Via Teleconference 

10:37 A.M. EDT

MR. ZIENTS: Good morning, and thank you for joining us. Today, Dr. Walensky will provide an update on the state of the pandemic, Dr. Fauci will highlight the latest science, and Dr. Murthy will share an update on our efforts to strengthen confidence in the vaccines.

First, I want to provide an update on the progress we are making on vaccinations and our all-out efforts in the next phase of getting more vaccinations to Americans.

After delivering an unprecedented 220 million shots in the President’s first 100 days and successfully getting shots in the arms to the bulk of those most at risk and those most eager to get vaccinated, we are far ahead of where anyone thought we would be in our war against the virus.

Importantly, as we continue to vaccinate more people, cases, hospitalizations, and deaths continue to fall. This vaccination campaign is curbing the spread of COVID-19, saving tens of thousands of lives, and allowing millions to start living life more normally once again. That’s why it’s so important that we keep pushing for continued progress.

In this next phase, we’re implementing a strategy that uses all the resources at our disposal to reach those who still need protection from this virus. Our approach and the pace of progress will look different as we reach deeper into communities and take an even more localized approach.

Earlier this week, the President set a new goal for this next phase of the vaccination program: 70 percent of adult Americans with at least one shot and 160 million Americans fully vaccinated by July 4 — Independence Day. That’s roughly 100 million shots in 60 days between May 4th and July 4th.

As you can see on our vaccination report, 57 percent of adult Americans now have at least one shot. So to meet the President’s goal of 70 percent of adult Americans with at least one shot, we need to vaccinate at least another 13 percent of adult Americans by July 4th.

Overall, by the end of today, we will hit two significant milestones in our vaccination program: 150 million Americans with at least their first shot and 110 million Americans fully vaccinated. Our wartime effort is mobilized to meet the President’s goal, and we’re in all-out implementation and execution mode.

We’re focused on three key areas: First, improving access and making it even easier for everyone to get vaccinated. Second, building confidence — vaccine confidence — by empowering every American with facts and answering their questions. And third, ensuring equity is at the center of everything we do.

To improve access and make it even easier and more convenient for Americans to get their shot, this week the President directed our Federal Pharmacy partners to start making no-appointment walk-up vaccinations available. Soon, Americans will be able to get vaccinated without an appointment at the vast majority of nearly 40,000 local pharmacy locations nationwide.

Already, CVS, Rite Aid, Walmart and Sam’s Club, Meijer and Hy-Vee, Southeastern, and H-E-B have announced that they’re offering walk-up vaccinations at all of their locations nationwide — more than 20,000 stores in communities across the country.

And to reach people where they are, FEMA is shifting from the high-volume vaccination sites that have served so many Americans so well to smaller, community-based sites and expanding the number of mobile clinics.

This week, we also made significant investments to get Americans the information they need on vaccines. Dr. Murthy will discuss this progress in his remarks. And we advanced equity by taking important steps to bolster our response for Americans living in rural communities, including by sending vaccine doses directly to an even greater number of rural health clinics and deploying almost $1 billion of American Rescue Plan funding to enhance and expand vaccine access and education and COVID-19 testing and mitigation in rural America.

The President also announced that should the FDA issue in emergency use authorization of the Pfizer vaccine for individuals ages 12 to 15, we already have in place the operational public education plan to immediately hit the ground running.

Over 15,000 local pharmacies will be ready to vaccinate 12- to 15-year-olds. And we are working to get more pediatricians and family doctors to offer vaccinations in their offices to make it as easy and convenient for adolescents to get vaccinated.

To be clear, across all fronts, we’re doing everything we can, bringing every resource to bear to reach Americans who need more convenience or more information. And we’re enlisting every American — every organization, every healthcare professional, every business and employer — to help Americans get the facts they need and to encourage vaccination.

Businesses across the country have stepped up and answered the President’s call to offer paid time off for their employees to get vaccinated.

Sports leagues are also joining the vaccination effort. In Indiana, INDYCAR has worked with the state to transform the Indianapolis Motor Speedway into a vaccination site that gives vaccine getters the unique experience of getting vaccinated in an actual F1 garage and the chance to drive through the main race tunnels. That’s pretty cool.

