Covid-19 Live Updates: Mask and Vaccine Mandate News – The New York Times

At a summer school at P.S. 15 in Red Hook, Brooklyn, last month.
Credit…James Estrin/The New York Times

Mayor Bill de Blasio of New York City laid out a series of long-awaited safety protocols for schools on Thursday as he seeks to reassure parents who are concerned that the Delta variant of the coronavirus will upend the school year.

The mayor’s announcement follows weeks of rising alarm from parents and educators about the city’s plan to reopen its schools at full capacity, without a remote learning option. The first day of school for city’s roughly 1 million students is Sept. 13.

“Think about a child who hasn’t been inside a classroom in a year in a half, that’s not supposed to happen, we can’t let that happen anymore,” Mr. de Blasio said during a news conference.

As part of the new protocols, the city will test a random sample of 10 percent of unvaccinated people in schools every other week, a group that will include only students later this fall, when all adults will be required to be fully vaccinated, the mayor said. That means all children in elementary school will be subjected to testing, pending parent consent, while only unvaccinated middle and high schoolers will be tested.

Children 12 and older have been eligible to get vaccinated since mid-May, but it remains unclear when those younger than 12 might become eligible.

The testing program is more modest in scope compared to last year, when there were roughly 600,000 fewer children in schools because so many families chose remote learning. Last school year, the city initially tested 10 percent of all people in schools, but increased it to 20 percent in the spring, when the mayor relaxed quarantining rules.

The mayor defended the plan on Thursday, saying the city did not need as much testing with all staff and many students vaccinated. He said the city could increase testing in schools or neighborhoods as needed.

Mr. de Blasio is also aiming to avoid the frequent classroom and school closures that proved so disruptive for children and educators during the last school year. This year, when someone in a classroom tests positive, only unvaccinated close contacts will have to quarantine for 10 days. (It was unclear who would be considered a close contact.) That system is more conservative than the Centers for Disease Control and Prevention recommends, but health officials said they were trying to strike a balance between safety and minimizing disruption.

Middle and high school students who are unvaccinated but are considered close contacts of an infected person can leave quarantine early if they receive a negative test result five days into their quarantine.

Buildings will close for 10 days if there is evidence of widespread transmission as determined by the city’s disease detectives.

Elementary school students learning at home during quarantine will receive live online instruction from their teachers, but quarantined older students will work on their assignments on their own at home. The city is still finalizing details with unions on who will teach remote classes.

The city is planning to expand an existing program that allows medically vulnerable children to get a few hours of in-person, at-home instruction a week or online learning. More students will qualify for that program this year compared to previous years, and the city expects several thousand students to participate.

All students and staff will be required to wear masks, and each classroom will also have two air purifiers. Principals have been instructed to keep three feet of distance between students everywhere possible, and city officials said distancing will be possible in the vast majority of classrooms. Recent federal guidance called for universal masking in schools, regardless of vaccination status, with a focus on returning to in-person learning in the fall.

City schools saw extremely low virus transmission last year; the test positivity rate was .03 at the end of the school year in June.

Earlier this month, the governor issued a mask mandate for students, faculty and staff in preschools, elementary and high schools throughout the state.
Credit…Taylor Glascock for The New York Times

CHICAGO — Gov. J.B. Pritzker of Illinois announced on Thursday a new, stricter set of coronavirus restrictions, ordering a statewide indoor mask mandate and requiring that all educators be vaccinated or face regular testing.

The mask mandate applies to all Illinois residents age 2 and older and begins on Monday. The vaccine rule, effective Sept. 5, affects all teachers and staff in schools from kindergarten through college.

“Unfortunately, we are running out of time as our hospitals run out of beds,” Mr. Pritzker said at a news conference on Thursday. “Hospital staff are becoming overwhelmed and overburdened. People are dying who don’t have to die.”

Mr. Pritzker, a Democrat, has taken an aggressive approach to restrictions intended to slow the spread of the coronavirus, which has spiked in Illinois in recent weeks, particularly in the downstate region, where intensive-care beds are scarce. Illinois reported a seven-day average of 3,547 cases on Wednesday, more than three times the average cases reported one month ago.

