Long-term health issues following COVID-19
1 year, 4 months ago

Long-term health issues following COVID-19

The Hindu  

In May 2023, WHO declared the emergency phase of the pandemic to be over. The Washington University/VA St. Louis Health Care System group looked at 1,38,818 people who survived COVID-19, among whom 20,580 were hospitalised. Among 80 health conditions that comprise Long COVID, 65% conditions persisted at two years in the hospitalised group, while 31% persisted in the latter. Compared with uninfected individuals, those who had prior COVID-19 had greater risk of blood clots, lung disease, fatigue, digestive ailments, muscle and joint problems and diabetes for up to two years. Among those who survived the first six months, the death rate declined afterwards, unexpectedly dropping below the average death risk of the comparison group.

Health Death Risk Covid Group Rate Two Years Survived  compared  issues  covid19  risk  problems  survived  group  following  persisted  health  death  longterm  rate

History of this topic

10,000 Long Covid patients on benefits, more may follow
3 months ago

10,000 Long Covid patients on benefits, more may follow

Dutch News  

Some four years after the beginning of the Covid pandemic some 10,000 Long Covid sufferers are living on benefits because they are unable to work or work fulltime, figures from state benefits agency UWV have shown. Some 9,746 people are on invalidity benefit because of complications following an infection while another 1,246 have health problems associated with Long Covid but …

10,000 Long Covid patients on benefits, more may follow
3 months ago

10,000 Long Covid patients on benefits, more may follow

Dutch News  

Some four years after the beginning of the Covid pandemic some 10,000 Long Covid sufferers are living on benefits because they are unable to work or work fulltime, figures from state benefits agency UWV have shown. Some 9,746 people are on invalidity benefit because of complications following an infection while another 1,246 have health problems associated with Long Covid but …

Covid tied to higher risk of depression, anxiety, PTSD and other conditions, with the unvaccinated most affected, study shows
4 months, 3 weeks ago

Covid tied to higher risk of depression, anxiety, PTSD and other conditions, with the unvaccinated most affected, study shows

CNN  

Editor’s Note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide & Crisis Lifeline by dialing 988 to connect with a trained counselor, or visit the 988 Lifeline website. CNN — Having a severe case of Covid-19 appears to be linked with an increased risk of subsequent mental illness, …

COVID-19 infections not problematic, experts say
4 months, 3 weeks ago

COVID-19 infections not problematic, experts say

China Daily  

The number of people in China being infected with COVID-19 is fluctuating reasonably and won't be a burden on medical resources or the public, experts said. However, the National Medical Center for Infectious Diseases said the percentage of people catching flu and testing positive for COVID-19 rose from 8.9 percent in early July to 18.7 percent late last month. "COVID-19 …

Long Covid: New insights into symptoms, mechanisms and treatment prospects
5 months ago

Long Covid: New insights into symptoms, mechanisms and treatment prospects

Hindustan Times  

Researchers from the Universities of Arizona, Oxford and Leeds examined dozens of previous studies on long Covid to investigate the number and range of people affected, the underlying disease mechanisms, the numerous symptoms that patients develop, and current and future treatments. Long Covid: New insights into symptoms, mechanisms and treatment prospects Long Covid, also known as post-Covid-19 condition, is described …

Study estimates 11.9 lakh excess deaths in 2020 during pandemic, 8 times more than official
5 months, 3 weeks ago

Study estimates 11.9 lakh excess deaths in 2020 during pandemic, 8 times more than official

Hindustan Times  

New Delhi, In India, 11.9 lakh excess deaths occurred in 2020 during the COVID-19 pandemic, 17 per cent higher compared to 2019, an international study has found. Study estimates 11.9 lakh excess deaths in 2020 during pandemic, 8 times more than official The estimate is about eight times higher than the official COVID-19 deaths in India, and 1.5 times the …

‘Still not over’: WHO cautions of COVID-19 threat ahead of summer holidays after US President Joe Biden tests positive
5 months, 3 weeks ago

‘Still not over’: WHO cautions of COVID-19 threat ahead of summer holidays after US President Joe Biden tests positive

Live Mint  

New Delhi: With US President Joe Biden testing positive for COVID-19 before the Presidential elections, the World Health Organisation has warned the public that Covid is still not over. WHO director-general Tedros Adhanom Ghebreyesus issued a warning, stating that vaccination rates among health professionals and the over-60s—two demographics most at risk of dying from COVID—are alarmingly falling. Globally, 9.8 million …

Health Talk | How real is cognitive impairment in Covid survivors?
5 months, 4 weeks ago

Health Talk | How real is cognitive impairment in Covid survivors?

