The C.D.C. said on Monday that research indicated that people who are fully vaccinated are less likely to have asymptomatic infections and “potentially less likely to transmit the virus that causes Covid-19 to other people.” Still, the agency did not rule out the possibility that they may inadvertently transmit the virus.

There is also uncertainty about how well vaccines protect against new variants of the virus that are more transmissible and possibly more virulent, as well as about how long the vaccine protection lasts. Some of the variants carry mutations that seem to blunt the body’s immune response.

The C.D.C. advised that vaccinated Americans do not need to quarantine or get tested if they are exposed to the virus, unless they develop symptoms of infection. If they do so, they should isolate themselves, get tested if possible and speak with their doctors.

Vaccinated Americans should not gather with unvaccinated people from more than one household, and should continue avoiding large and medium-size gatherings. (The agency did not specify what size constitutes a large or medium-size gathering.)

The guidance is slightly different for fully vaccinated residents of group homes and incarcerated individuals, who should continue to quarantine for 14 days and be tested if they are exposed to the virus, because of the higher risk of transmission in such settings.

Vaccinated workers in high-density settings like meatpacking plants do not need to quarantine after an exposure to the coronavirus, but testing is still recommended.

The C.D.C. did not revise its travel recommendations, continuing to advise that all Americans stay home unless necessary. Dr. Walensky noted that virus cases had surged every time there had been an increase in travel.

“We are really trying to restrain travel,” she said. “And we’re hopeful that our next set of guidance will have more science around what vaccinated people can do, perhaps travel being among them.”

The new guidelines clearly detail the rewards of vaccination and are likely to motivate even more Americans to seek immunizations and curb lingering vaccine hesitancy, said Dr. Rebecca Weintraub, an assistant professor of global health and social medicine at the Harvard Medical School.

“You can resume an activity that many people are yearning for — to be in proximity with those they love, in small gatherings where you can see each other smile and give each other a hug,” Dr. Weintraub said.

“It’s been well studied that anticipation is a significant component of joy,” she added. “These guidelines help each person coming in for a vaccine anticipate future joy. As a physician and vaccinator, I’m thrilled.”

Noah Weiland contributed reporting.

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C.D.C. Releases Guidance For Vaccinated Americans

The Centers for Disease Control and Prevention on Monday issued long-awaited guidance to Americans fully vaccinated against Covid-19, freeing them to take some liberties that the unvaccinated should not, including gathering indoors with others who are fully vaccinated without precautions while still adhering to masking and distancing in public spaces.

The agency offered good news to grandparents who have refrained from seeing children and grandchildren for the past year, saying that fully vaccinated people may visit indoors with unvaccinated people from a single household so long as no one among the unvaccinated is at risk for severe disease if infected with the coronavirus.

That means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren without masks or physical distancing. But the visit should be limited to one household: If the adult children’s unvaccinated neighbors drop by, the visit should move outdoors and everyone should wear masks and distance.

The recommendations arrived as state officials move to reopen businesses and schools amid a drop in virus cases and deaths. Federal health officials repeatedly have warned against loosening restrictions too quickly, including lifting mask mandates, fearing that the moves may set the stage for a fourth surge of infections and deaths.

might develop asymptomatic infections and spread the virus inadvertently to others, and urged those who are vaccinated to continue practicing certain precautions.

Agency officials encouraged people to get vaccinated with the first vaccine available to them, to help bring the pandemic to a close and resume normal life. The agency emphasized that vaccines are highly effective at preventing “serious Covid-19 illness, hospitalization and death,” and said its guidance “represents a first step toward returning to everyday activities in or communities.”

“We know that people want to get vaccinated so they can get back to doing the things they enjoy with the people they love,” said Dr. Rochelle P. Walensky, director of the C.D.C. “There are some activities that fully vaccinated people can begin to resume now in the privacy of their own homes.”

Still, she added, “Everyone, including those who are vaccinated, should continue with all mitigation strategies when in public settings.”

Many more Americans will need to be fully vaccinated before mitigation measures can be suspended, she and other officials said, as the majority of Americans have yet to get the vaccine.

according to the C.D.C. Providers are administering about 2.16 million doses per day on average.

