PHE chief admits it's not 'absolutely clear' if Kent strain is more deadly

A senior doctor at Public Health England has said it is not 'absolutely clear' if a UK variant of the coronavirus is more deadly amid concerns over a 'scaremongering' Downing Street press conference.

PHE medical director Dr Yvonne Doyle said more work was needed to determine whether the Kent strain was more likely to take people's lives.

It comes after a SAGE warning revealing that scientists are only 50 per cent sure the variant could be more fatal was handed to ministers just hours before last night's official address to the public.

Ministers were only informed about the development yesterday morning after scientists on the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), a subcommittee of Sage, discussed the issue on Thursday.

The group concluded there was a 'realistic possibility' the variant resulted in an increased risk of death when compared with the original strain.

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Evidence for increased mortality remains thin – Nervtag papers reveal the term 'realistic possibility' is used when scientists are only 40 to 50 per cent confident something is true.

But the decision to reveal the new information just hours after learning of the development is a yardstick of how alarmed ministers are.

Some critics accused ministers of 'scaremongering' by announcing their fears that the Kent strain is more deadly at short notice without strong supporting evidence.

Chief Scientific adviser Sir Patrick Vallance said during the press conference evidence the strain is indeed more deadly is still 'weak'.

Earlier yesterday, SAGE said the R rate was between 0.8 and 1. It is down from last week, when it was between 1.2 and 1.3 and and cases are also still falling, down 27 per cent yesterday compared to last week with 40,261 new cases and 1,401 new deaths.

And even a 30-40 per cent increase in the risk of death from the new strain would result in a small increase in fatalities.

The SAGE paper states 'it should be noted that the absolute risk of death per infection remains low'. Chief Medical Officer Chris Whitty said that if the evidence is correct it would mean three to four more deaths per 1,000 cases.

The Covid Recovery Group of Tory backbenchers and business chiefs are  growing increasingly alarmed at suggestions lockdown could stretch well into summer despite Britain's vaccination programme  

Tory backbencher Craig Mackinlay told MailOnline some of the scientific warnings were reminiscent of Project Fear and every time there was hope of easing lockdown there was 'a new twist'.

'It seems to me we are now being held hostage to a zero Covid policy which is completely unattainable – or if you do attain it we are going to be in lockdown for an incredibly long period. That just cannot be,' he said.

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The SAGE paper was released last night after being handed to ministers on Thursday. It cited three studies of the risk of death associated with the new strain:

A London School of Hygiene and Tropical Medicine study that said the hazard of death within 28 days of test for the mutant strain compared with non-mutant strains was 1.35 times higher. This was based on a study of 2,583 deaths among 1.2 million tested individuals; An Imperial College London study of the Case Fatality Rate of the new mutant strain that found the risk of death was 1.36 times higher. This study used mathematical analysis to look at all cases of new variant but the total number was not revealed in the papers. The SAGE paper said its data is based on just 8% of the total deaths occurring during the study period; A University of Exeter study that suggested the risk of death could be 1.91 times higher. This study matched those with the new variant to those of a similar demographic. The SAGE paper did not reveals its sample size, but its analysis was again based on 8% of the total coronavirus deaths during the study period. The base data used by all three studies is based on just 8% of the total deaths occurring during the study period.  SAGE states 'the results of all studies may not be representative of the total population'; Some of the analysis might be comparing frail elderly people in nursing home outbreaks of the Kent variant, which is more transmissible, with healthier elderly people infected with other strains in the community; An increase in the severity of infection with the variant would likely lead to an increased risk of hospitalisation, which there is currently no evidence of in individuals suffering from the strain; Analysis has not identified an increased risk of death in hospitalised cases of the variant. 