Earlier this month, Mr. Pritzker issued a mask mandate for students, faculty and staff in preschools, elementary and high schools throughout the state. He has also mandated masks in state-run nursing homes and similar facilities, and required vaccinations of people who work there. The Centers for Disease Control and Prevention has recommended masking for everyone in schools, regardless of vaccination status, and several states, including California and Connecticut, have school mask mandates in place.

Under the new vaccine rule in Illinois, educators who decline to be vaccinated will be required to submit to testing at least once a week.

The move comes as other states and cities weigh vaccine mandates after the Food and Drug Administration this week granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and older, making it the first to move beyond emergency-use status in the United States.

Earlier this week, Gov. Philip D. Murphy of New Jersey said that all teachers in that state would have to either be vaccinated or submit to weekly testing. California and Hawaii have similar mandates in place. And the cities of Los Angeles and Chicago, as well as Washington State and Oregon, have also recently announced full vaccine mandates for teachers.

On Wednesday, Mayor Lori Lightfoot of Chicago said she would require all city employees, including police officers, sanitation workers and park employees, to be fully vaccinated by Oct. 15. Chicago and Cook County already have indoor mask mandates in place.

Paramedics admitting a patient to the emergency room at the Morton Plant Hospital in Clearwater, Fla., this month.
Credit…Octavio Jones/Reuters

More people in Florida are catching the coronavirus, being hospitalized and dying of Covid-19 now than at any previous point in the pandemic, underscoring the perils of limiting public health measures as the Delta variant rips through the state.

This week, 227 virus deaths were being reported each day in Florida, on average, as of Tuesday, a record for the state and by far the most in the United States right now. The average for new known cases reached 23,314 a day on the weekend, 30 percent higher than the state’s previous peak in January, according to a New York Times database. Across the country, new deaths have climbed to more than 1,000 a day, on average.

And hospitalizations in Florida have almost tripled in the past month, according to federal data, stretching many hospitals to the breaking point. The surge prompted the mayor of Orlando to ask residents to conserve water to limit the strain on the city’s supply of liquid oxygen, which is needed both to purify drinking water and to treat Covid-19 patients.

Even as cases continue to surge, with more than 17,200 people hospitalized with the virus across Florida, Gov. Ron DeSantis, a Republican, has held firm on banning vaccine and mask mandates. Several school districts have gone ahead with mask mandates anyway.

Overall, 52 percent of Floridians are fully vaccinated, but the figure is less than 30 percent in some of the state’s hardest-hit counties.

On Monday, dozens of doctors and hospital employees in Palm Beach County gathered for an early morning news conference to beseech the unvaccinated to get shots, emphasizing that the surge was overwhelming the health care system and destroying lives.

“We are exhausted,” said Dr. Rupesh Dharia, an internal medicine specialist. “Our patience and resources are running low.”

A growing proportion of the people inundating hospitals and dying in Florida now are coming from younger segments of the population, particularly those ages 40 to 59, which were less vulnerable in earlier waves of the pandemic. The Delta variant is spreading among younger people, many who thought they were healthy and did not get vaccinated.

Dr. Chirag Patel, the assistant chief medical officer of UF Health Jacksonville, a hospital system in Northeast Florida, said the patients hospitalized with the virus during this latest surge tended to be younger and had fewer other health issues, but were nearly all unvaccinated. Of those who have died, including patients ranging in age from their 20s to their 40s, more than 90 percent were not inoculated, Dr. Patel said.

“We’ve had more patients this time around that have passed away at a younger age with very few if any medical problems,” he said. “They simply come in with Covid, and they don’t make it out of the hospital.”

Two months ago, the number of Covid-19 patients admitted at the system’s two University of Florida hospitals in Jacksonville was down to 14. On Tuesday morning, 188 coronavirus patients were in the hospitals, including 56 in the intensive care units.

One of the hardest parts of his job, Dr. Patel said, is having to tell family members that their unvaccinated loved one had succumbed to the virus. “It’s just such a senseless and preventable way of ultimately dying,” he said.

Lisa Waananen, Alison Saldanha and Sarah Cahalan contributed reporting.

An observation area for patients who received doses of Moderna’s Covid-19 vaccine in Tokyo in June.
Credit…Carl Court/Getty Images

TOKYO — The Japanese health authorities on Thursday announced that they would halt the use of over 1.6 million doses of Moderna’s coronavirus vaccine after some vaccination sites reported finding tainted vials.