The C.D.C.’s advice is aimed at Americans who are fully vaccinated, meaning those for whom at least two weeks have passed since they received the second dose of a two-dose vaccine series of Pfizer-BioNTech or Moderna vaccine, and those for whom at least two weeks have passed since receiving a single dose of the Johnson and Johnson single-dose vaccine.

What is safe for newly vaccinated Americans and their unvaccinated neighbors and family members has been uncertain in large part because scientists do not yet understand whether and how often immunized people may still transmit the virus. If so, then masking and other precautions are still be needed in certain settings to contain the virus, researchers have said.

There is also uncertainty about how well vaccines protect against emerging variants of the virus, and how long the vaccine protection lasts.

The C.D.C. said on Monday that “a growing body of evidence” suggests that people who are fully vaccinated are less likely to have asymptomatic infections and “potentially less likely to transmit the virus that causes Covid-19 to other people.” Still, the agency did not rule out the possibility that they could inadvertently transmit the virus.

Given the current state of research, the C.D.C. advised:

  • Fully vaccinated Americans may gather indoors in private homes with one another in small groups without masks or distancing. Vaccinated people may gather in a private residence with unvaccinated people from a single household who are at low risk for developing severe disease if they contract the coronavirus, also without masks or distancing.

  • Vaccinated Americans need not quarantine or get tested if they have a known exposure to the virus, as long as they do not develop symptoms of infection. If they do develop symptoms, they must isolate themselves, get tested and speak with their doctor.

  • In public, vaccinated people must continue to wear masks and maintain social distance, and take other precautions, such as avoiding poorly ventilated spaces, covering coughs and sneezes, washing hands often and following any other protocols that are in place.

  • Vaccinated people should continue to avoid large and medium gatherings, though the agency did not specify the gathering size with numbers.

The agency did not revise its travel recommendations, continuing to advise that all Americans refrain from travel unless absolutely necessary.

The advice is not legally binding, but the agency’s recommendations are usually followed by state public health officials. The recommendations seem likely to incentivize vaccination for many hesitant Americans by promising modest liberties after months of restrictions.

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Israel Reopens to Its Fully Vaccinated ‘Green Pass’ Holders

JERUSALEM — Prime Minister Benjamin Netanyahu of Israel enjoyed a cappuccino and cake on the terrace of a Jerusalem cafe on Sunday morning to mark the broadest reopening of the country’s economy since the first coronavirus lockdown began a year ago.

For the first time in months, restaurants have reopened, with restrictions on occupancy and social distancing and with indoor seating available only to so-called Green Pass holders, meaning people over 16 who are fully vaccinated.

Israel has outpaced the rest of the world in vaccinations, with 55 percent of the population having received one dose of the Pfizer-BioNTech vaccine and more than 41 percent two doses. It is now an international laboratory for the efficacy of the vaccine, and is becoming a test case for the practical, legal and ethical issues arising from a tier system for the vaccinated and unvaccinated.

Event halls are reopening for Green Pass holders and gatherings of up to 1,500 people will be allowed in stadiums and arenas. And after weeks of tight restrictions on entry to the country that left thousands of Israeli citizens stranded abroad, all citizens and permanent residents will be allowed to enter the country, but with a cap on numbers that will increase over the week from 1,000 to 3,000 people per day.

“This is a great day,” Mr. Netanyahu said, as he supped in the spring sunshine alongside the mayor of Jerusalem, Moshe Leon. “We are coming back to life.”

The “Back to Life” program is central to Mr. Netanyahu’s election campaign, with another ballot scheduled for March 23, Israel’s fourth in two years.

With new daily infections still in the thousands, health officials and experts have warned against opening up the airport to passengers from abroad who may carry contagious virus variants, and against relaxing restrictions too rapidly out of political considerations. But the government has also come under pressure from Israelis wanting to return to the country to vote.

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Dalai Lama Receives Covid Vaccine

The Dalai Lama, the Tibetan spiritual leader, received his first shot of the Oxford-AstraZeneca vaccine on Saturday in the northern Indian town of Dharamsala.

He used the moment to also encourage people to take the vaccine, saying it would prevent “some serious problem.”

