Source · Select Committees · Health and Social Care Committee
Third Report - Coronavirus: lessons learned to date
Health and Social Care Committee
HC 92
Published 12 October 2021
Government response
Government Response to the Health and Social Care Committee and Science and Technology Committee joint report: Coronavirus: lessons learned to date · published 16 Jun 2022
Recommendations & Conclusions
58
Conclusion
Accepted in Part
The UK has established procedures and structures to prepare for the nation’s major future risks,...
Conclusion
The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease …
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Government Response Summary
The government partially accepts the observation, committing to improve the NSRA methodology through an external review by RAEng and exploring ways to increase accessibility for external experts and diversify challenge in risk assessment.
Department for Science, Innovation and Technology
Department of Health and Social Care
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59
Conclusion
Accepted in Part
Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did...
Conclusion
Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures …
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Government Response Summary
The government partially accepts, acknowledging that lessons from previous pandemic exercises should have been better identified and implemented, and commits to improving future preparedness by developing a new pandemic strategy, investing in R&D, and strengthening international partnerships.
Department for Science, Innovation and Technology
Department of Health and Social Care
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64
Recommendation
Accepted in Part
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider...
Recommendation
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should …
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Government Response Summary
The government partially accepts the recommendation, agreeing on learning from diverse international expertise and detailing how the National Risk Register methodology is being reviewed by the Royal Academy of Engineering to increase external challenge and accessibility.
Department for Science, Innovation and Technology
Department of Health and Social Care
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66
Recommendation
Accepted in Part
The Government should ensure comprehensive plans are made for future risks and emergencies.
Recommendation
The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able …
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Government Response Summary
The government partially accepts, agreeing on positive learning and engagement with international partners and disciplines, and is considering ways to increase external expert accessibility and challenge in the National Risk Assessment process.
Department for Science, Innovation and Technology
Department of Health and Social Care
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67
Recommendation
Accepted in Part
The resourcing and capabilities of the Civil Contingencies Secretariat should be improved.
Recommendation
The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details …
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Government Response Summary
The government partially accepts, highlighting ongoing engagement with international practices and efforts to improve the National Risk Assessment (NSRA) methodology and external challenge, though it does not explicitly commit to increasing CCS resourcing or reporting specific stress test results.
Department for Science, Innovation and Technology
Department of Health and Social Care
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78
Recommendation
Accepted in Part
As a result, decisions on lockdowns and social distancing during the early weeks of the...
Recommendation
As a result, decisions on lockdowns and social distancing during the early weeks of the pandemic—and the advice that led to them—rank as one of the most important public health failures the United Kingdom has ever experienced. This happened despite …
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Government Response Summary
The government, without directly acknowledging the "public health failures" conclusion, commits to reforming SAGE in the future to include more diverse and international representation, aiming to improve learning and preparedness.
Department for Science, Innovation and Technology
Department of Health and Social Care
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112
Conclusion
Accepted in Part
We have referred to early evidence from Dr Richard Horton, the Editor of the Lancet,...
Conclusion
We have referred to early evidence from Dr Richard Horton, the Editor of the Lancet, who was concerned that SAGE in its early months was taking insufficient account of international perspectives. At the time he gave his evidence, Dr Horton, …
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Government Response Summary
The government partially accepts, stating it agrees on the importance of learning and engagement with other countries and is considering ways to increase external expert access and diversity of challenge, especially for the National Risk Assessment.
Department for Science, Innovation and Technology
Department of Health and Social Care
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122
Conclusion
Accepted in Part
There has also been a lack of transparency over the scientific case for particular interventions.
Conclusion
There has also been a lack of transparency over the scientific case for particular interventions. After the initial, broad lockdown had been lifted specific prohibitions were introduced in later months. Such restrictions were typically justified by Ministers as 186 Q164 …
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Government Response Summary
The government partially accepts the recommendation, stating it has published scientific evidence and advice, including SAGE papers, within 10 days of meetings, arguing this strikes a reasonable balance for transparency. They commit to continuing to publish advice and note this will be considered by the COVID-19 Public Inquiry.
Department for Science, Innovation and Technology
Department of Health and Social Care
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123
Conclusion
Accepted in Part
Scientific advice was cited in justification for increasingly fine-grained restrictions— with which some of the...