Hindustan Times  

The overall incidence of cognitive impairment among Covid-19 survivors aged 60 years and older was 19.1% at two-and-a-half years after infection, according to a new analysis published in Nature, which highlights the emerging evidence that suggests neurological and other post-acute sequelae of Covid-19 can persist beyond or develop following SARS-CoV-2 infection. For the Nature study, the researchers investigated cognitive changes …

Despite its ‘nothingburger’ reputation, COVID-19 remains deadlier than the flu
7 months, 3 weeks ago

Despite its ‘nothingburger’ reputation, COVID-19 remains deadlier than the flu

LA Times  

Since the earliest days of the pandemic, health officials have gauged the threat of COVID-19 by comparing it to the flu. Immunity from vaccines and past coronavirus infections has helped tame COVID-19 to the point that when researchers compared the mortality rates of hospitalized COVID-19 and seasonal influenza patients during the height of the 2022-23 flu season, they found that …

Covid 'radically altered' the top death causes for the first time in 30 years, Lancet says
9 months ago

Covid 'radically altered' the top death causes for the first time in 30 years, Lancet says

Hindustan Times  

Covid-19 became the second leading cause of death globally in the year after it was declared a pandemic, according to a study published in The Lancet. While heart disease remained the top killer, Covid “radically altered” the main five causes of death for the first time in 30 years, displacing stroke, the publication said. While heart disease remained the top …

COVID-19 second-leading cause of death globally in 2021; slashed life expectancy: Lancet study
9 months ago

COVID-19 second-leading cause of death globally in 2021; slashed life expectancy: Lancet study

The Hindu  

COVID-19 replaced stroke to become the second-leading cause of death globally in 2021, causing 94 deaths per one lakh population and slashing life expectancy by 1.6 years, an international research published in The Lancet journal has found. “Disrupting more than three decades of consistent improvements in life expectancy and deaths, COVID-19 reversed this long-standing progress to emerge as “one of …

Undiagnosed diabetes contributed substantially to COVID-19 hospitalisation and deaths in many LMICs, including India: study
10 months ago

Undiagnosed diabetes contributed substantially to COVID-19 hospitalisation and deaths in many LMICs, including India: study

The Hindu  

Undiagnosed diabetes contributed substantially to COVID-19 hospitalisations and deaths in many low- and middle-income countries, including India, a new study published in the medical journal The Lancet said. According to the study, while it is seen that patients with COVID-19 that had diagnosed chronic diseases — including diabetes — may experience higher rates of hospitalisation and mortality relative to the …

Nearly 10,000 COVID deaths reported globally last month, fueled by holiday gatherings and new variant
1 year ago

Nearly 10,000 COVID deaths reported globally last month, fueled by holiday gatherings and new variant

LA Times  

Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, speaks at a news conference in Geneva last year. The head of the World Health Organization said Wednesday that holiday gatherings and the spread of the most prominent coronavirus variant globally led to increased transmission of COVID-19 last month. Tedros Adhanom Ghebreyesus said nearly 10,000 deaths were reported in December, …

Nearly 10,000 died from COVID-19 last month, fueled by holiday gatherings and new variant, WHO says
1 year ago

Nearly 10,000 died from COVID-19 last month, fueled by holiday gatherings and new variant, WHO says

Associated Press  

GENEVA — The head of the U.N. health agency said Wednesday holiday gatherings and the spread of the most prominent variant globally led to increased transmission of COVID-19 last month. Tedros Adhanom Ghebreyesus said nearly 10,000 deaths were reported in December, while hospital admissions during the month jumped 42% in nearly 50 countries — mostly in Europe and the Americas …

COVID-19: Karnataka to soon direct doctors to focus on targeted treatment of comorbidities
1 year ago

COVID-19: Karnataka to soon direct doctors to focus on targeted treatment of comorbidities

