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险资进军长租市场引业内热议:有利于行业长期发展

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 置业:买房朝向到底怎么看?朝向的优缺点是什么? (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

河北10余家陶企停窑检修 估计20多条线停产

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.

3. “Bridge of Spies” Years ago, Steven Spielberg entered the ranks of Pantheon Directors, to borrow the most exalted category in Andrew Sarris’s taxonomic “The American Cinema” — and there he remains.
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A total of 1,300 fugitives suspected of economic crimes, 347 of whom were corrupt officials, returned to China from abroad to face justice last year, according to the country's top discipline watchdog.
社交时我找不到合适的话题
2016年,担忧和愤怒主导了英国和美国这两个最重要、稳定、悠久的民主政体的政治情绪。
你有D型人格特征吗?有测试表明,拥有这种鲜为人知的性格的人非常善于隐藏情感,甚至他们自己都没有意识到自己很孤单、很焦虑。

An EMBA also boosts corporate careers. “The skills I acquired were key to my promotion,” said one graduate. A fifth are now chief executives, managing directors or board members three years after graduation. Average salaries were up 52 per cent from $114,000 before the programme to $175,000 five years later.
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5. What are my core values? What is important to you as an individual? Is it family, health, spirituality, work, etc.? Make sure that you are living in alignment with what matters most to you.
?奥巴马总统在纽约和新泽西宣布一场“大灾难”。洪水摧毁了海岸和超过230万人失去了电。在新泽西国家警卫队从洪水中救出数百人。州长克里斯?克里斯蒂,共和党人,说这次损失是“无法想象的”。他赞扬了从奥巴马那收到的“突出”配合。
Song “Friends Forever” (Yang Kun and Zhang Liangying)

Footnotes

  • 福建水泥价格将掉头下跌
  • 单词affected 联想记忆:

“如果我们能找到在两个地方都购物的人,那就非常有价值。你知道他们是谁,他们买什么,他们哪些方面花钱,”哈勃补充说。“你可以给他们更加个人化的体验。”
The diplomatic row began when Ankara’s foreign minister was denied entry to the Netherlands on Saturday for a campaign rally in favour of Mr Erdogan’s constitutional reforms. Armed Dutch police also intercepted another Turkish minister, Fatma Betul Sayan Kaya, on her way to the rally in Rotterdam and escorted her back to the German border.
该排行榜为有工作经验的高级管理人员评出全球最优秀的100个EMBA项目。
Exports to both South Korea and Asean countries fell by about 3 per cent, however, while those to re-exporter Hong Kong dropped by more than 16 per cent.
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20. Best Advice for Movie Lovers In August, the scholar Wheeler Winston Dixon sounded an alarm: “If you go on Amazon and you see some great black-and-white film, and it’s going for $3, or any kind of foreign or obscure film, buy it, because it’s going out of print, and they’re not going to put them back into print.” Tens of thousands of films that were on VHS never made the jump to DVD or to Blu-ray, Mr. Dixon warns. And the brave new world of downloads (a.k.a. electronic sell-through) — well, tune in next year.

全国房价分化加剧:一线城市暴涨 三线城市全跌

References

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