New CDC COVID-19 isolation guidance weakens labor protections, discriminates against high-risk people, and does not match the science

On 1 March 2024, the CDC updated its COVID-19 isolation guidelines, removing their 5-Day isolation recommendation for COVID-19 and announcing a new guidance that will weaken labor protections, discriminates against high-risk people, and does not match the science of transmission or public health principles. The new "Respiratory Virus Guidance" rolls COVID-19 guidelines into a larger guidance that includes the flu and RSV, and it lowers isolation for people with COVID-19 to only 24 hours after being fever-free and other symptoms are improving if symptomatic, and no isolation at all if asymptomatic although still infectious. It also does not require or strongly suggest the use of masks when people "go back to [their] normal activities"; it only includes masks third on an either/or list of precautions to consider.

COVID-19 remains far more harmful and deadly than the flu and RSV, and it requires specific guidance and better protections, not worse. The new CDC guidance will contribute to employers forcing people back to work more quickly, schools forcing students back to school more quickly, and it puts an even larger burden on high-risk people to protect themselves. This has already been seen with similar isolation guidance changes in some states. In May 2023, Oregon guidelines were changed mainly so students didn't need to stay home for five days while infectious. In January 2024, California made similar changes to their guidelines which public health officials used to weaken state labor protections. This new guidance does nothing to address the ongoing pandemic and the real problems people face when infected with COVID-19, people will continue to be ill with COVID-19 but now with less ability to rest and isolate when needed.

This new guidance is dangerous, anti-science, anti-public health, discriminatory, and made without public comment. Please sign on to express your alarm for the updated CDC guidance and call upon the CDC to put in place better guidance and advocate for policies and programs that protect workers, students, high-risk people, and others!

SIGN-ON LETTER DELIVERED TO CDC:

8 July 2024

Dr. Mandy Cohen, MD, MPH, Director

Centers for Disease Control and Prevention

1600 Clifton Road

Atlanta, GA 30329

Dr. Cohen:

Pan End It! is a nationwide group of disabled, ill, and immunocompromised individuals and allies working for continued COVID-19 protections. We and the undersigned organizations, experts, and concerned individuals are writing to express our extreme disapproval of the CDC's changes to the COVID-19 isolation guidelines and its new "Respiratory Virus Guidance". This guidance is dangerous, anti-science, anti-public health, discriminatory, and made without public comment.

SARS-CoV-2 is an airborne virus. It does not exist in a separate realm; it requires interaction with people and spaces they inhabit to continue spreading. COVID-19 continues to strongly impact people, and there is no long lasting immunity against infection. Using a symptoms-based approach does not work with a virus like SARS-CoV-2 where it's known to have a large number of people who are asymptomatic yet infectious. Most people remain infectious with COVID-19 for more than five days, whether symptoms are present or not, and a fever is not a good indicator of infectiousness. An isolation period of ten days, not significantly less as the CDC has arbitrarily decided, is scientifically needed.

The CDC's recent guidance change indicates that the CDC either doesn't recognize this, that COVID-19 is spread among people, or they are completely detached from the realities of the lives of people who are impacted by their decisions. The CDC seems to think people who are high-risk - or those who simply don't wish to catch a contagious disease that has killed millions and disabled millions more in the last 4 years - exist in self-contained bubbles separate from "normal" society; that we aren't complete people with families, partners, roommates, friends, neighbors, and strangers we interact with every day. We apparently aren't workers without sick pay constantly exposed to sick co-workers and customers. We aren't teachers and students in overcrowded and unventilated or underventilated classrooms. We aren't people providing care to loved ones. We aren't commuters crammed into buses and trains with no air filtration. We are not people living in congregate settings with caregivers and visitors, incarcerated individuals without access to PPE, or unhoused members of society who are often not able to isolate at all. The lack of consideration of the needs and realities of people living in these situations indicates that, to the CDC, we are not people at all.