“This injection is very, very helpful,” the 85-year-old, a leader of Tibetan Buddhism, said in video message after the inoculation, indicating that he hoped his example would inspire more people to “have courage” to get themselves vaccinated for the “greater benefit.”

The Dalai Lama received the shot at a hospital in Dharamsala, which has served as the headquarters of the Tibetan government in exile for more than 50 years after a failed uprising against Chinese rule.

since the Dalai Lama’s exodus in 1959, on the condition that they not protest against the Chinese government on Indian soil. China considers the Tibetan leader to be a dangerous separatist, a claim that he denies.

Videos showed the spiritual leader being driven to the hospital and his followers, who were masked, lining up on both sides of the road, with hands folded and heads down as he waved.

Dr. G.D. Gupta, an official at the hospital where the shot was administered, said that the spiritual leader “volunteered to come to hospital” and that 10 others who live in his residence also received the Covishield vaccine, which was developed by AstraZeneca and Oxford University and manufactured by the Serum Institute of India.

As of Saturday, India has more than 11.1 million confirmed cases and the third-highest virus death toll in the world, after the United States and Brazil, at 157,656 deaths, according to a New York Times database. India began its nationwide vaccination campaign in mid-January with health care and frontline workers.

The country recently expanded eligibility to older people and those with medical conditions that put them at risk, but the ambitious drive to vaccinate its vast population has been slow.

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As Covid Deaths Soar in Brazil, Bolsonaro Hails an Untested Nasal Spray

RIO DE JANEIRO — Brazilians are dying in record numbers from Covid-19. Intensive care units in a growing number of cities are full or near capacity as more contagious variants drive up cases. Elderly people have begun sleeping outside vaccination centers hoping to score a shot from the country’s limited stock.

But this is no time for new restrictions on businesses and transit, President Jair Bolsonaro said defiantly on Thursday. Instead, his government is placing tremendous hope in an experimental nasal spray, under development in Israel to treat severely ill Covid-19 patients, that the president has called a “miraculous product.”

On Saturday, Foreign Minister Ernesto Araújo is scheduled to travel to Israel to meet scientists who are developing the spray, which has only undergone preliminary tests and is not being used in routine patient care anywhere. Mr. Bolsonaro’s government says it intends to test it on gravely sick patients in Brazil, where more than 260,000 people have died from the virus and where daily deaths hit a record 1,910 on Thursday.

Marcia Caldas de Castro, a Harvard University professor who studies global health, “and the way we measure the cost is in lost lives.”

Mr. Bolsonaro was an early and effusive champion of the anti-malaria drug hydroxychloroquine, which he ordered the government to mass produce. He continued to sing its praises this week, even after a team of experts from the World Health Organization strongly advised against its use, citing studies that have found it ineffective and potentially dangerous.

Brazil’s Covid-19 vaccination campaign is off to a slow and chaotic start because the government was late to start negotiating access to vaccines, whose safety and efficacy Mr. Bolsonaro has called into question.

Wednesday, the president sought to reassure Brazilians that help was on the way by announcing that his administration intended to sign a memorandum of understanding in Israel to test the nasal spray, which he said could emerge as “the real solution to treating Covid.”

The Israeli scientists who are developing the nasal spray say it’s too early to tell whether it will prove to be a pandemic game changer.

The drug, called EXO-CD24, aims to prevent “cytokine storms,” which are overwhelming immune-system responses to Covid-19 that can cause serious inflammation of the lungs, organ failure and sometimes death.

Initial clinical trials showed that 31 of 35 patients suffering from severe symptoms were discharged from the hospital after receiving two to five days of treatment with the drug, said Dr. Nadir Arber, a researcher at the Sourasky Medical Center in Tel Aviv who helped develop it. In the early trials, he said, the drug was administered by inhalation, but the goal is to administer it as a nasal spray.

Dr. Arber said he was optimistic, but urged caution. “We are still at the beginning of the process,” he said.

The first trials did not include a placebo for comparison. The treatment has not undergone advanced clinical trials and its efficacy has not been assessed in a peer-reviewed scientific journal.

about 6.6 million people in Brazil — about 3.1 percent of the population — had received at least one dose of a vaccine.

the governors wrote.

