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Can recovered coronavirus patients help combat the disease?

narvikk/iStock(NEW YORK) -- It's a critical, urgent question in the battle to save American lives -- and one that a growing number of institutions, including one of New York's preeminent medical centers, will attempt to answer.

Dr. David Reich, the president of Mount Sinai Hospital in Manhattan, said his team of experts is in the process of tracking down possible donors -- recovered patients whose blood antibodies could potentially curb the virus in the sickest patients.

“It’s great that we have some avenues and some options to try to improve the treatment of our patients,” Reich said in an exclusive television interview with ABC News' Diane Sawyer. “And we certainly hope the crisis in New York will abate soon and that we can save as many people as possible from this terrible disease.”

With an approved vaccine still months away at best, the experimental treatment offers a ray of hope for medical professionals and patients alike. The premise is simple: plasma isolated from blood donated by those recovered patients is transferred to a sick patient using an IV, which may then boost a patient with COVID-19's own defenses.

“Am I right that you are about to see if the antibodies of a recovering person can save the life of someone who is critically ill?” Sawyer asked.

“That is concept, Diane,” Reich said. “The idea is that -- as has been done in multiple previous epidemics -- if you give the plasma, the portion of the blood that contains the antibodies, from someone recovering from an illness, a viral illness like COVID-19 or Ebola -- it may help the patient overcome the disease.”

The practice is called convalescent plasma, and medical professionals in China have already used it on at least five critically ill patients with COVID-19, according to results published Friday in the Journal of the American Medical Association (JAMA).

The clinical data in China shows the five patients were in critical condition before the plasma infusion. Afterwards, according to the study, they began to recover.

“These preliminary findings raise the possibility that convalescent plasma transfusion may be helpful in the treatment of critically ill patients with COVID-19 and ARDS, but this approach requires evaluation in randomized clinical trials,” the JAMA study concluded.

Mount Sinai is not alone in this endeavor. A group of the nation’s top academic institutions recently launched a website with protocols for those interested in experimenting with convalescent plasma. A spokesperson for the Food and Drug Administration said Friday that a small but growing number of institutions are developing protocols for the procedure.

“We believe it can be disease-modifying and reduce duration and severity in some patients,” said Dr. Michael Joyner, a physiologist and anesthesiologist at the Mayo Clinic, one of the institutions mobilizing to start this.

Healthcare providers in the United States are optimistic, but the experimental therapy will take time to fully develop and is not without risk – and should not be perceived as a “magic bullet,” Reich warned.

“We can never know with a new therapy if we’re causing more good than harm or more harm than good, and that’s going to be always a concern for us, but we believe based upon the history of this therapy that it is the right and ethical and moral thing it to do in the face of a growing crisis,” he said.

Even so, Mount Sinai and others are moving forward. Reich said his team will aim to begin convalescent plasma treatments in the coming days, but the first order of business for medical staff is to find recovered patients – ideally those with a particularly high antibody count that could support more than one current patient.

A lab team at Mount Sinai has been working around the clock in recent days to find candidates, according to Reich. Prospective donors must be at least 21 days removed from the initial symptoms and be able to provide documentation of a positive case.

So far, the community has responded: the hospital says it has already received thousands of offers to donate blood. One of those recovered patients is 31-year-old Rich Bahrenburg.

“It feels like at least if I have to go through this and I’m one of the lucky ones who doesn’t have to be on a ventilator, one of the lucky ones who doesn’t have to be at the hospital, I feel like I owe it to people as a whole to try and give back if I can,” Rich told ABC News.

Reich and his Mount Sinai team are hoping others like Rich follow suit.

“I think that it’s beautiful if people who are recovering from the illness can, in the spirit of donation and helping others -- that some of them will have that capacity in having very high levels of immunity,” Reich said.

Copyright © 2020, ABC Audio. All rights reserved.

Iran confronts deadly alcohol crisis in midst of dealing with coronavirus

iStock(NEW YORK) -- Iran, already struggling to fight the growing spread of novel coronavirus, is now coming to grips with an alcohol poisoning problem that has killed hundreds of people this year.

In the wake of the deaths, officials initially blamed misinformation on social media for convincing victims that drinking alcohol could protect them against coronavirus. But a change in explanation from doctors is opening eyes to a larger problem of bootleg alcohol in the country.

"The first few days we all thought patients had drunken alcohol to protect themselves of corona, as some of them claimed so," Gholam Hosein Mohebbi, head of the public relation of Imam Hospital of Ahwaz, told ABC News.

"But later we realized from their families and friends that they were mostly alcohol users who would get their alcohol from bootleggers, but this time what they had been handed over was a methanol-based drink, not their usual booze, named araq, mixed with water and ethanol," he added.

Trading and drinking alcohol is illegal in Iran, and those seeking alcoholic drinks often rely on a chain of black market dealers without knowing where and how the drinks are produced. The dealers themselves are often not sure of the source of the alcohol.

"One of those [who] died of poisoning in our hospital was an alcohol dealer," Mohebbi said, cautioning people not to trust anyone selling alcoholic drinks and pleading on behalf of a medical staff already overwhelmed with coronavirus infections.

At least 2,197 people have been poisoned by alcohol across the country since the first reported cases of coronavirus in early February and 244 had died as of Sunday, Tasnim News Agency reported.

Iran is already reeling from the coronavirus pandemic; it is the hardest hit country in the Middle East.

The country has an official death toll of 2,378 from 32,332 infection cases, the spokesman of the health ministry, Kianoush Jahanpour, said on Friday, according to the Iranian Students' News Agency.

The rising number of poisoning casualties alarmed other alcohol users to avoid trusting their former dealers.

"People are afraid of buying booze from their dealers," said a 29-year old student who did not want his name to be mentioned for security reasons. He lives in Ahwaz, the capital of the province of Khuzastan, which ranks second in the number of alcohol poisoning casualties. The shortage and increasing price of ethanol has led some producers to end up adding poisonous methanol to the drinks instead of drinkable ethanol, he believes.

"My friend has started making alcohol at home after he lost a friend to poisoning earlier this month," he added.

However, making alcohol at home can also be dangerous.

"If you are unfamiliar with the process, you might end up poisoning your own stuff with a minor mistake. That's why I can't trust his first products," the student said. He said he rejected his friend's invitation to a drink at his place.