Conclusion
Scientific advice was cited in justification for increasingly fine-grained restrictions— with which some of the Government’s scientific advisers were often visibly uncomfortable. When Sir Patrick Vallance, the Government Chief Scientific Adviser, was asked on 3 November why children’s outdoor sport …
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Government Response Summary
The government partially accepts the recommendation, stating it has published scientific evidence and advice, including SAGE papers, within 10 days of meetings, arguing this strikes a reasonable balance for transparency. They commit to continuing to publish advice and note this will be considered by the COVID-19 Public Inquiry.
Department for Science, Innovation and Technology
Department of Health and Social Care
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135
Conclusion
Accepted in Part
Leading virologists who gave evidence to the Science and Technology Committee on 23 December said...
Conclusion
Leading virologists who gave evidence to the Science and Technology Committee on 23 December said that the Government had acted quickly in response to the new evidence. For example, Professor Peter Horby, Chair of the New and Emerging Respiratory Virus …
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Government Response Summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Department for Science, Innovation and Technology
Department of Health and Social Care
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137
Conclusion
Accepted in Part
Due to the much higher transmissibility of the Alpha variant, in the absence of a...
Conclusion
Due to the much higher transmissibility of the Alpha variant, in the absence of a test, trace and isolate system capable of arresting the spread of the virus, a circuit-breaker in September and an earlier, more stringent lockdown, would likely …
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Government Response Summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Department for Science, Innovation and Technology
Department of Health and Social Care
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156
Conclusion
Accepted in Part
The second wave of covid infections, hospitalisations and deaths during the autumn and winter of...
Conclusion
The second wave of covid infections, hospitalisations and deaths during the autumn and winter of 2020/21 was significantly driven by the emergence of a new variant, known as the Kent or Alpha variant. It is likely that a “circuit break” …
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Government Response Summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Department for Science, Innovation and Technology
Department of Health and Social Care
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171
Conclusion
Accepted in Part
As a result the UK squandered a leading position in diagnostics and converted it into...
Conclusion
As a result the UK squandered a leading position in diagnostics and converted it into one of permanent crisis. On 12 March, testing for covid-19 other than in hospitals was halted. In part this was because of the inadequacy of …
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Government Response Summary
The government partially accepts, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
Department for Science, Innovation and Technology
Department of Health and Social Care
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174
Conclusion
Accepted in Part
For a country with a world-class expertise in data analysis, to face the biggest health...
Conclusion
For a country with a world-class expertise in data analysis, to face the biggest health crisis in a hundred years with virtually no data to analyse was an almost unimaginable setback. The reasons for this initial inadequacy to translate testing …
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Government Response Summary
The government partially accepts, agreeing on the importance of learning and international engagement. It states the Cabinet Office is reviewing the NSRA methodology with the Royal Academy of Engineering and considering ways to increase external expert accessibility and challenge.
Department for Science, Innovation and Technology
Department of Health and Social Care
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176
Conclusion
Accepted in Part
It is clear that there should have been more challenge to Public Health England to...
Conclusion
It is clear that there should have been more challenge to Public Health England to increase testing capacity from the outset by Ministers, scientific advisers and the Department of Health and Social Care rather than accepting it as a fait …
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Government Response Summary
The government partially accepts the recommendation, agreeing on the importance of learning and engagement, and highlighting efforts to improve expert challenge to the National Security Risk Assessment (NSRA) methodology, including an external review by the Royal Academy of Engineering.
Department for Science, Innovation and Technology
Department of Health and Social Care
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178
Conclusion
Accepted in Part
The lack of data resulting from suspending community testing also affected the UK’s understanding of...
Conclusion
The lack of data resulting from suspending community testing also affected the UK’s understanding of the disease at that critical time. Professor Neil Ferguson explained to the Science and Technology Committee in June 2020 that low testing capacity meant it …
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Government Response Summary
The government partially accepts, agreeing on positive learning and engagement with other countries. It details ongoing reviews of the National Security Risk Assessment (NSRA) methodology, including commissioning an external group and considering ways to increase external expert accessibility.
Department for Science, Innovation and Technology
Department of Health and Social Care
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1
Recommendation
Accepted in Part
Para 58
The UK has established procedures and structures to prepare for the nation’s major future risks,...
Recommendation
The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease …
Read more
Government Response Summary
The government partially accepts the implicit recommendation, agreeing to learn from and engage with other countries. It details ongoing improvements to the National Risk Assessment (NSRA) methodology, including increasing expert challenge and international learning, to better prepare for a broader range of risks.
