New CDC updates to CSO?

[dandi799]

I just saw this on Facebook. Anyone know what the updates are? I don't want to get my hopes up. 

[twangster]

May 14, 2021

Added sections for Screening of Embarking Passengers for Restricted Voyages, Testing of Embarking and Disembarking Passengers for Restricted Voyages, Test Selection and Specifications for Passenger Screening Testing on Restricted Voyages, and Onboard COVID-19 Testing for Symptomatic Passengers and their Close Contacts.

[twangster]

 

Screening of Embarking Passengers for Restricted Voyages

• Cruise ship operators must screen passengers for signs or symptoms of COVID-19 and screen for a known close contact exposure to a person with COVID-19 within the past 14 days.
  • Passengers with signs or symptoms of COVID-19
    • Deny boarding if not fully vaccinated and without documentation of recovery².
    • May board at operator’s discretion if fully vaccinated or with documentation of recovery and embarkation day test is negative by viral test (antigen-negative must be confirmed with NAAT). If an alternate infectious etiology (e.g., influenza, respiratory syncytial virus (RSV), Legionella, Streptococcal pharyngitis) is identified through laboratory testing, routine infection control precautions recommended for the diagnosis should be followed.
  • Passengers who have a known close contact exposure in the past 14 days
    • Deny boarding if not fully vaccinated and without documentation of recovery²
    • May board at operator’s discretion if:
      • fully vaccinated and asymptomatic
      • with documentation of recovery from COVID-19 and asymptomatic

---

[2] Documentation of recovery from COVID-19 includes the following:

• Paper or electronic copies of their previous positive viral test result (dated no more than 90 days ago), and
• A signed letter, on official letterhead that contains the name, address, and phone number of a licensed healthcare provider or public health official, stating that the traveler has been cleared to end isolation and therefore can travel. A letter that states that they have been cleared to end isolation to return to work or school is also acceptable. The letter does not have to specifically mention travel.

[twangster]

No testing required for vaccinated.

Was Back to Back specifically called out before for testing'?

 

Testing of Embarking and Disembarking Passengers for Restricted Voyages

Screening Testing of All Embarking and Disembarking Passengers for Restricted Voyages

	Not Fully Vaccinated Passengers	Fully Vaccinated Passengers
Embarkation Day Testing	Viral (NAAT or antigen)	Not Applicable*
Disembarkation Day Testing	Viral (NAAT or antigen)	Not Applicable
Back-to-Back Sailing¥ Testing	Viral (NAAT or antigen)	Not Applicable

* While embarkation testing is not required, international travelers arriving in the U.S. are recommended to be tested 3-5 days after arrival, including those who are fully vaccinated. Cruise operators may follow this recommendation at their discretion.

[twangster]

Fully vaccinated don't need masks for extended meals or outdoors, at the cruise line discretion.   Not sure this changed from last week.

Mask Use

At this time, all persons, including port personnel, crew, and passengers are advised that CDC’s Mask Order remains in effect and requires the wearing of masks on conveyances entering, traveling within, or leaving the United States, and in U.S. transportation hubs. (see Maritime-specific Frequently Asked Questions).

• While the Order permits temporarily removing a mask for brief periods of time while eating or drinking, removal of the mask for extended meal service or beverage consumption would constitute a violation of this Order.
• Masks do not have to be worn while inside one’s own cabin.
• Travelers should not wear a mask when doing activities that may get the mask wet, like swimming at the beach or in recreational water facilities. A wet mask can make it difficult to breathe and may not work as well when wet. This means it is particularly important for bathers to maintain physical distancing of at least 6 feet (2 meters) when in the water with others who are not traveling companions or part of the same family.

Fully Vaccinated Travelers

• Cruise ship operators, at their discretion, may advise passengers and crew that—if they are fully vaccinated—they may gather or conduct activities outdoors, including engaging in extended meal service or beverage consumption, without wearing a mask except in crowded settings.

Requirements

To reduce the spread of SARS-CoV-2, cruise ship operators must:

• Provide passengers and crew with information on how to properly wear, take off, and clean (if reusable) masks.
• Remind passengers and crew not to touch their masks when wearing them.
• Position posters educating passengers on how to properly wear masks in high traffic areas throughout the ship.

[twangster]

Vaccinated can self explore.  Not sure this changed.