The SAGE paper cited three studies of the Kent strain: A London School of Hygiene and Tropical Medicine study (left) based on 2,583 deaths that said the hazard of death within 28 days of test for the mutant strain compared with non-mutant strains was 35% times higher An Imperial College London study (centre) of the Case Fatality Rate of the new mutant strain that found the risk of death was 36% times higher A University of Exeter study (right) that suggested the risk of death could be 91% higher. Both the Exeter and the Imperial studies were based on just 8% of deaths during the study period

The SAGE paper cited three studies of the Kent strain: A London School of Hygiene and Tropical Medicine study (left) based on 2,583 deaths that said the hazard of death within 28 days of test for the mutant strain compared with non-mutant strains was 35% times higher An Imperial College London study (centre) of the Case Fatality Rate of the new mutant strain that found the risk of death was 36% times higher A University of Exeter study (right) that suggested the risk of death could be 91% higher. Both the Exeter and the Imperial studies were based on just 8% of deaths during the study period

Nervtag concluded there was a 'realistic possibility' - detailed on the yardstick above as a probability between 40 and 50 per cent - that the variant resulted in an increased risk of death when compared with the original strain

Nervtag concluded there was a 'realistic possibility' - detailed on the yardstick above as a probability between 40 and 50 per cent - that the variant resulted in an increased risk of death when compared with the original strain

PHE's Dr Yvonne Doyle said it is still not 'absolutely clear' the new variant coronavirus which emerged in the UK is more deadly than the original strain. She said more work was needed to determine whether it was true.

She told the Today programme: 'There are several investigations going on at the moment. It is not absolutely clear that that will be the case. It is too early to say.

'There is some evidence, but it is very early evidence. It is small numbers of cases and it is far too early to say this will actually happen.'

Her comments follow fellow PHE doctor Susan Hopkins, who cautioned people from reading too much into the findings and suggested the evidence was still murky.

She added: 'There is evidence from some but not all data sources which suggests that the variant of concern which was first detected in the UK may lead to a higher risk of death than the non-variant. Evidence on this variant is still emerging and more work is underway to fully understand how it behaves.'

Kit Yates, a mathematical biologist at the University of Bath, slammed the Government for causing confusion and panic about the variant. He tweeted: 'I really dislike the way the news about the increased lethality of B1.1.7 was leaked out and then discussed in a press briefing. Where is the data? We want to be able to scrutinise it and to understand the detail, not just the summary.'

However, the long time lag from infection to hospitalisation means there isn't a huge amount of data available on the variant, with Nervtag saying analyses will become more definitive over the coming weeks. 

One theory as to why it may be more lethal, however, is the stickiness of the mutation and the way it gets into cells and replicates - a behaviour that also makes the variant more easy to transmit, the Telegraph reports. 

The Prime Minister told the Downing Street briefing: 'We've been informed today that in addition to spreading more quickly it also now appears that there is some evidence that the new variant – first identified in London and the Kent – may be associated with a higher degree of mortality.'

Sir Patrick said that even now the science is at an early stage.

'These data are currently uncertain and we don't have a very good estimate of the precise nature or indeed whether it is an overall increase, but it looks like it is,' he added.

He said for men in their 60s, the average risk was that for 1,000 who got infected, roughly ten would be expected to die, but with the new variant it might be 13 or 14. That equates to an increased relative risk of 30 to 40 per cent. 

Sir Patrick noted that estimates vary – and stressed some concluded there was no additional risk – but said his best guess was that deaths increase by about 30 to 40 per cent.

He added: 'The death rate is awful and it's going to stay, I'm afraid, high for a little while before it starts coming down – that was always what was predicted from the shape of this.'

Nervtag, with Professor Peter Horby of Oxford University as chairman, concluded that death rates have not increased among those in hospital.

But evidence suggests it raises the risk of being hospitalised in the first place, driving up the overall death figures. 

It comes as the public will be faced with a set of hard-hitting new adverts warning people to stay home as part of a change of tack in the bid to ensure people obey lockdown rules.

With close-ups of frontline medical practitioners and Covid-19 patients' faces, the advert will ask: 'Can you look them in the eyes and tell them you're helping by staying at home?'

The public will be faced with a set of hard-hitting new adverts warning people to stay home as part of a change of tack in the bid to ensure people obey lockdown rules

How deadly is the Kent Covid variant? Confusion mounts as scientists offer wildly different estimates 

There was confusion tonight about how deadly the Kent coronavirus variant really is after 10 SAGE studies came to wildly different conclusions about its lethality and the World Health Organization said it still hadn't seen any convincing data.