"I said no, but can't stop thinking about him as he is an alcoholic and can't just quit easily, especially now with so much free time he has under quarantine," he added.

Mohebbi expressed his concerns about people with alcohol problems, too.

"We know that those who have alcohol problem[s] have a tough time, but it is banned in our religion. I hope they try to stop drinking at least for now," Mohebbi said.

Despite the illegality of drinking alcohol, those who are poisoned and taken to the hospital are not being prosecuted or arrested, Mohebbi emphasized.

"As medical staff, we are loyal to our duty, which is treating everyone. It doesn't matter if a patient is poisoned by alcohol or is infected by corona," he said. However, to reach the main sources of methanol contamination, police ask questions from the patients.

"Police does not pressure the patients at all. They just try to gain as much information as they can to find the source and prevent more casualties," Mohebbi said.

Copyright © 2020, ABC Audio. All rights reserved.

What to know about the Navy hospital ships coming to New York and California

The USNS Comfort takes on fuel and supplies in preparation to deploy in support of the nation's coronavirus outbreak, March 25, 2020. (U.S. Navy) (NEW YORK) -- To help medical professionals focus on treating novel coronavirus patients, the Navy has deployed two hospital ships, to New York and to California, that will be used to treat people suffering from other ailments.

The United States Naval Ships Mercy and Comfort each are 894-foot vessels stocked with life-saving equipment.

As of Thursday, California had almost 800 confirmed cases of COVID-19 and New York State had over 30,000, including more than 17,000 in the five boroughs.

The USNS Mercy’s medical treatment facility has a medical crew, officials said, from the "Navy's Bureau of Medicine and Surgery responsible for operating and maintaining one of the largest trauma facilities in the United States."

USNS Mercy left San Diego for Los Angeles earlier this week, and USNS Comfort will head to New York Harbor from Norfolk, Virginia, by March 31.

What's inside these floating hospitals?

  • Up to 1,200 Navy medical and communications personnel and more than 70 civil service mariners.
  • Up to 5,000 unit of blood
  • 12 fully equipped operating rooms
  • 1,000 patient beds
  • 8 Intensive Care Unit beds
  • 4 radiology suites
  • 2 oxygen-producing plants
  • 1 isolation ward

Both ships also are equipped with digital radiological services, a medical laboratory, a pharmacy, an optometry lab and a CAT scan. They also have a helicopter deck capable of landing large helicopters and side ports to take on patients at sea.

Copyright © 2020, ABC Audio. All rights reserved.

What to do if you think you have coronavirus symptoms

Halfpoint/iStock(NEW YORK) -- As more people across the United States test positive for the novel coronavirus, or COVID-19, it's important to know what to do if you think you have the virus.

If you develop mild flu-like symptoms, call your doctor or your local health department and mention why you think you may have COVID-19, said Dr. Jennifer Ashton, ABC News’ chief medical correspondent.

Your doctor can work with the state and the Centers for Disease Control and Prevention (CDC) to decide if you should be tested.

It's important to call your doctor and not just go into a doctor's office without an appointment, the CDC said. That's because it'll give your health care provider the ability to keep other people there from being exposed.

You should get help immediately if you have trouble breathing, persistent chest pain or pressure, new confusion or bluish lips or face, according to the CDC.

If you are mildly sick with COVID-19 symptoms you can isolate at home, the CDC said. It's important to wear a mask at home and separate yourself from the others who live there.

Always cover your mouth and nose with a tissue when you cough, sneeze or blow your nose and then immediately wash your hands with soap and water for at least 20 seconds, the CDC said. Make sure to clean "high-touch" surfaces daily, like counters, computers, phones, toilets and doorknobs, the CDC advises.

Those with COVID-19 who are isolating at home can leave the house once they have accomplished these three things: at least one week has passed since symptoms started; symptoms have improved; no fever for at least three days without medicine that reduces fevers, the CDC said.

Copyright © 2020, ABC Audio. All rights reserved.

COVID-19 has been compared to the flu -- Experts say that's wrong

FilippoBacci/iStock(NEW YORK) -- Even with businesses closed, travel restricted and shelter-in-place orders issued around the world, many still wonder if such extremes are needed to battle the novel coronavirus.

Some people, including the president of the United States, have said COVID-19 isn't too different from the common flu.

But, according to experts, is COVID-19 actually worse?

The short answer? Yes.

An estimated 35 million Americans were infected last flu season, and about 500,000 were hospitalized. Approximately 35,000 died.

Even with more than 10% of the U.S. population affected by the flu most years, those are stunning numbers. But businesses aren't closed and people aren't asked to stay home.

What's different now?

COVID-19 in a novel virus, which means it's new. Although similar to SARS and MERS, it's wrong to assume it will follow the same path as its coronavirus cousins -- indeed, COVID-19 already has spread far beyond either of them.

So although the seasonal flu, at least to this point, has killed more Americans, COVID-19 appears more deadly and definitely spreads more quickly.

In other words, experts told ABC News, it's not the seasonal flu.

So exactly how much worse is it? Consider this chart, which compares COVID-19 to the flu using the most recently compiled statistics.

ABC Photo Illustration

It's still unclear exactly how deadly novel coronavirus is. The death rate may be overestimated because testing hasn't been ramped up and there could be hundreds of thousands or even millions not counted globally because they never get sick or show symptoms. The death rate, at least so far, similarly could've been affected by variables that have nothing to do with the virus itself, including overwhelmed hospitals, which contributed to Italy's estimated mortality rate of about 7%.

Perhaps most important, COVID-19 remains extremely dangerous because so many people show minimal or no symptoms -- a phenomenon often called "a silent infection." This can accelerate person-to-person transmissions because carriers of the virus simply don't know they have it.

"This disease seems to respond to social distancing, and so we can help reduce the number of people dying of COVID-19," said Dr. Pritish Tosh, medical director for Emergency Management at the Mayo Clinic. "This is not overhyping. These rather unprecedented social maneuvers are likely to help to keep otherwise vulnerable people from getting sick and dying."

More pronounced symptoms tied to COVID-19 probably would have slowed its spread.

"In general, when the flu hits you, people lie in bed and don't go out," said Dr. Simone Wildes, an infectious disease specialist at South Shore Health. "But something we are seeing with COVID-19 is that because the symptoms are mild for most of the population, they can go out and spread the disease quite easily, especially given how long you can be infectious for."

