The unhealthy air we breathe in: Covid-19 and its variants - towards a “New Normal”?
Pollution is not the only thorn in the side that inflicts our respiratory tracts. Coronaviruses are a family of viruses known to cause respiratory infections. There is no vaccine yet to prevent them and no specific treatment other than managing the symptoms. The raging pandemic wave has begun with a first case in the by now famous city of Wuhan in China on March 11, 2020, when the WHO declared that an outbreak of the viral disease Covid-19, had reached the level of a global pandemic, therefore calling for governments to take urgent action to stop the spread of the virus. Phenomenon that hasn’t given any sign to stop up to now. Despite years of scientific and laboratory researches haven’t been yet prepared so effective vaccines to stop this new sneaky scourge for the humankind. The billions dollars investments addressed to solve this issue have not been useful to set up measures of prevention often unsuitable and unsatisfactory and governments, in the impotence to make a point to this tremendous tragedy, limited themselves to impose isolation, quarantine, social distancing, measures that are currently risking to topple down Boris Johnson’s UK government bumped up by the “partygate”. We are by now forced to plunge ourselves in our solitudes and in our naked lives, to perpetually don a masks in horrors theatre, as if this life wasn’t already a charade, striving to anchor again ourselves to an alienating positive thinking, in a nightmare where no fairy godmother will come to rescue us by a stroke of magic wand, untangling the knots and solving to the roots the dramatic contingencies that we are dealing with day by day.
After the initial phases of minimization of the problem,
dictated by the fears of the Stock Exchange Index, and in order to elude a
collective panic, in which this pandemic hasn’t given no sign to be eager to
dampen and that presents itself always under new forms and new variants, that
has been compared to the spread of a banal flu, the mortality index and the
long hospitalizations have factually proclaimed large denials and make seeing
first-hand the seriousness of the situation, compelling the governments, in the
silliness of the official authorities and hesitations of the science, to impose
always awkward and peremptory measures, still remaining not very clear if undertaken
at the advantage or disadvantage of the civil population. For an excess of
prevention’s sake they are reduced us to live like in Alkatraz, the death row,
a lot of prisoners waiting for the end, for the averted and feared lethal
effect.
By this way, the more and more frustrated medical and nursing
staffs try to comply with and implement the guidelines and to impose
intransigence on measures like isolation and quarantine inside the hospitals,
as well as outside the medical, sometime makeshift, centers with social distancing
and lockdown, de facto limiting the freedom of movement, not only of the people
but also of the goods and capitals, freezing and bringing to an outright
bankrupt international economy and finance in a game of odds that the patients
could come out of the tunnel while the international monetary system shrinks,
even if it seems to get slowly out of recession and are engineered new
solutions more and more digital and green, increasingly fantastic and draconian
in order to fight the crisis. Not disappointed, deluded people, then, but
people of surrenders and the data day by day are more and more upsetting and
alarming, although the geoeconomics experts are currently talking about a
likely come back to a “new normal”.
International human rights law guarantees everyone the right
to the highest attainable standard of health and pushes governments to move
steps forward the prevention of threats to public health and to provide medical
care to those in need. At the same time are also recognized in case of serious
public health threats and public emergencies threatening the life of the
nation restrictions to these rights and freedoms when they have a legal basis,
are strictly necessary, based on scientific evidence and neither arbitrary nor
discriminatory, of limited duration, respectful of human dignity, subject to
review, and proportionate to achieve the objective.
Briefly giving some latest statistical updates given by the
WHO, globally, the number of new Covid-19 cases increased in the past week
(10-16 January 2022), while the number of new deaths remained similar to that
of the previous week. Across the six WHO regions, over 18 million new cases
were reported this week, a 20% increase, as compared to the previous week. Over
45 000 new deaths were also reported. As of 16 January, over 323 million
confirmed cases and over 5.5 million deaths have been reported worldwide.
Despite a slowdown of the increase in case incidence at the global level, all
regions reported an increase in the incidence of weekly cases with the
exception of the African Region, which reported a 27% decrease. The South-East
Asia region reported the largest increase in new cases last week (145%),
followed by the Eastern Mediterranean Region (68%). New weekly deaths
increased in the South-East Asia Region (12%) and Region of the Americas (7%)
while remaining approximately the same as the previous week in the other
regions.
