand for medical services during an emergency, such as a natural disaster or epidemic? Other hospitals in the region and nation can help. Medical professionals can work longer hours, and be reassigned from other services. Retired professionals can return to service; professionals can go where needed.

        What about equipment and supplies?

        Hospitals have reserves. Vendors can provide supplies from their warehouses. And if that’s not enough – there is the Strategic National Stockpile run by the Federal Dept of Health and Human Services. It costing $600 million per year to maintain – and is well worth the money. This stockpile is designed to supplement state and local inventories.

        “With approximately 200 federal and contract employees, the Strategic National Stockpile is organized to support any public health threat. Stockpile staff represent a variety of specialties, and all work together to ensure the right resources are ready and can get to the right place at the right time.”

        The inventory consists of twelve Push Packages, stored at secret facilities around the nation. Each occupies 124 cargo containers, weigh 94,424 pounds, and require 5,000 square feet of floor space for proper staging and management. A package fills a wide-body aircraft or seven tractor trailers. It can be deployed to arrive in any city in the continental US in 12 hours.

        The SNS has been supplemented by a second tier of medical products that are under the control and management of selected, pre-qualified vendors. The Vendor Managed Inventory (VMI) is designed to arrive 24-36 hours after SNS deployment.

        Here is a WaPo article about the program. See a detailed description here.

        Another line of defense

        The US Army has Combat Support Hospitals, successor to the Mobile Army Surgical Hospitals used in Korea and Vietnam. There are 8 active duty units and 14 reserve units (plus 3 overseas). A fully manned CSH has over 600 people when fully staffed 248 beds.

  4. As of February 15, the CDC estimates that so far this season (since September 9) there have been at least 29 million flu illnesses, 280,000 hospitalizations, and 16,000 deaths from flu.

    That is with a vaccine and a huge pressure to get it.

    When the new virus hits those levels I start to worry.

    1. My wife is fighting the flu right now and I can tell you that it’s certainly something to worry about. The economic cost of the COVID-19 is going to be very large but the flu is going to be much larger and, as Larry has said, America’s new motto is: “What, me worry?”


      1. Pluto,

        My best wishes for a fast recovery of your wife!

        It’s important to understand the underlying problem, as best as we can. I believe you are describing America’s broken OODA loop in action, our in ability to clearly see our world – and so we can’t effectively act. In this case, people ignore the certainly serious annual flu epidemics (one of which will almost inevitably be catastrophic) because it isn’t exciting. Many people prefer tall tales about covid-19.

        Mostly people in the middle class. The Upper Class and rich have real power, busying themselves with running America. The lower classes entertain themselves (when not working or taking care of their families) with sports, booze, drugs, etc.

        I’ve written about this a great deal. It’s not what people want to read.

      2. Larry, thanks for your best wishes. She’s going to recover but it was a very unpleasant experience.

        I’ve had a lot of time recently to think about the conundrum you’ve identified. I can see only three real paths out of ClownWorld. Mind you there are thousands of variations of these three paths but they all boil down to three options:

        America falls into squabbling micro-states or finishes becoming a tyranny. In either case, we will live with wrecked economies and sad memories of better days.

        Currently this is the most likely of the three options but it doesn’t have to be.

        America gets its wish of a superhero for a President in its moment of need. Obviously we’re not getting one in 2020 unless Buttigieg turns out to be a lot better than expected. Perhaps 2024 will provide a better hope if we can last that long.

        Even if we can get a superhero, as Lincoln or Roosevelt could tell them, America will not return to the good old days. The days may be good but the superhero will need to reforge the nation and it won’t be the same.

        I regard this as the least likely of the three options.

        Some event awakens enough people to the peril of ClownWorld to overcome it. This is your preferred scenario and mine as well. But I cannot see a way it can occur at the national level. There are too many people/organizations that benefit from ClownWorld and they have too many tools keep people disorganized and distracted.

        The same is not true at the State and Local levels, which are not as burdened by misdirection and craziness, but are drifting because a too many of them look to the Federal level for guidance. Now I’m seeing an increasing number of leaders at the State and Local levels breaking free from ClownWorld and regaining their effectiveness.

        The leaders are not seeking to oppose ClownWorld; that’s a sure way to lose at this stage of the game. They are just seeking to make sure that their communities are morally and economically healthy solely using local resources or using Federal resources in more effective ways. The best news is that they are succeeding and are beginning to be noticed. Interestingly, these leaders come from both the Republican and Democratic parties and are working together for the greater good.

        Will the positive local trends continue to grow? I cannot yet answer that question with any degree of accuracy. But I can see ways that it may blossom into a renaissance for the rest of America by providing examples of good government.

        Because I am Pluto, the traveler through the cold, dark, empty places, I can see too many ways for them to fail. They need help.

        Like Larry, I call on people to rise to the occasion and realize that trying to ignore Trump and ClownWorld is only going to make the problem worse.

        Donate what you can afford to leaders who build consensus around rational solutions based on facts rather than personal empires built on tweets based on fantasy. More important, donate your time, caring people are always more effective than money.

        The only modification I offer to the advice of the Fabius Maximus website is to start local.

        Practice with your local councilman or alderman rather than on the national stage. At worst you’ll get some protection from the insanity of ClownWorld. At best you and your 10,000 new best friends will find your hidden superpower and make the world around you better.

        My fellow Americans, the future is yours to control if you will. If you don’t, others will control it for you. The decision is yours, as are the consequences.

        What is your answer?

      3. My apologies for the rant I just wrote, Larry. I couldn’t seem to stop writing. Sorry if it offends you. This is the only place I currently have to write such thoughts.

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