The Hindu  

Following the State Death Audit Committee’s conclusion that COVID-19 was an incidental finding in nine of the 10 deaths that have been analysed so far, the State Health Department will soon issue directions to doctors to focus on targeted treatment of comorbidities. State Health Commissioner Randeep D. told The Hindu on Tuesday that early and proper triaging in comorbid COVID-19 …

Covid-19 not a concern for most US adults, who are split on the latest vaccine and other precautions, KFF survey finds
1 year, 1 month ago

Covid-19 not a concern for most US adults, who are split on the latest vaccine and other precautions, KFF survey finds

CNN  

CNN — Most adults in the United States are not worried about getting sick with Covid-19 or spreading it over the holidays, a new survey from KFF found. Concern about rising cases and hospitalizations is slightly higher, with nearly half of adults saying they are “very” or “somewhat” worried that Covid-19 hospitalizations will increase this winter – about the same …

Covid Australia: Fears grow that a new coronavirus strain is causing huge spike in hospitalisations
1 year, 2 months ago

Covid Australia: Fears grow that a new coronavirus strain is causing huge spike in hospitalisations

Daily Mail  

A new Covid subvariant could be causing a spike in hospitalisations and authorities are pleading with vulnerable and elderly patients to get booster shots to stave off the threat. Chief health officer Dr John Gerrard said the surge in cases was largely due to low booster rates in older Queenslanders and the possible emergence of a new Covid variant called …

Beyond the COVID-19 pandemic: Unanswered questions, lessons learnt and ongoing challenges
1 year, 2 months ago

Beyond the COVID-19 pandemic: Unanswered questions, lessons learnt and ongoing challenges

Firstpost  

The COVID-19 pandemic that impacted all aspects of human life, quite literally cancelled the planet. Was any internal advice given to the Government of India that the mRNA vaccines developed by Pfizer and Moderna were better, despite the fact that they were significantly more expensive and difficult to administer? Covishield, developed by Oxford-AstraZeneca in the UK, is similar to previous …

6.5% of Covid-19 patients died within year of hospitalisation: Study
1 year, 4 months ago

6.5% of Covid-19 patients died within year of hospitalisation: Study

Deccan Chronicle  

Hyderabad: A study by the National Clinical Registry for Covid-19 found that 6.5 per cent of patients discharged after Covid-19 treatment died of Covid-related conditions within the year. There may be cases of complete kidney and lung failures resulting in death.” Of 14,419 patients that the NCRC tracked, 942 died within a year of discharge, accounting for 6.5 per cent, …

Long COVID: What the latest research says about symptoms after two years.
1 year, 4 months ago

Long COVID: What the latest research says about symptoms after two years.

Slate  

Death rates from acute COVID infections have fallen at this point in the pandemic, but there’s still a lot of worry about long COVID. Headlines about it say it shows that long COVID is worse, on a population level, than heart disease or cancer, and that it can continue to cause issues two years after the initial infection. Here’s one …

At least single dose vaccine prior to COVID-19 infection provided 60% protection against post-discharge mortality: ICMR study
1 year, 4 months ago

At least single dose vaccine prior to COVID-19 infection provided 60% protection against post-discharge mortality: ICMR study

The Hindu  

At least one dose of vaccine prior to COVID-19 infection provided 60% protection against post-discharge mortality, an Indian Council of Medical Research study on factors related to mortality within one year after discharge in hospitalised COVID-19 patients has found. Overall, the study’s findings suggest that a post-discharge mortality rate of 6.5% in patients hospitalised for COVID-19 warrants a vigilant follow-up. …

Pre-Covid shots provided 60% protection against post-infection deaths: Study
1 year, 4 months ago

Pre-Covid shots provided 60% protection against post-infection deaths: Study

India Today  

The Indian Council of Medical Research, which studied the cause of death in people after recovering from Covid-19 infection, found that those who were vaccinated before contracting the virus had 60 per cent protection against post-discharge mortality. An expert team working at the National Clinical Registry for Covid evaluated factors related to post-discharge mortality during the first year after Covid, …

Brain fog and other long COVID symptoms affect millions. New treatment studies bring hope
1 year, 5 months ago

Brain fog and other long COVID symptoms affect millions. New treatment studies bring hope