Shore Excursions & Transportation Services

Participating in shore excursions and group transportation increases a person’s risk of getting and spreading COVID-19 by bringing people in close contact with others, often for prolonged periods. Additionally, participating in these activities in other communities and countries with high prevalence of COVID-19 further increases the risk of introduction of COVID-19 onto cruise ships.

Fully Vaccinated Travelers

• Cruise ship operators, at their discretion, may advise passengers and crew that—if they are fully vaccinated—they may engage in self-guided or independent exploration during port stops, if they wear a mask while indoors. The cruise ship operator is additionally advised that foreign jurisdictions may have their own requirements.

[twangster]

For simulated voyages, changes below.

I can't recall if un-vaccinated were allowed to participate in simulated voyages before.

May 14, 2021
Clarified screening and laboratory testing requirements for passengers.

• The cruise ship operator must ensure all volunteer passengers have either:
  • Proof of being fully vaccinated against COVID-19 using an S. Food and Drug Administration (FDA)-authorized vaccine or a vaccine product that has received emergency use listing from the World Health Organization (WHO); or
  • If not fully vaccinated, written documentation from a healthcare provider or self-certified statement that the volunteer passenger has no medical conditions that would place the volunteer at high risk for severe COVID-19 as determined through CDC guidance.

[dandi799]

This is all great news! Not sure if it will speed up the ability to get things moving from Florida, but it's progress! I knew I could count on you to find the details. Thank you!

[smokeybandit]

There's no change to the mask use or shore excursion sections, but they added three new sections regarding testing.

 

Key takeaways is that antigen testing is permissible now as well as proof of recovery.  This should benefit those on the Adventure/Vision cruises

 

Also some reassurance for the b2b folks

[smokeybandit]

14 minutes ago, twangster said:

For simulated voyages, changes below.

I can't recall if un-vaccinated were allowed to participate in simulated voyages before.

May 14, 2021
Clarified screening and laboratory testing requirements for passengers.

• The cruise ship operator must ensure all volunteer passengers have either:
  • Proof of being fully vaccinated against COVID-19 using an S. Food and Drug Administration (FDA)-authorized vaccine or a vaccine product that has received emergency use listing from the World Health Organization (WHO); or
  • If not fully vaccinated, written documentation from a healthcare provider or self-certified statement that the volunteer passenger has no medical conditions that would place the volunteer at high risk for severe COVID-19 as determined through CDC guidance.

This was included in the previous update.

[twangster]

Proof of recovery seems like a positive step so long as you have a willing doctor to put it in writing.

Or "self-certified statement" - Hmmm.

[smokeybandit]

"Symptomatic passengers must be isolated and re-evaluated,"

So if you're not symptomatic, you don't have to be isolated?

[JLMoran]

CDC needs to update the dining for fully vaccinated to allow extended indoor dining without any need for masks. They’ve already said it’s allowed on land, so why the heck would it not be allowed in the MDR of a ship that’s going to have the tables spaced out and no mixed group dining / large tables?

[smokeybandit]

Interesting that proof of recovery is only good for the last 90 days.

[Baked Alaska]

36 minutes ago, twangster said:

Fully vaccinated don't need masks for extended meals or outdoors, at the cruise line discretion.   Not sure this changed from last week.

Mask Use

At this time, all persons, including port personnel, crew, and passengers are advised that CDC’s Mask Order remains in effect and requires the wearing of masks on conveyances entering, traveling within, or leaving the United States, and in U.S. transportation hubs. (see Maritime-specific Frequently Asked Questions).

• While the Order permits temporarily removing a mask for brief periods of time while eating or drinking, removal of the mask for extended meal service or beverage consumption would constitute a violation of this Order.
• Masks do not have to be worn while inside one’s own cabin.
• Travelers should not wear a mask when doing activities that may get the mask wet, like swimming at the beach or in recreational water facilities. A wet mask can make it difficult to breathe and may not work as well when wet. This means it is particularly important for bathers to maintain physical distancing of at least 6 feet (2 meters) when in the water with others who are not traveling companions or part of the same family.

Fully Vaccinated Travelers

• Cruise ship operators, at their discretion, may advise passengers and crew that—if they are fully vaccinated—they may gather or conduct activities outdoors, including engaging in extended meal service or beverage consumption, without wearing a mask except in crowded settings.

