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1 minute ago, ricardo said:

This is because outbreaks are extremely localised. In vast areas of the country Covid wards are essentially empty.

 

 

It’s a national system so in theory could be allocated cases from anywhere in England, in addition to local referrals.

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Just now, Van wink said:

It’s a national system so in theory could be allocated cases from anywhere in England, in addition to local referrals.

My understanding is that Preston outbreak is being entirely handled locally.

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1 hour ago, Van wink said:

There have been hardly any shifts available for a while, now some have come along but no referrals. It may be that they freed up more resources than they actually needed, I don’t know, but it’s still frustrating.

Ne interested to know how it works.There's about 1000 cases a day.  Does each operator get one of these to follow through on?  If so and if there are more than 1000 operators then operator 1001 onwards will stand idle unless there is sharing down the chain.

As I said earlier the fact that you have done nothing is a cost (bad) but could be a good thing

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4 minutes ago, ricardo said:

My understanding is that Preston outbreak is being entirely handled locally.

Aye, I read a few local councils have set up their own systems, more localised and quicker.

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4 minutes ago, Herman said:

Aye, I read a few local councils have set up their own systems, more localised and quicker.

Yes, a much better idea.

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11 minutes ago, Barbe bleu said:

Ne interested to know how it works.There's about 1000 cases a day.  Does each operator get one of these to follow through on?  If so and if there are more than 1000 operators then operator 1001 onwards will stand idle unless there is sharing down the chain.

As I said earlier the fact that you have done nothing is a cost (bad) but could be a good thing

I’m tier 2 so employed by NHS and payed per shift. Tier 3 I believe are employed by private contractors, the interview Herman posted was tier 3 I suspect.Essentially cases will get escalated  depending on all sorts of factors, eg have there been contacts in a care setting. As cases become more complex they are escalated from tier 3 up to 2 and from 2 to 1. When you log on there may be a case waiting there for you to follow up, the full interview can take up to an hour, if the person wants you to ring back at a later time you could follow that up but if it’s after your shift has finished it will be reallocated. The script you follow and the guidance is updated very regularly and the training materials are pretty good now. 

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1 hour ago, keelansgrandad said:

The Sunday Times claims these could include giving everyone aged between 50 and 70 a personalised risk rating which could lead to more than the 2.2 million people who were already deemed the most vulnerable being told to remain at home.

What next? Means tested if you can afford to stay at home?

So per your comments this morning, people under 40 who don’t like having their “civil liberties” taken away are selfish and stupid, but you’re against people between the age of 50 and 70 having any “civil liberties” taken away? Let me guess which of those age brackets you fall into 😉

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23 minutes ago, Herman said:

Aye, I read a few local councils have set up their own systems, more localised and quicker.

There have been cases in Norwich which have been dealt with locally. It’s all a bit of a mish mash. Giving the full data to LA’s is a big step forward but it still depends on local resources being sufficient, which in most places they won’t be. The Guardian article suggested some of the national resource would be made available, which would be essential in most areas.

Edited by Van wink
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46 minutes ago, Van wink said:

I’m tier 2 so employed by NHS and payed per shift. Tier 3 I believe are employed by private contractors, the interview Herman posted was tier 3 I suspect.Essentially cases will get escalated  depending on all sorts of factors, eg have there been contacts in a care setting. As cases become more complex they are escalated from tier 3 up to 2 and from 2 to 1. When you log on there may be a case waiting there for you to follow up, the full interview can take up to an hour, if the person wants you to ring back at a later time you could follow that up but if it’s after your shift has finished it will be reallocated. The script you follow and the guidance is updated very regularly and the training materials are pretty good now. 

So there's a triage after which a case (a person who has tested positive) gets assigned to one of three tiers depending on complexity.  The case remains with an operator at that tier until one of three things happens: they've exhausted the intelligence and called/messaged everyone they can, the shift has ended and the next guy takes over or it becomes too complex for that tier

if it is as described twiddling of thumbs could be either a sign of a poor system or a sign that supply or operators exceeds demand for their services.  Do we have any insight into which it is?

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9 minutes ago, Barbe bleu said:

So there's a triage after which a case (a person who has tested positive) gets assigned to one of three tiers depending on complexity.  The case remains with an operator at that tier until one of three things happens: they've exhausted the intelligence and called/messaged everyone they can, the shift has ended and the next guy takes over or it becomes too complex for that tier

if it is as described twiddling of thumbs could be either a sign of a poor system or a sign that supply or operators exceeds demand for their services.  Do we have any insight into which it is?

If the numbers with covid are growing I would infer that the current track, trace and isolate hasn't been working effectively. As the numbers grow it only gets more difficult.