Boris Johnson and his science chiefs tonight made the claim that the strain — called B.1.1.7 — could be 30 per cent more deadly than older versions of the virus without presenting any evidence to back up the terrifying development.  

The announcement came after 10 studies submitted to SAGE overwhelmingly suggested that the strain was more lethal than past variants. But there are question marks over the findings because the estimates varied vastly and one study even found the strain was less deadly than the older version.

The London School of Hygiene and Tropical Medicine estimated the risk of death from the new variant could be 1.35 times greater, Imperial College London said it was between 1.29 and 1.36 times, Exeter University found it may be 1.91 and Public Health England said it could be as high as 1.6. But there are further questions over the reliablity of the data because the research was only based on a few hundreds deaths.  

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Despite acknowledging that cases are falling across the UK, the Prime Minister – accompanied by Sir Patrick Vallance and Professor Chris Whitty – decided to hone in on early analysis by a sub-group of SAGE that suggested the highly-infectious Kent mutation was more lethal.

But the trio resorted to explaining the risk out loud during tonight's Downing Street press conference, failing to offer any actual proof to back their terrifying claim. World Health Organization bosses claimed they had seen no evidence on the variant's lethality during a simultaneous briefing.  

Dr Mike Ryan - head of the WHO emergency programme - urged people to 'remain calm around the issues of these variants'.

He added: 'There is a big difference between the lethality of a virus, how many people on average a virus kills, versus the morality of the virus. If I have one million people infected and my lethality is 1 per cent, or two million people infected with a lethality of 1 per cent, twice as many people will die.

'We are not seeing so far, but we will wait to see, that the disease is more lethal. We are seeing that... increasing incidence leads to increasing mortality. If your cases get out of control, your deaths will get out of control as your health system is overwhelmed,' Dr Ryan said.

Professor Whitty, England's chief medical officer, claimed the findings showed a 60-year-old man faced a 1.3 per cent risk of dying of the Kent Covid variant, compared to the usual 1 per cent. But a 30 per cent increase in the risk of death means 13 out of 1,000 men in their 60s will succumb to the illness, instead of 10. Professor Whitty himself admitted the evidence was 'not yet strong'.

Data on the lethality of the Kent variant, which has been spotted in 60 countries around the world, was first leaked to the press ahead of Mr Johnson's TV appearance. ITV's political editor Robert Peston was told by Professor Neil Ferguson that there was a 'realistic possibility' that the variant was deadlier.

No10 insiders dismissed claims 'Professor Lockdown' – the Imperial College London epidemiologist whose grim modelling that hundreds of thousands of Britons could die without action spooked ministers into lockdown last March – had 'bounced' the Government into revealing NERVTAG's new evidence.

The doom-mongering came despite an array of statistics that showed the second wave has peaked already and may finally be coming under control. SAGE yesterday claimed Britain's R rate has fallen below the crucial level of one and separate surveillance studies estimated daily cases have halved in a fortnight.

Department of Health figures mirrored the trend, with infections falling by 30 per cent week-on-week as health chiefs announced another 40,261 cases. Officials also posted 1,401 deaths, up just 9.5 per cent on last Friday. But experts warned the fatality toll will continue to rise for at least another week because of how long it takes for infected patients to become severely ill.

Defying mounting pressure to commit to easing the current measures, Mr Johnson warned yesterday that the NHS is still under huge pressure and the curbs will only be lifted when it is 'safe'. The PM even set the scene for tougher restrictions tonight, warning: 'We may need to go further to protect our borders.' Nicola Sturgeon warned Scotland that life may not be 'back to normal' by the summer, in another sign that the UK won't be freed from the draconian restrictions from mid-February.

The 70-strong Covid Recovery Group of Conservative MPs is urging the government to start lifting the lockdown no later than March 8 - when vaccines given to the most vulnerable groups should have taken effect. But No10's refusal to give an exact day for when lockdown will end may have been fuelled by the new variant findings.

The variant has already been spotted in 60 countries, including the US, Australia, India, China and Saudi Arabia. But the Government's top scientific advisers believe the current crop of vaccines will work against the variant - but may be less effective against other South African and Brazilian mutations.