Fortunately for most patients, COVID-19 infections have proven mild, but current statistics still support recent statements by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and White House Coronavirus Task Force expert, that COVID-19 is over 10 times as lethal as the flu.

Although they could quickly change, current data paints a morbid picture.

Especially because there isn't a current treatment.

Especially because there isn't a vaccine.

Especially because no one's really sure how this pandemic will unfold.

Copyright © 2020, ABC Audio. All rights reserved.

Mother to baby transmission of COVID-19 cannot be ruled out, new study finds

Adene Sanchez/iStock(NEW YORK) -- Early in the novel coronavirus pandemic, encouraging data suggested that infants born to mothers with COVID-19 did not acquire the virus before birth, a process called vertical transmission. However, three new reports released in The Journal of the American Medical Association unfortunately suggest the opposite may be true.

Vertical transmission, or the spread of infectious disease from mother to child, initially seemed unlikely based on initial COVID-19 case reports as well as historical data from the outbreaks of MERS and SARS, close cousins of the novel coronavirus. To date, data has been published on 19 infants born to mothers with COVID-19, all of whom subsequently tested negative for the virus.

However, a study released from Wuhan’s Children’s Hospital evaluated 33 newborns born to mothers with COVID-19 pneumonia, finding that three of these infants (9%) fell ill. The physicians involved noted that strict infection control procedures were followed during delivery, suggesting that the virus didn’t infect the infants during or after delivery, and instead likely came from the mother while they were still in the womb.

Fortunately, all three infants pulled through. Two of the infants were born full-term via C-section and developed fever, lethargy and pneumonia on chest radiographs. The third infant required more intensive care, but was also significantly premature -- born at only 31 weeks gestation, or six weeks early.

The premature infant also was found to have sepsis, or a blood infection caused by a bacteria. With this, along with the complexity that inherently goes along with prematurity, it is unclear how significantly COVID-19 affected the infant’s health. Fortunately, respiratory support and antibiotics led to improvement and recovery.

Antibodies in newborns raise further concern

The two additional research letters released on March 26 report a different sign of potential mother-to-child transmission. In a bit of a medical mystery, researchers describe case studies of three infants that did not have symptoms nor test positive for active COVID-19 infections, but did have specific antibodies, or immune proteins, called IgM.

IgM is usually produced in response to a pathogen three to seven days after infection. It is not usually transferred from mother to fetus because of its larger structure, which is too big to cross the placenta.

Researchers suggest that if coronavirus-specific IgM is present at birth, it could either indicate that the infant had produced its own IgM in response to the virus or the mother’s IgM was transferred to the baby through a damaged placenta.

The first of these case reports reviewed the laboratory results of six pregnant women with mild COVID-19 who were admitted to Zhongnan Hospital of Wuhan University. All gave birth via C-section using multiple infection control measures, including isolation of their infants immediately following delivery. Two of these six infants had IgM present, but none had symptoms and were repeatedly negative when tested for the virus.

A separate report from Renmin Hospital of Wuhan University had similar findings, but focused on only one infant. This mother was sicker than the others and was treated with antiviral, antibiotic, corticosteroid and oxygen therapies. She gave birth via C-section nearly one month after contracting the virus and her infant, too, was positive for coronavirus-specific IgM.

While these findings are difficult to interpret given their paucity of accompanying clinical details, these isolated case studies are still worthy of special attention.

Scientists and researchers are still studying these cases to see if they offer any clues about how to best protect the health of infants and mothers with COVID-19 infection. Until we have more data, pregnant women and women hoping to soon become pregnant should continue to seek guidance and medical care from health professionals.

Copyright © 2020, ABC Audio. All rights reserved.

The little things we miss during coronavirus, and why it's normal to feel that way

LucaLorenzelli/iStock(NEW YORK) -- After spending time apart social distancing, and witnessing the devastation caused by the coronavirus crisis, many may also just miss simple social interactions.

Whether it's going for a cup of coffee, taking a stroll and sparking up conversations with a friendly dog owner or enjoying a meal with friends, even mundane moments of once daily routines feel like a luxury people are already eager to have back.

Keeping a safe distance has been an imperative for public safety during COVID-19, but it's OK to feel nostalgic for life's little moments that have temporarily fallen by the wayside.

Dr. Ilyse Dobrow DiMarco, a clinical psychologist and author, told ABC News it's "absolutely" normal to miss all the things we had going on in our lives.

"We humans thrive on predictability and routine. Even things like taking the same route to work or seeing the same people at our weekly Zumba class provide us with a sense of comfort," she explained. "We know what to expect, and that helps us feel in control."

As for why we feel so jolted by the sudden and seismic societal shift, DiMarco said, "anxiety is all about uncertainty and once you start removing certainties from people’s lives -- people start to feel unmoored."

Since the days, weeks and months ahead are still uncertain, DiMarco suggests people make a list and write down all the things they want to do when this is all over.

"I encourage them not to think of a timeline for these things but rather to think of it as a 'bucket list,' to be tackled whenever life resumes as usual," she said, adding that it's good to plan for "the first restaurant they will eat at and park they will visit once normalcy returns."

Here's a snapshot of some of the things people miss from everyday life and look forward to taking full advantage of once again when the pandemic is in the rearview:

Hugging friends and family

Aside from being able to just see family and friends in person, many people really miss the warm embrace that comes with a greeting or goodbye between loved ones.


Whether it's attending your favorite professional sporting events, playing a pickup game of hoops with friends or watching a live game on TV, people around the country have felt the weight of missing out on what has always been a fun, entertaining pastime.

Baseball fans struck out on Thursday since MLB postponed Opening Day; the NBA season is temporarily suspended; the NCAA March Madness tournament was canceled and the 2020 Summer Olympics in Tokyo have been postponed.

Going out to eat

Many people are missing the experience and excitement around Sunday brunch, a weeknight dinner at an undiscovered restaurant or even strolling into your favorite neighborhood spot for a quick bite.

As everyone resorts to cooking at home or ordering takeout, the idea of sitting down for a meal, prepared by chefs in a professional kitchen sounds like a dream.

Meeting up for coffee or drinks

Baristas and bartenders miss you as much as we miss them.

Grabbing an afternoon coffee with your co-worker or meeting up with friends for happy hour in person has been a widely missed ritual.