Additionally, the CDC categorizing COVID-19 as a respiratory illness in the same category as cold and flu is either a misleading oversight or a deliberate attempt to downplay the actual nature and severity of COVID-19. SARS-CoV-2 is much more dangerous than the flu, and a BSL-3 pathogen cannot be treated the same way. COVID-19 can affect every organ system and may cause Long COVID, with increased risk after reinfections. The chance of developing Long COVID increases with each infection, as does the chance of severe outcomes from COVID-19 with each reinfection. Although the new respiratory guidance's background document says that Long COVID is declining, according to the Household Pulse Survey, it is actually increasing.[1] COVID-19 remains a leading cause of death, disease, disability, and school and workplace absence. Having COVID-19 can weaken your immune system - it does not strengthen it - and can lead to an increase in getting other illnesses more regularly. COVID-19 remains a very serious multi-systemic disease spread primarily though airborne pathways, and none of this has changed. The only thing that has changed is the CDC's complete capitulation to political and business interests to force people into working and going to school while sick and ignoring their own needs.

This new guidance does nothing to address the ongoing pandemic and the real problems people face when infected with COVID-19. The CDC claims this change is to better align with what people need and are currently doing, but it doesn't address the underlying issues for people's behavior. The CDC accurately notes that people are unable to stay home when sick, or that doing so puts livelihoods at risk, because they do not have paid sick leave and can't make money while staying home sick. They also recognize that people are less likely to test for and report COVID-19 infections out of this concern for having to stay home without paid leave. But none of these are reasons that are the results of people's need to rest and isolate while sick; they are the reality of living in a society that does not provide proper support to people - ever - but especially when they need to stay home and cannot work. Many people are not choosing to work while sick; they have no other choice. These new guidelines are incredibly shortsighted.

Although the decision to remove isolation guidelines for COVID-19 is presented as one that benefits workers who are unable to follow the 5-day isolation guideline due to lack of paid sick leave, it does nothing of the sort. Instead of following the science and advocating for better policies, the CDC is putting workers at further risk. The isolation change is not a reflection of COVID-19's impact on workers, which remains substantial, as people are experiencing multiple infections a year. The new guidance was proposed because it serves the interests of corporations that forces workers to work while sick, and to remove any remaining rights they may have to rest and recover. Currently, nothing is stopping workers who want to go to work while COVID-19 positive from doing so if they choose not to test and isolate. This guidance change from the CDC does not affect that reality. What will change is the ability of employees who do need to stay home and rest from doing so. The new guidance gives employers leverage to end COVID-19 sick leave and prevent employees from utilizing and remaining sick leave - even when they want to do so. Ultimately, this goes much farther than isolating or COVID-19; it is an attack on workers' rights to use their sick leave now and opens the opportunity for additional attacks on workers' rights and ability to advocate for paid sick leave in the future.

Another important consideration is the impact of COVID-19 on children and schools. Children are also impacted by COVID-19, and the new respiratory guidance will cause them harm. The CDC has shared that from January 2022 to July 2023, half the children who died from COVID-19 had no underlying health conditions.[2] Children of color are hospitalized and die at higher rates from COVID-19.[3] It is estimated that 16% of children develop Long COVID after an infection.[4] Additionally, conditions resulting from COVID-19 infections such as childhood diabetes are on the rise.[5] Household spread often comes from a child.[6] The inclusion of cleaning the air in the new guidance will be outweighed by the increased exposures in schools, which will lower attendance and cause more infections and harm of children and staff.

This isolation guidance is also discriminatory and against state and federal law. Under the ADA, disabled people have an equal right to access public spaces as nondisabled people; under Section 504, disabled students have the right to a Free Appropriate Public Education (FAPE). Several communities are at increased risk for severe outcomes from COVID-19, including people of color, older people, and other individuals who are at high-risk (a significant portion of the population). The CDC is aware that these communities are at increased risk. This new isolation guidance will cause repeated exposure to students, teachers, workers, and other disabled people accessing public spaces who will get severely ill or die. This means many disabled children can no longer go to their school. It means many disabled workers can no longer work because of the risk of exposure. This also ignores that there are people who may not able to avoid exposure if a person who is COVID-19-positive returns to work, like people who are incarcerated, live in congregate settings, or rely on caretakers.

It is concerning to us that the new guidance is written in vague language that leaves out or de-emphasizes many important points and needed guidance for COVID-19. Masking and testing to protect oneself - two of the most important tools that we have against COVID-19 and other diseases - are listed as "additional prevention strategies" rather than "core prevention strategies," but hygiene such as washing one's hands is included as a core strategy, which is not protective against COVID-19. The photograph on the masking page is also of a surgical mask, thus not modeling an N95 as more protective.