Mr. Bolsonaro’s government maligned the Chinese vaccine that has been the most widely used in Brazil so far. It took a pass on an offer last August from Pfizer, of 70 million doses of its vaccine. It signed up for the W.H.O.’s vaccine procurement system, known as Covax, but only requested the minimum amount of doses required to participate: enough for 10 percent of a country’s population.

Still, Mr. Bolsonaro suggested on Thursday that the government is doing as well as can be expected in the global vaccine race.

“You have idiots, people on social media and in the press saying: go buy more vaccines,” Mr. Bolsonaro said Thursday, sounding exasperated.

He added: “There are none for sale around the world.”

Ernesto Londoño reported from Rio de Janeiro, Letícia Casado reported from Brasília and Adam Rasgon reported from Jerusalem.

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More in U.S. Embrace Covid Vaccines, Pew Poll Shows

Vaccine hesitancy has been a concern among U.S. public health experts for months now. But evidence increasingly suggests that as vaccination rates increase, many unvaccinated Americans are becoming more comfortable with the idea of receiving the shot themselves.

The proportion of adults in the country who intend to get vaccinated has increased significantly over the last several months, according to a survey released Friday by the Pew Research Center. Sixty-nine percent of the public now plans to get vaccinated — or already has — up from 60 percent who said in November that they intended to pursue it.

The issue has become more partisan over time, however. The new survey finds a 27-percentage point political gap, with 83 percent of Democrats saying they plan to get the vaccine or have already received it, compared to just 56 percent of Republicans.

Despite the divides, the new survey bolsters optimism that overall, Americans are increasingly open to receiving the vaccine. About 54 million people — 16 percent of the population — had received at least one dose of a Covid-19 vaccine as of Thursday, according to the Centers for Disease Control and Prevention.

vaccinated at lower rates in part because they face obstacles like language barriers and inadequate access to digital technology, medical facilities and transportation. Mistrust in government officials and doctors also plays a role, experts say, and is fed by misinformation that is spread on social media. President Biden has made equity a major focus of his pandemic response, saying he wants pharmacies, mobile vaccination units and community clinics that help underserved communities to help increase the pace of vaccinations.

Overall, those surveyed by Pew who say they do not plan to get the vaccine cite reasons including concerns about side effects and a feeling that the vaccines were developed too quickly. Others say they are waiting for more information about how well they work.

The Pew results echo a survey released last week from the Kaiser Family Foundation that found vaccine hesitancy declining among most demographic groups. That survey also found a significant political gap, but noted that both Democrats and Republicans were significantly more likely to say they intended to get the vaccine now than in December.

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The Pandemic Needs Its Smokey Bear

It was June 1942 and Henry Doorly, the publisher of The Omaha World-Herald, was driving his wife to Omaha’s train station. All the way there, he criticized the government’s mismanagement of the national rubber salvage drive to support World War II.

“What did you do about it?” his wife asked.

That gentle nudge, recounted in “Prairie Forge: The Extraordinary Story of the Nebraska Scrap Metal Drive of World War II,” by James J. Kimble, kept Mr. Doorly up late that night. He was thinking about the next national home-front campaign. Just months after the bombing of Pearl Harbor, the United States was desperately low on scrap metal, which meant that many steel mills were either slowing or shutting down. That would quickly lead to a steep drop in the number of guns, tanks and other combat essentials. Without enough scrap, the war could be lost.

“So there’s Doorly,” Mr. Kimble, a professor at Seton Hall University, said in an interview. “He says to himself: ‘I’m the publisher of a medium-sized newspaper in the Midwest. I don’t have the ear of the president because I backed his opponent, but I have a voice in Nebraska. Maybe if I can start a campaign here, I can make it an example for the country.’”

The next day, he gathered his staff and explained his idea: a competition, among all 93 of Nebraska’s counties, to scrounge up the most scrap metal per capita. A running tally would be publicized, as if the drive were a live baseball game, in The World-Herald’s sports section.