Associated Press  

WASHINGTON — The National Institutes of Health is beginning a handful of studies to test possible treatments for long COVID, an anxiously awaited step in U.S. efforts against the mysterious condition that afflicts millions. “This is a year or two late and smaller in scope than one would hope but nevertheless it’s a step in the right direction,” said Dr. …

Upsurge in hospitalisation rates across US spark fears of another COVID-19 'summer wave'
1 year, 5 months ago

Upsurge in hospitalisation rates across US spark fears of another COVID-19 'summer wave'

India TV News  

The United States might be experiencing another COVID-19 wave as hospitalisations surged more than 10% to 7,109 as of July 15, as compared to 6,444 the previous week, according to the US Centers for Disease Control and Prevention. This could be the start of a late summer wave," said Dr Brendan Jackson, the CDC's COVID-19 incident manager, to NPR. A …

COVID-19 data shows early signs of an increase in cases
1 year, 5 months ago

COVID-19 data shows early signs of an increase in cases

Salon  

Emerging data suggests that COVID-19 cases in the U.S. are on the rise again for the first time since January 2023, though the uptick is relatively small so far. Overall, COVID cases have been on a steep decline since January, but available data shows this trend is starting to reverse. Elsewhere in the world, many countries are also enduring prolonged …

Sudden deaths of youth have been reported after COVID-19: Health Ministry in Lok Sabha
1 year, 5 months ago

Sudden deaths of youth have been reported after COVID-19: Health Ministry in Lok Sabha

The Hindu  

Sudden death of some youth after COVID-19 have been reported but at present there is no sufficient evidence to confirm the cause of such deaths, said the Health Ministry in Lok Sabha on Friday adding that to ascertain the facts regarding the apprehension of rising cases of cardiac arrest after the pandemic, the Indian Council of Medical Research is conducting …

Nearly 36 million in Europe may have experienced long Covid, World Health Organization official says
1 year, 6 months ago

Nearly 36 million in Europe may have experienced long Covid, World Health Organization official says

Hindustan Times  

Nearly 36 million people in Europe may have had long-lasting health problems from coronavirus infections they got during the first three years of the COVID-19 pandemic, the World Health Organization's regional director said Tuesday. Statistics from the University of Washington researchers indicate that about one in 30 of the region's residents have experienced “long COVID.” in the past three years. …

Age and co-morbidity are definite factors that affect COVID and its outcome, says ICMR head
1 year, 6 months ago

Age and co-morbidity are definite factors that affect COVID and its outcome, says ICMR head

The Hindu  

Age and co-morbidity are definite factors that affect the outcome of contracting COVID-19, Rajiv Bahl, Director General of the Indian Council of Medical Research, has said. We should be able to share the information by this month-end,” Dr. Bahl said on the sidelines of the recently held G-20 meeting on health. Speaking on the work done to help bring in …

Health of long Covid patients worse than Stage-4 lung cancer patients: Study
1 year, 7 months ago

Health of long Covid patients worse than Stage-4 lung cancer patients: Study

Live Mint  

The impact of long Covid has devastating effects on patient's health, according to a new study. Patients who were infected from a long Covid-19 infection are witnessing a drastic change in their health which is more dangerous than a fatal illness such as stage-4 lung cancer, anemia, or stroke. The research, published in BMJ Open and funded by the National …

Long COVID takes heavy toll on health even as pandemic fades, study shows
1 year, 7 months ago

Long COVID takes heavy toll on health even as pandemic fades, study shows

LA Times  

Courtney Gavin, at her Irvine home in February, has been dealing with the effects of COVID-19 since March 2020 and uses a motorized lift to climb the stairs. “It’s trying to help all of us — both patients and doctors — figure out: How do we tell if someone has long COVID?” said Dr. Joann Elmore, a professor of medicine …

US study finds 1 in 10 get long COVID after omicron, starts identifying key symptoms
1 year, 7 months ago

US study finds 1 in 10 get long COVID after omicron, starts identifying key symptoms

Associated Press  

WASHINGTON — About 10% of people appear to suffer long COVID after an omicron infection, a lower estimate than earlier in the pandemic, according to a study of nearly 10,000 Americans that aims to help unravel the mysterious condition. Early findings from the National Institutes of Health’s study highlight a dozen symptoms that most distinguish long COVID, the catchall term …

