We’re answering your questions about the pandemic. Send yours to COVID@cbc.ca, and we’ll answer as many as we can. We publish a selection of answers online and also put some questions to the experts during The National and on CBC News Network. So far, we’ve received more than 55,000 emails from all corners of the country.
COVID-19 testing is a crucial part of tracking and managing the pandemic. It has become a part of daily life that’s often necessary for returning to work or school or for keeping friends and family safe.
But it also generates a lot of confusing news and advice from case counts to wait times to ever-changing instructions about who needs to get tested, when, how and why.
It’s no wonder CBC readers have lots of questions. We checked with experts to get some of the answers.
Is the present spike in COVID-19 cases in Canada related to the increase in testing?
Many provinces have been breaking daily new case records for COVID-19, including British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, and Quebec. But these provinces are all running more tests now than they were at the previous peak in the spring when a shortage of tests meant even people with very typical COVID-19 symptoms couldn’t get tested. So, are the increased case counts simply due to more testing? For the most part, no. But the amount of testing does make a difference.
For Ontario, the new records are partly due to the increase in testing, said Dr. Sumon Chakrabarti, an infectious disease specialist with Trillium Health Partners in Mississauga, Ont., in an interview with CBC News Network.
Ontario completed over 48,000 tests on Oct. 7 (two days before setting a record of 949 cases in one day) — about quadruple the 12,000 it ran on April 24 when the province hit a spring peak of 640 cases.
At that time, Chakrabarti estimates about three-quarters of cases were being missed, and there were likely closer to 2,500 cases a day in late April.
However, the real number of cases in Canada is definitely higher than it’s been since the spring peak.
All things being equal, if you test more of the population, you will end up testing more people with COVID-19, which will cause the case counts to go up, but you will typically test even more people without COVID-19, causing the percentage of positive tests to decrease, said Cynthia Carr, founder of the Winnipeg-based epidemiology consulting firm EPI Research Inc.
But in fact, the percentage of tests that come back positive is increasing in many places, including Manitoba. In that province, the real number of cases is “definitely an increase relative to the spring.”
Ottawa wastewater surveillance shows dip in COVID cases. The timing is too perfect. 2 weeks after new restrictions we’re seeing this strong a signal? Other explanations out there? I’m all ears. <a href=”https://t.co/VY9J53Lj5k”>pic.twitter.com/VY9J53Lj5k</a>
And in Ottawa, SARS-CoV-2 virus levels in waste water in recent weeks are the highest they’ve been since testing began in June. That’s a measure of COVID-19 prevalence independent of the amount of testing at testing centres, said Raywat Deonandan, an associate professor of epidemiology at the University of Ottawa.
The good news? Coronavirus levels in waste water seem to be going down since the province imposed stricter restrictions on social gatherings in the city before Thanksgiving.
WATCH | How sewage can be used to track COVID-19:
If we can test feces in waste water for coronavirus, why are we still doing invasive nasal swabs?
Having your nose swabbed can feel really uncomfortable, but Dr. Matthew Cheng, an assistant professor of medicine at McGill University, said there are practical reasons for it:
Public health doctors are more interested in knowing if the virus is in the respiratory tract, which the nose is part of, as it’s mainly spread via the respiratory tract.
Lab protocols are optimized to process lots of respiratory samples and having other kinds of samples could slow down analysis.
He said that there’s lots of work underway to be able to quickly analyze respiratory tract samples that are easy for people to collect themselves, such as “swish and gargle” saliva tests. Lastly, many people may not find collecting a stool sample easier than getting a swab in the nose.
WATCH | A closer look at saliva-based tests:
How long are test samples good for?
With backlogs in testing in Ontario this fall, at least one local health director has complained about tests spoiling and having to be redone after they weren’t processed within 72 hours. Dr. Robert Cushman, acting medical director of Renfrew County and District Health Unit in Ontario, reported that the testing lab told him that about 10 tests had to be redone due to delays in processing.
So how long do they last?
It depends on how the swab is stored after collection, said Allison McGeer, an infectious disease specialist at Toronto’s Mount Sinai Hospital, but generally speaking, it should last weeks.
Benoît Hébert, a Quebec-based biotechnology consultant, said most biological samples including nasopharyngeal swabs can be stored at regular fridge temperatures for up to 72 hours and should be deep frozen if there is any delay in testing or shipping.