While people have gotten creative with virtual happy hours and hangouts, we can all add raising a glass to our health and routines whenever those activities can resume in person.

Fitness classes, the gym and working out

Yoga, pilates, spin, swim, Zumba, boxing, running, weightlifting -- you name it -- people miss it. With gyms closed in most places, people have had to reinvent their workout routines where they can.

From group fitness classes to running clubs, making it to your mat or cruising through a finish line with a huge crowd after 13.1 miles -- working out has also taken a turn.

While some people have jokingly seemed shocked by the notion that they miss working out, many have had an epiphany that the absence of physical activities really does make the heart grow fonder.

Instructors have gotten creative by bringing so many of their workout routines to virtual platforms online, but performing bodyweight moves in a studio apartment doesn't exactly hit the same levels of intensity as a high-octane, fast-paced HIIT class.

Going to work

In what has felt like an eternal Sunday for some folks, there are millions of previously employed Americans who have lost jobs across a multitude of different industries that have seen a sharp decline in operations due to coronavirus. The service industry was among the hardest hit -- particularly foodservice and hospitality.

Restaurant and bar owners, chefs, managers, sommeliers, hostesses, servers and more have banded together to raise funds for their impacted community.

For those fortunate enough to still be employed, many Americans wish they could go into their respective place of work. Be it behind a chef's counter of a busy kitchen or a desk inside an office building, lots of folks miss the daily social interactions with co-workers and getting their jobs done where the magic is meant to happen.

"Even patients who formerly complained about their desk job now wax sentimental about their cubicles, because at least those cubicles were next to other people’s cubicles," DiMarco said. "Now, they’re totally by themselves at their desks at home and truly craving the cubicle-to-cubicle interaction."


Sure, preschoolers may not think twice about remote learning, but lots of teachers and students alike are missing the classroom. And probably a few thousand parents too, who have had to adjust to take on both work-from-home and teach-from-home double duty.

"I walked both my sons to elementary school every single school day this year, not thinking twice about it, and now, I miss it desperately," DiMarco said of her own top missed activity.

Grocery shopping in peace

No panic buying in bulk or seeing rows upon rows of empty shelves, but seeing people calmly pick up all the products they need, when they need it and get in a normal-sized line to pay for it.

Making memories big and small

Milestones have been missed -- weddings canceled, funerals forgotten, family reunions postponed, half-marathon races restricted and more daily interactions for people to cherish that were supposed to happen and didn't.

Di Marco suggests tapping into the various virtual options right now.

Using Zoom, FaceTime or Skype to create hangouts, workouts, happy hours and birthday parties are all great options, she said.

"I think the key is to think through the things that you miss and consider how you can recreate them virtually," DiMarco explained.

She also said it's a good idea to stretch the legs and get outside.

"There’s always the neighborhood walk/bike ride," she said.

Copyright © 2020, ABC Audio. All rights reserved.

Chloroquine: Coronavirus savior or the Wild West of medicine?

BartekSzewczyk/iStock(NEW YORK) -- If drugs can be famous, chloroquine is as close as it comes.

Chloroquine, and its derivative hydroxychloroquine, were touted by President Donald Trump as potential “game changers” when combined with azithromycin, and were elevated to stardom practically overnight. Previously approved as anti-malarial drugs, for systemic lupus erythematosus and rheumatoid arthritis, these drugs are now used by some front line clinicians “off-label” for their patients with severe illness from COVID-19.

The “off-label” use means the medications have not been adequately tested or approved for that specific disease or illness. So why would clinicians risk it and why would politicians prematurely praise it?

For now, there is no approved treatment, vaccine or cure for COVID-19. With confirmed cases of COVID-19 surpassing the half a million mark worldwide, clinicians all around the world are learning from each other’s experiences and drug cocktails, trying to give their patients the best chance they can.

Dr. Michael J. Ackerman, Mayo Clinic genetic cardiologist and director of the Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program, explains that one of his colleagues described the consequences of using medications “off-label” for COVID-19 as "friendly fire."

They throw everything at it and hope the benefits outweigh the risks. However, Ackerman explains that it may have led to the Wild West, where “drugs are being used without proven therapeutic efficacy- based on hope and promise.” He says he does believe they may work, but emphasizes the need for “rational, careful, prudent guidance.”

Guidance is particularly paramount for chloroquine and hydroxychloroquine because of a known side effect: drug-induced arrhythmias from prolonged QTc intervals that can be detected by echocardiogram. In rare cases, your heart can stop and you can die.

“How do we navigate while we’re waiting for clarity on the drug’s therapeutic efficacy? How do we respect this unwanted side effect, which happens to not just be lightheadedness, dizziness and tingling fingers, but sudden death?” said Ackerman.

To answer these questions, Ackerman and his colleagues set out to create a clinical algorithm to help determine each patient’s risk.

The risk categories they developed put people into three groups, simplified as ‘green light’ for low risk, ‘yellow light’ for moderate risk, and ‘red light’ for high risk. Having a high risk for drug-induced arrhythmias doesn’t automatically mean you shouldn’t take chloroquine and hydroxychloroquine. But it does mean that your doctor should carefully weigh the risks versus the potential benefits.

"If we know their QTc, they are going to be ‘green light,’ go! There is going to be tremendous safety margin with these medications for 90% of the patients," said Ackerman.

"For 5 to 10%, they’re going to be in a caution light, a ‘yellow light’ because they are already showing that they’re kind of on the high edge of normal of the QTc even before we add these medications, and for 1% they’re going to already be at the ‘red light,’ be very, very careful. The risk-benefit balance better be there, and if we still think we should proceed, we better do what we would call our QT sudden cardiac death countermeasures preemptively,” he said.

If the patient needs the medications, there are ways to reduce the risks such as correcting electrolyte abnormalities, discontinuing other medications that could cause problems if taken at the same time as hydroxychloroquine, keeping patients on heart monitors, or asking them to wear an external defibrillator.

Ackerman fully expects the use of hydroxychloroquine to skyrocket. In fact, there are already reports of patients who take the drug for its other approved purposes, such as rheumatoid arthritis, not being able to get their medication at the pharmacy.

If these medications get approved for COVID-19, “we’re going to be seeing hundreds and hundreds of thousands of people, potentially millions being put on these medications. When you scale it up to that level, this unwanted side effect which happens to be a big deal is going to show itself, and it’s going to show itself in a significant way," Ackerman said.