MailOnline also revealed that Health Secretary Matt Hancock claimed vaccines may be 50 per cent less effective on the South African variant. He warned allowing the variant to become the dominant strain in the UK could ruin Britain's vaccination drive - which yesterday saw a record 400,00 doses administered in one day.

And grim figures laying bare the economically-crippling side of lockdown revealed business activity has fallen even more than expected this month, leaving the UK looking down the barrel of a double dip recession. Number 10 borrowed more than £34billion in December - the third highest monthly total ever - as it scrambles to keep millions of jobs and stricken firms afloat while tax revenues dwindle. 

In a dramatic sign that the outbreak could be flattening out, SAGE said the R rate was between 0.8 and 1. That is down sharply from last week, when it was between 1.2 and 1.3

In a dramatic sign that the outbreak could be flattening out, SAGE said the R rate was between 0.8 and 1. That is down sharply from last week, when it was between 1.2 and 1.3

Worrying strains around the world: Since the Covid pandemic began there have been at least six new stains which appear more infectious and have mutations that open the door to vaccine resistance

Worrying strains around the world: Since the Covid pandemic began there have been at least six new stains which appear more infectious and have mutations that open the door to vaccine resistance 

The ONS report today said the number of people likely to test positive for coronavirus came down from 1.122million on January 2 to 1.023million on January 16

The ONS report today said the number of people likely to test positive for coronavirus came down from 1.122million on January 2 to 1.023million on January 16

Passengers wait at  Heathrow Airport today as ministers mull even tighter rules

Passengers wait at  Heathrow Airport today as ministers mull even tighter rules

The number of people developing Covid-19 every day appears to have halved in a fortnight from 70,000 on January 8 to 34,000 today, according to the Covid Symptom Study, which uses self-reported symptoms through a mobile app used by around a million people

The number of people developing Covid-19 every day appears to have halved in a fortnight from 70,000 on January 8 to 34,000 today, according to the Covid Symptom Study, which uses self-reported symptoms through a mobile app used by around a million people

Grim figures published today showed government borrowing soared to £34.1billion in December - the third highest monthly figure on record - amid growing fears about the UK's debt mountain

Grim figures published today showed government borrowing soared to £34.1billion in December - the third highest monthly figure on record - amid growing fears about the UK's debt mountain

Closely-watched PMI data for the private sector showed a reading of 40.6 so far in January - with anything blow 50 pointing to a contraction

Closely-watched PMI data for the private sector showed a reading of 40.6 so far in January - with anything blow 50 pointing to a contraction

Has the UK passed the worst of second peak? 

The UK's R rate has dropped below one in a dramatic sign that the peak could have been passed.

Scientists said the level was down to between 0.8 and 1, compared to 1.2 and 1.3. 

The number represents how many people an infected individual passes the disease on to, and anything below one means the outbreak is shrinking. 

Meanwhile, the Office for National Statistics said the total number of people with coronavirus dropped last week - but there were still more than a million people infected. 

And the symptom-tracking Covid Symptom Study estimates that the number of people developing symptoms each day has halved in a fortnight, down to 34,000 a day from 70,000 on January 8, while official death counts show fatalities appear to be declining in London.

Numbers of people testing positive through NHS Test and Trace have also tumbled for twelve days in a row, with the daily average tumbling from 60,000 on January 10 to 40,000 yesterday. And an array of other data also suggests the epidemic is coming under control, with Public Health England figures showing positive test rates are down in all regions and age groups.

London's average daily death count fell from 169 to 163 in the most recent four days of data and could be set to fall further as official statistics remain lower than they were at the start of this month. 

Professor Tim Spector, a King's College London epidemiologist, said today that the 'signs are hopeful we're on our way out of this situation'.

But he cautioned the virus is still widespread all over the country, with huge numbers of people infected. NHS hospitals are under immense strain and intensive care wards twice as busy as last year, despite thousands of extra beds. 

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No10 insiders flatly dismissed the idea that Prof Ferguson had been told to brief Peston – and said the suggestion he 'bounced' them into the announcement was 'rubbish'.

Sources suggested Prof Ferguson is on Nervtag and knew the announcement was going to be made.

The Nervtag report with the evidence on lethality is understood to have landed on the PM's desk this morning, and he was given a 'detailed briefing' on the content by Patrick Vallance.

