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宜家与物流闹纠纷 广州送货濒临瘫痪

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 国管公积金“认房又认贷”? 客服称未接到相关通知 (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

大学生暑期实习租房难 签约绑贷“套路”多

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.

中国富豪王健林旗下拥有AMC Theaters等产业,在今年的榜单上进入了前20位。
《生活大爆炸》中绝不缺少天才。不只是因为这部剧向观众展示了很多绝顶聪明的科学家,同时,演员玛伊姆·比亚利克还拥有神经学博士学位。因此,演员们想要在剧中展示他们的聪明才智,并将整部剧做到精益求精,这也不足为奇。剧中谢尔顿和莱纳德的公寓里有一块很大的白板,这对铁哥们几乎在处理任何事时都会用到它,从完成从学校带回来的工作,到决定是否等到看完最新一部《蜘蛛侠》再吃饭,都离不开这块白板。
The value of goods that crossed international borders last year fell 13.8 per cent in dollar terms — the first contraction since 2009 — according to the Netherlands Bureau of Economic Policy Analysis’s World Trade Monitor. Much of the slump was due to a slowdown in China and other emerging economies.
谷歌的品牌价值现在超过了1090亿美元,比苹果公司要高大约20亿美元,这使其成为了全世界最赚钱的公司。
反对:尽管该片被洛杉矶影评人协会评为最佳剪辑奖,但却没有受到纽约影评人的重视。它的势头会逐渐减弱吗?
《花千骨》
Good luck, good health, hood cheer. I wish you a happy New Year.

A moment of panic followed, before the teenager decided to take matters into his own hands and find a way out.
French business schools top the 2017 ranking. Edhec Business School, based in Lille and Nice, leads the field for the first time. HEC Paris, which dominated this ranking since its first edition in 2011, drops to second place.
如果在“消极情感”和“社交抑制”两个维度得分均为10分或10分以上,那么你就是一个有D型人格特征的人。
立场:承诺聘用老兵
statement

Footnotes

  • 上市与倒闭 上半年家居业冰火两重天
  • If you work hard and benefit the company you work for, you deserve to be rewarded for that. If your boss hasn't given you a raise in the last two years, ask for one. If he or she says no, get out now.

v. 戴面具,掩饰,遮
外部事件的影响。《消费者报告》(Consumer Reports)杂志曾经对Model S大加吹捧,但最近该杂志也报道了它的一些常见故障,包括门把手失效,中控触屏白屏,导致车内大部分功能不能使用等等。汽车网站Edmunds.com也找了Model S的麻烦。更多此类报告无疑会影响特斯拉到目前为止非常正面的声誉。
[.reidi'ein]
《至暗时刻》
The Great Recession had devastating effects across the U.S. and few places were as hard hit as Arizona. The state was booming on the strength of its tourism and real estate markets during the 2000s. Median home prices jumped 70% between 2003 and 2006—only Nevada had bigger gains—fueling more building and construction jobs. Monthly unemployment was at 3.5% through much of 2007. But then the bottom fell out. Home prices plummeted more than 50% from their peak and 6% Arizona properties received foreclosure filings in 2009. Unemployment stubbornly remained in double-figures for most of 2009 and 2010 and only Nevada lost a higher percentage of jobs over the last five years. Household incomes declined at the fastest rate in the country since 2008.
Baby Driver

佛山照明高管抱团辞职“掀出”企业控制权争夺“车轮战”内幕

References

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