Department for Science, Innovation and Technology
Department of Health and Social Care
View Details →
2
Conclusion
Accepted in Part
Para 59
Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did...
Conclusion
Previous exercises to test the national response capability, namely Exercises Cygnus and Winter Willow, did not squarely address a disease with the characteristics of covid-19. Nevertheless, some useful lessons were learned and applied, such as the drafting of legislative measures …
Read more
Government Response Summary
The government partially accepts, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
Department for Science, Innovation and Technology
Department of Health and Social Care
View Details →
5
Conclusion
Accepted in Part
Para 62
Protocols to share data between public bodies involved in the response were too slow to...
Conclusion
Protocols to share data between public bodies involved in the response were too slow to establish and to become functional. This was especially true in the data flows from national to local government.
Government Response Summary
The government partially accepts the observation, acknowledging that more needs to be done to improve data sharing and interoperability. It cites numerous ongoing programs and initiatives, including the Data Standards Authority and the NHS Data Sharing Service, and commits to making further progress in this area.
Department for Science, Innovation and Technology
Department of Health and Social Care
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7
Recommendation
Accepted in Part
Para 64
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider...
Recommendation
A greater diversity of expertise and challenge—including from practitioners from other countries and a wider range of disciplines—should be included in the framing of the National Risk Register and the plans that emanate from it. Plans for the future should …
Read more
Government Response Summary
The government partially accepts the recommendation, agreeing on the importance of diverse expertise and international learning, which it says it already does flexibly. It highlights commissioning an external review of the National Risk Assessment (NSRA) methodology and is considering ways to increase external expert accessibility and challenge.
Department for Science, Innovation and Technology
Department of Health and Social Care
View Details →
10
Recommendation
Accepted in Part
Para 67
The resourcing and capabilities of the Civil Contingencies Secretariat should be improved.
Recommendation
The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details …
Read more
Government Response Summary
The government partially accepts the recommendation, stating improvements to CCS resourcing are being considered following a review. It claims CCS already conducts stress tests and is considering how to report exercise outcomes in the annual report, balanced against security.
Department for Science, Innovation and Technology
Department of Health and Social Care
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13
Recommendation
Accepted in Part
Para 70
The Government and the NHS should consider establishing a volunteer reserve database so that volunteers...
Recommendation
The Government and the NHS should consider establishing a volunteer reserve database so that volunteers who have had appropriate checks can be rapidly called up and deployed in an emergency rather than needing to begin from scratch.
Government Response Summary
The government partially accepts the recommendation, highlighting existing partnerships with St John Ambulance and Royal Voluntary Service for volunteer deployment in specific programmes like vaccinations, and states NHS England is continuing to consider improvements to the volunteer model.
Department for Science, Innovation and Technology
Department of Health and Social Care
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21
Conclusion
Accepted in Part
Para 155
Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence.
Conclusion
Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence. Yet Ministers and other advisers reported that they felt it difficult to challenge the views of their official scientific advisers. Those in Government have a duty …
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Government Response Summary
The government partially accepts the recommendation, agreeing on learning from diverse international expertise and detailing how the National Risk Register methodology is being reviewed by the Royal Academy of Engineering to improve expert challenge and accessibility.
Department for Science, Innovation and Technology
Department of Health and Social Care
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25
Recommendation
Accepted in Part
Para 159
In future an approach of greater questioning and challenge should characterise the development of policy.
Recommendation
In future an approach of greater questioning and challenge should characterise the development of policy. Ministers should have the confidence to follow a scientific approach themselves—being prepared to take a more robust approach to questioning and challenging the advice given. …
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Government Response Summary
The government partially accepts, agreeing to learn from other countries and disciplines. It describes how the Cabinet Office is reviewing the NSRA methodology to increase expert and diverse challenge during and after the process.
Department for Science, Innovation and Technology
Department of Health and Social Care
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26
Recommendation
Accepted in Part
In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK...
Recommendation
In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, …
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Government Response Summary
The government partially accepts the recommendation, agreeing to learn from international engagement and committing to review the National Risk Assessment (NSRA) methodology to increase external expert challenge and diversity.
Department for Science, Innovation and Technology
Department of Health and Social Care
View Details →
28
Recommendation
Accepted in Part
The Government, via the World Health Organisation, should make the case for an international standard...