'The PM has always been very clear that we have to be transparent with people about the information we had on the variants,' one source said. 'The idea that we could have done the press conference without giving the public the information… would have been the wrong thing to do.'

Tory backbencher Craig Mackinlay told MailOnline some of the scientific warnings were reminiscent of Project Fear and every time there was hope of easing lockdown there was 'a new twist'.

'It seems to me we are now being held hostage to a zero Covid policy which is completely unattainable – or if you do attain it we are going to be in lockdown for an incredibly long period. That just cannot be,' he said.

'The next thing will be 'oh dear, this new variant from Timbuktu is not responsive to the vaccine', or 'the vaccine doesn't work against it'.'

The South Thanet MP, a member of the CRG, went on: 'Because Covid has been with us now for a year it is not at all surprising if the evolution or mutation is going to be towards a different type of which these vaccines can't work against.

'That doesn't matter as such because you then need to formulate a new vaccine. But we are just adding more delay.'

Matt Hancock claims South African variant may make vaccines 50% less effective 

The mutant South African coronavirus variant may make the current crop of vaccines 50 per cent less effective, Matt Hancock has sensationally claimed.

In footage obtained by MailOnline, the Health Secretary warned allowing the variant to become the dominant strain in the UK could ruin Britain's vaccination drive and send the country 'back to square one'.

Mr Hancock is understood to have made the astonishing comments during an online webinar with travel agents this week, to the shock of everyone on the call.

He said there was 'evidence in the public domain' that the South African variant reduces vaccine efficacy by 'about 50 per cent'.  Although he followed up by saying: 'We are not sure of this data so I wouldn't say this in public.'

The South African strain — called B.1.351 — has key mutations on its spike protein which scientists fear might make it difficult for the immune system to recognise. 

These alterations open the door to it being resistant to vaccines, which train the body to spot the spike protein, or natural immunity from previous infection.  

It comes after South African scientists found that 48 per cent of blood samples from people who had been infected in the past did not show an immune response to the new variant - raising red flags about possible vaccine resistance. 

The South African version is also though to be at least 60 per cent more infectious than regular Covid and even more transmissible than the Kent variant that ripped through the UK and plunged England into its third national lockdown. 

The South African strain has already been spotted in the UK 73 times, according to the Covid-19 Genomics Consortium UK (COG-UK). Although it is likely to be far more widespread because COG-UK only analyses 10 per cent of random positive samples. 

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Mr Mackinlay said: 'There has got to be a time when you have done the elderly, you've done the vulnerable… but the words I seem to be hearing is that this lockdown has got no end to it, because there always seems to be a new twist and turn – a reason why it should continue.'

He said: 'It does seem to me that scientists are in control of this. I know you wouldn't put an economist in charge of vaccine control, but you wouldn't put these scientists in charge of the economy.'

Speaking at this evening's Downing Street press conference, Mr Johnson said: 'We've been informed today that in addition to spreading more quickly it also now appears that there is some evidence that the new variant, the variant that was first identified in London and the South East, may be associated with a higher degree of mortality.'

And the PM handed over to his chief scientific adviser, Sir Patrick Vallance, who added: 'If you took a man in their 60s, the average risk is that for a thousand people who got infected, roughly 10 would be expected to, unfortunately, die… with the new variant, for a thousand people infected, roughly 13 or 14 people might be expected to die.

'That's the sort of change for that sort of age group.'

He added: 'I want to stress that there's a lot of uncertainty around these numbers and we need more work to get a precise handle on it, but it obviously is of concern that this has an increase in mortality as well as an increase in transmissibility, as it appears of today.'

The estimates for R and the growth rate are provided by the Scientific Pandemic Influenza Group on Modelling (Spi-M), a sub-group of Sage.

The growth rate, which estimates how quickly the number of infections is changing day by day, is between minus 4 per cent and minus 1 per cent for the UK as a whole.

It means the number of new infections is shrinking by between 1 per cent and 4 per cent every day.

Scientists advising the Government said that all regions of England have seen decreases in the R number and growth rate estimates compared with last week, and R is below or around 1 in every region.

However, they warned that despite the reductions, case levels 'remain dangerously high and we must remain vigilant to keep this virus under control, to protect the NHS and save lives'.