Edited by Yellow Fever

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47 minutes ago, Aggy said:

So per your comments this morning, people under 40 who don’t like having their “civil liberties” taken away are selfish and stupid, but you’re against people between the age of 50 and 70 having any “civil liberties” taken away? Let me guess which of those age brackets you fall into 😉

That is a silly thing to post.

My beef with the Government is that they are categorising this crisis.

Nothing is clear about the virus. Statistics can probably prove that the most people who have it shop at Tescos and wear Primark underwear and earn minimum wage.

Until there is certainty, and that is a proven vaccine, we are all in this together. And everyone has to take precautions. It is their duty.

So stopping youngsters crowding pubs and bars irresponsibly is nothing to do with the Government deciding to unilaterally decide who should stay at home. Why 50? Why not 49? Why not BAME if they are apparently more vulnerable? No, because it isn't as simple as that.

Aberdeen is locked down. Fair decision if there is a spike. Yet two players have tested positive and 6 others quarantining from Aberdeen FC but their match on Saturday can go ahead. How responsible governing is that? A bleddy football match, being played closed doors, is going ahead.

What message is that sending?

The Government got it wrong from the start and this is still getting it wrong. If you are vulnerable, you don't need to be told. If you are 70 or over, you don't need to be told. We don't need categorising.

 

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36 minutes ago, keelansgrandad said:

That is a silly thing to post.

My beef with the Government is that they are categorising this crisis.

Nothing is clear about the virus. Statistics can probably prove that the most people who have it shop at Tescos and wear Primark underwear and earn minimum wage.

Until there is certainty, and that is a proven vaccine, we are all in this together. And everyone has to take precautions. It is their duty.

So stopping youngsters crowding pubs and bars irresponsibly is nothing to do with the Government deciding to unilaterally decide who should stay at home. Why 50? Why not 49? Why not BAME if they are apparently more vulnerable? No, because it isn't as simple as that.

Aberdeen is locked down. Fair decision if there is a spike. Yet two players have tested positive and 6 others quarantining from Aberdeen FC but their match on Saturday can go ahead. How responsible governing is that? A bleddy football match, being played closed doors, is going ahead.

What message is that sending?

The Government got it wrong from the start and this is still getting it wrong. If you are vulnerable, you don't need to be told. If you are 70 or over, you don't need to be told. We don't need categorising.

 

Wasn’t the supposedly proposed government scheme you mentioned about identifying vulnerable people and protecting them? What was the issue with it? 
 

As for not categorising - it’s a national pandemic and one ‘category’ is massively more at risk than another. Why would you not categorise people so you can identify the most at risk and protect them? When/if a vaccine is developed, I hope those categorised as most vulnerable get vaccines before fit and healthy 30 year olds. Or are you suggesting that shouldn’t be the case?

Edited by Aggy

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24 minutes ago, Yellow Fever said:

If the numbers with covid are growing I would infer that the current track, trace and isolate hasn't been working effectively. As the numbers grow it only gets more difficult.

You are starting with a conclusion and working backwards, which is a bit naughty

I don't disagree with most of your analysis but the specific thing I was enquiring about was whether or not VWs pointless labour was a sign that the system is broken.  I am not sure we have enough data to really tell.

To the more general question on track and trace rising infections is a sign of failure if your expectation was of a panacea.  If not then success or failure is measured not by counting Infections but by estimating how many infections were averted. Quite honestly I don't know how well it is doing as I have no way of making this estimate.

 

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There is no doubt that the UK has failed to deal well with Covid-19. The only debate is why and the sooner that is had the better given this is not going away anytime soon but the UK government even fail to do that. A culture of incompetence. 

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8 hours ago, Barbe bleu said:

To the more general question on track and trace rising infections is a sign of failure if your expectation was of a panacea.  If not then success or failure is measured not by counting Infections but by estimating how many infections were averted. Quite honestly I don't know how well it is doing as I have no way of making this estimate.

Success would be if track and trace demonstrably reduced community transmission measured in part through the R rate, enabled the country to get operational and enabled targeted action to deal with outbreaks quickly when they occured.

It has failed on all three counts.

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37 minutes ago, BigFish said:

Success would be if track and trace demonstrably reduced community transmission measured in part through the R rate, enabled the country to get operational and enabled targeted action to deal with outbreaks quickly when they occured.

It has failed on all three counts.

It certainly has, and its been a spectacular failure, not just on health grounds, but even more so on financial grounds - the government has spent billions with private companies who have absolutely no experience or track (no pun intended 😀) record in this area for reasons about which we can only speculate - although they seem pretty obvious as they follow a well established pattern for this government.