In an overview of the international applicable standards, under
the International Covenant on Economic, Social and Cultural Rights,
which most countries have adopted, everyone has the right to “the highest
attainable standard of physical and mental health.” (art.12). Governments are
obligated to take effective steps for the “prevention, treatment and control of
epidemic, endemic, occupational and other diseases.” (art. 12,2 p.)
The United Nations Committee on Economic, Social and Cultural
Rights, which monitors state compliance with the covenant, has proclaimed
that the right to health is closely buckled up to the realization of other
human rights, including the rights to food, housing, work, education, human
dignity, life, non-discrimination, equality, the prohibition against torture,
privacy, access to information, and the freedoms of association, assembly and
movement. The right to
health provides that health facilities, goods, and services should be
sufficient, indiscriminately accessible to everyone and affordable for all,
even marginalized groups; acceptable, that’s to say respectful of medical
ethics and culturally, scientifically and medically appropriate and of good
quality. For the
protection’s sake of this right must be guaranteed a true equality access to
vaccines.
The Siracusa
Principles, adopted by the UN Economic and
Social Council in 1984, and UN Human Rights Committee general comments on states
of emergency and freedom of movement provide authoritative
guidance on government responses restricting human rights for the above
mentioned reasons of public health or national emergency. It’s important to remember, in fact,
that the states of emergency need to be limited in time and any curtailment of
rights needs to be careful about the impact on specific populations or
marginalized groups.
Emergency declarations based on the COVID-19 outbreak should
not be used as a basis to target particular groups, minorities, or individuals.
They should not be functional to cover up repressive action under the guise of
protecting health and should not be used to quash dissent.
The Siracusa Principles specifically trace the same milestone
principles set by United Nations Committee on Economic, Social and Cultural
Rights.
Restrictions
such as mandatory quarantine or isolation of symptomatic people must be carried
out in accordance with the law. Broad quarantines and lockdowns of
indeterminate length rarely meet these criteria and are often arbitrary or
discriminatory in application. Freedom of movement under international
human rights law protects the right of everyone to leave or to enter any
country, including one’s own, and the right to move freely in the whole
territory of the country. Restrictions on these rights can only be imposed when
lawful, for a legitimate purpose, and be proportionate. Travel bans may not have
the effect of denying people the right to seek asylum or of breaching the
absolute prohibition of refoulement where they face persecution or torture.
As dead-killing infectious pandemic, Covid-19, poses a higher
risk to populations that live in close proximity to each other and it
disproportionately affects older people and individuals with dangerous
illnesses, such as cardiovascular or chronic respiratory disease, diabetes and
hypertension. This risk is particularly critical in places of detention,
such as prisons, jails, and immigration detention centers, as well as
residential institutions hosting people with disabilities and nursing
facilities for older people, where the virus can infect rapidly, especially if
access to health care is already poor. States have the obligation to ensure
medical care for those in their custody at least equivalent to that available
to the general population, and must not deny detainees, including asylum
seekers or undocumented migrants, equal access to preventive, curative or
palliative health care. Asylum seekers, refugees living in camps, and people
experiencing homelessness may also be at increased risk can also face even
worse hardships because of their lack of access to adequate water and hygiene
facilities.
In nursing and other facilities with large numbers of older
people, visitor policies should balance the protection of older and at-risk
residents with their need to meet their family and acquaintances. Many NGOs are
denouncing that people in prisons and immigration detention centers often
don’t get a proper health care in normal circumstances, even in economically
developed countries such as the USA where many people are not convicted of a crime but
are locked up simply because they cannot afford to pay the bail set
in their case. Here prisons are frequently overcrowded of older men and women, other
than immigrants, mainly due to lengthy sentences and forced to live in poor
medical conditions.
In Italy prisoners have protested over fears of
contagion in crammed facilities and against bans on family visits and
supervised release during the coronavirus pandemic. Consequently, authorities
have authorized the use of email and Skype for their contacts with relatives
and for educational purposes and announced a plan to release and
place under house arrest prisoners with less than 18 months on their sentence.