According to Public Health Ontario, tests have about a 95 per cent accuracy rate as long as the test is processed within seven days of collection, and the sample is taken using a nasopharyngeal swab.
As of mid-October, more than half the tests in Ontario were processed within two days, the Health Ministry told CBC News in an email. It said that accredited labs conducting testing must have equipment in place to keep specimens at a stable temperature before testing, and it recommends freezing samples to preserve them.
“In the event a laboratory would report a specimen as expired, they would contact the testing site to ensure that re-collection occurs,” the ministry said.
WATCH | A closer look at rapid COVID-19 testing:
I got COVID-19 and isolated for the required time. But I’m still testing positive. What does that mean?
“Many people have these lingering positive tests,” acknowledged Chakrabarti, and that can happen weeks or months after they recover. But at that point, he said, “they’re not actually contagious.”
Dr. Zain Chagla, medical director of infection control at St. Joseph’s Healthcare in Hamilton, explained that’s because COVID-19 tests detect genetic material from the virus, which can be shed from your body even when all the viruses are dead.
So how long is a COVID-19 patient contagious?
Chagla said that researchers trying to culture live virus from patients have found there are minimal amounts in most people 10 days after they experience their first symptoms and after 20 days in critically ill patients. That suggests they’re not contagious after those periods.
“There’s also been no case reports of people being infected by others who are 10+ days into their illness,” Chagla added in an email.
It also means long-haulers, people who are still experiencing symptoms months after they got infected, are not contagious.
WATCH | Doctors take questions and give answers about COVID-19 testing:
I’ve recovered from COVID-19, but my boss says I need to test negative before I can return to work. Can they ask me for one?
Given that people can test positive for weeks or months after recovery and aren’t contagious, a request like this may be frustrating.
But the answer is yes.
Even if you’ve completed isolation and public health has cleared you, employment lawyer Howard Levitt said it’s within your employer’s rights to require a negative test — and they’re not obliged to pay you if you’re unable to work.
“Safety trumps privacy. That’s the bottom line,” said Levitt, noting that employers could ask for a negative test result every two weeks, if they wanted to, needing no other reason than ensuring a safe workplace.
So what can workers do?
You could try talking with your boss or getting a doctor’s note, said Maggie Campbell, a partner at Vancouver law firm Roper Greyell.
Other than that, Levitt says there isn’t much you can do. You can offer to work from home, if possible, or you could take your employer to court, but he cautioned that courts may not be in workers’ favour in the current climate.
“Employees should understand that anything an employer is doing to protect other employees of theirs will be seen very sympathetically by the courts.”
However, companies should be up-to-date with the latest public health guidelines, he said.
If your employer sends you home without pay while awaiting a negative test result, you could apply for Canada Recovery Sickness Benefit, providing you are eligible.
WATCH | Labour lawyer answers questions about work during pandemic:
I have symptoms but tested negative. Do I still have to self-isolate?
It’s always best to check with your health-care provider or local public health unit for advice specific to your personal situation. But symptomatic individuals may be advised to continue isolating for the remainder of the isolation period, even if they get a negative result.
That’s because a negative result isn’t a guarantee that you don’t have the virus.
According to Dr. Kelly MacDonald, head of the infectious disease program at the University of Manitoba, the nasal swab test is accurate 99 per cent of the time in a laboratory setting, but in a clinical setting errors can happen when the sample is taken. For example, the swabbing may not be done properly.
A negative test could also mean that you were tested too early before viral levels are high enough to be reliably measured.
Ultimately, context is important, and your doctor or local health unit would form their advice on a number of factors, including whether there was exposure to a known case, the kind of symptoms you have, how long you’ve had them and whether you’re a student, or you work with vulnerable individuals, for example.
And even if you don’t have COVID-19, you could still be contagious with something else — perhaps the flu — in which case, the same public health advice to stay home when sick would still apply.
On the other hand, if you get a positive test, you almost certainly have COVID-19 — the false positive rate is very low — less than one per cent of tests overall, estimates Dr. Philippe Lagacé-Wiens, a medical microbiologist at St. Boniface Hospital in Winnipeg.