In the new guidance, the CDC does not tell people to mask if they are COVID-positive or feeling sick - or even strongly recommend it - but instead lists masking as the third item presented in an either/or list, thus downplaying it as an essential tool to make public spaces accessible. In addition, the high-risk groups list appears narrowed and doesn't include other groups at heightened risk, including people of color; the CDC's main People with Certain Medical Conditions page has also not been migrated over, which is an important page many people access to learn about their own risk and use for documentation of being high-risk. There is also concern about other COVID-19-specific pages being marked as no longer up-to-date, when COVID-19-specific information is still needed for people to stay safe.

The continued chipping away of guidelines continues to reduce people's abilities to keep themselves safe now and in the future. What will we do when COVID levels reach or exceed previous surge wastewater levels again? What will be do when we need paid sick leave? What will we do when the next pandemic hits? The CDC must provide leadership with public health guidelines that reflect the path that we should be taking, not the path that has been forced upon us for the sake of convenience. The CDC should not make recommendations that make people sicker.

The consequences of health outcomes from COVID-19 will affect citizens, health policies, and resources for years to come. The CDC is shirking their responsibility to public health and equal rights under the law. The CDC must rescind these new guidelines and address that the lack of paid sick leave in the United States is a public health emergency by working with other agencies in support of universal paid sick leave. The CDC should emphasize in updated guidance that masking and testing are core prevention strategies. More specific information on groups and individuals who are high-risk needs to be added to future guidelines, and the CDC high-risk conditions page retained. The CDC must cease capitulating to business interests and political pressure and recommend scientifically-based isolation guidance in order to protect people and reduce the burden of COVID-19.

Citations

1. Centers for Disease Control and Prevention. (2024, February 23). Long COVID - Household Pulse Survey. https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm

2. Evidence to recommendations framework. (n.d.). https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/11-COVID-Wallace-508.pdf

3. Two-year study finds black children with Covid-19 had twice as many deaths as white children with the virus. Morehouse School of Medicine. (n.d.). https://www.msm.edu/RSSFeedArticles/2023/March/2022BCAC_Report.php

4. A Systematic Review of Persistent Clinical Features After SARS-CoV-2 in the Pediatric Population. American Academy of Pediatrics. (n.d.). https://publications.aap.org/pediatrics/article/152/2/e2022060351/192816/A-Systematic-Review-of-Persistent-Clinical

5. Children's Health. (n.d.). COVID-19 and diabetes in children. https://www.childrens.com/health-wellness/can-covid-19-cause-diabetes-in-children

6. More than 70% of us household COVID spread started with a child, study suggests. CIDRAP. (n.d.). https://www.cidrap.umn.edu/covid-19/more-70-us-household-covid-spread-started-child-study-suggests

Signed,

Sponsor:

Pan End It!

Co-Sponsors:

Long COVID Justice

Mask Together America

Organizations:

Progressive Democrats of America

PDA Disability Team

National Progressive Council on Disability

Oregon Health Equity Alliance

Massachusetts Coalition for Health Equity

Northern Youth Project

Senior and Disability Action

Ecohesian

Celebrate 845

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Fight Covid NOLA

Mask Bloc MKE

Mask Up Morris

Diekman Dysautonomia, LLC

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Monica Allen

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Heidi Andersen, Online Math and Writing Teacher with Long COVID

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Katherine McGinn

Devan McGirr

Jeanette McGregor

Ellen McGregor

Morgan McGrew

Michelle McGrover

Caitlin McKenna

Vanessa McKinney

Hannah Mclain

Megan McLaws, BS in Public Health Promotion, Clinical Study Coordinator at Huntsman Cancer Institute, CHES