Whatever the reasons, the result has been a hugely expensive shambles of a system which is performing so badly than in a number of the worst (highest infection rate) areas local councils are now creating their own teams to try and plug the gaps - which is of course is precisely the way the system should have built in the first place and would have been if the control freaks in Westminister had for once overcome their obsession with centralising everything and listened to advice from the experts. They could even have broken the habit of a lifetime, overcome their arrogance and taken a look at what was working well elsewhere - e.g. Germany if they wanted an example close to home.

We don't have a world beating system no matter how many times the idiot Johnson says so, we have another home grown, self inflicted injury.

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CM

"a system which is performing so badly than in a number of the worst (highest infection rate) areas local councils are now creating their own teams to try and plug the gaps - "

I'm not happy with the way centralised track and trace works, the idea is misconceived. However in our efforts to chastise lets keep to the facts, Local Councils should have produced local outbreak plans sometime ago, for those that were interested I posted the link to the Norfolk plan, so the idea of local councils being involved isn't something that has just happened, it has been part of the plan from very early on. The problem has been the lack of transfer of data from the central system to the local one. Some has been getting through and local investigations have created their own data, but the detail from the centre has been nowhere near enough. It almost feels like Public Health England want to keep the baby to themselves, I'll rephrase that, it in my view is the case that Public Health England have been reluctant to share data. It does look as if this problem is now being resolved which should make for much better success rates and a better system. This is far too late in the process but at least things seem to be getting sorted before the pandemic takes off again in the UK, which imo it will. A decent test T and T system wont prevent this imo, but it should limit the scale.

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10 hours ago, Barbe bleu said:

You are starting with a conclusion and working backwards, which is a bit naughty

I don't disagree with most of your analysis but the specific thing I was enquiring about was whether or not VWs pointless labour was a sign that the system is broken.  I am not sure we have enough data to really tell.

To the more general question on track and trace rising infections is a sign of failure if your expectation was of a panacea.  If not then success or failure is measured not by counting Infections but by estimating how many infections were averted. Quite honestly I don't know how well it is doing as I have no way of making this estimate.

 

I think you are the one guilty of clutching a bit at straws there BB.

Obviously we all accept post lock down the odd local flare-up would occur. But if TT & isolate was working effectively it should (must) be capable of quickly controlling the outbreak and eliminating it. It's not, case are growing, generally almost everywhere. R > 1.

Conclusion has to be TTI in it's current form isn't fit/capable for purpose with the current level of lock down relaxation.

Action - Need to re-introduce lock down measures (i.e. pubs, restaurants) such that TTI can again become effective and R < 1. Alternatively need to beef up and make more effective TTI.

Yes it's yet another political failure either way.

 

 

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1 hour ago, Van wink said:

 

CM

"a system which is performing so badly than in a number of the worst (highest infection rate) areas local councils are now creating their own teams to try and plug the gaps - "

I'm not happy with the way centralised track and trace works, the idea is misconceived. However in our efforts to chastise lets keep to the facts, Local Councils should have produced local outbreak plans sometime ago, for those that were interested I posted the link to the Norfolk plan, so the idea of local councils being involved isn't something that has just happened, it has been part of the plan from very early on. The problem has been the lack of transfer of data from the central system to the local one. Some has been getting through and local investigations have created their own data, but the detail from the centre has been nowhere near enough. It almost feels like Public Health England want to keep the baby to themselves, I'll rephrase that, it in my view is the case that Public Health England have been reluctant to share data. It does look as if this problem is now being resolved which should make for much better success rates and a better system. This is far too late in the process but at least things seem to be getting sorted before the pandemic takes off again in the UK, which imo it will. A decent test T and T system wont prevent this imo, but it should limit the scale.

I don't think I have departed from the facts at all, of course local Councils produced their plans and in many cases they actively offered to implement the necessary track and trace systems in their area - as I posted months ago track and trace (albeit it for different infections) has been a standard process operated by local council public health departments for many years. I don't know how many made that offer but I know for a fact that my local council (large northern city) did and I believe several of the neighbouring councils did as well.

Trouble is at the time the government wasn't interested, there were no resources or cash made available to councils for this and then evenually, as we now know, the government awarded these massive contracts to private companies without the expertise and seemingly without any decent system specification of what was required - as you say yourself the data is locked inside some mickey mouse central system and not interfaced into the NHS systems, the council Public Health systems, and they don't even seem to be very good at contacting the individuals involved - I must admit that I've always assumed that this was simply the usual incompetence of the government but as time has gone I tend agree with you that it seems more and more as though the control freaks in Westminister simply don't want to share the data.

