Bulgaria

1 Preparedness 

1.1 Preparedness Before the Outbreak

As PreventEpidemics.org states: „The relationship between preparedness and COVID-19 impact is difficult to answer, as both are complex and hard to measure.“ [1] Furthermore, the coronavirus outbreak was a not pleasurable surprise for the whole world. So there is not an official unitary index that can perfectly and objectively tell how the countries were prepared for COVID-19 in practice. 

I found two important indicators of states preparedness before the crisis, which can help gain some impressions and give a basis for comparison:

1.1.1 Number of Critical Care beds 

https://doi.org/10.1007/s00134-012-2627-8
An observational study published in 2012 titled “The variability of critical care beds numbers in Europe” marks “heterogeneity in the numbers of critical care beds between European countries” (Rhodes, Ferdinande, Flaatten, Guidet, Metnitz & Moreno, 2012, p.1649). [2]
Bulgaria is on the 11th place with 12.5 critical care beds per 100.000 inhabitants, 1.7 beds more than Europe’s average. I would evaluate these scores positively. 
However, the study has been conducted between 2010 and 2011, about 10 years before the COVID-19 pandemic, so it gives only broad guidance about where Bulgaria has been placed concerning this dimension.

1.1.2 GHX Index

The Global Health Security Index (GHS Index) “is the first comprehensive assessment and benchmarking of health security and related capabilities”.[3]  Its aim is to point out the level of preparedness and capacity in order to stimulate political action.
Bulgaria is defined as “More Prepared” country. Its overall Index Score is 45.6 and it on the 61st place from 195 countries. In the category “Prevents” Bulgaria scores 37.6 – little above the average 34.8. Further topics of the Wiki refer to the other categories. 
Bulgaria's score is not excellent, but still relatively good.
For more information see: https://www.ghsindex.org/wp-content/uploads/2019/08/Bulgaria.pdf

1.2 Bulgaria's Preparedness Compared to Other Countries (from the Wikis) 

After considering the indicators of preparedness, I can state that Bulgaria is a good example of how a not perfectly prepared state manages to mobilize its citizen and administrators to act in favor of the public health, adapt preventative measures fast, and prepare its health care system and facilities for the crisis. However, this statement does not imply an overall evaluation of the crisis-management in Bulgaria. This topic is discussed further in this Wiki. 

1. France
According to the Critical Care Beds Index, Bulgaria has 0.6 more critical care beds on average than Frace. However, the GHX Index shows that France is a lot more well-prepared than Bulgaria on the different dimensions. 

2. Switzerland
Compared to Switzerland, Bulgaria has 1.2 more critical care beds on average. 

3. India
The GHX Index shows, that Bulgaria (45.6) is nearly as prepared as India (46.5). On the dimensions "Detect" and "Respond" Bulgari performs better. 

1.3 The Make-up of Arena Armeec 

Arena Armeec is the biggest multi-purpose indoor arena in Bulgaria, located in Sofia. It was designed for cultural events and sports. [4] Arena Armeec is usually related to the biggest concerts in Bulgaria or some other kind of exiting events and so with a lot of fun.
Just two weeks after the first confirmed cases Arena Armeec was turned into a temporary emergency hospital with 500 beds. [5] At the beginning it was used as a field for practical training and the beds were officially put there in order to be used if the capacity of health care facilities gets exceeded. [6] There is a photo which has probably be seen by most of the people in Bulgaria. It does look quite creepy.[7]
Source: Dnevnik.bg
Nevertheless, there are no official publications about what actually happened with the beds and if they have been used. Some people came up with the critique that it was just a trick of the National Staff to make people more conscious. [8] Further information is required for more objective conclusions on the topic.