Ackerman thinks that the best initial defense is turning the QTc value into a global vital sign.

“Just like a diabetic needs to know or does know his or her glucose, this QTc value is essentially a vital sign," he said.

Knowing your QTc interval is not only important for COVID-19 treatment, but also because of countless other medications that exist.

“This isn’t the only scenario where the medication inadvertently, suddenly killed the patient because of drug-induced long QT syndrome and drug-induced sudden cardiac death,” Ackerman said.

In fact, he points out that “the single most common reason why a drug gets removed from development or market is drug-induced sudden cardiac death because of drug-induced long QT syndrome.”

QTc is undoubtedly an important way to screen patients with COVID-19 who might be good candidates for the experimental hydroxychloroquine, but this may pose a challenge. Administering an ECG to patients with COVID-19 would mean a technician would risk exposure and use precious personal protective equipment for each ECG that was needed, according to Ackerman.

For now, by not screening patients with COVID-19 before starting these medications, doctors are effectively shooting in the dark.

Fortunately, the Food and Drug Administration approved a personal ECG device that would allow accurate ECG recordings (and therefore QTc calculations) to be taken by patients on their smartphones without potentially exposing a technician to COVID-19 multiple times.

By understanding everything about a patient, their risk factors, their medications, their vital signs -- in this case their QTc interval -- doctors can use the model to pinpoint a patient's risks versus benefits, and treat them with more accuracy. Broadly speaking, doctors refer to this concept as "precision medicine," meaning they try to tailor each treatment to make it unique for each patient.

Ackerman, who has spent the last 20 years of his career focused on patients with congenital prolonged QT, believes “that this is the time to really put precision medicine into action. It has been a buzz phrase for too long. And now I think we’ll see how well can actually do this. We know our patient’s profile, we know the drug’s profile, we try to see if we can match that and really do precision medicine. I think we can. I mean, we should be able to. We have the knowledge, we have the technology, we have the ability.”

Copyright © 2020, ABC Audio. All rights reserved.

Study concludes COVID-19 'is not a laboratory construct'

BlackJack3D/iStock(NEW YORK) -- Conspiracy theories claiming COVID-19 was engineered in a lab as part of a biological attack on the United States have been gaining traction online in recent weeks, but a new study on the origins of the virus has concluded that the pandemic-causing strain developed naturally.

An analysis of the evidence, according to the findings first published in the scientific journal Nature Medicine, shows that the novel coronavirus "is not a laboratory construct or a purposefully manipulated virus," with the researchers concluding "we do not believe that any type of laboratory-based scenario is plausible."

"There’s a lot of speculation and conspiracy theories that went to a pretty high level," Dr. Robert Garry, a professor at the Tulane University School of Medicine and one of the authors of the study, told ABC News, "so we felt it was important to get a team together to examine evidence of this new coronavirus to determine what we could about the origin."

Dr. Francis Collins, the director of the National Institutes of Health, supported the study’s findings, writing on his blog, "This study leaves little room to refute a natural origin for COVID-19."

Researchers concluded that the novel coronavirus is not a human creation because it does not share any "previously used virus backbone." It likely arose, the study said, from a recombination of a virus found in bats and another virus, possibly originating from pangolins, otherwise known as scaly anteaters.

COVID-19 is 96% identical to a coronavirus found in bats, researchers said, but with a certain variation that could explain what has made it so infectious.

"We know from the study of other coronaviruses that they’re able to acquire this [variation] and they can then become more pathogenic," Garry told ABC News. "This is a good explanation as to why this virus is so transmittable and has caused this pandemic."

The mutation in surface proteins, according to Garry, could have triggered the outbreak of the pandemic, but it’s also possible that a less severe version of the illness was circulating through the population for years, perhaps even decades, before escalating to this point.

"We don’t know if those mutations were picked up more recently or a long time ago," Garry told ABC News. "It’s impossible to say if it actually was a mutation that triggered the pandemic, but either way, it would have been a naturally occurring process."

And while many believe the virus originated at a fish market in Wuhan, China, Garry said that is also a misconception.

"Our analyses, and others too, point to an earlier origin than that," Garry said. "There were definitely cases there, but that wasn’t the origin of the virus."

Copyright © 2020, ABC Audio. All rights reserved.

How anesthesia machines can help hospitals with ventilator shortages fight coronavirus

lyosha_nazarenko/iStock(NEW YORK) -- Anticipating ongoing shortages of ventilator machines as the coronavirus continues to spread across the country, states and hospitals are preparing to convert anesthesia machines for use on COVID-19 patients in need of breathing assistance.

The effort to utilize anesthesia gas machines, approved by the Food and Drug Administration earlier this week, could make tens of thousands of additional machines available for the fight against the coronavirus.

The mechanical ventilators in such short supply around the world support critically-ill COVID-19 patients by helping them breathe, using a pump and a breathing tube to support weakened lung function.

Using computer-driven technology, the most advanced models include sophisticated software that provides doctors with immediate feedback on a patient’s breathing and lung capacity.

Anesthesia machines are constructed to deliver oxygen and gas mixtures to place patients under anesthesia during surgical procedures, but can be modified to aid patients struggling to breathe on their own.

“They provide the basic components of ventilation, but they don’t provide the alarms, monitoring and sophistication that critical care ventilators do,” Tim Myers, a registered respiratory therapist and chief business officer for the American Association of Respiratory Care, told ABC News.

But with roughly 150,000 to 200,000 ventilators in the United States -- far short of the one million breathing machines that could be needed to treat the coronavirus -- the more basic anesthesia machines could make a difference in hospitals running low on the lifesaving machines, which are among the most effective tools available to help severely-ill COVID-19 patients struggling to breathe.

"You have a ready-made solution that can offset a large part of this problem without needing to rely on ventilator manufacturers ramping up production,” Dr. Lew Kaplan, president of Society of Critical Care Medicine, told ABC News.

State and federal officials have increasingly pointed to the anesthesia machines as a resource for hospitals.

“We have determined several weeks ago that the devices that anesthesiologists use for outpatient surgery can be converted with the change of a single vent to a very useful ventilator,” Vice President Mike Pence said Wednesday in the daily COVID-19 task force press briefing. “We literally believe there are tens of thousands of ventilators that can be converted now.”