Maybe things are starting to change but I see little evidence of it to date. Hopefully you are right and that it will be a case of better late than never because all the ingredients for a resurgence of the infection in England appear to be in place.

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image.png.68e2c437e9fcbfeec0d5282b357de019.png

New ONS data out today has found that last week an estimated 28,300 people in England had COVID-19. This represents 0.05% of the community population. Far from a second wave, it marks a fall from the previous week’s estimate of 0.07%.

Whereas testing data shows a mild uptick, the number of tests being carried out in the UK has also zoomed up, meaning this data could simply be showing a reduction. It’s worth reading this explanation of why cases are not in fact rising, by the director of Oxford University’s Centre for Evidence-Based Medicine Carl Heneghan. The new ONS number seem to support his research…

 

 

spacer.png

 

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Jools loves a comedy web site, usually Guido.

The link in his post concludes

Disclaimerthe article has not been peer-reviewed; it should not replace individual clinical judgement, and the sources cited should be checked. The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care. The views are not a substitute for professional medical advice.

 

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14 hours ago, Aggy said:

Wasn’t the supposedly proposed government scheme you mentioned about identifying vulnerable people and protecting them? What was the issue with it? 
 

As for not categorising - it’s a national pandemic and one ‘category’ is massively more at risk than another. Why would you not categorise people so you can identify the most at risk and protect them? When/if a vaccine is developed, I hope those categorised as most vulnerable get vaccines before fit and healthy 30 year olds. Or are you suggesting that shouldn’t be the case?

The Government scheme is for 50 upwards to be told to stay at home. That is supposed to be including the vulnerable as well. And you just cannot categorise someone 50+ as more likely.

No-one can say for certain, the scientists argue amongst themselves, what the virus can or cannot do. Statistics say the younger you are the less likely to suffer from it but not carrying it. 

We have seen and heard different ways to attack the virus. And the most sensible one is stop the transmission and check those who have had it. Allowing the greater part of the population to wander around will not stop transmission.

But we hold out hope that with new cases apparently diminishing, there may not be a need to lockdown anyone.

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4 hours ago, Yellow Fever said:

I think you are the one guilty of clutching a bit at straws there BB.

Obviously we all accept post lock down the odd local flare-up would occur. But if TT & isolate was working effectively it should (must) be capable of quickly controlling the outbreak and eliminating it. It's not, case are growing, generally almost everywhere. R > 1.

Conclusion has to be TTI in it's current form isn't fit/capable for purpose with the current level of lock down relaxation.

Action - Need to re-introduce lock down measures (i.e. pubs, restaurants) such that TTI can again become effective and R < 1. Alternatively need to beef up and make more effective TTI.

Yes it's yet another political failure either way.

 

 

If T&T was working as well as we would like it would be eliminating the disease, I agree. But what we would like and what is realistically possible are different.

There is much more to getting rid of this disease than contact tracing.  Its a big part for sure (I have posted before that I suspecy it as being a big part of why Germany and UK are/were on different trajectories) but its not the be all and end all. You could speak to100% of possible contacts and still not control the disease if they cannot or will not stay away from others.

I am not saying that the scheme is a success or failure. I am saying that the data is insufficient to draw either conclusion.I also say that it is dangerous to condemn it and require reform if it is actually doing quite well. That doesn't, of course, mean that it is beyond scrutiny, quite the opposite in fact. It just means that our biases habe done their job in flagging this up but must take a back seat.

It does sound inefficient if the anecdotal evidence of operators standing idle is true on an aggregate basis, but perhaps it is better to be inefficient than overstretched.

And of course there is no evidence that infection is currently increasing on a nationwide basis according to the ONS, but that is another matter...

 

 

Edited by Barbe bleu

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49 minutes ago, keelansgrandad said:

The Government scheme is for 50 upwards to be told to stay at home. That is supposed to be including the vulnerable as well. And you just cannot categorise someone 50+ as more likely.

No-one can say for certain, the scientists argue amongst themselves, what the virus can or cannot do. Statistics say the younger you are the less likely to suffer from it but not carrying it. 

We have seen and heard different ways to attack the virus. And the most sensible one is stop the transmission and check those who have had it. Allowing the greater part of the population to wander around will not stop transmission.

But we hold out hope that with new cases apparently diminishing, there may not be a need to lockdown anyone.

I wouldnt argue with most of that. If we want to see this thing off this side of a vaccine the only way to do it is to stop evwryone and anyone leaving their house. Even if we don't achieve elimination (we wouldn't) we will reduce transmission.

