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阎焱辞任雷士照明董事长

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 在线短租房 可能让你住的很糟心 (Published 14 August 2020) Cite this as: BMJ 2020;370:m3181

Read our latest coverage of the coronavirus outbreak

  1. Shamil Haroon, clinical lecturer in primary care1,
  2. Joht Singh Chandan, academic clinical fellow in public health12,
  3. John Middleton, president3,
  4. Kar Keung Cheng, professor of public health and primary care1
  1. 1Institute of Applied Health Research, University of Birmingham, Birmingham, UK
  2. 2Warwick Medical School, University of Warwick, Coventry, UK
  3. 3Association of Schools of Public Health in the European Region (ASPHER)
  1. Correspondence to: S Haroon s.haroon{at}bham.ac.uk

建材业85家公司中30家净利下滑:供给侧改革成一根“救命稻草”

The UK is one of the countries most severely affected by covid-19. Recent outbreaks in English towns such as Oldham, probably involving transmission within large multigenerational households, show the importance of getting the right public health measures in place now to prevent more widespread surges in infections.1

Current test and trace policies have mainly focused on preventing spread in care homes, hospitals, and in the community.2 However, contact within households is thought to be responsible for roughly 70% of SARS-CoV-2 transmission when widespread community control measures are in place.3 In Wuhan, the reproduction number (R) dropped from 3.54 to 1.18 after lockdown and cordon sanitaire. But the epidemic was only brought under complete control when Fangcang (field) hospitals were introduced to isolate cases outside the home, with R dropping to 0.51 after two weeks.4

Current UK guidance advises household contacts to isolate within the same home as the index case for 14 days.5 They make up the majority of contacts for infected individuals and are likely to remain exposed to the infected household member during this period of isolation.6 Despite guidance advising household members to socially distance, contacts are likely to interact repeatedly—during mealtimes, for example—and to share facilities such as bathrooms.

We know that transmission is more likely to occur indoors than outdoors.7 The cumulative risk to household contacts from an infected person is likely to be substantial during peak viral shedding. In one study in New York State, 38% of household contacts tested positive for SARS-Cov-2, and similar secondary infection rates have been reported in China.89 Transmission may be even higher among household contacts of essential workers, who are at greater risk of being infected than the general population.10

Household members who are older, have underlying medical conditions, or share a bed or vehicle with the index case are the most susceptible.91112 Children seem to be at lower risk of being infected.13 However, their stool samples and nasopharyngeal swabs can remain positive for SARS-CoV-2 for more than two weeks after symptom resolution,14 although their role in transmission remains to be established.

Governments should consider new public health measures to prevent household transmission as we prepare for a potential second wave. Household quarantine is likely to remain an important pandemic control measure, and government support for people quarantined at home is conspicuously absent in the UK: this position has been challenged by independent experts.15

Effective isolation

Effective isolation of index cases from household members could reduce secondary infections.12 Wearing masks within quarantined households may help, particularly if used by the index case as soon as infection is suspected.16 The World Health Organization recommends that infected people and unavoidable close contacts, particularly those in vulnerable groups, should wear medical masks, but Public Health England does not currently recommend this. Other measures that should be considered (and evaluated) include clear advice on enhanced personal hygiene; cleaning and disinfecting shared toilets and other common spaces, door handles, and touch points; and staggering mealtimes.

People who are unable to self-isolate safely at home could be accommodated in special isolation facilities such as hotels and hostels, an approach adopted by some other countries, including Italy, Finland, and Lithuania.17 In China, field hospitals were created to manage and strictly isolate patients with mild-to-moderate covid-19.18 Nightingale hospitals in the UK could be similarly repurposed to support isolation of infected people with mild-to-moderate disease. As medical and nursing care needs are mostly modest, the cost would be relatively low. However, such a system depends on access to rapid testing for anyone with symptoms or possible exposure so that infection can be confirmed and isolation started before transmission occurs. It would also require public trust that isolation in these facilities would be voluntary, safe, and supportive.

它轻便易折叠,适合携带出行。
The two pleasure devices both made of bronze date back more than 2000 years to China's Han Dynasty (206 BC–220 AD).
survey
Tumor Biology, a journal published by Springer Nature, announced last week that it had retracted the papers after an investigation showed the peer review process had been compromised.
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Although foreign trade accounts for a greater share of the economy than ever, the United States is still more insulated than virtually every major competitor in Europe and Asia. Such everyday purchases as haircuts, dry cleaning, financial advice and eating out are virtually immune from foreign competition.
中国最高纪律监管机构日前表示,去年共有1300名涉嫌经济犯罪的外逃人员回国接受审判,其中腐败官员347人。

To be sure, that excitement can certainly lead to unrealistic declarations from those in the community. Some bitcoin developers and investors proclaim that within five years, all the major banks will be accepting bitcoin. That’s a stretch, acknowledges Peter Smith, COO of the bitcoin wallet Blockchain (not to be confused with the actual bitcoin block chain). “I hear a lot of predictions about how soon the whole world will be using bitcoin, and most of the time, those are unrealistic,” he says. “What we’re trying to do as an ecosystem is incredibly audacious, so it’s going to take a lot of time.”
他会在自己的独唱专辑中尝试什么样的歌曲呢:《Sweet Creature》(《可爱的人儿》)和《Ever Since New York》(《自从来到纽约》)是温馨的原声抒情歌曲;而在《Kiwi》(《奇异果》)这首歌中,他大声地炫耀着自己的欢乐;《Two Ghosts》(《两只幽灵》)则是一首为分手而惋惜的歌曲。
There were multiple instances of the glamourous royalty keeping Canadians waiting, including the arrival, where the family took a whole 20 minutes to disembark in order to be greeted by the Canadian welcome party.
设在日内瓦的国际移民组织星期二公布的数字显示,一百万零五千五百零四名非洲和中东的流动人口,以非常规方式通过陆路和海路进入欧洲大陆,这个数字是2014年的四倍。
据报道,霍莉·亨特(Holly Hunter)因出演《钢琴课》(The Piano)获最佳女主角奖,她的小金人放在科恩兄弟纽约的办公室中,它旁边还有因出演《冰血暴》(Fargo)而获得的奖杯。

Footnotes

  • 督查组暗访:入户调查5户群众 4户不知是否发了社保卡
  • "Game of Thrones" was not only the most downloaded show of the TV season, but also the most downloaded show of the year. In fact, the per episode illegal downloads figure is higher than the best ratings "Game of Thrones" has ever had。

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马特·达蒙凭借他在《火星救援》中扮演的被困宇航员一角而荣获喜剧类最佳男主角奖项。
最后西蒙点评:“你们在唱的时候眼睛里透露出坚定,唱得相当投入,第一次我听到你们唱这首歌的时候我觉得很惊艳,而这一次提高了不少,更上了一个台阶。”
户外空间:这栋房屋占地面积五分之一英亩(约809平方米)由纽约公司Landgarden负责景观设计。房屋前面的这座日式花园中采用了当地的植物。这栋房屋后面还有一处露台和院子,那里还有一座日式花园。
3. Piggyback Rider
“研究数据时,我不断回到这个问题上来,它其实是个身份政治问题,”挪威卑尔根大学(University of Bergen)研究欧洲极右翼党派的教授伊丽莎白?伊法斯夫拉腾(Elisabeth Ivarsflaten)说。“这是民粹主义者获得支持的最有力的征兆。”

房贷新政利好 北京周边楼市到访量成倍增长

References

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