Requirements

To reduce the spread of SARS-CoV-2, cruise ship operators must:

• Provide passengers and crew with information on how to properly wear, take off, and clean (if reusable) masks.
• Remind passengers and crew not to touch their masks when wearing them.
• Position posters educating passengers on how to properly wear masks in high traffic areas throughout the ship.

I'm not reading that the same way you are @twangster. To me it reads, if you are fully vaccinated you don't have to wear a mask while participating in extended OUTDOOR dining. 

[twangster]

8 minutes ago, smokeybandit said:

Interesting that proof of recovery is only good for the last 90 days.

Isn't there some data that a recovered person doesn't have the same level of immunity as a vaccinated person?

i.e. - having been infected is not permanent protection from the virus.

They seem to cap this form of protection at 90 days.  Is there data to the contrary? 

[smokeybandit]

A recent study showed viable antibodies 9 months after infection, though the caveat was that this was in severe case patients.

[JLMoran]

7 minutes ago, twangster said:

Isn't there some data that a recovered person doesn't have the same level of immunity as a vaccinated person?

i.e. - having been infected is not permanent protection from the virus.

They seem to cap this form of protection at 90 days.  Is there data to the contrary? 

Current evidence indicates that natural immunity to “OG Covid-19” confers little immunity to the variants that have emerged and become the dominant strains in multiple regions. The Pfizer and Moderna mRNA vaccines have so far been shown to confer significant immunity against at least a couple of the variants (UK, South Africa); and May similarly confer increased resistance to the other variants, although evidence is still being gathered. And it’s not clear yetif J&J or AZ have similarly broad protection.

[twangster]

The CDC wants previously infected to get vaccinated so their guidance is going to slant that way. 

[wordell1]

Good news regardless of the full details as it shows that the CDC is still changing the CSO.  They basically said they wouldn't a few weeks ago and they have now changed it a few times.  There is a long way to go before July so a lot can still change as the country opens up.

[JeffB]

7 minutes ago, twangster said:

Isn't there some data that a recovered person doesn't have the same level of immunity as a vaccinated person?

i.e. - having been infected is not permanent protection from the virus.

They seem to cap this form of protection at 90 days.  Is there data to the contrary? 

Anecdotally, conferred immunity from previous infections is not as robust as that obtained by vaccination. Studies have not been completed (peer reviewed/submitted to a journal and accepted for publication) to give that assumption both power (reliability) and depth, e.g., previously infected and recovered people have a less than 3% chance or a 90% chance of reinfection. Don't know that kind of detail yet. That sort of study requires sophisticated serology testing for ABs and long term follow-up.

There is data to suggest that in both fully vaccinated and previously infected and recovered persons, reinfection is "rare." Medically that means less than 3 or 4% chance.

What's noteworthy here is that the CDC, being ultra safe, risk averse and conservative before it provides guidance, wants the kind of data I provide examples of above. WHne they don't have it thier guidance tends to waffle, be ambiguous and confusing. Updated guidance for masking in general and particularly aboard ship is a good example of that.

 

[smokeybandit]

10 minutes ago, wordell1 said:

Good news regardless of the full details as it shows that the CDC is still changing the CSO.  They basically said they wouldn't a few weeks ago and they have now changed it a few times.  There is a long way to go before July so a lot can still change as the country opens up.

Until the shore agreement stuff gets nixed, cruises won't be happening.

[twangster]

Hence Mr. Bayley's carefully chosen words.

[CGTLH]

27 minutes ago, wordell1 said:

Good news regardless of the full details as it shows that the CDC is still changing the CSO.  They basically said they wouldn't a few weeks ago and they have now changed it a few times.  There is a long way to go before July so a lot can still change as the country opens up.

What is being changed is are the instructions for operation. I really never viewed that part as a "set in stone" item.

 

23 minutes ago, smokeybandit said:

Until the shore agreement stuff gets nixed, cruises won't be happening.

This is my thought as well. This has also been something the CDC has been using as part of their defense. Claiming that some Alaska communities are worried about an overrun in the event hospitalization/housing is needed.

[jticarruthers]

38 minutes ago, Baked Alaska said:

I'm not reading that the same way you are @twangster. To me it reads, if you are fully vaccinated you don't have to wear a mask while participating in extended OUTDOOR dining. 

