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Abstract

Background

Evidence for face-mask wearing in the community to protect against respiratory disease is unclear.

Aim

To assess effectiveness of wearing face masks in the community to prevent respiratory disease, and recommend improvements to this evidence base.

Methods

We systematically searched Scopus, Embase and MEDLINE for studies evaluating respiratory disease incidence after face-mask wearing (or not). Narrative synthesis and random-effects meta-analysis of attack rates for primary and secondary prevention were performed, subgrouped by design, setting, face barrier type, and who wore the mask. Preferred outcome was influenza-like illness. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality assessment was undertaken and evidence base deficits described.

Results

33 studies (12 randomised control trials (RCTs)) were included. Mask wearing reduced primary infection by 6% (odds ratio (OR): 0.94; 95% CI: 0.75–1.19 for RCTs) to 61% (OR: 0.85; 95% CI: 0.32–2.27; OR: 0.39; 95% CI: 0.18–0.84 and OR: 0.61; 95% CI: 0.45–0.85 for cohort, case–control and cross-sectional studies respectively). RCTs suggested lowest secondary attack rates when both well and ill household members wore masks (OR: 0.81; 95% CI: 0.48–1.37). While RCTs might underestimate effects due to poor compliance and controls wearing masks, observational studies likely overestimate effects, as mask wearing might be associated with other risk-averse behaviours. GRADE was low or very low quality.

Conclusion

Wearing face masks may reduce primary respiratory infection risk, probably by 6–15%. It is important to balance evidence from RCTs and observational studies when their conclusions widely differ and both are at risk of significant bias. COVID-19-specific studies are required.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
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2020-12-10
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References