In addition to the machines, the postponement of elective surgeries across the country has helped to free up anesthesiologists and nurse anesthetists who can best operate them, Dr. Deborah Birx, the coordinator of the White House coronavirus task force, said Wednesday.

“Changing that elective surgery piece over a week ago has freed up a lot of additional resources,” she said.

There are approximately 70,000 anesthesia machines in the United States, according to Dr. Jeffrey Feldman, an attending anesthesiologist at Children’s Hospital of Philadelphia, who is also an officer in the American Society of Anesthesiologists -- including roughly 30,000 machines in other medical facilities.

Along with anesthesia machines, new techniques to put multiple patients on single ventilator units have emerged as potential options for hospitals preparing to treat a surge in coronavirus patients with a limited number of ventilators.

Gov. Andrew Cuomo on Thursday approved the use of so-called split-ventilation in New York State, to allow hospitals to put two patients on one ventilator, a protocol developed by New York Presbyterian Hospital.

But the public health community is divided on the emergency technique: A group of seven medical organizations came out against sharing ventilators, warning in a statement that it could lead to “poor outcomes and high mortality rates for all patients cohorted.”

“It diverts our attention from things that we know will be effective,” Feldman said, pointing to anesthesia machines and manual ventilation.

“When it comes to saying, ‘How am I going to keep this patient alive,’ all of the anesthesia machines should be able to do that,” he said.

Copyright © 2020, ABC Audio. All rights reserved.

'Don't bury us before we're dead': Sister mourns elderly sibling taken by coronavirus

Nancy Ann Hamilton, seen as a young girl with dark hair in the middle of this undated family photo with her kid sister, Janet, on her lap, died on March 21, 2020, in Skagit County, Wash., after contracting the coronavirus. (Courtesy Barbara Friedman)(NEW YORK) -- Had she been asked several months ago, before the coronavirus pandemic began to disproportionately kill people over the age of 60 like her sister, Janet Lane might have shrugged it off. But while in a supermarket this week, the Maryland woman found the question cringeworthy.

An engaged couple standing in line behind her had struck up a casual conversation with her about the practice of social distancing and eventually got around to how Lane was doing amid these dark days of COVID-19 horror and hysteria.

"Because it was so fresh, I blurted that I was not so well as I had just lost my sister due to complications from the virus, and that she lived in Washington state," Lane told ABC News.

She said the young woman then asked something that took her aback.

"But how old was she?" the woman asked.

"The 'but' says it all," Lane said. "Looking at me, she surmised my sister must have been old, dispensable, had underlying conditions, was replaceable, unnecessary, irrelevant, expensive, wasting our precious resources."

But to Lane, her big sister, Nancy Ann Hamilton, was none of the above.

“She was very smart," Lane said of her sister, a graduate of Smith College and a New York native. "She was very hard to contain. She had strong opinions. She was a life-long Democrat. She was a singer. At one point, she was a private pilot. She had her own pilot's license. She produced a production called ‘Montage’ on television years ago. She worked for the post office for 10 years and started a whole campaign to improve their lighting."

“She didn’t ever have a lot of money, but she traveled all over the world," Lane added. "She found a way to do it on a shoestring by staying with friends and remote relatives. She loved being involved with things."

She was also the stepsister of ABC News producer Barbara Friedman.

Up to the point of her death on Saturday at a hospital in Skagit County, Washington, where county health department officials say 63 people have been diagnosed with coronavirus, Hamilton had been an active senior citizen.

“Despite the fact that she did indeed have underlying health conditions, she was extremely active in her community," Lane said. "She was probably with large groups of people. She was very active in politics, she was active in choral there. So that may have exacerbated her opportunities to get infected."

On March 19, Hamilton fell gravely ill and was admitted to the hospital, where tests confirmed she had the virus and she was placed in isolation, Lane said. Her husband was immediately put on quarantine at their home in Mt. Vernon, Washington, preventing him from being near his wife when she died on Saturday, Lane said.

With much-needed medical equipment like ventilators in short supply, some prominent politicians have suggested in recent days that senior citizens who contract the virus should be willing to be "sacrificed" for the sake of their children and grandchildren, and to keep the country out of economic turmoil. Lane said she finds such a proposition preposterous and, ironically, short-sighted.

"The COVID-19 crisis and the subsequent loss of my sister has confirmed to me what I suspected before, which is that older Americans are not valued by many," said Lane, who works full-time for an agency that helps prisoners reenter society. "But there are a tremendous number of people, let's start at the top with (Supreme Court Justice) Ruth Bader Ginsburg, who, despite whatever their conditions, are functioning at the very top level. I think that people are not recognizing the fact that older Americans are still quite able to contribute to our society."

She said that when she and her family safely receive her sister's ashes, they plan to have a celebration and "tell some Nancy stories."

"Last Friday I had a sister, and on Saturday I did not," Lane said. "She was strong and brave and had no edit mode. She would be the first voice to say, 'Don't bury us before we're dead."

Copyright © 2020, ABC Audio. All rights reserved.

Nurse who's pregnant amid coronavirus outbreak shares how she's coping

Heather Hodnicki(NEW YORK) -- A nurse who is pregnant during the novel coronavirus outbreak is sharing important facts for other expectant mothers who may be on-edge during these unprecedented times.

Heather Hodnicki of Hamilton, New Jersey, is 26 weeks along. The mom of one recently shared a PSA with her 20,000 Instagram followers, urging them to keep calm and practice safe health practices amid the pandemic.

"There's not much that has been proven on pregnant women or if it could pass to your baby," Hodnicki told ABC News' Good Morning America.

She went on, "That is scary, along with the high risk of being exposed because you are working in a hospital or medical facility. I think everyday that goes by people are more anxious and scared. I try to reassure myself mentally."

Hodnicki is mom to 18-month-old Cole and a nurse at an in-patient acute rehab facility. She's expecting a girl June 29.

The outbreak of coronavirus, or COVID-19, as it's officially known, has led pregnant women to question everything from whether they should travel to whether they should work from home, self-quarantine or are fine to continue their lives as normal.

Because COVID-19 is a new virus, there are no published scientific reports on whether pregnant women are more susceptible than the general population. The U.S. Centers for Disease Control and Prevention does point out though that pregnant women do have weakened immune systems and may be more susceptible to viral respiratory infections, including COVID-19, so should be considered an at-risk population for COVID-19.