The main prisoner rights organization in Italy, Antigone, estimated this could
benefit at most 3000 detainees, while the penitentiary system is at around
14000 over capacity, calling for more significant measures to allow the release of a
greater number of prisoners, especially older people and for alternatives to
detention due to the increased risk of infection and no prospect for
deportation, i.e. for those whose scheduled release may be soon, those who are
in pre-trial detention for non-violent and lesser offenses, or whose continued
detention is unnecessary or not justified, other than for other sensitive
categories such as people with underlying health conditions, in order to protect
their health, to guarantee access to treatment, also taking into consideration
factors such as the gravity of the crime committed. If safe and legal
deportations are suspended due to the virus, the legal justification for
detaining deported people may no longer exist and, in these cases, authorities
should release them and set out alternatives to detention. Authorities should
publicly disclose their plans of action to reduce the risk of infection in
their facilities and the steps they will take to contain it and protect
prisoners. Persons in any form of detention have the same right to health
as the non-incarcerated population and are entitled to the same standards of
prevention and treatment. Moreover, they should ensure to be appropriately
coordinated with public health departments and openly communicating with staff
and people in custody, keeping on screening and testing for Covid-19, providing
proper hygiene training and supplies, ensuring that individuals released or put
on supervised leave have adequate accommodations and health care. Detention
centers should consider alternative strategies such as video conferencing for
individuals to be able to connect with family or legal counsel. Authorities
should provide public notice that there will be no negative repercussions for
missed court dates or check-ins during the time of the outbreak. In the absence
of adequate State support, the UN and other inter-governmental agencies
should press for access to formal and
informal detention facilities to provide detainees with life-saving assistance.
As part of the right to health, the ICESCR pledge
governments to create conditions that “would assure to all medical service and
attention in the event of sickness.” They have an obligation to
minimize the risk of occupational accidents and diseases, including
workers access to health information and adequate protective clothing and
equipment, ensuring that facilities have adequate water, sanitation, hygiene,
healthcare waste management, and cleaning. Anxiousness and depression are
not over, not only for the pandemic beaurocracy but above all due to the sharp
job cuts causing many people be slashed from their workplace, fact that have
the huge backlash of throwing many families in a complete desperation. Dr Fauci
said “We are not out of the woods yet”. According to HRW research into hospitals
and the acquired infections in Hungary, highlights the nation’s
mismanaged, underfunded, and understaffed public healthcare system, poorly
equipped to handle the aftermaths of the pandemic. Patients and medical experts
denounced a lack of basic hygiene protocol, of isolation rooms, and a shortage
of health professionals and medical supplies. In Venezuela, HRW has
documented a health system in total collapse: hospitals shut down or operating
at a fraction of their capacity, many are left without regular access to
electricity or water. Again, sanctions imposed by the US on Iran have
drastically constrained the ability of the country to finance humanitarian
imports, including medicines. Concerned governments should support Iran’s
efforts to contrast the pandemic, including by providing access to medical
devices and testing kits. In Thailand, public health capacity has been curtailed
by corruption.
Low-wage workers must be protected and employees encouraged
to work from home. Remote work is not an option for millions of workers in
fields like retail, restaurants, personal services, the gig economy, and
informal sectors, more precarious sectors where wages tend to be lower and that
have low rates of paid sick leave, especially in countries such as
the US. HRW has long urged governments to guarantee paid sick and
family leave to enable workers to take time off to care for new children
or ill or older family members or to deal with their own serious health conditions
without losing pay. In the context of Covid-19 and other disease
outbreaks, paid sick and family leave helps ensure workers who are
sick can stay home to minimize the spread of the virus. In facts, many
governments guarantee some paid sick leave to all workers, others do not,
exacerbating economic inequality and also contributing to gender inequity.
Global supply chains have already been disrupted by Covid-19, which
has led to reduced manufacturing and factory closures.
Moreover, governments should provide the right to education
to all, even if schools are temporarily closed and the learning and education
of hundreds of millions of students are interrupted. To guarantee education
systems respond adequately, UNESCO has recommended that States “adopt a variety
of hi-tech, low-tech and no tech solutions to assure the continuity of
learning.” In many countries, teachers already use online learning platforms to
complement normal contact hours in classrooms for homework, classroom
exercises, and research, and many students have access to technological
equipment at home. However, not all countries, communities, families, or social
groups have adequate internet access, and many children live in places
with frequent government-led internet shutdowns.