  1. World Health Organization (WHO). Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Geneva: WHO; 2020. Available from: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)
  2. World Health Organization (WHO). WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Geneva: WHO; 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
  3. John Hopkins University Coronavirus Resource Centre. Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Baltimore: JHU; 2020. Available from: https://coronavirus.jhu.edu/map.html
  4. Gajanan M. Can Face Masks Prevent Coronavirus? Experts Say That Depends. Time. 2020 31 Jan.
  5. Asgari N, Wells P. Face mask shortage hits Europe and US as coronavirus spreads. Financial Times. 2020 30 Jan.
  6. Carter SL. Sold-Out Coronavirus N95 Face Masks Offer a Lesson in Price Gouging. Bloombergcom. 2020 31 Jan.
  7. O'Connor K. Coronavirus: face masks sell out but are unlikely to stop germs. The Times. 2020 1 Feb.
  8. Taylor K. Costco is selling out of surgical masks in South Korea, as the country battles the spread of the coronavirus. Business Insider. 2020 3 Feb.
  9. Wu H, Huang J, Zhang CJ, He Z, Ming W. Facemask shortage and the novel coronavirus disease (COVID-19) outbreak: Reflections on public health measures. EClinicalMedicine.2020;21:100329.  https://doi.org/10.1016/j.eclinm.2020.100329  PMID: 32292898 
  10. Seriously people - STOP BUYING MASKS! [press release]. Twitter, 29 Feb 2020.
  11. Saunders-Hastings P, Crispo JAG, Sikora L, Krewski D. Effectiveness of personal protective measures in reducing pandemic influenza transmission: A systematic review and meta-analysis. Epidemics. 2017;20:1-20.  https://doi.org/10.1016/j.epidem.2017.04.003  PMID: 28487207 
  12. Jefferson T, Foxlee R, Del Mar C, Dooley L, Ferroni E, Hewak B, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. BMJ. 2008;336(7635):77-80.  https://doi.org/10.1136/bmj.39393.510347.BE  PMID: 18042961 
  13. Wong VWY, Cowling BJ, Aiello AE. Hand hygiene and risk of influenza virus infections in the community: a systematic review and meta-analysis. Epidemiol Infect. 2014;142(5):922-32.  https://doi.org/10.1017/S095026881400003X  PMID: 24572643 
  14. bin-Reza F, Lopez Chavarrias V, Nicoll A, Chamberland ME. bin-Reza F, Lopez Chavarrias V, Nicoll A, Chamberland ME. The use of masks and respirators to prevent transmission of influenza: A systematic review of the scientific evidence. Influenza Other Respi Viruses. 2012;6(4):257-67.  https://doi.org/10.1111/j.1750-2659.2011.00307.x 
  15. Wang M, Barasheed O, Rashid H, Booy R, El Bashir H, Haworth E, et al. A cluster-randomised controlled trial to test the efficacy of facemasks in preventing respiratory viral infection among Hajj pilgrims. J Epidemiol Glob Health. 2015;5(2):181-9.  https://doi.org/10.1016/j.jegh.2014.08.002  PMID: 25922328 
  16. Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020;395(10242):1973-87.  https://doi.org/10.1016/S0140-6736(20)31142-9  PMID: 32497510 
  17. Cowling BJ, Zhou Y, Ip DKM, Leung GM, Aiello AE. Face masks to prevent transmission of influenza virus: a systematic review. Epidemiol Infect. 2010;138(4):449-56.  https://doi.org/10.1017/S0950268809991658  PMID: 20092668 
  18. MacIntyre CR, Chughtai AA. Facemasks for the prevention of infection in healthcare and community settings. BMJ. 2015;350(apr09 1):h694.  https://doi.org/10.1136/bmj.h694  PMID: 25858901 
  19. Barasheed O, Alfelali M, Mushta S, Bokhary H, Alshehri J, Attar AA, et al. Uptake and effectiveness of facemask against respiratory infections at mass gatherings: a systematic review. Int J Infect Dis. 2016;47:105-11.  https://doi.org/10.1016/j.ijid.2016.03.023  PMID: 27044522 
  20. Benkouiten S, Brouqui P, Gautret P. Non-pharmaceutical interventions for the prevention of respiratory tract infections during Hajj pilgrimage. Travel Med Infect Dis. 2014;12(5):429-42.  https://doi.org/10.1016/j.tmaid.2014.06.005  PMID: 24999278 
  21. Aiello AE, Murray GF, Perez V, Coulborn RM, Davis BM, Uddin M, et al. Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a randomized intervention trial. J Infect Dis. 2010;201(4):491-8.  https://doi.org/10.1086/650396  PMID: 20088690 
  22. Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, Monto AS. Facemasks, hand hygiene, and influenza among young adults: a randomized intervention trial. PLoS One. 2012;7(1):e29744.  https://doi.org/10.1371/journal.pone.0029744  PMID: 22295066 
  23. Canini L, Andréoletti L, Ferrari P, D’Angelo R, Blanchon T, Lemaitre M, et al. Surgical mask to prevent influenza transmission in households: a cluster randomized trial. PLoS One. 2010;5(11):e13998.  https://doi.org/10.1371/journal.pone.0013998  PMID: 21103330 