Based on data from previous coronaviruses, like SARS and MERS, some experts believe pregnant women may be at higher risk for severe illness and death, but that data is limited and inconclusive.

For now, neither the CDC nor the American College of Obstetricians and Gynecologists recommends any specific guidance for pregnant women beyond what's recommended to the general public.

While Hodnicki is still working with hospital patients, she expects to not be assigned to those who have COVID-19. There are no known cases of COVID-19 at her hospital, according to Hodnicki.

"We took precautions when there was a COVID-19 scare days ago, but the patient tested negative," she said. "That shows how real the situation is."

Hodnicki learned she was pregnant with this current child after having a miscarriage in August of 2019. She said the experience changed her way of thinking during the COVID-19 outbreak.

"I have a totally different outlook with this pregnancy and everything I come into contact with," she said. "[As mothers] we want to protect our growing fetus the second we see that positive line."

It's unknown whether a pregnant woman with coronavirus could pass the virus to her fetus before, during or after delivery, according to the CDC.

There are a few recent cases of infants born to women with coronavirus. While initial reports were encouraging with no infants contracting COVID-19, three reports released on March 26 showed that infants may be at risk of the virus being passed from mother to infant before birth. Although data is now mixed, all of these infants have either had no or mild illness and recovered without complication.

On March 14, Hodnicki shared photos on Instagram to mark her 24th week of pregnancy. She and her toddler were wearing expired personal protective equipment, as there are a shortage of masks in the U.S.

Hodnicki said she wore gloves and a mask to draw attention to the information listed in the caption.

Hodnicki's post was accompanied by everyday precautions that people -- pregnant or not -- should take to prevent COVID-19.

Hodnicki said quite a few pregnant women have reached out in regards to her post. She's been offering an ear to listen as well as safety measures in accordance with the CDC.

"Keep calm and follow the general precautions that are suggested to the public," Hodnicki said of the advice she gives.

Here are the health and safety guidelines listed in Hodnicki's post, along with the CDC's recommendations:

Wash your hands, don't touch your face, eyes or mouth

Hodnicki reminded the importance of hand washing: "Scrub for at least 20 seconds, sing "Happy Birthday" twice," she wrote.

The CDC offers the same guidelines, recommending the general public, including pregnant women, take "everyday preventive actions" to help stop the spread of germs, including getting a flu vaccine, washing your hands, avoiding touching your eyes, nose and mouth, staying home when sick and avoiding close contact with people who are sick.

Social distancing

Person-to-person transmission is mostly likely between people in close contact, within about 6 feet, according to the CDC. When a person infected with novel coronavirus sneezes or coughs, respiratory droplets could land on people nearby or possibly be inhaled by those people.

Further precautions, including avoiding crowds and stocking up on supplies, are recommended only for older people or people with severe chronic conditions like diabetes, heart disease and lung disease.

Disinfect frequently touched areas and clean your phone

According to the World Health Organization, "studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days."

The WHO said, "If you think a surface may be infected, clean it with simple disinfectant to kill the virus and protect yourself and others."

The CDC said, "It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads."

If you're feeling symptomatic

Pregnant women should call their doctor before going to the hospital if showing symptoms. A hospital visit is not always necessary and could put you at risk for exposure to other sicknesses. If you are having problems breathing you should seek medical help immediately.

Novel coronavirus can cause symptoms ranging from mild to severe, including cough, fever and shortness of breath. Since the symptoms are similar to those of pneumonia, influenza and the common cold, only a diagnostic test can confirm whether an individual has coronavirus.

Don't wear a face mask unless you're already sick

The CDC said healthy people should not wear a mask, and doctors warn that fiddling with putting on and taking off a mask could backfire by exposing germs on your hands to your face.

Moreover, there is a severe shortage of masks which protect health care workers from contracting COVID-19.

The U.S. has a stockpile of 13 million N95 respirator masks. But the federal government has said up to a billion might be needed over the next six months.

"Please consider donating any unused masks to your hospitals who are in dire need," Hodnicki wrote in her post.

Copyright © 2020, ABC Audio. All rights reserved.

Promising new 15-minute test for coronavirus comes with caveats

narviikk/iStock(NEW YORK) -- As COVID-19 continues to spread, health experts say that efficient testing will be one of the keys to containing the coronavirus. Companies are now scrambling to come up with new, rapid tests -- among them a company called Coris BioConcept, which recently announced a test that can deliver results in just 15 minutes.

Testing availability has been a significant challenge in the U.S., but the situation is slowly getting better. The CDC continues to distribute its test kits to public health laboratories across the nation, while large diagnostics companies like Quest Diagnostics are ramping up to be able to run tens of thousands of tests per day.

The FDA recently updated its policy on diagnostic testing for COVID-19, which helped free up companies to begin distributing their own tests to laboratories, hospitals and other clinical settings. The Coris BioConcept test is not available for at-home use by everyday people, although experts say these types of rapid tests may soon be more widely available.

Right now, the majority of COVID-19 test are real-time polymerase chain reaction tests (RT-PCR). These tests “amplify and detect the virus’ genetic material,” according to College of American Pathologist Microbiology Committee Chair Dr. Bobbi Pritt.

It can take anywhere from four to six hours to run an RT-PCR test. In contrast, the test developed by Coris BioConcept takes only 15 minutes. That's because Coris BioConcept's test uses a different technology that detects antigens.

The COVID-19 Ag Respi-Strip test detects viral antigens obtained from a nasal swab sample, as opposed to viral RNA. “This test uses a very common approach called “immunochromatography” or “lateral flow immunoassay,” explained Dr. James Faix, the director of clinical chemistry and immunology at New York City's Montefiore Medical Center.

It works kind of like a pregnancy test.

“The dipstick is a membrane which contains antibody to a part of the CoVID-19 virus, and this antibody is attached to a colored particle," said Faix. "As the diluted sample moves through the membrane, if there is any viral protein in it, the antibody will attach to it, forming a complex. Further down, there is another antibody to the viral protein immobilized on the membrane so the initial antigen-antibody complex will be stuck to this part of the membrane as the sample passes through. This creates the color at the test line, meaning that the result is positive.”

This entire process takes 15 minutes.

Experts say not so fast. BioConcept's test is fast, but it's not as good at detecting positive cases of COVID-19 as the PCR tests used today. Specifically, the test's "sensitivity" -- a measure of its ability to detect true positives -- is only 60%.