WATCH | Why people with COVID-19 symptoms should be reassessed if they test negative:
If you’re a contact of someone who tested positive, why are you supposed to get tested within 2 weeks of exposure? Wouldn’t the virus still be developing?
While it can take up to 14 days for symptoms to develop, Charkrabarti said that most people start to develop symptoms within seven days.
“And you can actually test positive a couple of days before that,” he said.
So ideally, you should wait about three to four days after exposure before getting tested, he recommends.
However, any result could still be a false negative, so if you were exposed, you should remain in quarantine for 14 days even if you test negative.
Are tests at pharmacies as accurate as those at provincial testing centres?
In general, people with no symptoms are more likely to get a false negative than those with symptoms, but it’s not known by how much.
In Alberta, the tests are identical to those offered at provincial testing sites and analyzed at the same labs, the provincial Health Ministry says. That means they should have similar accuracy to tests of asymptomatic people at testing centres. However, Alberta announced on Oct. 20 that it would stop testing asymptomatic people with no known exposure to COVID-19 — the only people who could get tested in pharmacies.
In Ontario, there are some differences between pharmacy tests and those offered at provincial testing centres. Pharmacy tests use shorter nasal swabs instead of the long nasopharyngeal swabs, and they’re sent to the California lab of Quest Diagnostics instead of in-province labs, says the provincial Health Ministry.
Chagla says the sensitivity may be slightly lower with the shorter swabs, but this shouldn’t be a big risk, as the probability of asymptomatic people having COVID-19 is lower than people with symptoms, especially if they haven’t been exposed.
WATCH | How pharmacy testing works in Ontario:
I think I had COVID-19, but I’m better now. Can I be tested to confirm?
The nose swabs at testing centres can only detect current or very recent infections, not whether you’ve been previously infected. To find that out, you need an antibody test. Such tests are available 14 days after active infection, with a doctor’s prescription, in some provinces. Dynacare offers the service in Ontario and Quebec. Ichor Blood Services offers it in some communities in Alberta, Ontario and New Brunswick. The fee is typically $70 to $80.
However, studies have shown that even among those infected, antibodies fade with time, and it happens far more quickly in those who never showed symptoms.
WATCH | A closer look at the 1st antibody test Health Canada approved in May:
The latest on the coronavirus outbreak for Dec. 3 – CBC.ca
National vaccine deployment plan calls for up to 205 vaccine distribution locations across Canada
Canadians heard extensively for the first time on Thursday from Maj.-Gen. Dany Fortin, who has been tasked by the federal government with leading vaccination logistics and operations. While the country is facing unprecedented “logistical complexities,” the military and its partners will be ready to deploy COVID-19 vaccines as soon as they are approved in Canada, Fortin said.
The former NATO commander, along with the other public health officials who spoke at Thursday’s news conference, tried to provide assurances for the many questions still swirling in the air, including the cold storage capacities for feeding the supply chain given the temperature requirements of some of the vaccines.
Eventually, there will be 205 “points of issue” locations across the country where health-care professionals can administer the vaccine, Fortin said. It will be up to the provinces and territories to specify where and when individual Canadians will be inoculated.
The national operations centre has conducted one dry run scenario, with others planned. Fortin said exercises and planning have contemplated a number of possible complications, including treacherous winter delivery conditions, fires at distribution hubs and cyberattacks.
With respect to Pfizer’s vaccine, which needs to be kept at approximately -80 C to remain stable, Fortin said his team is in daily contact with the company and there have been no hiccups with Canada’s plans. The Pfizer product will be delivered by that company directly to provincial and territorial distribution points as early as the end of the month, he said, and the federal government has secured the cold storage required for this vaccine. In addition, the provinces have indicated where the Pfizer-specific fridges should be placed, according to Fortin.
The total supply of doses and prioritization of vaccine recipients will be key, ongoing questions. Government officials have previously said they hoped some three million people could get vaccinated through the first quarter of 2021, but Canada is not manufacturing COVID-19 vaccines and will rely on importing them through deals it’s struck with the pharmaceutical companies.
Health Canada has said its approval of at least one vaccine could come within the next two weeks, not long after U.S. regulators meet.