  24. Cowling BJ, Chan KH, Fang VJ, Cheng CKY, Fung ROP, Wai W, et al. Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial. Ann Intern Med. 2009;151(7):437-46.  https://doi.org/10.7326/0003-4819-151-7-200910060-00142  PMID: 19652172 
  25. Cowling BJ, Fung ROP, Cheng CKY, Fang VJ, Chan KH, Seto WH, et al. Preliminary findings of a randomized trial of non-pharmaceutical interventions to prevent influenza transmission in households. PLoS One. 2008;3(5):e2101.  https://doi.org/10.1371/journal.pone.0002101  PMID: 18461182 
  26. Larson EL, Ferng YH, Wong-McLoughlin J, Wang S, Haber M, Morse SS. Impact of non-pharmaceutical interventions on URIs and influenza in crowded, urban households. Public Health Rep. 2010;125(2):178-91.  https://doi.org/10.1177/003335491012500206  PMID: 20297744 
  27. Lau JTF, Lau M, Kim JH, Wong E, Tsui HY, Tsang T, et al. Probable secondary infections in households of SARS patients in Hong Kong. Emerg Infect Dis. 2004;10(2):236-43.  https://doi.org/10.3201/eid1002.030626  PMID: 15030689 
  28. Lau JT, Tsui H, Lau M, Yang X. SARS transmission, risk factors, and prevention in Hong Kong. Emerg Infect Dis. 2004;10(4):587-92.  https://doi.org/10.3201/eid1004.030628  PMID: 15200846 
  29. MacIntyre CR, Cauchemez S, Dwyer DE, Seale H, Cheung P, Browne G, et al. Face mask use and control of respiratory virus transmission in households. Emerg Infect Dis. 2009;15(2):233-41.  https://doi.org/10.3201/eid1502.081166  PMID: 19193267 
  30. Simmerman JM, Suntarattiwong P, Levy J, Jarman RG, Kaewchana S, Gibbons RV, et al. Findings from a household randomized controlled trial of hand washing and face masks to reduce influenza transmission in Bangkok, Thailand. Influenza Other Respi Viruses. 2011;5(4):256-67.  https://doi.org/10.1111/j.1750-2659.2011.00205.x  PMID: 21651736 
  31. Suess T, Remschmidt C, Schink SB, Schweiger B, Nitsche A, Schroeder K, et al. The role of facemasks and hand hygiene in the prevention of influenza transmission in households: results from a cluster randomised trial; Berlin, Germany, 2009-2011. BMC Infect Dis. 2012;12(1):26.  https://doi.org/10.1186/1471-2334-12-26  PMID: 22280120 
  32. World Health Organization (WHO). WHO surveillance case definitions for ILI and SARI 2014. Geneva: WHO; 2014. Available from: https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/
  33. Menni C, Valdes AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med. 2020;26(7):1037-40.  https://doi.org/10.1038/s41591-020-0916-2  PMID: 32393804 
  34. The Cochrane Collaboration. Review Manager (RevMan). 5.3 ed. Copenhagen: The Nordic Cochrane Centre; 2014.
  35. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490.  https://doi.org/10.1136/bmj.328.7454.1490  PMID: 15205295 
  36. Choudhry AJ, Al-Mudaimegh KS, Turkistani AM, Al-Hamdan NA. Hajj-associated acute respiratory infection among hajjis from Riyadh. East Mediterr Health J. 2006;12(3-4):300-9. PMID: 17037698 
  37. Alfelali M, Haworth EA, Barasheed O, Badahdah A-M, Bokhary H, Tashani M, et al. Facemask versus No Facemask in Preventing Viral Respiratory Infections During Hajj: A Cluster Randomised Open Label Trial. Social Science Research Network (SSRN). 2019. Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3349234
  38. Tahir MF, Abbas MA, Ghafoor T, Dil S, Shahid MA, Bullo MMH, et al. Seroprevalence and risk factors of avian influenza H9 virus among poultry professionals in Rawalpindi, Pakistan. J Infect Public Health. 2019;12(4):482-5.  https://doi.org/10.1016/j.jiph.2018.11.009  PMID: 30578143 
  39. Zein U, editor. The role of using masks to reduce acute upper respiratory tract infections in pilgrims. 4th Asia Pacific travel health conference; 2002 Oct 20; Shanghai, PR China.
  40. Gautret P, Vu Hai V, Sani S, Doutchi M, Parola P, Brouqui P. Protective measures against acute respiratory symptoms in French pilgrims participating in the Hajj of 2009. J Travel Med. 2011;18(1):53-5.  https://doi.org/10.1111/j.1708-8305.2010.00480.x  PMID: 21199143 
  41. Hashim S, Ayub ZN, Mohamed Z, Hasan H, Harun A, Ismail N, et al. The prevalence and preventive measures of the respiratory illness among Malaysian pilgrims in 2013 Hajj season. J Travel Med. 2016;23(2):tav019.  https://doi.org/10.1093/jtm/tav019  PMID: 26858268 
  42. Zhang D, Liu W, Yang P, Zhang Y, Li X, Germ KE, et al. Factors associated with household transmission of pandemic (H1N1) 2009 among self-quarantined patients in Beijing, China. PLoS One. 2013;8(10):e77873.  https://doi.org/10.1371/journal.pone.0077873  PMID: 24205006 