“It is not very sensitive for detecting the virus in patient specimens," Pritt said. “A sensitivity of 60% means that only 6 out of every 10 cases of COVID-19 will be detected by this test, and 4 will be missed.”

Faix noted that these type of tests “usually have pretty good specificity,” meaning they are unlikely to show a false positive. “But they suffer from generally poor sensitivity -- not identifying most of the people with the disease. This means that a positive result might be helpful for detecting a positive patient but a negative result won’t mean that the patient is not infected.”

Regarding the tests Coris BioConcept ran to determine the sensitivity, Faix said that the two studies cited by the manufacturer were small ones.

“It’s possible that larger studies may show better performance,” he said. “Also, other companies are developing similar assays with different ways of detecting the 'color.' These may enhance the sensitivity of the approach.”

“While I think that this rapid antigen test may have some role in detecting the coronavirus causing COVID-19, the low sensitivity severely limits the utility of this method," said Pritt. "Physicians could use a positive result as evidence that a patient has COVID-19, but they couldn’t use a negative result to rule out the possibility of infection. Instead, all negative results would still have to be confirmed using a more sensitive method such as RT-PCR.”

Nevertheless, this new rapid test is could prove very helpful in expanding U.S. testing capabilities.

“There is no perfect test, and it’s important for physicians to understand the limitations of the tests that they are relying on to make diagnoses,” Pritt said.

The CDC provides guidance regarding who should be tested, but leaves the decision to the discretion of health departments and health care providers. Given that there is no treatment specifically approved for the virus at this time, the CDC recommends that those with mild illness self-isolate and recover at home. Anyone with shortness of breath or fever greater than 100.4F should alert their doctor.

THis article was written by Angela N. Baldwin M.D., M.P.H., a pathology resident at Montefiore Health Systems in New York City and a contributor to the ABC News Medical Unit.

Copyright © 2020, ABC Audio. All rights reserved.

ER doctor has comfort dog on the front lines to soothe health care workers during coronavirus

Courtesy Dr. Susan Ryan(DENVER) -- When hospital workers face the untold stress of an unprecedented health care challenge this furry friend is sharing puppy love to help ease their burden.

Wynn is a service dog in training that’s delivering mental health breathers at Rose Medical Center in Denver. Emergency room staffers cuddle with the yellow Labrador in one-minute meditation sessions, providing a moment of escape before running back to the fight against COVID-19.

"She has the ability to really calm people down," said Susan Ryan, Wynn's trainer and an emergency room physician at the hospital. "We’re working in a unique time and she helps us stay grounded."

Ryan has been training Wynn for 11 months now. She brings her four-legged friend to work regularly, but the dog’s lovable energy has been a particularly welcome sight in recent days.

"Our whole team has been very stressed lately," said Ryan. "We needed to come up with a way to manage each other’s anxiety during this difficult time."

Ryan got together with a co-worker and set aside office space where nurses and doctors could grab a warm blanket, sit down with Wynn and relax for a moment -- all to the tune of guided meditation playing in the background.

"One of our staffers was crying and truly overwhelmed with everything that’s been going on so we had her go into the office with Wynn and it changed her immediately," said Ryan.

She added Wynn’s collar and leash are cleaned regularly as a precaution and everyone is required to wash their hands before each session.

The 1-year-old dog is having an impact on lives outside the ER, too. Ryan's photo of her sitting on the hospital floor with Wynn posted to Instagram Sunday has since gone viral.

"She has saved us because we are very stressed and anxious. Sometimes too busy to be scared," Ryan wrote in the post. "We can find comfort in each other when we know I have your back and you have mine."

Wynn is being trained by Ryan on behalf of Canine Companions for Independence, a nonprofit that provides assistance dogs to adults and children with disabilities -- free of charge. As a board member of the organization, Ryan frequently takes pups on before they’re placed with owners.

Copyright © 2020, ABC Audio. All rights reserved.

Clinical trials may begin next week in New York for coronavirus treatments: Health official

Mladen Sladojevic/iStock(NEW YORK) -- Officials are working out final details in plans to begin clinical trials next week for a malaria drug combination that appears to hold some promise for confronting the coronavirus pandemic.

New York state Health Department officials are making arrangements to determine what patients at which hospitals will be allowed to participate in trials with hydroxychloroquine, Zithromax and chloroquine, a senior official at the department with knowledge of the plan told ABC News. The bulk of the patients are expected to be in the New York City metro area because the region has the biggest cluster of cases.

New York Gov. Andrew Cuomo announced earlier this week that he was eager to get the trials started. By Tuesday, the drugs were in New York and officials were working to identify who could participate.

The medications, originally developed to fight malaria, have raised hope among many that they could aid in treating coronavirus. The core of the medical therapy is chloroquine, closely related to hydroxychloroquine, which has been used to treat malaria since 1944. It can be given before exposure to malaria to prevent infection, and it can also be given as treatment afterward. It's also currently used to treat autoimmune diseases like lupus. Doctors are adding the antibiotic Zithromax to the cocktail.

Malaria is caused by a parasite, unlike COVID-19. But laboratory studies show chloroquine is effective at preventing as well as treating the virus that causes severe acute respiratory syndrome, or SARS, a close cousin of COVID-19.

The plan is for officials to find coronavirus patients with moderate and severe cases whose medical histories suggest they could benefit from the drugs.

Officials don’t expect to see critical patients going from grave conditions to full recovery instantly. "We’re looking to see much more subtle measurable outcomes, including lower viral loads, shorter duration of illness," the official said.

Both President Donald Trump and Cuomo have made no secret of their optimism for the drugs’ possibilities in treating coronavirus disease.

"It may work, it may not work," Trump said at a White House briefing. "I feel good about it." The president has called the anti-malarial drugs a potential "game changer" in the coronavirus fight.

At the same briefing last week, Dr. Anthony Fauci, the nation's top infectious disease expert, cautioned that there has only been "anecdotal evidence" that the drugs would be effective against the coronavirus. He said the lack of clinical trials, so far, meant "you really can't make a definitive statement about it."

New York now has 70,000 doses of hydroxychloroquine; 10,000 doses of Zithromax and 750,000 doses of chloroquine, officials have announced. Different patients will be given varying doses of the medications.

New York health officials are also working out standardization protocols so the trial results could be studied and applied elsewhere.

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