Dr. Howard Njoo, Canada’s deputy chief public health officer, said the federal government is now refining who is best suited to first get a dose of a vaccine. Early guidance from the National Advisory Committee on Immunization (NACI) suggests seniors in long-term care homes and front-line health-care workers will be among the first to get a shot.
Click below to watch more from The National
Alberta planning for COVID-19 field hospitals, according to internal document
An Alberta Health Services document obtained by CBC News shows the province has been planning for more than a week to set up indoor field hospitals that could treat up to 750 COVID-19 patients.
The document dated Nov. 28 outlines plans for 375 beds each in Calgary and Edmonton for patients with mild-to-moderate symptoms. Patients requiring intensive care would remain in city hospitals.
The field hospitals draft plan underscores the severity of the public-health crisis Alberta faces — and provides a sobering sign of where officials believe the trajectory of virus infections could be headed. There were 504 people in hospitals and 97 in ICUs in Alberta on Wednesday. A total of 561 people in the province have died from the disease since the start of the pandemic.
The greatest challenge to making the hospitals operational by December or January would be staffing, and the document references potentially calling in the military to assist. Other logistical challenges would be building adequate toilet, shower and handwashing facilities at the proposed sites as well as determining whether an oxygen supply infrastructure could be established.
Dr. Noel Gibney, a veteran Edmonton critical-care doctor who has publicly criticized the government’s pandemic response, says the field hospital planning is sensible due diligence planning, but he said the government has clearly not told the public the degree of risk they are now facing while continuing with policies that downplay the risk.
“On one hand, we are having provincial planning at a disaster level or for an upcoming disaster,” he said. “And on the other hand, we are being told everything is fine.”
In addition, CBC News has learned through a source close to the federal government that Alberta has inquired with the Trudeau government and the Red Cross about supplying field hospitals to help offset the strain COVID-19 is having on the province’s health-care system.
Quebec cancels plans to allow Christmas gatherings as COVID-19 cases surge
Quebec Premier François Legault on Thursday backtracked on his plan to allow gatherings over the Christmas holiday period after a rise in cases, hospitalizations and deaths that caused doctors at some hospitals to voice their concerns.
Legault said that gatherings in the province’s hard-hit “red zones,” which encompass most of the province, will be prohibited over the holidays.
“When we look at the situation, we are forced to realize that it is not realistic to think that we are going to succeed in reducing the progression of the virus in a satisfactory way by Christmas,” he said.
Legault announced last month that people would be allowed to gather in groups of 10 over a four-day period, from Dec. 24 through Dec. 27, if they isolated for a week before and after. He later said people should only gather twice during that period.
The province reported more than 1,500 daily cases for the first time ever on Wednesday, and more than 1,400 again Thursday.
“If we continue in this direction, hospitals will start to overflow. We have a limited number of nurses, and our nurses are very tired,” the premier said.
Legault did allow that Quebecers could individually visit a person living alone, particularly the elderly, over the holidays. But he stressed visitors in such circumstances need to be wearing masks, maintaining a two-metre distance and not staying very long. Visits to the province’s long-term care homes and seniors’ residences, however, will be prohibited — with the exception of caregivers.
Dozens of internationally educated nurses are on the sidelines in Manitoba
Manitoba Health Minister Cameron Friesen said recently a special designation will be granted to 39 internationally educated nurses waiting on English tests so they can practise in Manitoba and have the language requirement temporarily waived, but it’s not clear when that will happen.
Bhupinder Grewal, originally from India, is among the internationally educated nurses who’ve struggled and been inconvenienced by a recurring two-year English language test that is required for licensing. Both of the English tests that would be suitable to take are not being administered this year because of the pandemic.
Darlene Jackson, president of the Manitoba Nurses Union, said it’s a shame the internationally educated nurses are unable to work because of a language test when they have otherwise shown the necessary skills through bridging tests to meet Canadian standards. The union says the nursing vacancy rate in the Winnipeg Regional Health Authority and Shared Health combined is around 16 per cent.
“We are in a nursing shortage. We’re at a critical nursing shortage in many areas. We are desperate to have every possible nurse that can work in the system,” she said.
The Touchstone Institute, responsible for administering the Canadian English Language Benchmark Assessment for Nurses, says the two-year expiry date on the language requirement, is “based on the assumption that the measure of examinees’ capabilities at a given point in time may become less trustworthy indicators of those capabilities as time passes.”