1.4 National Crisis-management Staff

On the 24 of February (about one week before the first confirmed case of COVID-19 in Bulgaria), the National Crisis-management Staff was formed by the government to deal with the coronavirus pandemic. The main mission of the Staff is operational - to manage the crisis and make the most important decisions regarding the preventative measurements. The National Staff is still the main actor during the pandemic, coordinating and giving guidelines. [9]
The members of the National Crisis-management Staff are Major General Ventsislav Mutafchiyski – Chairman of the National Staff, Docent Angel Kunchev - Chief Health Inspector, and Professor Todor Kantardziev. [10]

In daily live briefings the National Staff reported about the sense-making, the number of new cases and deaths as well as the newest measurements and any information which must reach the population. Worldwide news, ways to lower the risk of infection, and self-care were discussed as well. Journalists were able to ask questions concerning any aspects of the pandemic. During the quarantine, these briefings were the main and most reliable source of information and a good coping mechanism, since they provided some kind of reliability and security. Since May 2 there have been only weekly briefings because the National Staff believed that the citizens are already well informed about the current situation. [11]

During this time I was in Bulgaria myself so I had the opportunity to experience the direct influence of the National Crisis-management Staff's briefings and decision-making. 

 
There is a link to the official website with the most recent information and statistics about COVID-19 in Bulgaria:

1.4.1 The Chairman of the National Crisis-management Staff 

Major General Professor Doctor Ventsislav Mutafchiyski was appointed by the Government as the Chairman of the Staff. He is a Military Doctor, Professor at Military Medical Academy (MMA), Major General from the Military Medical Service, and Director of MMA. [12] Meanwhile, he has gotten one of the most important and recognizable figures in Bulgaria’s public life, but also quite controversial. His role was not only to lead the National Crisis-management Staff, but he also played an important role in the whole sensibilization of people’s perceptions about the importance of this pandemic. А very powerful speech was held by him right after the first confirmed cases of COVID-19 in Bulgaria, which helped him gain people’s trust and respect, as well as make them aware of the coming danger. [13] His art is quite harsh and direct so he is associated with most of the Bulgarian Memes regarding the coronavirus. But many people believe that his persistence is what Bulgaria really needs in times like this.   [14]
There are not two identical responses to the COVID-19 pandemic. This is why working on these Wikis is different for everyone. I tried to find information about other countries' decision-making and particularly if anywhere was formed a new Crisis-management-institution as the National Staff in Bulgaria. In Sweden there is a Crisis-management-system, which was already existing before the pandemic and was not formed especially for the case of COVID-19 as in Bulgaria. Another example is South Korea.

2 Sense-making

Sense-making is defined as “shaping a common and widely supported understanding of what the crisis is about and what needs to be done to deal with it.” (Boin et al., 2016, p.79) The process of it has two parts – formulating a persuasive message and delivering it. (Boin et. al., 2016). [15]
The National Crisis-management Staff is primarily responsible for the sense-making. It formulates the messages (or did so at the beginning of the pandemic)  and is also accountable for delivering it as well as giving the newest updates every day. Speaking from experience, in a matter of one to two weeks everyone knew what is going on and the situation started to be taken seriously. In my personal opinion, the National Staff did a very good job at the beginning of the pandemic concerning the sense-making and sensitizing the public. [16] Further in this section I am going to report the development of the pandemic in Bulgaria.
 
The first four cases of COVID-19 in Bulgaria were confirmed on 8 March, about 10 days after the first test and one week after the formation of the Crisis-management Staff. Two men from Pleven and two women from Gabrovo were tested positive, even though none of them had traveled abroad. However,"Patient zero" is still unknown, in contrast to Norway, New ZealandSpainNetherlandsCroatiaTaiwan and Israel for example. [17] The National Crisis-management Staff had already been formed and prepared for the outbreak in Bulgaria. [18]  

2.1 Testing and Reporting 

Thе first test has been done on 28 January. By 18 April 26 417 tests had been done. The number of tests done per day has been increasing rapidly. However, in the beginning, not all of the tests have been processed right-away, which means that the capacity of tests with outcomes per day has increased from 400 to 2500-3000 as well. Important is to denote, that the number of tests doesn’t perfectly coincide with the number of tested people. [19] It is important to point out, that not only the daily new cases have been reported, but also the tests that have been made for the last 24 hours. In this way, it is easier to understand the development of the pandemic better.  

As the statistics show, the number of daily new cases in Bulgaria has increased a lot. Furthermore, there are a lot more cases now than there were during the actual worldwide quarantine. So what is going on? Are more tests made or did people stop caring about the pandemic? On the 5th of July, 2591 tests were made and the positive ones were 180. One of the members of the National Staff reports, that the main reason is not the tests, but the loosen measurements. [20] Some other experts think that the loosening of measurements can not really explain the number of cases. [21]   So there Is neither a common opinion nor a common explanation. 