Cruel as it sounds though the question is can we afford to do this?  The answer from every part of the world is 'no' and hence we are all moving to the swedish model.

This model means those in greatest risk taking the most measures.  Whether we like it or not as we get older that risk increases, every graph tells us this (although admittedly the risk to the 50ish group doesn’t appear to be that elevated when compared with older cohorts).

Edited by Barbe bleu

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42 minutes ago, Barbe bleu said:

If T&T was working as well as we would like it would be eliminating the disease, I agree. But what we would like and what is realistically possible are different.

There is much more to getting rid of this disease than contact tracing.  Its a big part for sure (I have posted before that I suspecy it as being a big part of why Germany and UK are/were on different trajectories) but its not the be all and end all. You could speak to100% of possible contacts and still not control the disease if they cannot or will not stay away from others.

I am not saying that the scheme is a success or failure. I am saying that the data is insufficient to draw either conclusion.I also say that it is dangerous to condemn it and require reform if it is actually doing quite well. That doesn't, of course, mean that it is beyond scrutiny, quite the opposite in fact. It just means that our biases habe done their job in flagging this up but must take a back seat.

It does sound inefficient if the anecdotal evidence of operators standing idle is true on an aggregate basis, but perhaps it is better to be inefficient than overstretched.

And of course there is no evidence that infection is currently increasing on a nationwide basis according to the ONS, but that is another matter...

 

 

ONS data encouraging today, wide margin of error of course. T and T is clearly doing a job, it’s not getting to everyone but a hell of a lot of people have been contacted. This will be having a significant effect in reducing spread, my worry is that it’s not enough. I’ve posted below some stats from the weekly digest we are sent.

NHS Test and Trace Stats
 
Latest NHS Test and Trace stats show the service continues to break chains of transmission.
  • Almost a quarter of a million people have now been reached by NHS Test and Trace
  • More than 79% of those that test positive are reached and asked for their contacts
  • Dedicated contact tracing teams are being rolled out in areas of high prevalence to work in partnership with local health protection teams
Statistics from the ninth week (23 to 29 July) of operation of NHS Test and Trace published todayshow the service is consistently reaching the majority of those testing positive and their contacts, and delivering rapid testing at scale. 
 
Data from the ninth week of operation (23 to 29 July) of NHS Test and Trace shows that: 
  • 79.4% (3,688) of the people who had tested positive for coronavirus and were transferred to NHS Test and Trace were reached by our contact tracers and asked to share details of their close contacts. This compares to 82.2% in the previous week.
  • 72.4% (13,866) of close contacts were reached and advised to self-isolate. This compares to 76.2% in the previous week. Where contact details were provided, NHS Test and Trace reached 82.4%. This compares to 84.8% in the previous weekYour

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2 hours ago, keelansgrandad said:

The Government scheme is for 50 upwards to be told to stay at home. That is supposed to be including the vulnerable as well. And you just cannot categorise someone 50+ as more likely.

 

My confusion is why you disparagingly used the phrase “civil liberties over health eh” when discussing others, but then seem to have a problem with the civil liberties of over 50s being infringed. 

The stats clearly show that on average over fifties are at greater risk than under fifties.

You seem to suggest it’s unfair for all over-fifties to be lumped into the same category, because not all over fifties are at high risk. Yet you have no problem with young healthy people being lumped in the same category as far more at risk people, despite young healthy people being at extremely low risk. 

(Ps I said months ago that there are serious ethical issues with allowing some sections of society to be released from lockdown but not others - I don’t for one second think all over fifties should be forced to stay at home. I’m just intrigued why it’s acceptable for over fifties to get annoyed about this, but people in their twenties and thirties who have hardly any risk at all of dying from covid are expected to just suck it up, have their lives ruined, are called “selfish and stupid” for daring to say anything about it.)

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Has this government been able to hide (or cover over) decisions that ordinarily they wouldn't have made outside of a national health crisis? And for the Tory voters on this thread (or government supporters) what is your view? Do you think it's simply what all government's do (politicians being mendacious sorts kinds of arguments) or are there things that makes you feel uncomfortable. Or do you not notice or feel sensitive to it at all? If a Labour administration was in power right now and doing similar things would you feel annoyed or exercised?

Or is this article so one sided you ignore it out of hand?

My sense is that Covid 19 has facilitated all kinds of decisions that seem to follow so quickly one after another, enough to overwhelm any opportunity to challenge... And that is before you take into account their handling of the crisis.

 

 

https://www.theguardian.com/commentisfree/2020/aug/07/its-taken-just-12-months-for-boris-johnson-to-create-a-government-of-sleaze?

Edited by sonyc

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