The problem comes as Japan, which initially struggled to get its vaccination program into full gear, confronts its worst wave of Covid-19 cases since the pandemic began, raising concerns that medical systems in some parts of the country could be overwhelmed.

Unspecified contaminants were discovered in nearly 40 doses of the vaccine at eight locations across Japan, prompting the decision to pull the lot that included them, as well as two other lots produced at the same location, the public broadcaster NHK reported.

In a statement, Takeda Pharmaceutical, the company that distributes the shots in Japan, said that it had asked Moderna to carry out an urgent investigation into the cause of the problem. Takeda did not report any concerns about health issues arising from use of the tainted vials.

Speaking to reporters on Thursday, the chief cabinet secretary, Katsunobu Kato, said that an unknown number of people had been vaccinated with the contaminated doses, but that the government had received no reports of ill effects. He urged people with concerns to consult their doctors.

After getting off to a slow start, Japan is now administering over a million vaccine doses each day. Currently, about 43 percent of the population is fully vaccinated. In addition to Moderna, Japan has approved the use of vaccines produced by Pfizer and AstraZeneca.

However, as the inoculation program has accelerated, so has the virus. Tokyo declared its fourth state of emergency in July as it confronted a rapid rise in cases driven by the Delta variant. The situation has since deteriorated rapidly, with daily case numbers reaching over 25,000 for the first time on Friday. Total deaths are at nearly 15,700.

The decision to withdraw the Moderna doses is not expected to have a major impact on the overall vaccination program, Mr. Kato said, adding that the government was working to reduce any disruptions.

Despite the rising numbers, Tokyo has carried on more or less as usual. The city is currently hosting the Paralympics, which opened on Tuesday.

Much like for the Olympics, which were held for two weeks starting at the end of July, the organizers of the Paralympic Games have adopted strict measures — such as daily testing of athletes — to try to keep infection rates down. Since Aug. 12, 184 people associated with the Paralympics have tested positive for Covid-19. On Thursday, Japanese news media reported that an athlete had been hospitalized with the virus, which would be a first for the event.

Medical professionals sanitizing at a coronavirus testing site in Omaha, Neb., last year.
Credit…Calla Kessler for The New York Times

Health officials in Nebraska are so desperate for staff that they are recruiting unvaccinated nurses, an unconventional attempt to plug the shortage of nurses as the state battles a surge in coronavirus cases.

The advertisements for unvaccinated nurses are popping up on postcards, on Facebook and on state job postings: “$5,000 sign-on bonus!” and “No mandated Covid-19 vaccinations,” the notices say. The ads are for positions in veterans’ homes, psychiatric treatment facilities and other locations.

State Senator Carol Blood first heard about the advertisements on Monday, she said, when she was inundated with messages from constituents criticizing the outreach.

“Our health care professionals were calling my office in tears,” she said. “It’s a slap in the face to them.”

New cases in Nebraska have jumped, with hospitalizations rising to the highest level since January, according to a New York Times database. Nebraska’s nurses, like health care workers across the country, are a year and a half into a relentless battle to care for Covid patients. The latest and most severe cases, across the country, are among those who have yet to be vaccinated.

As the highly contagious Delta variant pummels the United States, nurses are reporting that they feel depleted and traumatized, their ranks thinned by early retirements or career shifts that traded the emergency room for less stressful jobs.

Gov. Pete Ricketts of Nebraska, a Republican, directed the state authorities to recruit unvaccinated nurses, said Taylor Gage, a spokesman for the governor.

“The state responded with this campaign so nurses throughout Nebraska know that state government is an alternative career choice,” Mr. Gage said in a statement.

The decision came after eight state hospitals mandated vaccines for their employees, KETV reported.

Ms. Blood, a Democrat, wrote a letter to the governor on Monday criticizing the recruitment scheme, saying the state’s decision was “of grave concern to myself and countless people in my district.”

“I do understand that we have a serious shortage of staff,” she wrote. “With that said, putting those who live in these facilities at risk because we need to find bodies to hire is not acceptable.”

Ms. Blood said on Wednesday night that she had not received a reply from the governor’s office.

The surge is being driven by the highly contagious Delta variant and low vaccination rates, health experts said. The authorities in Nebraska are struggling to vaccinate its citizens, with only 57 percent of people at least partially vaccinated. The national rate is 61 percent, according to the Centers for Disease Control and Prevention.