And in communities across the country, Americans are going above and beyond to encourage vaccinations and get people vaccinated — like in Alaska, where workers are delivering vaccine to deep-sea fishermen using a contraption called a “man basket” — a bucket suspended in the air that swings from one ship to a neighboring vessel, vaccinating more than 100 people on each ship. Now, that’s what I call meeting people where they are.

We’re also in a new phase of our work in the global front. As the President has said, the pandemic knows no borders, and he has committed that the United States will become an arsenal of vaccines for other countries. We’re taking steps to execute on this strategy.

First, on Wednesday, because of the extraordinary circumstances of the pandemic call for extraordinary measures, U.S. Trade Representative Ambassador Tai announced our support for the waiver of intellectual property protections for COVID-19 vaccines.

Second, driven by the aggressive actions we’ve taken together to accelerate vaccine manufacturing and production lines in the U.S., both Pfizer and Moderna have executed well and have now increased their capacity to produce vaccine for countries around the world.

Third, we’ve committed to sharing vaccines with other countries, including approximately 60 million doses of the AstraZeneca vaccine by the end of June.

These steps build on the actions we took in our first 100 days to support global pandemic response and vaccination efforts, including rejoining the World Health Organization, providing the most funding to COVAX of any country in the world, working with our Quad partners to help expand vaccine manufacturing facilities in India, and helping India respond to its ongoing outbreak.

We know we have more work to do, and we know it will not be easy, but we’ve already seen what America is capable of when we come together and all of us do our part. That’s how we delivered 220 million shots in our first 100 days. And that’s how we will meet the President’s new goal of 70 percent of adult Americans with at least one shot by July 4th: each of us doing our part.

So, please, if you’re already vaccinated, share your story and encourage your family, friends, and neighbors to get vaccinated.

If you haven’t gotten your shot yet and have questions, talk to your doctor or pharmacist. And when you’re ready to roll up your sleeve, visit, or text your ZIP Code to 438829 to find a vaccine near you. Let me repeat that: Text your ZIP Code to 438829. It’s free, it’s easy, it’s convenient, and it’s how we save lives and return to a more normal lifestyle.

With that, over to you, Dr. Walensky.

DR. WALENSKY: Thank you so much, and good morning to everyone. Let’s begin again with the state of the pandemic.

Yesterday, CDC reported over 41,900 new cases of COVID-19. Our seven-day average is about 45,800 cases per day, a decrease of about 13 percent from our prior seven-day average and another hopeful sign that we are on the right track.

The seven-day average of hospital admissions is 4,640. Again, an 8 percent decrease from our prior seven-day average.

And the seven-day average daily deaths is now at 656 per day. We have still recorded over 700 deaths these last two days.

I am enormously proud of the work put forward by so many towards vaccinating our entire country. It’s truly been a remarkable feat, and I am so thankful to the millions and millions of Americans who have rolled up their sleeves.

As you heard from Andy on Wednesday, there’s power in hearing the reasons why each of us are rolling up our sleeves and getting vaccinated. The decisions of where, when, and why to get our vaccines are unique and they’re personal. We need to share these stories in encouraging others to do the same to follow what we’ve done and to join us in the community in this effort.

As you all know, I’m a physician and a researcher. But my most important job is as a daughter, a wife, and a mother of three sons. And when it came to vaccinating my family, we all leaned in. My husband is a pediatric oncologist. He did, of course, get vaccinated to protect himself and to protect our family, but also to ensure he could minimize the risk of transmitting disease to his very vulnerable patients.

As for my boys, my older two — 19 and 21 — really wanted to get vaccinated. They did so having much — lost much of their college experience this past year, and they wanted to be sure they could get back that college experience next year.

My youngest son, 16, is now, just recently, fully vaccinated. And I am happy to say that tonight he is having two fully vaccinated friends over to watch a movie. It’s been a long and coming, seemingly mundane, but now very luxurious event, and he can do so because he’s fully vaccinated.

And I rest easy knowing my family will be safe and that is simply the best Mother’s Day gift I could get this year.

We have a long way to go to get young Americans vaccinated. Only about one fifth of 18- to 29-year-olds and less than one third of 30- to 39-year-olds are fully vaccinated.

By contrast, more than two thirds of people over the age of 65 are already fully vaccinated. Our country, our families, our children have been through so many challenges. If you haven’t been vaccinated, now’s the time; it’s easier than ever. And you — if you have kids, 16 or older, who still haven’t vaccinated, talk to them. Please, encourage them to roll up their sleeves because the COVID-19 vaccines will help protect those who we clo- — hold closest to our hearts.