Elizabeth McLister, Registered Nurse

Kate McNulty

Heather McTammany, JD

Marc Meadows, PhD, AFSCME

Claudia Megaro

Mae Melaku

Maria Pia Meli

Zoya Melkova

STEPHANIE MELVIN

Gwen Mendoza

Sam Mendoza, RMA

August Metzger

Marsha Michel

Amy MICHELS

Lisa Milbrand

Mari Milkie

Bethany Miller

Crystal Miller

Zaria Miller

Ann Miller-Larson

Kathleen Minnix

Jolie Misek

Mary Mitchell

Clarissa Mitchell

Taiji Miyagawa

Michelle Miyagi, RN

Katelyn Miyasaki, Bioengineering MS, World Health Network

Keely Mizell

Karen Modell

Maria Monks Gillespie, Colorado State University, Ph.D., Mathematics

Sonya Montour

Martha Moore

Melina Moore

ned moran

Janna Moreau, RN

Hillary Morgan, United Healthcare

Ray Morrison, MPH

Lauren Moss

Celeste Moye

Mackenzie Moyer

Ahona Mukherjee

rachel mulder

Avi Mulhern

Vienna Mumm, Disabled person, regularly reads studies about covid

Ellen Munson

Aidan Muraca

Stephanie Muraca

Sydney Muraca

Erin Murphy

Elizabeth Murphy

Meredith Murphy

Tiffany Murray

Gretchen Musa, Transplant recipient on immunosuppressants

Angela Myers, RDN, LDN

Brenna Myers

Sarah Myers

Jessica Mytrohovich

Lori N

Jay Nadolski

Kat Naphas

Emma Narkewicz, MPA

Betty Nash

Kate Nash

Danielle Naughton

Shawn Nead

Anna Neher

Margaret Neher

James Nehmer

Sarah Nehmer

Michael Neil

Dana Nelson

Jay Nenninger

Sarah Nero

Nathanael Nerode, Expert on Covid-19 prevention, published paper on the topic, World Health Network

Judi Nesselbush

Jennifer New

Henry Newman

Emily Ngo

Alicia Nguyen

Lucas Nguyen

Alex Nicholls

Emily Nicholson

Jannell Nickols

Santiago Nicolella

Joseph Nield

Linda Nielsen

Meredith Nimz

Nanyamka Noel

Rosie Nolan

Elizabeth Norris

Sarah Norton

Nia Nottage, patient / concerned citizen, member of ACT UP NY and Peoples CDC

Hannah Nowland

Don Nowland

Claire O

Claire O'Brocta

Jenny O'Connell

Kathy O'Connor

Noelle O'Dell

Kelly O’Donnell, WWFR

Voula O'Grady, Long COVID Justice / Strategies for High Impact

Dan O'Neal, Progressive Democrats of America, PDA Az State Coordinator

Shea Oneil, BA Psychology, World Health Network Volunteer

Siobhan O’Reilly

Talana Ocampo

Raul Odo

Miranda Oehler

Emily Oelberg

Molly Officer

Lisa OHare

Hillary Okun

han olliver

Caitlin Olson

Erica Olson

Lisa Oshima, Msc Oxon

Mackenzi Oswald

Kristen Otenti

Kris Owens

Meghan Oxley

Emma Ozark

Cori P

Nicholas Pahl Skinner

Merry Palachek

Berthe Palmrose

iele paloumpis

Irene Papaefthemiou

Emily Parker

Jamie Partridge, Portland Jobs with Justice, Medical Lab Tech, American Society for Clinical Pathology

Crystal Pasiliao

J Stephanie Pasvankias

Emily Patchin

Khushi Patel

Emma Pauly

Alejandro Peña Gorbe

Nora Pearson

Julian Pecina

Kim Peirano, DACM, LAc

Kevin Pelletier

Jane Penn

Jennifer Pereira

Rocio Perez

Priscilla Perez

Laura Perez

Janine Perlman, Ph.D.

Ash Peterson

Jessica Peterson, Concerned individual, Medically Vulnerable

Kendra Peterson

Susan Peterson

Zara Petkovic

Nicole Petrin

Darren Petronella

Sara Phalen

Charles Phillips, former medical worker & clinic manager

Justin Philipps

Kim Phillips

scout Phillips

Skye Phillippe

Kay Pho, MD

Brianna Pickett

Rachel Pike

Oren Pilinger, L.Ac.