Recommendation
The Government, via the World Health Organisation, should make the case for an international standard of reporting covid-19 deaths and a framework for reporting disease related deaths for future pandemics. (Paragraph 162) Testing and contact tracing
Government Response Summary
The government partially accepts, agreeing on positive learning and engagement with other countries, but the response largely details ongoing reviews of the National Security Risk Assessment (NSRA) methodology and increasing external expert accessibility, rather than committing to making the case for international death reporting standards via WHO.
Department for Science, Innovation and Technology
Department of Health and Social Care
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30
Conclusion
Accepted in Part
Para 233
Testing capacity was treated too much as a parameter rather than a variable that could...
Conclusion
Testing capacity was treated too much as a parameter rather than a variable that could be changed by the Department of Health and Social Care and scientific advisers. What was being achieved in other countries, particularly East Asia, appeared to …
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Government Response Summary
The government partially accepts the conclusion, agreeing on the importance of learning from other countries and enhancing challenge. It notes an ongoing review by the Royal Academy of Engineering of the National Security Risk Assessment methodology, and the Cabinet Office is considering ways to increase external expert input.
Department for Science, Innovation and Technology
Department of Health and Social Care
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31
Conclusion
Accepted in Part
Para 234
The resulting requirement to abandon testing people in the community during the critical early period...
Conclusion
The resulting requirement to abandon testing people in the community during the critical early period of the pandemic cost many lives for a number of reasons including because: a) many asymptomatic carriers were not tested and therefore identified and asked …
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Government Response Summary
The government partially accepts the committee's findings, agreeing on the vital need for operational competence to rapidly scale up test, trace, and isolate programmes in future emergencies. It highlights UKHSA's current surge capacity (700-800k PCR, 2.5m LFD daily) and commits to working with local authorities and maintaining local relationships to build resilient and scalable infrastructure.
Department for Science, Innovation and Technology
Department of Health and Social Care
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34
Conclusion
Accepted in Part
Para 237
We recognise that the effectiveness of test and trace in reducing transmission is likely to...
Conclusion
We recognise that the effectiveness of test and trace in reducing transmission is likely to be reduced when the prevalence of the virus is high, as highlighted by Professor Whitty and others, but it is clear from the latest data …
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Government Response Summary
The government partially accepts the recommendation, agreeing on the vital need for operational competence to scale up test and trace. It details UKHSA's current surge capacity (700-800k PCR, 2.5m LFD daily) and commits to working with local authorities and maintaining local relationships to build resilient and scalable infrastructure for future emergencies.
Department for Science, Innovation and Technology
Department of Health and Social Care
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50
Recommendation
Accepted in Part
Para 295
We endorse the Health and Social Care Committee’s call for additional resources to be directed...
Recommendation
We endorse the Health and Social Care Committee’s call for additional resources to be directed to social care. That Committee has made the case for an increase of £7 billion a year by 2023/4. We note that despite the Government’s …
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Government Response Summary
The government partially accepts, detailing a commitment of £5.4 billion over three years for social care reforms and an additional £1.7 billion for the charging system, with more details to be announced later.
Department for Science, Innovation and Technology
Department of Health and Social Care
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54
Conclusion
Accepted in Part
Para 332
Staff from Black, Asian and minority ethnic backgrounds are crucial to the NHS and care...
Conclusion
Staff from Black, Asian and minority ethnic backgrounds are crucial to the NHS and care sectors. The covid-19 pandemic has brought the experiences of these staff into sharp focus. It is telling that the first ten NHS staff to die …
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Government Response Summary
The government accepts the recommendation to develop a strategy for securing appropriate PPE for all NHS and care staff, including those from BAME backgrounds, acknowledging the committee's concerns about inequalities. It highlights existing efforts to ensure good fit-test performance for masks and engagement with BAME staff, while asserting that fit-test rates are not generally low.
Department for Science, Innovation and Technology
Department of Health and Social Care
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57
Recommendation
Accepted in Part
Para 335
The Government should ensure its ‘levelling up’ agenda includes specific policies to reduce health inequalities,...
Recommendation
The Government should ensure its ‘levelling up’ agenda includes specific policies to reduce health inequalities, with a particular focus on ensuring that certain groups, including people from Black, Asian and minority ethnic backgrounds, do not continue to face unequal health …
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Government Response Summary
The government accepts the recommendation, stating it will consider how to reduce health inequalities as part of the levelling up agenda and commits to continued action including developing a Staff Network Maturity Framework and Staff Network Chair development programme through NHS England.
Department for Science, Innovation and Technology
Department of Health and Social Care
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