To all of you mothers out there, I wish you a very Happy Mother’s Day. Please stay safe.

And now to you, Dr. Fauci.

DR. FAUCI: Thank you very much, Dr. Walensky. I’d like to spend the next couple of minutes talking a bit about the striking effectiveness of COVID-19 vaccines not only in the United States, but in those countries which have the capability of administering it.

I’ve spoken to you on previous press briefings about the real-world effectiveness of the vaccines here in the United States, but I want to share with you some examples of recently published data.

Can I have the next slide?

Yesterday, published online in the Lancet, is an important paper from Israel, which is an observational study using their national surveillance data. And I’m going to show you a couple of slides that are really striking and I hope you pay attention to.

Next slide.

This slide, though it looks busy, is really a very important message. If you move from the left of the slide to the right, you see what was going on in Israel from November the — 2020 to April 3. They launched their vaccine campaign on December the 20th, with the red arrow, but they were having a surge of cases, which — on the second arrow, which is blue — prompted them to begin an initial lockdown. The cases continued to surge. They added an additional lockdown on January 8th while still administering on a daily basis, the way we are doing, vaccines. Then they got to that interesting turning point that I have referred to multiple times in different briefings.

So take a look at right around February the 1st. What they did is they began to reopen, and one would expect you might see a surge to reopen. But as they reopened in Phase One, the cases continued to come down. In Phase Two, on February 21st, the cases continued to come down. And then when they were fully reopen with a substantial proportion of their population vaccinated — the way we want to be — they went down to practically no cases. 

Next slide.

Put in a more simple form, this is what happened: The red line are the number of cases, which, as you can see, continued to go up in the beginning of their vaccine program. But they reached that critical crossroads that you’ve heard Dr. Walensky and I talk about in the past, where the vaccine doses kept on coming up and the cases came down to literally minimal number, with new cases on a seven-day rolling average of 63; new deaths, 1.3; and hospitalized, 164.

Next slide.

Now let’s take a look at how impressive the data are. Israel has predominantly the B117, which is the dominant variant in our own country.

Take a look at the effectiveness on the righthand part of the slide of every type of infection. Infection in general, everything over 90 percent — asymptomatic, symptomatic, hospitalization, severe hospitalization, and death — with numbers ranging from 91 to 97.5 percent.

Next slide.

All ages are favorably involved. Take a look at this slide. Every age from 16 to 44, up to greater than 85, have anywhere from a 94 to a 96 effectiveness.

Next slide.

So one can make, from this study, which the authors’ reported, that these findings are of international importance as vaccination programs ramp up across the rest of the world, suggesting that other countries can similarly achieve sustained decline if they achieve a high vaccine uptake.

Next slide.

And indeed, let’s take another country: In this case, Qatar, which looked at over 385,000 people in a mass vaccination campaign. The effectiveness, not only against B117 — which was close to 90 percent — but even the very problematic variant that we’ve spoken of in South Africa, the 351, which shows a 75 percent effectiveness.

If you look at severe, critical, or fatal disease with both the 117 and the problematic 351, both had 100 percent efficacy after two doses.

And so, on the final slide, what we’ve all been saying: Let’s go for the 70 percent of adults vaccinated with at least one dose by July 4. And I’m confident that we can mimic the pattern that I’ve just showed you on the previous slide.

I’ll stop there, and over to you, Dr. Murthy.

SURGEON GENERAL MURTHY: Thanks so much, Dr. Fauci. I appreciate it. And it’s great to be with all of you again this morning. I want to say a few words about our public education efforts and our broader confidence campaign.

We’ve continued our public education and engagement campaign, and we continue to see positive movement toward our vaccination goals. There’s new data out this week that shows vaccine confidence and vaccination continue to increase.

The proportion of adults who either received the vaccine or are planning to get it rose to 64 percent. And just for perspective: This number was 34 percent in December, and it has increased each month since then.

Additionally, at least 50 percent of every major adult demographic group across age, race, gender, education, and political leaning now has already gotten vaccinated or wants to. That is real progress.

With that said, there is no doubt that many people still have questions about the vaccines, and that’s why we will continue to work hard to ensure people get science-based information from voices they know and trust.