Ellen Pimentel

Adrianna Pisacane

Tania Pivawer, Long COVID patient, High risk autoimmune

Amy Poague

karyn pomerantz, Retired, Mls Mph

Acacia Pottschmidt

Minou Pourshariati

Angel Powell

Olivia Powell

Erin Powers, MS, CCC-SLP

Jessi Presley-Grusin

Shoshanna Press, MD

Leah Pruente

Colleen Pryke

Angela Pryor

Shelby Pumphrey

Milo Quinn

Leonor Quintos

Rachel R

alexa r

Toby Raab

Connie Rab

Scott Raboy

Rachel

Amanda Randolph

Teri Jo Rask

MARY RATHBUN

Katherine Ray, Human being

Rose Redwood

Dawn Reed

Angela Reed

Sadie Reid

Jessica Reigelman

Lauren Reinbold

Kimmie Remis

Kelly Renee

Jennylynde Renteria-Packham, MSN, RN

Jordan Rhea

Rachel Rhodes

Sarah Ribero

Patricia D. Richards

Michal Richardson

Rebecca Richardson

Colt Richey

Emily Richey-Stavrand

Henry Richmond-Boudewyns

Madeline Riggins

Anne Riley

Claudia Rios, MS RD

Rissa

Jennifer Ritz Sullivan

Nicole Rizzo

Jean Roberts

Howard Robinson

Kim Robinson

Stacy Robinson

Chelsi Robnett

Michelle Rochniak

Xandra Rodriguez

Alia Rogers, MSW

Chuan Rogers, Healthcare

Eli Rojas

Karimah Rokins

Cassidy Romaire

Armay Roque

K. Ros

lisa rosati

Colette Rose, MSc

Dominique Rose

Lauren Rose

Maya Rose

Cara Rosenburg

Shara Rosko

D. Ross

Lori Ross

shema ross

Danielle Rossoni, MSPH

Ariana Rowberry

Samwise Rowe

Dianne Russell

Hannah Ryan

Janine Ryan

Martha Ryan

Elisa Ryder

Angel S

Anna S, teacher

E S

Jade S

Natalie S

Andrea Salazar

Christie Salema

Michelle Sanchez

Gabriela Santiago

Marta Santos

Sabrina Sayegh

Izzy Sazak

Scarlet

Greg Schacht

Annalisa Schaefer, The WHN

Edie Schaffer

Melissa Scharfinski

Amy Schemmel

Alan Schmidy

Katie Schotman

Stephanie Schroeder, JD, Person with Long COVID

Grayson Schultz, MS

Stefanie Schulyk

Debby Schwartz, Do Good Multnomah, Case Manager, Multnomah County

Sarah Scott

Kelly Scott

Juniper Sedlock, Do Good Multnomah, Social worker

Elliot Seiler

Rhea Sellitto

Pooja Sen

Rachael Shapiro Majka

Rachel Shaw

siobhan shea

Bob Shephard

maeve sherry

Nikul Sheth

Elaine Shilstut

Francis Shiner

Carla Short

Leah Short

Sylvia Shread

Erin Sindewald

Nora Slott

Alexandra Smith

Ardis Smith

Bonnie Smith

Bridget Smith

Elisabeth Smith

Emma Smith

Jen Smith

Lauren Smith, AA (Sociology), BA (Sociology)

Lora Smith

Sarah Smith

Jessica Sobel, Rn

Deborah Socolar, MPH

Ray Soller

Ryan Soller

Hannah Song

Mary Sorensen

Maighread Southard-Wray

Millie Southern

Christina Spangler

Spearance, early childhood educator

Leif Speck

Alana Spence

Erica Spencer

Claryn Spies

John Spillane

Jenna Spitz, LCSW

Scott Squires

Amie Stager

Jennika Stamm, MS

Mallory Stanislawczyk, CPNP

Lauren Stark, Ph.D.