When contacted by CBC for this story, Friesen’s office declined to comment, but said it will provide an update on the special designation soon.
Stay informed with the latest COVID-19 data.
Why children in Canada won’t immediately receive a COVID-19 vaccine
There is currently no human pediatric data for vaccine candidates to protect against COVID-19, although that could change in 2021.
Federal statistics show that at 8.1 million Canadians, children and teens make up one-fifth of the population. But younger immune systems are more active than those of adults, and children often show stronger immune reactions to vaccines in terms of side-effects.
“Children often will need either a slightly different formulation or a smaller dose of a vaccine, so it’s appropriate to ensure the vaccine is safe and effective in adults and then move on to that testing,” said Shannon MacDonald, an assistant professor in the faculty of nursing at the University of Alberta who conducts public health research, including on vaccines.
Earlier this week, Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said on NBC’s Meet the Press that it could take months before those younger than 18 in the U.S. general public could get a coronavirus vaccine, if approved by regulators.
Pfizer announced in October it was expanding vaccine testing to those 12 and older, while Moderna said this week it expects to test the vaccine on children between the ages of 12 and 17 in the coming weeks and on younger children in 2021. The developments are likely welcomed by the American Academy of Pediatrics (AAP), which wrote an open letter to U.S. federal health officials to ensure children are not left out of vaccine efforts.
Although it’s far from guaranteed, it is possible adults will gain enough immunity from vaccinations that widespread vaccinations of children will not be necessary.
“Some vaccines contribute to herd immunity because the person who gets the vaccine doesn’t spread any infection,” says Dr. Joanne Langley of Dalhousie University, who is the co-leader of Canada’s COVID-19 vaccine task force. “We don’t know for sure yet whether that occurs with the COVID vaccines and how effective it is.”
From a tiny outport to a Vietnamese city, how one Newfoundlander is enduring the pandemic
Many Canadians who live abroad won’t be coming home for the holidays for safety reasons or because of the complications involved with travel quarantines, but Newfoundland and Labrador native Sabrina Pinksen is in one of the safest spots in the world, statistically speaking, with respect to the coronavirus.
Pinksen, who is originally from tiny Wild Cove, near the Baie Verte Peninsula, has been living in Hanoi since 2017. It’s a city nearly twice as populous as Canada’s biggest, but with one-third of the physical space.
But as of Wednesday, Vietnam has recorded 1,351 cases and 35 deaths since the pandemic began, according to the World Health Organization. Even if there was a moderate amount of underreporting, it would be a status that ranks favourably with any country in the world.
“I don’t even think about COVID, going out into my daily life,” Pinksen said. “It’s almost like it wasn’t real.”
Pinksen, who’s passionate about her art but earns her income teaching English through a school, said the disruptions that have occurred with daily life have actually led to more of a demand for her services, as some Vietnamese have more free time.
Unlike in North America, there is no cultural resistance to the most publicly visible mitigation measure. Pinksen said: “This is a mask-wearing country anyway. So even before COVID, a lot of people would wear masks.”
Pinksen is not able to travel to Canada for the holidays and admits to being homesick — it’s been 15 months since she’s been home and her father has a serious health issue.
But, she said, “I’m very grateful that everything in Newfoundland is OK right now.”
Find out more about COVID-19
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Airbnb rolls out restrictions in Canada to prevent New Year's Eve parties – CBC.ca
Airbnb says it has a plan to curb New Year’s Eve parties this year while Canada works to slow the spread of the COVID-19 virus, with the announcement coming not long after a short-term rental was the site of a 60-person party in Mississauga, Ont.
In addition to its ongoing ban on parties, Airbnb now says guests will need a history of positive reviews on its app to reserve an entire home for New Year’s Eve in Canada.
Airbnb is making an exception for one-night bookings made up to Tuesday, based on data that suggests bookings made before early December rarely involve parties.
Most guests and hosts “are quite responsible, but there’s always a couple people who try to skirt those rules,” said Nathan Rotman, senior manager of public policy at Airbnb.
“We want to make sure that people are both adhering to public health guidelines and following the policies that we’ve put in place and our hosts have put in place.”