I read it the same way as you.

[twangster]

I suppose the good news is that the CSO is being updated even if it isn't to the degree that we see on land (or anywhere close to that).

[JeffB]

16 minutes ago, JLMoran said:

The Pfizer and Moderna mRNA vaccines have so far been shown to confer significant immunity against at least a couple of the variants (UK, South Africa); and May similarly confer increased resistance to the other variants, although evidence is still being gathered. And it’s not clear yetif J&J or AZ have similarly broad protection.

The Economist just published an article on the new UK Variant. The article was informative wrt to the question, are variants going to evade natural, conferred or immunized immunity.

You know my record here on COVID. I push back against the fear monkey narrative and in general, think the severity of mitigation measures from the start of the pandemic have not produced the desired PH benefits given the staggering economic and social costs. The world over-reacted and in a big, harmful and costly way. The CSO, IMO is a gross over-reaction to COVID transmission risks on cruise ships. JMO.

Having said that and noting my record of currently advocating for abandoning most mobility and behavior mitigation measures, I continued to have this nagging concern about the impact of variants on ending the pandemic. I dismissed these concerns of mine as it became obvious by mid-February that vaccines worked, including reducing transmission, against known variants at the time. Part of that dismissiveness was probably irrational because I have a bias. The actual science of trajectories of viral mutations is also complex and not easily reduced to one line news stories and explanations.

So, where are we these variants? In the news late this week was the emergence of B1.617.2 in the UK, thought to have come from India, possibly explaining the rapid increase in hospitalizations and deaths there. The UK and subsequently the WHO labeled it as variant of concern. Two areas of the UK were seeing increased case numbers involving B1.617.2. Boris warned if this variant takes hold (out competes the currently predominant variant there - B1.1.7), it could jeopardize his aggressive re-opening plans. On Monday, unless these orders get cancelled, pubs will be allowed to serve drinks and food inside. On June 15th, most COVID restrictions will be relaxed. These orders were based up the UK's remarkable success with their vaccination program that had reduced new cases by 90% and just about stopped COVID related hospitalizations and deaths.

If B1.617.2 takes hold in the UK and causes an increase in COVID hospitalizations and deaths, that's a big deal. Given the high % of UK citizens having been vaccinated it would mean those vaccines are not effective against this new variant. It's worth noting that the UK's testing and genomic sequencing capacity is the gold standard globally. We should be paying attention to what goes down wrt COVID in the UK.

An important qualifier here is that Boris Johnson pursued a unique vaccine roll out approach. He eschewed the recommended two dose regimen timing (extended the time frame for the second dose) and focused on getting the maximum number of Brits inoculated out of the gate. If it turns out that variants can evade the ABs produced in the one dose approach, that would suggest the recommended 2 dose regimen and the timing of the second dose is the regimen that should be followed.

What's actually "going down" there? The new variant has just recently appeared. It is only a small percentage of variant detections with B1.1.7 still predominant (95%/5%). OTH, new diagnosed cases caused by B1.617.2 are doubling every week. Importantly, the majority of new cases are being detected in young, mostly unvaccinated people. Hospitalizations and death rates, so far, are flat. Still, it's a valid concern and Boris has now recommended Brits over 60 to receive a second dose ASAP.

When you start reading about this variant in the news and the UK's experience with it in the coming days and weeks be mindful of the metrics that count. New case numbers rising due to this new UK variant presented out of context is, as usual, meaningless. What is meaningful is this: If the metrics that count (age v. illness v. hospitalizations and excess deaths due to COVID) rise, it means the vaccines, or at least the Boris Johnson regimen for administration of them can be evaded by mutations. If they remain flat, the natural selection process of SARS2 - it's capacity to mutate and survive - is not trending toward more deadly strains that might render the current vaccines ineffective in preventing illness and death..

We should know in a couple of weeks. As far as how the CDC views the requirement for the CSO wrt to the risk of variants spreading disease on cruise ships, we know they will take the most risk averse pathway. This must be understood in the context that the CDC sees cruise ships as residential congregate settings requiring a higher level of monitoring and mitigation. That's why restarurants, bars and casinos on land are viewed differently than those aboard a cruise ship.  You can see this in the updated onboard masking policy. I'm pretty certain that the caution reflective in these is a valid concern about the interlocution of variants aboard a cruise ship - a residential congregate setting - and the potential for these to spread as passengers disembark and go home. 