2.2 "Three Months After the Beginning: Coronavirus in Bulgaria Graphs" 

On the 4th of June Дневник.бг published some statistics about the coronavirus outbreak.
This is the URL to the webpage: 
Translation: Lia Stambolieva

2.3 Recent Information 

All of the statistics in this section refer to the period from the first confirmed case - 8 March to 13 July 2020. The same information can also be found on the official Bulgarian page [22] , but I have chosen statistics that are already in English since they seem more representative and should not be translated unprofessionally (by myself). The graphs is from two main sources:
Bulgaria. (n.d.). Retrieved July 13, 2020, from https://www.worldometers.info/coronavirus/country/bulgaria/ [23]  
Bulgaria COVID-19 Corona Tracker. (n.d.). Retrieved July 13, 2020, from https://www.coronatracker.com/country/bulgaria/ [24]

2.3.1 Overview

https://www.coronatracker.com/country/bulgaria/

2.3.2 Daily New Cases

https://www.worldometers.info/coronavirus/country/bulgaria/

2.3.3 Daily New Deaths

https://www.worldometers.info/coronavirus/country/bulgaria/

2.3.4 Confirmed, Recovered, Deaths in the Last 2 Months 

https://www.coronatracker.com/country/bulgaria/
This graph combines the information shown in the two previous ones. What can be observed is that the number of daily new cases is going upward a lot faster than in other countries. In New Zealand for example, the coronavirus is almost completely gone. India is having similar problems as Bulgaria. It is also important to denote, that the number of daily new death has not increased, so the death rate has not increased rapidly.
Some countries have already implemented restrictions for tourists from Bulgaria. One example is Greece, which is a popular destination in the summer. [25]
The reasons for this new outbreak are not cristal clear, as I already mentioned. The development of the crisis will show all of the new outcomes.  

3 Decision-making

There have been different examples of crises in the world. COVID-19 is a worldwide crisis, which could barely be compared to other types of emergencies. This automatically aggravates decision-making. Decision-making is one of the central aspects of crisis management (Lægreid & Rykkja, 2018). [26]  Decision-making and coordinating are defined as “making critical calls on strategic dilemmas and orchestrating a coherent response to implement those decisions.” (Boin et al., 2016, p.15). Boin et al. (2016, p.49) claim further that “both success and failures of crisis management are often related to such monumental decisions.” [27]  In this section, I will examine the decision-making in Bulgaria during the Coronavirus pandemic. 
In Bulgaria, every decision is made by the Government after the National Staff has given certain guidelines and suggestions. [28] Nevertheless, the Government also takes into consideration experts' opinions on the matter, even if they don't come directly from the National Staff. [29]

3.1 State of Emergency

The National Crisis-management Staff declared a state of emergency on 13 March (when the number of infected people reached 23 and just 6 days after the first confirmed case) which was planned to end on 13 April. [30] Unfortunately, it got extended to 13 May. [31] After that, it shifted to an epidemic situation, which particularly means the same, until 14 June. [32] Five days before the end, the epidemic situation got extended to 30 June. [33]

During this time I was in Bulgaria myself and remember how my mum and I were drinking coffee and the waitress just came to us and said we had to go before 18oclock since the police would start to legitimately close all of the restaurants and cafes. It was a sunny Friday afternoon, the life was going just perfectly well. One day later the streets were empty and everyone was stuck home without knowing how long. It was really scary and depressive, the speech of the Chairman of the National Staff made everything seem so serious and even more dangerous. It really took 4 days after the first confirmed cases to declare State of emergency and close everything (including schools and universities) on 13 April. 
Some other countries which have declared State of emergency are: Spain- 13 March, on the same day as Bulgaria, Portugal - 18 March, 3 days after Bulgaria, New Zealand - 25 March, about 2 weeks after Bulgaria. 