Soon after the contest was unveiled, every newspaper in the state backed the idea. For three weeks, Nebraskans ransacked their homes for metal, or roamed the countryside in search of abandoned tractors or idle windmills. On some days, The World-Herald ran nothing but scrap metal contest stories on its front page.

The results were such a triumph — the equivalent of 100 pounds of scrap for each resident — that identical, three-week contests were soon staged in every other state. Ultimately, five million pounds of scrap was delivered to the War Production Board using what became known as the Nebraska Plan. The World-Herald was awarded the Pulitzer Prize in public service.

From its inception, Mr. Doorly knew his idea wouldn’t work without winning the trust of Nebraskans. A national aluminum drive the previous year had inspired many in the state to collect kitchenware, which sat in unused heaps because of government inaction. “Aluminum Pots Dot Landscape Weeks After Drive for Metal,” read a Washington Post headline in October 1941.

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San Diego Zoo Apes Get an Experimental Covid Vaccine

The San Diego Zoo has given nine apes an experimental coronavirus vaccine developed by Zoetis, a major veterinary pharmaceuticals company.

In January, a troop of gorillas at the zoo’s Safari Park tested positive for the virus. All are recovering, but even so, the zoo requested help from Zoetis in vaccinating other apes. The company provided an experimental vaccine that was initially developed for pets and is now being tested in mink.

Nadine Lamberski, a conservation and wildlife health officer at San Diego Zoo Global, said the zoo vaccinated four orangutans and five bonobos with the experimental vaccine, which is not designed for use in humans. Among the vaccinated orangutans was an ape named Karen, who made history in 1994 when she became the first orangutan to have open-heart surgery.

Dr. Lamberski said one gorilla at the zoo was also scheduled to be vaccinated, but the gorillas at the wildlife park were a lower priority because they had already tested positive for infection and had recovered. She said she would vaccinate the gorillas at the wildlife park if the zoo received more doses of the vaccine.

the danger the virus poses to great apes and other animals, but also about the potential for the virus to gain a foothold in a wild animal population that could become a permanent reservoir and emerge at a later date to reinfect humans.

Infections in farmed mink have produced the biggest scare so far. When Danish mink farms were devastated by the virus, which can kill mink just as it kills people, a mutated form of the virus emerged from the mink and reinfected humans. That variant showed resistance to some antibodies in laboratory studies, raising suspicion that vaccines might be less effective against it.

That virus variant has not been found in humans since November, according to the World Health Organization. But other variants have emerged in people in several countries, proving that the virus can become more contagious and in some cases can diminish the effectiveness of some vaccines.

Denmark ended up killing as many as 17 million mink — effectively wiping out its mink farming industry. In the United States, thousands of mink have died, and one wild mink has tested positive for the virus.

Although many animals, including dogs, domestic cats, and big cats in zoos, have become infected by the virus through natural spread, and others have been infected in laboratory experiments, scientists say that widespread testing has yet to find the virus in any animal in the wild other than the one mink.

National Geographic first reported the vaccination of the apes at the San Diego Zoo.

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The World Needs Syringes. He Jumped In to Make 5,900 Per Minute.

BALLABGARH, India — In late November, an urgent email popped up in the inbox of Hindustan Syringes & Medical Devices, one of the world’s largest syringe makers.

It was from UNICEF, the United Nations agency for children, and it was desperately seeking syringes. Not just any would do. These syringes must be smaller than usual. They had to break if used a second time, to prevent spreading disease through accidental recycling.

Most important, UNICEF needed them in vast quantities. Now.

“I thought, ‘No issues,’” said Rajiv Nath, the company’s managing director, who has sunk millions of dollars into preparing his syringe factories for the vaccination onslaught. “We could deliver it possibly faster than anybody else.”

As countries jostle to secure enough vaccine doses to put an end to the Covid-19 outbreak, a second scramble is unfolding for syringes. Vaccines aren’t all that useful if health care professionals lack a way to inject them into people.

will spend $1.2 billion over four years to expand capacity in part to deal with pandemics.

The United States is the world’s largest syringe supplier by sales, according to Fitch Solutions, a research firm. The United States and China are neck and neck in exports, with combined annual shipments worth $1.7 billion. While India is a small player globally, with only $32 million in exports in 2019, Mr. Nath of Hindustan Syringes sees a big opportunity.