[smokeybandit]

10 minutes ago, JeffB said:

possibly explaining the rapid increase in hospitalizations and deaths there.

Funny thing is, cases are dropping in India just as fast as they rose.

[JeffB]

7 minutes ago, smokeybandit said:

Funny thing is, cases are dropping in India just as fast as they rose.

All viruses, including SARS2 have a definite pattern of rapid rise in new cases, rapid fall as PH authorities implement mitgation measures or people become more cautious, followed by another rise but usually the slope is flatter and the peak lower. These waves repeat until the pandemic ends as a result of the virus running out of people to infect or immunity is conferred through vaccination. Deaths always lag this predictable virus pattern.

So, what's going on in India is expected. What wasn't expected was the collapse of parts of India's health care system which resulted in horrific numbers of dead from COVID. The Modi government has also bungled the vaccine program, caveat that India has 1.4 B citizens but nonetheless not enough people were vaccinated to blunt the current wave as it has been blunted elsewhere where vaccine programs were well executed.

[twangster]

https://www.royalcaribbeanblog.com/2021/05/15/cdc-adds-new-rules-screening-cruise-ship-passengers-and-back-back-cruisers

[stevendom57]

The CDC is still self inconsistent. Do I have to wear a mask in between bites in the MDR?

[Matt]

1 hour ago, twangster said:

I suppose the good news is that the CSO is being updated even if it isn't to the degree that we see on land (or anywhere close to that).

Agreed. By definition, it's progress. And it's encouraging they have been making many updates over the last ~2 weeks.

However...

There are still glaring discrepancies in the guidelines that don't match what the rest of the country is doing. Nevermind the fact no other company or industry needs CDC approval to re-open/operate due to Covid-19.

My hope is this "trend" of updates continues to a point where we get reasonable rules that match up with other changes we are seeing in CDC guidelines.

[smokeybandit]

21 minutes ago, stevendom57 said:

The CDC is still self inconsistent. Do I have to wear a mask in between bites in the MDR?

Only if the MDR is inside. The outdoor MDRs, no.

[JeffB]

@stevendom57 you're not alone in being confused. The entire US is confused about the CDC's new no-masking mandate for vaccinated people let alone the confusion that reigns wrt to the CSO's mitigation measures......even the new ones released on Friday. Matt, above, notes the "glaring discrepancies" even in the newly released CSO guidance.

This is condemnation of our entire public health apparatus in the US. We should be pushing back on PH guidance coming from all levels that is patently absurd or inconsistent with publicly available data. On land, write your local county commissioners and keep hounding them until they reveal on what basis PH measures are being implemented or until they relent and issue appropriate guidance. In the meantime don't be an ass. Comply with the rules in place, until they are relaxed.

Brings to mind the outrageous, pre-pandemic behaviors of cruisers who flaunt on-board rules that are designed to keep people safe or provide a modicum of good behavior or etiquette. It's likely to be worse once we start sailing again - there will be "those people" (obviously none of us) - who brazenly flaunt whatever additional measures the lines end up putting in place to keep us from getting sick. I don't look forward to that. 

[cruisellama]

7 minutes ago, JeffB said:

@stevendom57 you're not alone in being confused. The entire US is confused about the CDC's new no-masking mandate for vaccinated people let alone the confusion that reigns wrt to the CSO's mitigation measures......even the new ones released on Friday. Matt, above, notes the "glaring discrepancies" even in the newly released CSO guidance.

This is condemnation of our entire public health apparatus in the US. We should be pushing back on PH guidance coming from all levels that is patently absurd or inconsistent with publicly available data. On land, write your local county commissioners and keep hounding them until they reveal on what basis PH measures are being implemented or until they relent and issue appropriate guidance. In the meantime don't be an ass. Comply with the rules in place, until they are relaxed.

Brings to mind the outrageous, pre-pandemic behaviors of cruisers who flaunt on-board rules that are designed to keep people safe or provide a modicum of good behavior or etiquette. It's likely to be worse once we start sailing again - there will be "those people" (obviously none of us) - who brazenly flaunt whatever additional measures the lines end up putting in place to keep us from getting sick. I don't look forward to that. 

This what happens when agencies are serving as political agents instead of sticking with ground truth science.   The days of objectivity are gone. 