Governments should adopt measures to mitigate the
disproportionate effects on children who already experience barriers to
education by cooperating with teachers, school officials, and teachers’ unions
and associations, or who are marginalized for various reasons. They should
monitor students most at risk and making sure students receive printed or
online handbooks and stationary on time, with particular attention to students
with disabilities who may require proper, accessible material.
In countries with high school drop-out, closures may
jeopardize efforts to increase
enrollments and retention, particularly at the secondary level and
should be monitored compliance with compulsory education and ensured returns
once schools reopen. Education officials should focus attention on areas with
high incidence of child labor or child marriage and ensure all children come
back to school.
Furthermore, governments must address disproportionate
impacts on women and girls. Specific risks to pregnant women exposed to Covid-19
are not yet clear even if the outbreak could negatively affect sexual and
reproductive health and rights. Overloaded health systems, reallocation of
resources, shortages of medical supplies, and disruptions of global supply
chains could harm women’s access to contraception and pre- and post-natal and
birth care. Although the risk of infection through breastfeeding is not known,
the UN Population Fund has recommended that breastfeeding mothers who become
ill should not been separated from their children. Another aspect to be
examined is the higher incidence of the quarantine on domestic violence, as
it’s happening in China, phenomenon altered and heightened by factors such
as stress, cramped and difficult living conditions, and breakdowns in community
support mechanisms.
Not enough, women globally do almost 2,5 times as
much unpaid care and domestic work as men, and they are more likely than men to
face additional care giving duties when schools close, making it harder to
maintain paid employment. Japan is trying to help families with young
children by offering to offset costs to businesses for workers taking paid
leave to care for children during school shutdown, although the offered amount is
quite low. Also Italy is trying to mitigate the effects of the
lockdown on families with children through measures encompassing emergency paid
parental leave or vouchers for families with children up to 12 years old or
with disabilities. Up to 95% of female workers in some regions are
employed in the informal sector where there is no job security and safety if a
crisis like Covid-19 destroys their earnings. Informal work includes many
occupations most likely to be harmed by a quarantine, social distancing, and
economic slowdown, such as street vendors, goods traders, and seasonal workers.
Worldwide, 70% of outfront health and social service
providers are women and may be heavily exposed to the virus at work more than
other sectors of employment. Some female care and domestic workers are migrant,
often vulnerable to abusive employment conditions, at risk of abuse,
without adequate protections, and of being trapped and unable to reach their
homes during a crisis.
Authorities should take steps to ensure that responses do not
perpetuate gender inequity. When education is moved online, governments and
education providers should monitor participation and retention of students in
online courses for a gendered impact and respond quickly with strategies to retain
and reengage women and girls if their participation falls off. They should also
address the particular risks of job losses to women who may take on additional
caregiving during school closures. They should ensure public awareness
campaigns and that services are available to all victims. They have to root out
discrimination against religious, ethnic or marginalized groups and stigma and
to protect patient confidentiality. HRW found that people living with HIV
in Kenya, South Africa, the Philippines and the US faced not
impartial treatment due to their HIV status and have been prevented from
accessing health care, getting jobs and attending school. Since the
coronavirus outbreak, news reports from a number of countries have
documented bias, racism, xenophobia, and discrimination against people of
Asian descent, as they are apparently linked to the origin of the Covid-19, especially
in the UK, US, Spain and Italy. President Donald Trump have fomented
anti-Chinese sentiment by referring to the coronavirus as the “Chinese Virus”.
Anti-immigrant leaders like Orban in Hungary and Salvini in Italy have seized
on the pandemic to stoke xenophobic sentiment. Governments should make sure
that patient confidentiality is protected even as authorities take steps to identify
those who may have been exposed to the virus. The UN High Commissioner for Human
Rights, Michelle Bachelet, had declared that “to effectively combat
the outbreak means ensuring everyone has access to treatment, and is not denied
health care because they cannot pay for it or because of stigma.” Another
undermined category is that of LGBT people. Furthermore, in the US, 28 million people
do not have medical insurance and nearly a third of the country have
difficulty affording payments for treatment even though they are insured. Many
people in the US report avoiding medical care or buying prescription
medication because of the costs and, in an epidemic, avoidance of medical care
not only harms those with the illness but also could lead to increased the spread
of the virus.