  43. Tuan PA, Horby P, Dinh PN, Mai LT, Zambon M, Shah J, et al. SARS transmission in Vietnam outside of the health-care setting. Epidemiol Infect. 2007;135(3):392-401.  https://doi.org/10.1017/S0950268806006996  PMID: 16870029 
  44. MacIntyre CR, Zhang Y, Chughtai AA, Seale H, Zhang D, Chu Y, et al. Cluster randomised controlled trial to examine medical mask use as source control for people with respiratory illness. BMJ Open. 2016;6(12):e012330.  https://doi.org/10.1136/bmjopen-2016-012330  PMID: 28039289 
  45. Wu S, Ma C, Yang Z, Yang P, Chu Y, Zhang H, et al. Hygiene behaviors associated with influenza-like illness among adults in Beijing, China: A large, population-based survey. PLoS One. 2016;11(2):e0148448.  https://doi.org/10.1371/journal.pone.0148448  PMID: 26840614 
  46. Balaban V, Stauffer WM, Hammad A, Afgarshe M, Abd-Alla M, Ahmed Q, et al. Protective practices and respiratory illness among US travelers to the 2009 Hajj. J Travel Med. 2012;19(3):163-8.  https://doi.org/10.1111/j.1708-8305.2012.00602.x  PMID: 22530823 
  47. Fan J, Liu X, Shao G, Qi J, Li Y, Pan W, et al. The epidemiology of reverse transmission of COVID-19 in Gansu Province, China. Travel Med Infect Dis. 2020;37:101741.  https://doi.org/10.1016/j.tmaid.2020.101741  PMID: 32407893 
  48. Deris ZZ, Hasan H, Sulaiman SA, Wahab MSA, Naing NN, Othman NH. The prevalence of acute respiratory symptoms and role of protective measures among Malaysian hajj pilgrims. J Travel Med. 2010;17(2):82-8.  https://doi.org/10.1111/j.1708-8305.2009.00384.x  PMID: 20412173 
  49. Shirah BH, Zafar SH, Alferaidi OA, Sabir AMM. Mass gathering medicine (Hajj Pilgrimage in Saudi Arabia): The clinical pattern of pneumonia among pilgrims during Hajj. J Infect Public Health. 2017;10(3):277-86.  https://doi.org/10.1016/j.jiph.2016.04.016  PMID: 27262693 
  50. Mccollough JB. ‘You could literally kill someone’: Masks become a new COVID-19 battleground. Los Angeles Times. 2020 May 4.
  51. Zhang JG. Food Workers Are Experiencing Hostility and Violence From Customers Refusing to Wear Masks. EATERcom. 2020 May 21.
  52. Hunter PR, Colon-Gonzalez F, Brainard JS, Rushton S. Impact of non-pharmaceutical interventions against COVID-19 in Europe: a quasi-experimental study. medRxiv. 2020.05.01.20088260; (Preprint). https://doi.org/10.1101/2020.05.01.20088260.
  53. Brauner JM, Sharma M, Mindermann S, Stephenson AB, Gavenčiak T, Johnston D, et al. The effectiveness and perceived burden of nonpharmaceutical interventions against COVID-19 transmission: a modelling study with 41 countries. medRxiv. 2020.05.28.20116129; (Preprint). https://doi.org/10.1101/2020.05.28.20116129
  54. Zhang R, Li Y, Zhang AL, Wang Y, Molina MJ. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proc Natl Acad Sci USA. 2020;117(26):14857-63.  https://doi.org/10.1073/pnas.2009637117  PMID: 32527856 
  55. Cheng VC, Wong S-C, Chuang VW, So SY, Chen JH, Sridhar S, et al. The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. J Infect. 2020;81(1):107-14.  https://doi.org/10.1016/j.jinf.2020.04.024  PMID: 32335167 
  56. Lyu W, Wehby GL. Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US: Study examines impact on COVID-19 growth rates associated with state government mandates requiring face mask use in public. Health Aff (Millwood). 2020;39(8):1419-25.  https://doi.org/10.1377/hlthaff.2020.00818  PMID: 32543923 
  57. Centre SM. Expert reaction to preprint looking at a possible blueprint out of lockdown based on analysis of effects of various measures used in several European countries: Science Media Centre; 2020. Available from: https://www.sciencemediacentre.org/expert-reaction-to-preprint-looking-at-a-possible-blueprint-out-of-lockdown-based-on-analysis-of-effects-of-various-measures-used-in-several-european-countries/
  58. Haber N, Larremore DB, Goodman SN, Grabowski MK, Wada N, Lessler J, et al. Formal request for the retraction of Zhang et al. 2020: META-RESEARCH INNOVATION CENTER AT STANFORD; 2020. Updated 18 June 2020.
  59. Soltesz K, Gustafsson F, Timpka T, Jaldén J, Jidling C, Heimerson A, et al. Sensitivity analysis of the effects of non-pharmaceutical interventions on COVID-19 in Europe. medRxiv. 2020.06.15.20131953; (Preprint). https://doi.org/10.1101/2020.06.15.20131953
  60. Cochrane AL. Archie Cochrane in his own words. Control Clin Trials. 1989;10(4):428-33.  https://doi.org/10.1016/0197-2456(89)90008-1  PMID: 2691208 