3.2 Full Lockdown of Bansko

On March 16 two cases of COVID-19 were confirmed in one of the most popular ski resorts in Bulgaria – Bansko. This prompted the government to impose a full shutdown of the resort. Bansko was the first city in Bulgaria in which such strict measurements were taken into consideration. The idea was that foreigners (as well as Bulgarians from other cities) vacationing in the resort must leave the resort until 8:00 p.m. on March 18. Otherwise, all of them would have stayed locked in during the whole 2 weeks of quarantine. [34]
This a good and representative example of how fast the National Crisis-managements Staff managed to take control of the potential emerging threat.
After the lockdown mass testing was conducted. In 112 people (from a total of 2250 people testes) antibodies were present. The city was afterward declared “clean” from Coronavirus. [35]

3.3 COVID-19 in Bulgaria: Timeline of the Measures

This is a custom-made timeline of the measures in Bulgaria starting from the first one and ending with the last before the deadline for the presentation in the seminar. 
Main source: 
Коронавирусът COVID-19 в България - факти и дати. (2020, July 30). Свободна Европа. Retrieved July 30, 2020, from https://www.svobodnaevropa.bg/a/30490101.html
For the timeline: 
https://www.visme.co/

4 Legitimacy

Legitimacy can be defined as "popular acceptance of a government, political regime, or system of governance". 
[36]
And trust in the government is an important aspect of legitimacy. Trust, on the other hand, can be explained as the confidence of the citizens that the government would act legitimately and serve the commonwealth (Citrin et al., 1999). [37]

4.1 Alpha Research - Social Survey 

Alpha Research, founded in 1997, is “one of the leading agencies for social and political research in Bulgaria.” [38]

In May 2020 Alpha Research published a survey called “Impact of the First Stage of the Coronavirus Pandemic on the Political Situation in Bulgaria”: https://alpharesearch.bg/post/969-otrajenie-na-purvia-etap-ot-krizata-s-koronavirusa-vurhu-politicheskata-kartina-v-stranata.html. [39]

I will describe three of the statistics which are relevant for the topics "Trust in Officials" and "Satisfaction with the Crisis-management among the population". 

4.1.1 Trust in Officials 

1) Trust in the President of Bulgaria Rumen Radev and in the Prime Minister Boyko Borisov in December 2019 and January 2020.
Translation: Lia Stambolieva
The two most important tendencies are:

Firstly, the rating of the President is the lowest that has ever been. Compared to December 2019 the number of people who evaluate his activities positively has decreased by 8%, whereas the number of unsatisfied people has increased by 10%. This might also have an impact on the elections next year.

On the other hand, the trust in the Prime Minister has improved. Compared to December 2019 10% more people are satisfied with his work, whereas the number of people evaluating his work negatively has decreased by 8%.
The tendencies differ among the countries. Chile and Thailand show lower trust in the government, whereas South Korea and Taiwan do trust it. In France and Sweden people trust the health authorities more than they trust the government. This can also be seen in Bulgaria when it comes to the National Crisis-management Staff. 
2) Trust in the Chairman of the Nationa Crisis-management Staff 
Translation: Lia Stambolieva
Evaluation of the work of the Chairman of the National Staff. As it was already mentioned Major General Ventsislav Mutafchiyski is a dominant and controversial figure during the COVID-19 outbreak in Bulgaria. The outcomes of the statistics are not surprising. According to the pie chart the majority of the people, 60 %, are satisfied with his work and only 15% evaluated him negatively. There is not a further explanation of the results and of potential consequences. 
The overall scores indicate that the trust in officials was relatively high in the middle of the pandemic in Bulgaria. Furthermore, they may also show that Bulgaria’s citizens do not underestimate the danger. This might be correlated with the fact that the people were not confident with the President’s opinion, who was usually criticizing the work of the National Staff. Further proves of this statement should be tested. 

I would like to point out that the data was collected at a point where all the measures were still in force and Bulgaria was in lockdown. At the time Bulgarian officials were mobilized and did their best to win people's trust. However, I suppose that the outcomes might look different if such a survey was to be conducted today. Hopefully, there would be a second part and an overall assessment of the change in the trust in officials during the different phases of the pandemic outbreak. 