It’s essential to promote the right to water and sanitation,
as an integral part of the right to an adequate standard of living and the
right to health, as underlined by the UN Committee on Economic, Social and
Cultural Rights. WHO has noted that billions of people around the world do not
have access to safe drinking water, sanitation, and hygienic conditions, that must
be improved waste management practices in communities, homes, schools, markets,
and healthcare facilities, that more research is needed to understand
the risk of contaminated drinking water, environmental transmission, and that
wastewater operators must be trained and supported throughout the crisis.
According
to the UN, a number of the many countries affected by Covid-19 are already dealing
with emergency crises due to conflicts, natural disasters, or climate change
and many people rely on humanitarian aid to survive and it should be provided
as much support as possible.
Nowadays,
the number of weekly deads is remained more or less constant, roughly 7.000 per
day. Thus, globally the apparent lethality rate of the virus is fallen down
from about 1,4% to 0,3% in a month. This is the main reason why are spiralling
rumours about “the end of the pandemic” not by negationists or minimizers but
by reknown experts, such as Christopher Murray, director of the Institute for
Health Metrics and Evaluation (IHME), according which Covid-19 will
persist but the end of the pandemic is very close.
As in Italy the number of hospitalized people is tripled
since Dec 10 to Jan 20 from 7.000 to more than 21.000 and that of patients in
intensive care is more than doubled, from 8000 to 1700, is comprehensible why
many are wondering when this wave will start to decrease. Over two months,
according to a study conducted by ISPI in 46 countries out of a sample of 130 we
are already in a decreasing stage. 37 out of the total is already in an
advanced fall or completed: 28 of Subsaharian Africa countries but also
European ones: the UK, Ireland, Greece, Malta, Cyprus and Montenegro. USA,
Spain, Australia, Qatar and other 5 countries have already reached the peak of
Omicron infections and are now in their way down.
In addition to the countries on the wane there are also 6
climbing down or plateau. These States have reached a peak of cases even if not
registering net decline. In this small group there is Italy along with Croatia,
Switzerland, Turkey, Lebanon and Thailand. For other 24 countries seems already
started a slowing phase but has not been registered a peak of cases, above all
in Latin America, India and Israel, instead in the last 54 we are still in the
increasing phase of the epidemic curve including a majority of European
countries, in particular in the Middle and Eastern Europe, (eminently Germany),and
a consistent slash of Asiatic countries.
Italy is part of a little small group of countries in which
the Omicron curves are not crumbled down so rapidly. In the 88% of the cases
the epidemic Omicron curves have reached a peak in few weeks to suddenly
abruptely drop.
The fact that Italy, along with few others, is at the moment
an exception in comparison with the rest of the world can be interpreted in two
ways: a negative one according to is likely that Omicron has different
characterics in our country, perhaps because of different habits like social
distancing in times of very rapid increases in the number of cases; or a
positive one of the saturation of the national testing system. We are assisting
today to a moment in which curve of the new positive cases “hold on” that the
number of cases sufficiently drop down to reconnect to it and start once again
to rapidly go down. Up to now the Omicron wave in Italy is lasted a
little more than 3 weeks, thus in its course the phase of elevated cases is
lasting more in comparison with what is happened in many other European
countries. It’s therefore legitimate expecting that also in Italy it could be
possible to see a sharp downturn of cases very soon. Only then we could finally
draw conclusions and wonder if the end of the pandemic is close.
About the International trade in 2022 it must be remembered
that if last year started by an up-and-coming resumption of the exchanges,
after a negative 2020 because of the pandemic, these latest months the
optimistic sensation that had characterized the first part of 2021 has to come
to terms with some economic and geopolitical hurdles. The forecasts for next 12
months are overall positive, thanks to the global economy that should continue
its recovery, even if the prolongation of the sanitary emergency could oblige
to reconsider the estimations downward but the likely slowing down of the
growth rate, the persistence of dysfunctions
in the supply chains and the worsening of the geopolitical tension could
take back once again the renaissance of that multilateral spirit held on for
several years. After all, 2020 was not the expected annus horribilis: the flows of
the Foreign Direct Investments are plummeted of 40% because of the strong uncertainty
caused by the pandemics but the exchanges of goods shrinked just a little more
than 5% if compared with 2019, although lockdown and bottlenecks
along the Global Value Chains (GVCs). This has shown off that the
International trade system, strongly globalized, has overall handled even
exogenous shocks, unforeseen and strongly impacting as the pandemic is.