Hundreds of millions of life years lost to pandemic: WHO
1 year, 7 months ago

Hundreds of millions of life years lost to pandemic: WHO

The Hindu  

Nearly 337 million life years were lost in the two first years of the Covid-19 pandemic, as millions of people died prematurely, the World Health Organization said on Friday. While the WHO officially registered 5.4 million Covid deaths in 2020 and 2021, its excess mortality data shows around 14.9 million people actually likely died due to the crisis over that …

Hundreds of millions of life years lost to COVID-19 pandemic, according to WHO
1 year, 7 months ago

Hundreds of millions of life years lost to COVID-19 pandemic, according to WHO

Firstpost  

According to the World Health Organisation, about 337 million life years were lost in the first two years of the Covid-19 pandemic, when millions of people died prematurely. While the WHO officially registered 5.4 million Covid deaths in 2020 and 2021, its excess mortality data shows around 14.9 million people actually likely died due to the crisis over that period. …

US ends COVID-19 health emergency today: Key figures defining the pandemic
1 year, 8 months ago

US ends COVID-19 health emergency today: Key figures defining the pandemic

Firstpost  

Though daily life has long returned to near-normal for many in the United States, the official end of the COVID-19 health emergency Thursday night still marks a new post-pandemic era for the country. Three years of health emergency A state of emergency was first declared in the United States in January 2020, more than three years ago. 1.1 million deaths …

What you need to know to stay safe from COVID now that the public health emergency has ended
1 year, 8 months ago

What you need to know to stay safe from COVID now that the public health emergency has ended

LA Times  

Ready or not, it’s over. And roughly three-quarters of those surveyed by KFF that same month said they believe the public health emergency’s end will either have a “positive impact” or “no impact” on the country overall. But you are in diminishing company: That March Gallup Poll found that 3% of U.S. respondents remained “very concerned” about coming down with …

COVID ebbs, doctors say stay alert
1 year, 8 months ago

COVID ebbs, doctors say stay alert

Deccan Chronicle  

Hyderabad: The World Health Organisation declared an end to Covid-19, which claimed 69 lakh lives over three years, as a global health emergency. Dr Ranga Reddy Burri, president of Infection Control Academy of India and public health policy advisor, speaking to Deccan Chronicle, said, “One thing which we have to bear in mind that the health emergency has to come …

Covid-19 dropped to 4th leading cause of death in US in 2022: Report
1 year, 8 months ago

Covid-19 dropped to 4th leading cause of death in US in 2022: Report

Hindustan Times  

US deaths fell last year, and COVID-19 dropped to the nation's No. Read here: Exiled billionaire's assets worth $280 million seized by Ukraine, ‘aided Russia’ COVID-19 deaths trailed those caused by heart disease, cancer and injuries such as drug overdoses, motor vehicle fatalities and shootings. The death rates for heart disease and cancer increased during the pandemic, the CDC said. …

Cancer, heart disease beat Covid as leading cause of death in 2022
1 year, 8 months ago

Cancer, heart disease beat Covid as leading cause of death in 2022

NL Times  

Cancer and heart disease were the leading causes of death in the Netherlands last year, claiming slightly more than half of the people who died last year. Mental disorders and diseases of the nervous system, which include dementia and Alzheimer's, were the third leading cause of death at 13 percent, followed by respiratory diseases, non-natural causes, and Covid-19. “Viewed across …

Covid-19: Hospitalisation low in Bihar despite rise in active cases
1 year, 8 months ago

Covid-19: Hospitalisation low in Bihar despite rise in active cases

Hindustan Times  

PATNA: Bihar reported as many as 133 new cases of Covid-19 on Sunday, a marginal dip from 198 on Saturday — the highest spike in a day this month — pushing the number of active cases to 857 in the state, as per government data on Sunday. Despite an increase in the number of active cases, only 20 patients required …

People with intellectual disabilities were hit harder by Covid
1 year, 8 months ago

People with intellectual disabilities were hit harder by Covid

Dutch News  

People with intellectual disabilities were more likely to die from coronavirus than others during the pandemic, and the virus has had a worse impact on their general health, according to researchers at Radboud teaching hospital in Nijmegen. At least 785 people with an intellectual impairment died of Covid in the two years of the pandemic, but proportionally, the total should …

People with intellectual disabilities were hit harder by Covid
1 year, 8 months ago