4.1.2 Satisfaction with the Crisis-management among the Population 

Translation: Lia Stambolieva
The pie chart shows people’s satisfaction with Bulgaria’s crisis management compared to other European countries. The majority believe that Bulgaria is either managing the crisis better than the other European countries (40%) or that it depends on the measure (38%). Only 14% of the people believe that Bulgaria is doing the worst in the European Union context. The results confirm the fact that the National Crisis-management Staff and the Executive enjoy people’s approval and there is high satisfaction with the current measures. That is a really important part of the successful implementation. As stated In the section “The National Crisis-management Staff”, the goal of the National Staff to sensitize the public about the threat went well.

While evaluating the statistics, we should take into consideration the time when the study was conducted. The way people think about the whole pandemic has probably changed, just like the measures and the density of the cases did.  

4.2 The "Opposition"

Another important emerging figure during the coronavirus pandemic in Bulgaria was Docent Atanas Mangurov – playing the role of the “opposition”. He is a Pediatric Infectious Diseases Specialist, who is unfortunately not a member of the National Crisis-management Staff. [40] Nevertheless, Infectious Disease is his field of study (and the coronavirus is such a disease), so his opinion has scientific reasons. Docent Mangurov was against the measurements, claiming that they were exaggerated since the coronavirus itself was just as normal as any other seasonal flu. The examples and comparisons he makes (such as saying that using masks against the virus is like using a grid against flies, or that using gloves could only lead to skin fungal infections) are usually humorous and lead to a lot of discussions and hate, of course. [41] The opinion of Docent Magurov was justified, but he only had the power to give interviews and make unofficial statements, since he had no power. [42]
It would have been an interesting scenario if he was the Chairman of the National Staff and. One important statement of him is that no one had died due to coronavirus itself, so the virus should not be taken into such a huge consideration worldwide. [43] While people are scared of a second wave, he says that the disease would slowly wither away.[44]  No one would know for sure if he was right or not, but he certainly served a good portion of entertainment and laughter. 

5 Overall evaluation

I take into consideration that my Bulgarian identity might influence my perception. However, I am trying to be as objective as possible, while giving examples and relating to reliable sources of information. The sections “Decision-making” and “Sense-making” include detailed information about the measurements and their implementation, as well as the action of the National Crisis-management Staff. If I was to present Bulgaria’s crisis-management one month ago, I would have said that the government did a great job and probably surprised everyone. Even some articles published in France applauded Bulgaria:
1. Coronavirus : Les députés et ministres bulgares offrent leur salaire à la santé publique. (2020, April 07). Retrieved July 11, 2020, from https://www.leparisien.fr/international/coronavirus-les-deputes-et-ministres-bulgares-offrent-leur-salaire-a-la-sante-publique-07-04-2020-8295351.php%C2%A0%C2%A0 [45]
2. Bulgarie : Les députés et les ministres offrent leur salaire à la santé publique. (2020, April 07). Retrieved July 10, 2020, from https://www.lefigaro.fr/flash-eco/bulgarie-les-deputes-et-les-ministres-offrent-leur-salaire-a-la-sante-publique-20200407 [46]
3. En Bulgarie, députés et ministres offrent leur salaire à la santé publique. (2020, April 07). Retrieved July 10, 2020, from https://www.20minutes.fr/monde/2756355-20200407-coronavirus-bulgarie-deputes-ministres-offrent-salaire-sante-publique [47]
Before the actual outbreak, some sources claimed that Bulgaria was not prepared. [48] But it turned out that it could act really fast. This is why I would personally evaluate Bulgaria’s state response very positively. However, the cases are going upwards and the main reason is still uncovered. In order to be able to include this to my aspect, I would probably have to go back to the topic after a certain period of time. [49]
In the section “Legitimacy” there are some statistics about the trust in officials and approval of the crisis-management. While being in Bulgaria myself I had the opportunity to observe how people’s minds changed in a very short period of time and how the National Staff did not always act in agreement with the statement it had already made, which led to big concerns. In such times it takes very little to make crucial mistakes. Some sources indicate mistakes in Sweden's approach. [50]  Spain might also be a good example that “something went wrong” [51]
However, it is difficult to talk about the mistakes that have been made, before the whole thing has gone to an end. It might all look different in a few months, but Bulgaria with its Face-mask-dilemma is probably a good source of ideas and a field of research.
To evaluate the crisis-management regarding the coronavirus outbreak in Bulgaria, I want to process three main points, which are in my opinion related to the three key aspects of a crisis. A crisis is defined as a situation in which"a social system – a community, an organization, a policy sector, a country, or an entire region – experiences an urgent threat to its basic structures or fundamental values, which harbors many “unknowns” and appears to require a far-reaching response" (Boin et al., 2017, p. 5). The three components of the definition of a crisis are uncertainty, threat, and urgency (Boin et al., 2017). 
 