In 2021 the trade of goods was fine: according to l’UNCTAD they
increased of 23% if compared with 2020, and even 11% if compared with pre-Covid
levels. Not so good was the trade of services whose level is instead still
inferior to 2019, above all because of the negative performance of sectors,
such as tourism. Moreover, the last part of the year have been characterized by
a slow down of the recovery because of a physiological component due to a
normalization after the bounce back upwards, the beginning of the fourth
epidemic wave and the long lasting bottlenecks along the GVCs. These have been
overall the reasons that have been detrimental for the trade in combination
with the peak of the demand in Europe and US in Christmas time that provoked
prolongations in the delivery times and contributed to increase inflation. More
concrete results would have been expected for multilateral governance: the
nomination of Ngozi Okonjo-Iweala as new General Director of WTO, along with
the election of Joe Biden as President of the USA created strong
expectations about the solutions of the paralysis of the organization but the
results have not come out essentially due to the sudden spread of Omicron
variant. Moreover the Ministerial Conference that should have been held in
December has been postponed.
From the perspective of the flows of goods and services, is
legitimate expecting that the lately begun year is projected towards a
continuation of the growth, following the consolidation of the global economic recovery.
The International trade should expand of the 5,4% in 2022 (4,9% according to
the IMF), a data definitely positive because superior to the PIL global growth:
it should be therefore the confirmation that the economic crisis caused by the
pandemic has been overcome with a major momentum in comparison with the
financial 2008-9 crisis but it will take a little longer for the supply
chains to come back to efficiently work. The come back to a new normal
could be delayed by the persistent imposition of lockdowns by China in the
attempt to nip in the bud likely resurgence of the pandemic: the implementation
of the rigid “zero Covid policy” could be very expensive not only for Beijing,
at the moment grappling with the Olympic Games that will take place next February,
that is scrambling to contain the outbreak on the successful example of Tokyo, but also for the rest of
the world that still importantly depends from the exchanges with China. Once
for all, France is nowadays registering the highest number of cases in Europe,
notwithstanding just 10% of population is unvax. Moreover, it’s hoped that this will be the
golden moment for WTO come back to well perform and tackle a bunch of
priorities. It will be fundamental searching for an agreement on the management
of the intellectual property inherently to vaccines (liberalization of
trademarks, granting licenses, easing a production of vaccines on large scale),
matter that last year saw the emerging countries and advanced economies
divided. Furthermore, it would be fundamental taking steps onwards on
innovative topics for the International trade, as the l’e-commerce and
the so-called “environmental goods”, in order to prepare engaging negotiations
on the likely adoption of a carbon border adjustment mechanism, in a
stance that see EU and USA isolated, upsurging accusations of a protectionism
in disguise from the developing countries.
The fragmentation that characterized the last years on the
level of the International relations will determine very likely the situation
of the global exchanges even in 2022: it would be very hard that the
relationships between USA and China will reach a settle down of the controversy
that, from the merely economic matters (i.e., the increasing deficit of the
American trade balance), are stretching also to the political and strategic
ground. Furthermore, the mid-term elections in the USA and the taking place of
the XX Congress of the Chinese Communist Party could focus the attention of
Biden and Xi more on the domestic matters than on the international ones,
leading to a further stiffness of the respective stances in behalf of the
“adverseries”. The tip of the balance, represented by EU, is inclining now once
again Washington following the strenghtening of the transatlantic relations
thanks to the resolution of the Donald Trump duties war.
But must be considered also other dynamic initiatives, above
all on the Asia- Pacific region: the Rcep agreement in which China takes
part, recently become operative, and the African Continental Free Trade Area, AfCFTA, could
be an important asset in order to uphold an economic recovery in the continent.
The commercial regionalism will be a trend to keep tabs on, along with the
projects of nearshoring e reshoring that
could delay the globalization process and progressively redesign the geography
of the GVCs. There will be then new opportunities but also challenges for a
commercial system that will continue to be determined by the international
balance of power.
Internet sources:
Percorso
a ostacoli verso la normalità | ISPI (ispionline.it)
Omicron:
la fine (dell'ondata) è vicina? | ISPI (ispionline.it)
Human
Rights Dimensions of COVID-19 Response | Human Rights Watch (hrw.org)
WHO | World Health
Organization
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