But it’s also true that vaccine confidence is only one piece of the puzzle. The barriers to getting vaccinated fall into three main categories: vaccine confidence, motivation, and access.

And we see this reflected in this week’s data, which found that a substantial portion of unvaccinated people cited other reasons other than confidence for not yet getting their shots, and those reasons included: not enough time, conflicts with work hours, uncertainty about eligibility, lack of information about where to get the vaccine, and feeling the vaccine may be unnecessary, among other reasons.

The good news is that our COVID-19 Community Corps is working hard to address all three challenges of vaccine confidence, motivation, and access. And today, I want to share a few stories about their work.

One of our members, PrepareSTL, is engaging communities of color in St. Louis through peer-to-peer outreach. They’re hosting small-group conversations of 10 or fewer people. And they ultimately aim to share vaccine information with over 6,000 community members.

The Congdon Street Baptist Church and other churches in Providence, Rhode Island, have been using their existing phone trees to call community members about getting vaccinated, even offering to drive them to vaccination sites when they’re ready.

And finally, I want to highlight BAPS Charities, a Hindu-American organization that has turned their temples into vaccination centers. For elderly members of these temples, it’s been easier to get vaccinated at their own temple, surrounded by trusted friends and familiar settings, than it may have been for some of them to get vaccinated at an unfamiliar location.

So, from California to Missouri to Rhode Island, these organizations are showing us that we need a strong, people-powered movement to address these three main barriers to vaccination: vaccine confidence, motivation, and access. And that’s why we’re also making significant federal investments towards these goals.

We’ve dedicated $250 million for community organizations to provide vaccine information, help make appointments, and assist with transportation to those appointments. We also, this week, announced an additional $130 million, which will support equity efforts for hard to reach and high-risk communities; and another $100 million will support rural health clinics in their education and outreach efforts in rural communities. On top of this, nearly $250 million will be available to states and other jurisdictions to power the next phase of their outreach efforts.

This is also why the administration this week rolled out additional tools to make it even more convenient to find a vaccine. So you can now enter your ZIP Code on, which is in English and Spanish, and get locations where you can get vaccinated around you.

And you can also text your ZIP Code to the number, 438829, which spells “GetVax”; or to 822862, which spells “Vacuna”, and you’ll receive these vac- — three vaccination sites near you. It’s really quick and easy to do. I find myself doing it a few times just to see what comes up and make sure everything is still working. And everything is great and it’s a tool that we’ve had a lot of good feedback on so far. So I encourage you to use that text tool, use the website. It makes it easy to find out where to get vaccinated.

I lastly just want to speak directly to the people who are wondering in this moment if it’s still important for them to get vaccinated: Please do get vaccinated. It really does matter. Because even if you’re not at high risk for severe illness from COVID-19, we know that you can still get infected even without symptoms and spread the virus to others who are at higher risk of hospitalization and death. We saw that time and time again over the past year, and that is in fact how many people acquired the virus and ultimately passed away from it.

When you get vaccinated though, you break that chain of transmission by giving the virus one less place to hide in your community. The only way to get cases to come down and stay down is for everyone to get vaccinated. That’s how you can protect your community and help all of us return to the activities and the life we love.

I know it’s been a difficult year and that everyone in our country has been asked to step up and sacrifice in a big way. And I want to be clear that this pandemic will end. The faster we get vaccinated, the faster that day will come.

And finally, I just want to wish everyone out there a Happy Mother’s Day. I particularly want to recognize all the moms out there who have shouldered often a disproportionate amount of the challenge of COVID-19 of having to manage children and telework, as well as manage virtual learning. Moms and dads have shared in that burden, but I know it has disproportionately followed — fallen on moms. And one of the most powerful things I — we think we can do for moms out there is to help end this pandemic quickly.

That’s why vac- — getting vaccinated is so important. It’s our quickest way to ending the pandemic.

Thank you for your time. I’ll look forward to your questions.

Back to you, Jeff.

MR. ZIENTS: Thanks, Doctors. Let’s open it up for a few questions.

MODERATOR: Thanks, Jeff. Reminder: Keep your questions to one question so we can get as many through.

First, let’s go to David Lim at Politico.

Q  Hi guys. Thanks for taking the question. Nancy Messonnier, who was among the first to warn Americans of the threat that COVID-19 posed last year, announced this morning she is resigning from the CDC.