President Biden delivering remarks on Cpvid-19 in June.
Credit…Oliver Contreras for The New York Times

President Biden, who has pledged to fight the coronavirus pandemic by making the United States the “arsenal of vaccines” for the world, is under increasing criticism from public health experts, global health advocates and even Democrats in Congress who say he is nowhere near fulfilling his promise.

Mr. Biden has either donated or pledged about 600 million vaccine doses to other countries — a small fraction of the 11 billion that experts say are needed to slow the spread of the virus worldwide. His administration has also taken steps to expand Covid-19 vaccine manufacturing in the United States and India, and is supporting production in South Africa and Senegal to expand access to locally produced vaccines in Africa.

But with the administration now recommending booster doses for vaccinated Americans starting next month, outraged public health experts and many Democrats on Capitol Hill are calling on the president to move more aggressively to scale up global manufacturing. In an analysis published on Thursday, the AIDS advocacy group PrEP4All found that the administration had spent less than 1 percent of the money that Congress appropriated for ramping up Covid-19 countermeasures on expanding vaccine manufacturing.

Congress put a total of $16.05 billion in the American Rescue Plan this year, in two separate tranches, that could be used to procure and manufacture treatments, vaccines and tools for ending the pandemic. But PrEP4All found that all told, the administration had spent $145 million — just $12 million of it from the American Rescue Plan — to expand vaccine manufacturing.

The United States has donated 115 million surplus doses, and has purchased 500 million more from Pfizer and BioNTech to be distributed through Covax, more than any other country. But that is still a minute fraction of the 12 billion doses Duke University’s Global Health Innovation Center predicts the world needs by the end of 2021.

James Krellenstein, a founder of PrEP4All and the author of its report, said “if they don’t change course pretty soon, the Biden administration is going to be remembered in terms that the Reagan administration is remembered today in not dealing with the AIDS crisis.”

Administering a dose of the Pfizer-BioNtech vaccine at a mobile clinic near Moshav Dalton in northern Israel in February.
Credit…Jalaa Marey/Agence France-Presse — Getty Images

The Pfizer-BioNTech Covid-19 vaccine is associated with an increased risk of myocarditis, an inflammation of the heart muscle, a large new study from Israel confirms. But the side effect remains rare, and Covid-19 is more likely to cause myocarditis than the vaccine is, scientists reported on Wednesday.

The research, which is based on the electronic health records of about two million people who are 16 or older, provides a comprehensive look at the real-world incidence of various adverse events after both vaccination and infection with the coronavirus.

In addition to myocarditis, the Pfizer vaccine was also associated with an increased risk of swollen lymph nodes, appendicitis and shingles, although all three side effects remained uncommon in the study. Coronavirus infection was not associated with these side effects, but it did increase the odds of several potentially serious cardiovascular problems, including heart attacks and blood clots.

“Coronavirus is very dangerous, and it’s very dangerous to the human body in many ways,” said Ben Reis, a co-author of the new study and the director of the predictive medicine group at the Boston Children’s Hospital Computational Health Informatics Program.

He added, “If the reason that someone so far has been hesitating to get the vaccine is fear of this very rare and usually not very serious adverse event called myocarditis, well, this study shows that that very same adverse event is actually associated with a higher risk if you’re not vaccinated and you get infected.”

The data arrived in the middle of an intense discussion among federal regulators about the risks of myocarditis and pericarditis, which is inflammation of the lining around the heart, in younger recipients of both the Pfizer-BioNTech and Moderna vaccines.

Administering the domestically developed Medigen vaccine in Taipei, Taiwan, on Monday.
Credit…Annabelle Chih/Reuters

Taiwan’s nettlesome relationship with China caused the self-governing island to struggle for months to acquire doses of BioNTech’s coronavirus vaccine before a deal was finally reached in July.

But in a surprising turn of events, Taiwanese health officials now say that China’s delay in approving the German drugmaker’s shot for its own domestic use could allow Taiwan to receive doses ahead of schedule.

The island’s government is working to acquire BioNTech shots from a batch that was originally intended for China, Taiwanese officials said this week. The shots are expected to leave the factory gates late this month, officials said. But it is unclear how many Taiwan might receive and when they might arrive.