Still, Rotman says there are plenty of good reasons why hosts might get bookings over the holidays, including people who might need to use rental suites for isolation purposes after returning to Canada. This new restriction, he says, is to target people who are ignoring company policies.
The app is loosening its standards from a similar policy on Halloween by allowing users with previous positive reviews to book a home for one night.
But Airbnb says it will put more stringent policies in place as the new year nears, by using technology that blocks certain kinds of last-minute bookings.
Airbnb’s announcement comes after Deputy Chief Marc Andrews of the Peel Regional Police said a short-term rental unit was the site of a 60-person party this past weekend, resulting in thousands in fines to partiers who violated COVID-19 restrictions.
Canada will have vaccine infrastructure in place around ‘Christmas,’ 1st doses in January – Global News
The federal government laid out details for Canada’s coronavirus vaccine rollout Thursday, saying it plans to have logistics and infrastructure in place before Christmas, according to Dany Fortin, the lead on the nations’ COVID-19 distribution of a vaccine.
Speaking at a media conference, Fortin said although Health Canada is still reviewing approval for vaccines, the federal government and provinces are working on a rollout plan and will do a trial run next week.
“We’re not going to wait until the end of December … we are getting ready so that when it becomes possible we are poised to distribute,” he said.
Fortin said the vaccines that require colder storage, such as Pfizer and Moderna, are most likely to be first distributed in January.
But the initial shipments of vaccines to arrive in Canada, called “track one,” will be rolled out differently.
For example, Moderna’s vaccine will first be shipped to one location in Canada and then sent to communities across the country. But the Pfizer vaccine will be sent directly to the communities, according to the federal government.
This is because Pfizer’s vaccine requires specially designed temperature-controlled shipment and storage containers — the temperature has to be -70 C for up to 10 days unopened.
Alberta health minister expects shipments of COVID-19 vaccine to arrive in early January
Fortin said the military, federal government and provinces are implementing a “soft launch” of the distribution plan in order to ensure authorities are ready to handle the ultra-low temperatures required for Pfizer and Moderna.
Fourteen sites across Canada will be ready for Pfizer, he said.
Moderna expects the vaccine to be stable at normal fridge temperatures of two to eight degrees Celsius for 30 days and it can be stored for up to six months at -20 C.
Fortin said every province has already identified the “points of use” where the vaccines will be distributed. And by Dec. 14, he added that these locations are expected to be ready for the vaccines.
“So this gives you a sense that in December, we’re hard at it in the next couple of weeks to ensure you that we are ready,” he said. “I kind of like the idea of being ready before the Christmas timeframe so that we’re certain to be ready when it comes in January.”
First vaccines will cover 3M Canadians
Currently, Health Canada is reviewing approval for four coronavirus vaccines.
Deputy chief public health officer Dr. Howard Njoo said Thursday that he is “optimistic” that reviews of Pfizer, Moderna and several other vaccines will be complete soon, and expects the Pfizer one to be “a favorable one.”
The federal government plans to give three million Canadians the first round of coronavirus vaccines when they are approved and arrive in the country, Njoo said.
“We will immunize as many Canadians as possible, as quickly as possible and ensure that high-risk populations are prioritized,” Njoo said. “We expect certain Health Canada-approved vaccines to become available in early 2021. The initial supply of these vaccines will be limited, such that we will be able to vaccinate around three million Canadians. That means we need to be strategic on who gets vaccinated first.”
He said the National Advisory Committee on Immunization will release guidelines in the coming days that will help identify who receives the COVID-19 shots first, he said.
“Although the initial supply will be limited I want to be clear there will be enough vaccines for every Canadian,” Njoo added.
Coronavirus: O’Toole blames ‘secrecy and incompetence’ of Trudeau government for vaccine delay
On Wednesday, Canada’s chief public health officer, Dr. Theresa Tam, described the country’s vaccine effort as “one of the most consequential scientific endeavours in living memory” and “one of the most complex operations ever taken in public health.”
Speaking at a vaccine conference, she said the country is working to further refine the list of who gets the vaccine first, since the initial six million doses expected to come in early 2021 — enough for three million people — aren’t enough for everyone on the national vaccine advisory committee’s list of priority groups, which include the ill and elderly, health-care workers, essential workers and Indigenous communities.
© 2020 Global News, a division of Corus Entertainment Inc.
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