This question is for Dr. Walensky: Can you explain why she was reassigned two weeks ago away from the agency’s COVID-19 vaccine taskforce? And why is she now leaving the CDC?

DR. WALENSKY: Thank you very much for that question. As you note, Nancy has — Dr. Messonnier has been a true hero. And through her career, in terms of public health, she’s been a steward of public health for the nation. Over this pandemic and through a many-decade career, she’s made significant contributions, and she leaves behind a strong, strong force of leadership and courage in all that she’s done.

I want to wish her the best in her future endeavors. And I have no other comment. Thank you.

MODERATOR: Issam Ahmed, New York Public Radio.

Q  Hi, this Issam Ahmed with AFP. No, my question was on vaccinating with Pfizer — when it becomes — when it — if it gets full approval, will that mean it’s then a standard of care? And will trials be able to continue with a placebo or not after that?

MR. ZIENTS: So, I’ll go first and then maybe, Dr. Fauci, you can also chime in if I — if I miss anything here.

Pfizer announced today that it’s applying for full approval from the FDA. It’s important to start with: Nothing changes right now. The vaccine — the Pfizer vaccine is still authorized under emergency use authorization. So Pfizer has announced that it has initiated its application for full approval. And we anticiplate — anticipate that it will complete that application across the coming weeks.

These reviews generally take a few months, is our understanding. This is all over at the FDA, of course. Given the nature of the pandemic, FDA will move as expeditiously as possible without compromising its gold standard for safety.

Our focus remains on getting 70 percent of Americans — adult Americans at least one shot by July 4th, as the President has laid out that goal. And it will certainly be an important day if full approval is granted, but the process will be fully led and run by the FDA.

Dr. Fauci, anything to add here?

DR. FAUCI: Well, the question was about placebo. Right now, given the availability of vaccines, you’d have to have a really very good reason to do a placebo-controlled trial right now. Most of the trials that they — when they do occur, would likely be of non-inferiority or superiority trials, where you would have to compare it to another product, as opposed to giving a placebo.

You give a placebo-control trial in a country in which there is no access whatsoever so that if the people in the trial were not in the trial, they still would not have access to a vaccine. That’s not the situation in the United States.

So regardless of whether it’s an EUA or it’s a BLA — the same thing — you don’t want to do a placebo right now.

MR. ZIENTS: Thank you Dr. Fauci.  Next question.

MODERATOR: Shira Stein, Bloomberg.

Q  Hi. Thanks. What impact would a TRIPS waiver have on U.S. production, and could it undercut supply? And in addition to TRIPS, does the White House have any plans to push for broader international manufacturing capabilities?

MR. ZIENTS: Yeah, I think — let me start with: The right thing to do is the waiver. We are in unprecedented, once-in-a-hundred-year pandemic, and that calls for extraordinary measures in an extraordinary times.

You know, experts agree that the waiver alone won’t result in the scale and speed we need to make enough vaccines to end this pandemic, and that’s why we will continue to ramp up our efforts — working with the private sector and all possible partners — to expand vaccine manufacturing and distribution around the world and increase, as you point out, the important supplies, the raw materials, the equipment needed to make the vaccines.

Next question.

MODERATOR: Tommy Christopher, Mediaite.

Q  Hi, can you hear me now? Hello?


Q  All right, good. Yes, thank you. My question is, I guess, for all of you. There’s a new IHME report out that says the true death toll in the U.S. from coronavirus is over 900,000. And I’ve been wondering this for a while — I know the CDC tracks excess death figures and I’ve been wondering if there’s been any discussion of or plan to incorporate those figures into the official death toll, which, I guess, currently, is just confirmed deaths.

MR. ZIENTS: Dr. Walensky?

DR. WALENSKY: Yeah, thank you for that. So that’s a study that just came out from the IHME, where they’re now adding their excess deaths into their — their attributable deaths directly from COVID-19.

As you know, we have been collecting not only — and we’ve known that the toll of this pandemic is not necessarily just those who’ve passed from COVID-19 specifically, but excess deaths relating to access to care, not presenting to care, and many other things.

So, we will look at this carefully, and then we will work with — within the CDC to make decisions as to whether to count them as excess or to count them as COVID-specific.