  61. Paulo AC, Correia-Neves M, Domingos T, Murta AG, Pedrosa J. Influenza infectious dose may explain the high mortality of the second and third wave of 1918-1919 influenza pandemic. PLoS One. 2010;5(7):e11655.  https://doi.org/10.1371/journal.pone.0011655  PMID: 20668679 
  62. Baracco G, Eisert S, Eagan A, Radonovich L. Comparative cost of stockpiling various types of respiratory protective devices to protect the health care workforce during an influenza pandemic. Disaster Med Public Health Prep. 2015;9(3):313-8.  https://doi.org/10.1017/dmp.2015.12  PMID: 25874891 
  63. Rivera P, Louther J, Mohr J, Campbell A, DeHovitz J, Sepkowitz KA. Does a cheaper mask save money? The cost of implementing a respiratory personal protective equipment program. Infect Control Hosp Epidemiol. 1997;18(1):24-7.  https://doi.org/10.2307/30141959  PMID: 9013242 
  64. McGain F, Story D, Lim T, McAlister S. Financial and environmental costs of reusable and single-use anaesthetic equipment. Br J Anaesth. 2017;118(6):862-9.  https://doi.org/10.1093/bja/aex098  PMID: 28505289 
  65. Coulter J. Air pollution masks symptom of throwaway society. China Daily. 2017 18 Jan.
  66. Al-Jasser FS, Kabbash IA, Almazroa MA, Memish ZA. Patterns of diseases and preventive measures among domestic hajjis from Central, Saudi Arabia. Saudi Med J. 2012;33(8):879-86. PMID: 22886122 
  67. Barasheed O, Almasri N, Badahdah AM, Heron L, Taylor J, McPhee K, et al. Pilot randomised controlled trial to test effectiveness of facemasks in preventing influenza-like illness transmission among Australian hajj pilgrims in 2011. Infect Disord Drug Targets. 2014;14(2):110-6.  https://doi.org/10.2174/1871526514666141021112855  PMID: 25336079 
  68. Emamian MH, Hassani AM, Fateh M. Respiratory tract infections and its preventive measures among Hajj pilgrims, 2010: A nested case control study. Int J Prev Med. 2013;4(9):1030-5. PMID: 24130944 
  69. Jolie R, Bäckström L, Thomas C. Health problems in veterinary students after visiting a commercial swine farm. Can J Vet Res. 1998;62(1):44-8. PMID: 9442939 
  70. Kim CO, Nam CM, Lee DC, Chang J, Lee JW. Is abdominal obesity associated with the 2009 influenza A (H1N1) pandemic in Korean school-aged children? Influenza Other Respi Viruses. 2012;6(5):313-7.  https://doi.org/10.1111/j.1750-2659.2011.00318.x  PMID: 22151080 
  71. Shin K, Wakabayashi H, Sugita C, Yoshida H, Sato K, Sonoda T, et al. Effects of orally administered lactoferrin and lactoperoxidase on symptoms of the common cold. Int J Health Sci (Qassim). 2018;12(5):44-50. PMID: 30202407 
  72. Uchida M, Kaneko M, Hidaka Y, Yamamoto H, Honda T, Takeuchi S, et al. Effectiveness of vaccination and wearing masks on seasonal influenza in Matsumoto City, Japan, in the 2014/2015 season: An observational study among all elementary schoolchildren. Prev Med Rep. 2016;5:86-91.  https://doi.org/10.1016/j.pmedr.2016.12.002  PMID: 27981021 
  73. Wu J, Xu F, Zhou W, Feikin DR, Lin CY, He X, et al. Risk factors for SARS among persons without known contact with SARS patients, Beijing, China. Emerg Infect Dis. 2004;10(2):210-6.  https://doi.org/10.3201/eid1002.030730  PMID: 15030685 
  74. Zhang L, Peng Z, Ou J, Zeng G, Fontaine RE, Liu M, et al. Protection by face masks against influenza A(H1N1)pdm09 virus on trans-Pacific passenger aircraft, 2009. Emerg Infect Dis. 2013;19(9):1403-10.  https://doi.org/10.3201/eid1909.121765  PMID: 23968983 
Community use of face masks and similar barriers to prevent respiratory illness such as COVID-19: a rapid scoping review
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Julii+Brainard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brainard Julii</a>, <a href="/search?value1=Natalia+R.+Jones&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jones Natalia R.</a>, <a href="/search?value1=Iain+R+Lake&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lake Iain R</a>, <a href="/search?value1=Lee+Hooper&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hooper Lee</a>, <a href="/search?value1=Paul+R+Hunter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hunter Paul R</a></span>. Community use of face masks and similar barriers to prevent respiratory illness such as COVID-19: a rapid scoping review. <a href="/content/ecdc">Euro Surveill.</a> 2020;25(49):pii=2000725. <a href="https://doi.org/10.2807/1560-7917.ES.2020.25.49.2000725" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2020.25.49.2000725</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 23 Apr 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 25 Aug 2020 </span> </p>
/content/10.2807/1560-7917.ES.2020.25.49.2000725
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