People with intellectual disabilities were hit harder by Covid

Dutch News  

People with intellectual disabilities were more likely to die from coronavirus than others during the pandemic, and the virus has had a worse impact on their general health, according to researchers at Radboud teaching hospital in Nijmegen. At least 785 people with an intellectual impairment died of Covid in the two years of the pandemic, but proportionally, the total should …

Four times more Covid deaths in people with intellectual disabilities
1 year, 8 months ago

Four times more Covid deaths in people with intellectual disabilities

NL Times  

The Covid-19 mortality rate among people with an intellectual disability was over four times higher than the general population. "In the two coronavirus years, at least 785 people with an intellectual disability died from Covid, more than 600 more than would be expected based on mortality in the general population," wrote Maarten Cuypers, one of the researchers. "We also saw …

Ready, or not: The Hindu Editorial on rising numbers of COVID-19 cases and India’s state of preparedness
1 year, 8 months ago

Ready, or not: The Hindu Editorial on rising numbers of COVID-19 cases and India’s state of preparedness

The Hindu  

The better part of management is preparedness. On April 12, a total of 7,830 new cases were reported in a 24-hour period, according to the Union Health Ministry’s data, possibly the highest in over 200 days. However, health systems can scarcely afford to be under prepared, especially considering the recent traumatic experience of a raging pandemic taking a huge toll. …

Covid-19 scare: India logs over 3,000 new cases with daily positivity rate at 6.1% | Check active cases tally
1 year, 9 months ago

Covid-19 scare: India logs over 3,000 new cases with daily positivity rate at 6.1% | Check active cases tally

India TV News  

Covid in India: Amid the rising coronavirus cases in the country, India logged 3,038 fresh infections, taking the active cases tally to 21,179. As per the Union health ministry, the daily positivity rate of Covid-19 currently stands at 6.1% The Covid case tally was recorded at 4.47 crore. The active cases now comprise 0.05 per cent of the total infections …

With new variant XBB1.16 making its way, COVID-19 is far from being called ‘over’, say experts
1 year, 9 months ago

With new variant XBB1.16 making its way, COVID-19 is far from being called ‘over’, say experts

The Hindu  

The COVID-19 cases with the new variant XBB1.16 have been on the rise in recent times, becoming a cause of worry for the medical system in the country and the people in general. While the country currently has 10,981 active cases, Andhra Pradesh has reported 35 active cases, according to the latest Union Health Ministry update. “XBB1.16 variant is an …

Nothing to panic about Covid and H3N2 co-infection, say doctors
1 year, 9 months ago

Nothing to panic about Covid and H3N2 co-infection, say doctors

Deccan Chronicle  

Hyderabad: Hyderabad has been reporting a slight spike in Covid-19 cases over the last two weeks, while there are 146 active cases across the state, pointed out doctors here on Friday. "Given the rise in Covid-19 and H3N2 cases across the country, one should get into the Covid ritual of regular washing of hands, using face masks and maintaining social …

DC Edit | Covid isn't over, be cautious
1 year, 9 months ago

DC Edit | Covid isn't over, be cautious

Deccan Chronicle  

After lying low for quite some time, the Covid-19 virus has started rearing its head again in the country. The daily caseload which came down to two digits towards the end of the last year has of late been crossing 1,000; as per the health ministry data, India logged 1,300 new cases, the highest in 140 days, on Thursday while …

Why the US Covid-19 death toll is still rising
1 year, 10 months ago

Why the US Covid-19 death toll is still rising

Live Mint  

The U.S. has dodged a major wintertime Covid-19 surge as the pandemic continues to recede into the background. The U.S., which recently topped 1.1 million Covid-19 deaths since the pandemic began, continues to record several hundred more each day, death-certificate data show. The U.S. averaged about 400 deaths a day in a three-month span covering November through January, based on …

COVID-19 survivors develop natural immunity against severe illnesses: Lancet
1 year, 10 months ago

COVID-19 survivors develop natural immunity against severe illnesses: Lancet

Live Mint  

Protection against COVID-19 re-infection is very high, found a study by The Lancet. For those who had at least one prior infection with COVID-19, natural immunity against severe illness was potent and enduring for all variations. Previous exposure to pre-Omicron variants significantly weakened natural immune defences against Omicron BA.1 reinfection. Also, the research reveals that the amount and duration of …

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