Regardless, I think we need to understand that the death toll of this disease has been attributable directly from COVID, as well as — as the collateral damage, I would say, of what has happened from COVID-19. And that, in my mind, is just more and more reason to continue to get vaccinated.

MR. ZIENTS: Next question.


Q  Thanks for doing this. We heard the President say that he wants to turn the U.S. — the U.S. sharing vaccinate — vaccines around the world to the arsenal of democracy. Now, a couple of weeks into this — this phase, I was hoping, Jeff, you might have some more guide — outlines on where the — on what criteria the White House will use to determine how to share vaccines with the rest of the world. Will it only be with allies? Will it be through COVAX, sort of, on a need basis? Is it a tool of foreign policy or is it a tool of philanthropy and public health?

MR. ZIENTS: So, Zeke, at — you know, at the moment, there are no AstraZeneca doses that completed and cleared the process to send to other countries. We expect there will be approximately 10 million doses that could be released in the coming weeks, after FDA concurrence. There’s an estimated 50 million doses, in addition, that are in various stages of production that could be completed across May — or should be completed across May and June.

So, in sum, we’re talking about about 60 million doses of AstraZeneca in the U.S. that cou- — that could be shared — will be shared with other countries over the next couple of months. As these doses become available, the plans will be finalized as to where they go.

Next question.

MODERATOR: Last question. Let’s go to Jeremy Diamond at CNN.

Q  Hey, thanks so much. Just to follow up on what Zeke was asking: Do you have any metrics currently that you can share about how you’re going to determine which countries receive the doses? And do you have an update on the status of the FDA’s quality control review? And then, just secondly, according to this Kaiser Family Foundation poll, we now see that 18- to 29-year-olds are the most hesitant demographic. What do you guys see is the best way to move numbers with that age group?

MR. ZIENTS: Well, let me start with handing it over to Dr. Murthy on 18- to 29-year-olds.

Dr. Murthy.

DR. MURTHY: All right. Thanks, Jeff. I — so I appreciate that — the question about 18- to 29-year-olds. One of the reasons I specified that there are three distinct reasons that we think, at this point, people may not want to take a vaccine is because we’ve got to — we’ve got to assume that everybody has doubts about the vaccine. We know some people have questions. We know some people just may not feel motivated, may not think it’s important, and other people have access issues.

For 18- to 29-year-olds, what we know is that there’s some combination of these three things going on. And so what — our approach is, number one, make sure that people can get accurate information from trusted messengers. Eighteen- to twenty-nine-year-olds may listen to very different messengers than I would or perhaps some of us on this panel.

So part of our work through the Community Corps has been mobilizing, engaging those messengers.

The second thing that we’re also doing is we’re making sure that it’s easy to get a vaccine. What you heard today from the President — or rather earlier this week from the President — was that a number of steps were being taken to set up mobile units, pop-up options for getting the vaccine, and walk-in options in pharmacies now to make it — again, lower the barriers to getting vaccine.

And finally, just remember this — that we have to continue to — to help, you know, people across the country understand why it’s important to get vaccinated, even if you yourself may be at lower risk of complications.

Dr. Walensky mentioned her own children, you know, who are — who — two of whom were eager to get vaccinated, one of whom, you know, will likely get vaccinated soon.

And the point is: Now they can do things with their friends that they otherwise wouldn’t — weren’t able to do. They can go back to college, potentially feel much safer, you know, about not only their own risk of getting sick, but potentially the contribution they may make to other people getting sick by being transmitters.

So these are the messages we’re going to continue to take to young people. And we’re seeing more young people step up to want to carry this message, because, again, I believe strongly that young people are not just interested in staying healthy themselves, but they are the leaders in building a better future. And we are going to need them to step up to help spread this message and to get other young people vaccinated as quickly as possible.

MR. ZIENTS: On AstraZeneca, you know, the timing — as I mentioned earlier — for the first 10 million doses, we expect that across the coming weeks, all pending FDA concurrence.

And as those doses become available, the specific plans as to where they go will be announced at that point, and also the — you know, the framework for — for future decisions will also be articulated. So, no further news on that front.

With that, let me add my well wishes to all the moms out there: Happy Mother’s Day. And we look forward to seeing everybody next week. Thank you.

END          11:13 A.M. EDT

To view the COVID Press Briefing slides, visit

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