Firstly, the uncertainty could be easily explained by the measures concerning wearing a face mask. Boin et al. state that urgency “affects the search of solutions” (2017, p. 7). As highlighted in the Decision-making timeline, the measurements concerning face masks have been quite contradictory. To sum up, all of the possible varieties of the compulsory wearing of face masks have been implemented in Bulgaria – form no masks to masks also while walking on the streets completely distant from people. At the beginning of the pandemic, it was believed that only infected people should wear a mask in order not to spread the virus, since being healthy and wearing a mask will not be that helpful.[52] A few days before Easter in Bulgaria, wearing a face mask became obligatory. Speaking from experience, it was quite disturbing to go jogging with a mask, even though you have absolutely no contact to people. That was probably the first time that the people started to question the effectiveness of the measures and the assurance from the National Staff that they had anything under control. [53]

A similar situation with the masks faced France as well, which is directly related to the trust in the officials in the Wiki about France. Croatia also faced some misunderstandings, as explained in the Wiki. InSwitzerland masks were not obligatory until the beginning of July and only in public transport. Which makes me believe that the face-masks-situation was not problematic only in Bulgaria, but represents the uncertainty in many cases. The problem is that people start to question the effectiveness of the whole decision-making and subsequently slowly reduce their own trust in the ability of the officials to cope with the crisis right away.
This leads to the second point – urgency, represented by the National Crisis-management Staff in the case of Bulgaria, which became a real symbol of the coronavirus pandemic. The section “National Crisis-Management Staff” provides detailed information about its main role. The point here is that the formation of the National Staff was an urgent decision and any measures taken and implemented were urgent as it should be in times of crisis. I would evaluate this aspect very positively – the National Staff acted on time and kept this under control. Concerning the situation in Bulgaria now – I am actually afraid that the overall evaluation of the crisis-management might change since we are just halfway there – the coronavirus is still present, Bulgaria is still in an Epidemic situation and there are protests against the government, which are not a direct consequence of the crisis management but might be correlated with it. It is important to point out, that I am evaluating the period from the formation of the staff until now. For this time, the urgency was present. However, things are rapidly changing and the action seems not as urgent as it was three months ago. And the situation was a lot more under control. It is difficult for me to make a final statement.
 
The third and last point here is the threat which occurs when safety and security are no longer being provided (Boin et al., 2017). The biggest threat in Bulgaria right now is the face of the “second wave”. The statistics in the section “Sense-making” show that the number of daily new infected patients is rapidly growing. Furthermore, there are a lot more daily new cases now than there were in March. This is another interpretation of a threat, while the first one I would characterize as the whole pandemic. Here my focus is on a particular aspect of the threat which is at stake in Bulgaria at the moment. Unfortunately, no conclusions can be made at this point, since no outcomes have been observed yet. There might be different reasons for it as I already mentioned, but time will show how the pandemic in Bulgaria will end. There is even more to it than that, with the massive protests, the infection could spread very quickly. So the next few weeks or probably months would be very dynamic for Bulgaria. People seem to have forgotten the threat, but it is certainly present. Even though all of the three components are related to each other, I believe that they can be differently weighted at least for the current situation in Bulgaria. The situation is still urgent and uncertain, but not as much as it was at the beginning. On the other hand, the threat is even more present than it used to be.

Unfortunately, I will not be able to evaluate the crisis-management as a whole, since the pandemic is still developing.
 
 
 
 
 
 
 

6 Country's favourite stay-at-home song


[1]
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[2] Rhodes, A., Ferdinande, P., Flaatten, H. et al. (2012). The variability of critical care bed numbers in Europe. Intensive Care Med 38, 1647–1653. https://doi.org/10.1007/s00134-012-2627-8
Access date: 01.06.2020
[3]
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https://www.ghsindex.org/about/
[4]
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[6]
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[9]
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[10]
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[11]
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