The island had been scheduled to begin receiving BioNTech shots in late September from Fosun Pharma, the Chinese company that is distributing the vaccine in mainland China, Hong Kong, Macau and Taiwan.

China has administered nearly two billion Covid-19 vaccine doses, all of them made by domestic producers such as Sinopharm. BioNTech, which developed its vaccine with Pfizer, expressed confidence months ago that Chinese regulators would approve the shot quickly. But their blessing has yet to materialize.

Fosun Pharma did not respond to a request for comment. In a midyear financial report published this week, the company said that Phase 2 clinical trials of the BioNTech vaccine in mainland China were “progressing in an orderly manner.”

Taiwan has administered first vaccine doses to more than 40 percent of its 23.5 million people, according to government statistics. The island has reported only a trickle of new infections per day in recent weeks.

A Delta Air Lines counter at Los Angeles International Airport on Wednesday. Starting Nov. 1, employees who have not received a vaccine will have to pay an additional $200 per month to stay on the company’s health plan.
Credit…Mario Tama/Getty Images

Delta Air Lines’ plan to charge unvaccinated employees more for health insurance is an idea that has been widely discussed but is mired in legal uncertainty.

Starting Nov. 1, employees who have not received the vaccine will have to pay an additional $200 per month to remain on the company’s health plan. It is part of a series of requirements that unvaccinated workers will face in the months to come, the airline’s chief executive, Ed Bastian, said in a memo to staff.

“We’ve always known that vaccinations are the most effective tool to keep our people safe and healthy in the face of this global health crisis,” he said. “That’s why we’re taking additional, robust actions to increase our vaccination rate.”

Every Delta employee who has been hospitalized because of the coronavirus in recent weeks was not yet fully vaccinated, with hospital stays costing the company an average of about $50,000. Like most large employers, Delta insures its own work force, meaning it pays health costs directly and hires an insurance company to administer its plans.

Insurance surcharges may appeal to companies that are seeking a less coercive means to increase vaccination rates, said Wade Symons, a partner at Mercer, a benefits consulting firm. He has had conversations with about 50 large companies that are considering imposing such fees, he added.

Legally speaking, insurance surcharges are more complicated than simple employment mandates, which are widely considered legally sound. Federal law bars employers and insurers from charging higher prices to people with pre-existing health conditions. But the vaccine surcharges are being structured as employer “wellness” incentive programs, which are permitted under the Affordable Care Act. Such programs must be voluntary but can involve rewards or penalties as large as 30 percent of an employee’s health insurance premium.

Under federal law, employers must provide accommodations for workers who cannot receive a vaccine for health reasons or sincerely held religious beliefs.

“This is not rocket science, but it is not easy,” said Rob Duston, a lawyer with Saul Ewing Arnstein & Lehr in Washington, D.C., whose focus includes employment and disability issues.

“You are dealing with the overlap of at least three different laws,” he added, referring to the Employee Retirement Income Security Act, the Affordable Care Act, and the Equal Employment Opportunity Commission’s wellness plan, as well as Covid-19 guidelines. The companies would have to abide by the Americans With Disabilities Act and health privacy laws, too.

A popular tourist spot on Hawaii’s Maunawili trail. As surging Covid-19 cases strain hospitals, the Honolulu mayor declared restrictions on public gatherings and the governor asked tourists to stay away.
Credit…Michelle Mishina Kunz for The New York Times

At the emergency department of Hilo Medical Center on the island of Hawaii Wednesday, patients lay on beds in the hallway as staff members scrambled to find space in other parts of the hospital.

“Today is the fullest we’ve been in over 15 years — maybe even ever,” said Elena Cabatu, director of public affairs at the hospital. Nurses “are almost beside themselves at this point,” she said.

Across the islands of Hawaii, hospitals are facing an acute shortage of beds and medical staff as the Delta variant causes a surge far worse than any the state experienced during earlier coronavirus waves of the pandemic.

By virtue of its geographical isolation and stringent government restrictions, Hawaii maintains its position as the state with the lowest rates of Covid cases and deaths. But in recent months, as restrictions have loosened and travel has resumed, case numbers have skyrocketed.

On July 1, the state’s seven-day average was 40 new cases daily. By Aug. 19, the new case reports had peaked at 729 a day, according to a New York Times database, more than double the state’s previous high in September.