Lori Stefano

Jennifer Stefanow

Rebekah Steiner

Jenifer Steinmeyer

Rachel Steuer

David Stevens, PMHNP

Rey Stevens

Max Stewart, University of Washington Department of Biology

Brezlyn Stork

Taylor Stover

J. David Strickland

Cameron Strider, ABOC, Arden Optometric Associates

J Striegel

Diana Striplin, MS, Concerned citizen

Rebecca Stuebe

Elizabeth Suffern

Hikari Sugisaki

Kaitlin Sullivan

Jen Sun

Jacinda Swanson

Reema Sweidan

Cole Swenson

Lindsay Swingle

Andrew Sylvester

Kathryn Sylvia

Meli Syphus

Sarah Sypris

Amy T

D. T.

Ryan Takakawa

Jessica Tang

Jessica Tardieu Haines

Kay Tavarez

Tjaša Tavčar, Lawyer, Covid victims organization

Allison Taylor

T Taylor

Abby Taylor

Gabriella Telaroli

Naia Tenerowicz

Gideon TG

Susan Thomas

Kali Thomas

Ananda Thompson

Annie Tilton

Patty Tobin

Kendra Todd

Renee Tomek, Long covid survivor 2 years

Ursula Tooley

Iran Torres

Celines Torres

Cass Torrez

Debbie Trachtenberg

Track Trachtenberg

Anne Trafton

Hannah Tralka

Taryn Tranby, A Citizen and Employee in the US

Abigail Trapp

Kaila Trawitzki

Frieda Tresvan

Emily Trower-Young, Em & El Organics, LLC

Chelsea Trull

Luke Turek

Grace Turkis

Keren Turner

Katie Turner, Self

Kathleen Turturice

Kaitlyn Tykhonovska

Carmen Ubarri, Self -employed

Aliyah Uhlig

Eli Underwood

Alex V.

Selfling Vail, Disabled lol

Scott Valdes

Adam Van Bavel

Julie Vanderschaegen

mik varunok

Patrick Vaughan, General Member of Public, M.S in Biomedical Engineering

Tara Velarde

Henry Venneman

Daphnnee Venneman

Kirsten Verclas

Alexandra Vernon

Mary Vest

Erica Victoria, Mental Health Worker, University of Vermont

Andrea Villarreal

Fern Viridian

Zoe Vock

Robert Vogel

Jill Vosberg

Wiley W

Aliya Wadood, MPH

Artesia Wagersreiter

Dana Walker

Karen Walker, Registered Nurse, CCM

Anders Mordechai Walkington

Candice Wanca

Buck Wands

Amy Wang

Claire Wang

Sarah Warzecha

T. WATANABE

Emily Watson

Alex Watson, Mater’s of Public Health

Bridget Watts, sentient human being

Shelby Wayment, Lawyer

Winifred Weaver, Retired, Rehabilitation Counselor, Community Projects

Terrie Weeks, RN, JD

Julie Wegener, MD

Beck Wehrle, PhD

Fiona Wei

Corina Weidinger

Joanna Weids

Ethan Weinstein

Sarah Weir

Anthea Welbourn

Raleigh Welch

W. Werosh

Whitney West

Caleb Wetzel, Mechanical Engineering

Gloria Whipple

atiyah white

khadijah white

Dana Whitfield

Salome Whittamore

DeForest Wihtol

Kari Wilder-Romans

Austin Wilkes

Kathryn Willey

James Williams

Jennifer Williams

Leslie Williams

William Williams

Daniel Willows

Jordan Wilmot

Lisa Wilson

Stephanie Wilson-Krause

Benny Winer, Community Healthcare Network

Nicholas Winningkoff

Yehudah Alan Winter, Compassionate Listening Oregon, Retired RN

Loren Witcher

Danielle Wogulis

Constance Wold, Attorney, Retired

Sarah Wong Thompson

Brian Woo

Sindri Woodard

Connie Woods

John Woodward

Kyla Worrell

Alison Wortz

Emily Wright

Flora Wright

Lea Wright

Melisssa Wright

Rebecca Wright

Victoria Wu

Barbara Wyckoff, Masktogetheramerica, Mask ambassador

Heather Wylie

Sophia Yau-Weeks

Cristy Yeung

Stephanie Yoakum

Dara York, RN

Dennis Young, Self

Martha Young

Emma Youngblood

Emily Yurina

Djaz Z

Hollie Z.

Rachel Zaidman

Sarah Zarzynski, CCRA, University of Minnesota School of Public Health

Jillian Zdepski

Mariah Zeisberg, Ph.D.

Rob Zeno

Maria Ziegelbauer

Danielle Zimmerman

Jason Zimmerman, High-risk person, covid advocate

Ana Zink, PhD

Ames Zocchi

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