[twangster]

The role of a public health agency to possess this level of power and authority over a single industry has to be reviewed before Congress.  That won't likely happen in time for this pandemic but it has to be corrected before the next one.  

If the CDC is right then they should have this level of control over so much more.  If they are wrong then they shouldn't have this level of control over any industry.  Given the voodoo science they are using clearly no sane person would want the CDC having this kind of control over more.  

[JeffB]

18 minutes ago, twangster said:

The role of a public health agency to possess this level of power and authority over a single industry has to be reviewed before Congress.  That won't likely happen in time for this pandemic but it has to be corrected before the next one.  

If the CDC is right then they should have this level of control over so much more.  If they are wrong then they shouldn't have this level of control over any industry.  Given the voodoo science they are using clearly no sane person would want the CDC having this kind of control over more.  

Completely on point. I don't know the details as well as I should but several of the bills introduced in the US Congress over the last month or so include rewriting applicable U.S.C. that tends to grant HHS this level of sweeping authority to regulate businesses without appropriate over-sight. 

I get the knee-jerk reactions in February to what was going on globally with the SARS2 outbreak.  But within hours of what amounted to wholesale shutdown of economic activity in the US accompanied by severe restrictions to personal freedoms, Congressional over-sight and review should have commenced. I find it disturbing that it didn't and it was just assumed all these PHE declarations that authorized state and local governments to lock everything down were needed to contain the virus. There is a review process but it's internal to HHS and the CDC. No other government agencies appear to have participated. That this review process only occurs every 90d is shockingly inappropriate given the level of restrictions imposed.

[Jill]

2 hours ago, smokeybandit said:

A recent study showed viable antibodies 9 months after infection, though the caveat was that this was in severe case patients.

I know a husband and wife who after a full year still have antibodies. Both had mild cases

[UNCFanatik]

1 hour ago, JeffB said:

Completely on point. I don't know the details as well as I should but several of the bills introduced in the US Congress over the last month or so include rewriting applicable U.S.C. that tends to grant HHS this level of sweeping authority to regulate businesses without appropriate over-sight. 

I get the knee-jerk reactions in February to what was going on globally with the SARS2 outbreak.  But within hours of what amounted to wholesale shutdown of economic activity in the US accompanied by severe restrictions to personal freedoms, Congressional over-sight and review should have commenced. I find it disturbing that it didn't and it was just assumed all these PHE declarations that authorized state and local governments to lock everything down were needed to contain the virus.

When did CDC "guidelinuides" become defacto law of the land in some peoples minds? But its interesting now to watch the people who said you need to always follow what the CDC says are now saying ignore the CDC when it comes to masking now. The CDC has always had "guideline" and "recommendations" in all areas of public health but people chose to ignore. BUT with Covid, all of a sudden the CDC is the gold standard, never to be questioned authority. 

There is a reason that governments never tried wide spread lockdowns on countries before for pandemics. They do not work. We have been part of the worst human experiment in history. Now we are reaping what we sowed. Long term harm to our children, opioid abuse, mental health issues on the rise, serious diseases not detected early enough, economic destruction, inflation, etc Lockdowns didnt stop Covid spread. Mask mandates didnt stop Covid spread. Japan has one of the highest mask compliance among its populace in the world and they have recently had a large uptick in Covid spread. Sweden turned out to be the example we should have followed. 

People forget in 2009-2010, there were 60 million cases of the swine flu, H1N1 in the US. AND if we tested the way we test now, there would have been more cases detected. But we didnt see daily tickers of cases or the government and media push panic porn the way we have seen in the last year. 

The problem now is that after a year of all the Covid fear and panic pushing, its hard for people to recover from that. Just look at the number of vaccinated people that still cling to their cloth masks and refuse to not wear them now no matter what the CDC says or better yet what REAL science and data say. Their masks were truly a symbol of who they are. They are now gripped with irrational fear and in effect they believe in a cloth mask protecting them from an aerosolized virus more than they trust a vaccine. These same people mock those that wont get the vaccine as anti-vaxxers but in effect they are as well and they add to vaccine hesitancy. 

 

[TXcruzer]

42 minutes ago, Jill said:

I know a husband and wife who after a full year still have antibodies. Both had mild cases

Being able to detect antibodies, is not the same as having “viable immune response”