Each of his syringes sells for only three cents, but his total investment is considerable. He invested nearly $15 million to mass-produce specialty syringes, equal to roughly one-sixth of his annual sales, before purchase orders were even in sight. In May, he ordered new molds from suppliers in Italy, Germany and Japan to make a variety of barrels and plungers for his syringes.

cleared Pfizer’s vaccine for emergency use, Robert Matthews, a UNICEF contract manager in Copenhagen, and his team needed to find a manufacturer that could produce millions of syringes.

“We went, ‘Oh, dear!’” said Mr. Matthews, as they looked for a syringe that would meet W.H.O. specifications and was compact for shipping. Hindustan Syringes’ product, he said, was the first.

The company is set to begin shipping 3.2 million of those syringes soon, UNICEF said, provided they clear another quality check.

Mr. Nath has sold 15 million syringes to the Japanese government, he said, and over 400 million to India for its Covid-19 inoculation drive, one of the largest in the world. More are in line, including UNICEF, for which he has offered to produce about 240 million more, and Brazil, he said.

Marc Koska, a British inventor of safety injections, and its ability to produce all of the components in-house. Hindustan Syringes makes its needles from stainless steel strips imported from Japan. The strips are curled into cylinders and welded at the seam, then stretched and cut into fine capillary tubes, which machines glue to plastic hubs. To make the jabs less painful, they are dipped in a silicone solution.

The syringe business is a “bloodsucker,” Mr. Nath said, where upfront costs are astronomical and profits marginal. If demand for his syringes drop by even half in the next few years, he will lose almost all of the $15 million he invested.

It’s clearly a frugal operation. The blue carpet in Mr. Nath’s office looks just as old as his desk or the glass chandelier by the stairs, fixtures his father put in place in 1984, before he handed over the company to Mr. Nath and his family.

A family business is exactly how he likes it. No shareholders, no interference, no worries. In 1995, when Mr. Nath needed money to increase production and buy lots of new machines, he sought private capital for the first time. Had that been the case today, he said, he wouldn’t be able to follow his gut and produce his syringes at this enormous scale.

“You have a good night’s sleep,” Mr. Nath said. “It’s better to be a big fish in a small pond.”

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Desperate Italy Blocks Exports of Vaccines Bound for Australia

Nevertheless, European governments have been scrambling for more doses. Some have gone ahead without the E.U. and procured Russian and Chinese vaccines; others are eyeing doses sold in a black, or at least gray, market.

The European Union has some additional leverage over the shipment of vaccines because Belgium, the seat of the bloc, is also home to some of the world’s most important vaccine factories, including ones making the Pfizer-BioNTech and AstraZeneca-Oxford shots. Italy, Germany and Spain are also home to facilities for several vaccine makers.

The doses blocked by Italy this week had been filled and finished there, though they were expected to be distributed throughout the E.U.

In a statement on Friday morning, Australia’s health minister, Greg Hunt, said his country had enough doses to “take us through” until domestic production begins later this month.

Australia has had fewer coronavirus cases, relative to its size, than almost any other large developed country, and has been recently averaging only nine new cases a day, according to a New York Times database. Italy is averaging more than 18,000 new cases a day, a pace that, adjusted for population is more than 800 times as high as Australia’s.

Still, the vaccine rollout has also been slow in Australia, which had planned to rely heavily on AstraZeneca. The country had signed a contract for 3.8 million AstraZeneca doses made in Europe, a stopgap until a manufacturer in Australia was able to get started on vaccine production.

In January, its expected delivery from Europe was cut to 1.2 million doses amid AstraZeneca’s production problems, despite lobbying efforts by Australia’s foreign minister, Marise Payne. Only one major delivery has arrived. As of February 28, only 33,702 doses had been administered nationwide, according to government figures.

“There is great prudence in us sourcing a number of vaccines but also starting domestic production as well,” said Home Affairs Minister Peter Dutton.

Benjamin Mueller reported from London and Matina Stevis-Gridneff from Brussels. Emma Bubola contributed reporting from Rome, Monika Pronczuk from Brussels, and Damien Cave from Sydney.

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