Sage scientists said: 'Cases remain dangerously high and we must remain vigilant to keep this virus under control, to protect the NHS and save lives. 

'It is essential that everyone continues to stay at home, whether they have had the vaccine or not. 

'We all need to play our part, and if everyone continues to follow the rules, we can expect to drive down the R number across the country.'

What do we know about the Kent variant? 

Name: B.1.1.7, formerly VUI-202012/01

Where did it come from? The variant was first found in Kent and can be traced back to September 2020. Scientists noticed that it was spreading in November  and it was revealed to the public in December.

What makes it new? The variant, which is a version of the SARS-CoV-2 coronavirus that causes Covid-19, has a series of mutations that change the shape of the spike protein on its outside. The main one is known as N501Y. This appears to make it better able to stick to the cells inside the body and makes it more likely to cause infection and faster to spread.

How did that happen? Viruses, particularly ones spreading so fast and in such huge numbers, mutate all the time. To reproduce they basically force living cells to copy and paste the viral genetic code, and this can contain errors that lead to slightly different versions of the virus. Often these mutations make no difference but, if they make the virus stronger, they can stick around for further generations and become the norm. 

What can we do about it? Nothing much. People who catch the virus won't know which type they have, and it will still cause the same symptoms and illness. Officials can try to contain it by locking down the areas where it is most prevalent, but if it is stronger than other versions of the virus it will eventually spread everywhere and become dominant as long as people continue to travel. 

Will it make Covid-19 worse? Scientists aren't sure whether it affects the severity of the disease. Because it is so new, no official data yet exists to track if it is more deadly. If it is, it may be the first of thousands of mutations since the start of the pandemic to increase the risk of death.

Will our vaccines still work? Yes, it's very likely they will. Scientists on SAGE are fairly sure the mutations the Kent variant carries do not significantly affect how well the immune system can handle it. People who have a vaccine modelled on an older version of the virus, or who have been infected with Covid-19 before, are likely to be immune to it. This is because the main mutations are only on one part of the spike protein, whereas the immune system is able to target various other parts of the virus. 

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Professor Sir David Spiegelhalter, from the maths faculty at the University of Cambridge, said the drop in R was 'very encouraging news'.

He said the decline in positive cases has been slow but cases are 'nearly half what they were three weeks ago, which is enormously hopeful'.

Sir David told the BBC that, by next month, the UK will start seeing the benefits of the vaccine rollout.

But he also gave a stark vision of the competing concerns that the government is wrestling with. 

'The one thing I can be absolutely confident about is that, by this time next month, there is going to be the mother of all argument,' he said.

'Because it's quite feasible that deaths will have come down considerably, infections should have come down considerably, hospitalisations and ICU will still be under a lot of pressure.

'There will be enormous pressure to loosen things up.

'Loosening it up will inevitably lead to an increase in cases, a resurgence of the pandemic among younger groups, and we can see then that does seep through into hospitalisations.

'So there's going to be a real battle going on.'

Hopes have been fuelled that the UK might have passed the worst of the second wave, with the Office for National Statistics saying the total number of people with coronavirus dropped last week - but there were still more than a million people infected.

And the symptom-tracking Covid Symptom Study estimates that the number of people developing symptoms each day has halved in a fortnight, down to 34,000 a day from 70,000 on January 8, and that the R rate of the virus in the UK is just 0.8, while official death counts show fatalities appear to be declining in London.

Numbers of people testing positive through NHS Test and Trace have also tumbled for twelve days in a row, with the daily average tumbling from 60,000 on January 10 to 40,000 yesterday, and Public Health England figures show positive test rates were down in all regions and age groups last week.

Professor Tim Spector, a King's College London epidemiologist, said today that the 'signs are hopeful we're on our way out of this situation'.

London's average daily death count fell from 169 to 163 in the most recent four days of data and could be set to fall further as official statistics remain lower than they were at the start of this month.

But he cautioned the virus is still widespread all over the country, with huge numbers of people infected. NHS hospitals are under immense strain and intensive care wards twice as busy as last year, despite thousands of extra beds.

Kent variant timeline  

September 20 - Variant emerges

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