And, with just 55 percent of the state’s population fully vaccinated, according to a New York Times database, health care providers worry that the worst is yet to come.

Models show that the state could reach a daily average of 1,500 Covid hospitalizations by the end of September, said Hilton Raethel, president of the Healthcare Association of Hawaii. The state normally maintains just 2,000 staffed hospital beds across the islands.

“The numbers don’t work, obviously,” said Mr. Raethel. Options for obtaining additional beds are limited. “It’s not like New York where you can truck people or beds in from New Jersey. We’re a five-hour flight away from the mainland.”

Over 200 health care workers have been dispatched from the mainland to assist the strapped hospitals. Three hundred more will be on the way next week.

At the same time, officials are rushing to reinstate restrictions to temper the surge. On Monday, Mayor Rick Blangiardi of Honolulu prohibited indoor gatherings of more than 10 people and outdoor gatherings of more than 25 people for at least 28 days.

And at a news conference Monday, Gov. David Ige discouraged tourists from coming.

“It’s not a good time to travel to the islands,” he said. “The visitors who choose to come to the island will not have the typical kind of holiday that they expect to get when they visit Hawaii.”

Businesses in Hamburg, Germany, will soon be allowed to voluntarily bar entry to the unvaccinated.
Credit…Hayley Austin for The New York Times

BERLIN — In what is a first in Germany, the city state of Hamburg will allow restaurants, hairdressers, clubs and religious institutions to bar entry to unvaccinated adults or those who have not built up immunity through a Covid infection. The businesses can then forego strict limits on indoor seating, dancing and mandatory minimum distancing requirements.

Masks, when not eating, will remain obligatory.

Currently people can show documentation of a recent negative Covid test and be allowed into these spaces. But starting this weekend, Hamburg vendors can sign up for the voluntary programs that bar unvaccinated people.

“It’s totally voluntary. Everyone can decide whether they go ahead or not,” said Daniel Schaefer, a spokesman for the city.

Many business are expected to take a wait-and-see approach, as it is not clear yet whether losing a younger, unvaccinated clientele outweighs the larger capacity the rules will allow. The rules affect places where people eat or gather. Most stores in Germany where people merely shop, but do not stay or sit down, do not require proof of immunity or a test.

Currently about 65 percent of people living in Germany and 62 percent of people living in the city are fully vaccinated.

While these new freedoms for the vaccinated are being mandated in Hamburg and discussed in other German state capitals, infections among the unvaccinated have been surging. According to a New York Times database, there has been a 186 percent change over the last two weeks.

On Wednesday, the German Parliament, or Bundestag, voted to extend by three months a state of emergency allowing the federal and state governments to implement specific rules to curb infections.

Tumon Bay beach in Guam last week. The country once welcomed 1.7 million visitors a year. That number has fallen to a tiny trickle.
Credit…Anthony Henri Oftana for The New York Times

While much of the United States has returned to something resembling life before the coronavirus, the tiny American territory of Guam in the Western Pacific is stuck in time.

Its tourism-dependent economy remains paralyzed, and officials say a full recovery is probably years away. The South Korean and Japanese visitors who once thronged the island for its year-round sun and luxury boutiques are long gone.

To entice tourists, the government has created a program that offers not just a vacation, but also vaccination. The program, called Air V&V, offers visitors their choice of any of the C.D.C.-approved vaccines for $100 or less per dose.

By the end of August, at least 2,100 vaccine tourists will have arrived on chartered planes, according to the Guam Visitors Bureau — all from Taiwan, where shots have been hard to come by. A relatively small number of others have flown in on regular flights.

But that’s little consolation on an island that recorded 1.7 million arrivals the year before the pandemic began. Only a few businesses said they had noticed the small bump in visitors.

“It’s not even a drop in the bucket,” said Bob Odell, the owner of a water sports shop called Guam Ocean Adventures. “I don’t think anybody here is faring well.”

Sorgente articolo:
Covid-19 Live Updates: Mask and Vaccine Mandate News – The New York Times

User ID Campaign ID Link
d9a95efa0a2845057476957a427b0499 l-99999984 Free Web Hosting
d9a95efa0a2845057476957a427b0499 l-99999993 First on Search Engine
d9a95efa0a2845057476957a427b0499 l-99999994 Email Campaign
d9a95efa0a2845057476957a427b0499 l-99999979 Ugo Fiasconaro