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Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 调查显示:四季度我国城镇居民投资意愿略有上升 (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

重点城市楼市库存下降 杭广房价上行压力大

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.

IE’s alumni have the second-highest average salary increase following graduation, at 39 per cent. The school is ranked first for aims achieved and for international mobility. It is third for career progress. “There is a definite ‘before and after’ for career progression,” says one former student. “Post-MBA I felt I had more of a sense of direction not only of where I wanted to be, but also why, and how to make it happen.”
中国进口下降在很大程度上源于大宗商品价格走低,而后者反过来又是中国总体需求下降的结果。中国已经多年是铁矿石、煤炭、铜等材料的世界最大消费国。
单词invigorate 联想记忆:
"It is a massive jump in very little time: there were just about 30 cases when I became interior minister (in mid-2012), and 1,400 today," said Valls.
第10、11题,选0得4分,选1得3分,选2得2分,选3得1分,选4得0分。
'It surprised me, but it's a good sign for Tencent getting abroad, because in particular WeChat is a combination of WhatsApp and Instagram, so it's a unique value proposition that is probably pretty good for emerging market consumers,' he said.
《火线警探》,FX,1月20日。副警长瑞兰·吉文斯(Raylan Givens,蒂莫西·奥利芬特[Timothy Olyphant]饰)与他的朋友兼天敌博伊德·克劳达(Boyd Crowder,沃尔顿·戈金斯[Walton Goggins]饰)之间爱恨交织的关系贯穿了整部剧,不管怎样,这个问题将在第六季,也就是最终季中得到最终解决。

中国为包括棉花、糖和玉米在内的大宗商品设置的最低价格过高,当这些价格偏离市场价格时,政府鼓励了过度生产以及强劲的进口。
周边环境:斯托宁顿位于康涅狄格州东南部的小纳拉甘西特湾(Little Narragansett Bay),从哈特福特(Hartford)和罗德岛的普罗维登斯(Providence, R.I.)开车约1小时可达,从纽约市开车约3小时。这里曾是一个具有悠久历史的繁忙港口,至今仍然保留着一支商业捕鱼船队,有几个分布着殖民式和联邦式建筑的历史区,以及一个繁荣的航海社区。在该镇的一端有个小型的公共海滩,而在另一端罗德岛的沃奇·希尔(Watch Hill)则有个大得多的海滩,开车大约20分钟可到。这栋希腊复兴式房屋带有此类建筑必不可少的爱奥尼亚柱和山形墙上的扇骨半圆窗,房屋就坐落在市镇中心。
4. No talking during the game, wait for half-time or end of the game.
众所周知,中国国家主席习近平也是一个足球迷,他曾多次表达了自己对中国足球发展的支持。
Opinion: China’s Commercial Aerospace Dream Edges Closer To Reality

Footnotes

  • 价格战改变LED照明格局 或催熟智能照明
  • Cheng继续说道:“一旦你找到适合自身需求的列表,只需轻按该列表即可看到推荐店铺的位置,然后通过左右滑动来查看更多选项,点击"阅读更多"或者屏幕底部的箭头可以选择地点和获得更多细节。”

Paddington 2
莎拉奥康纳(Sarah O'Connor)是就业记者
中国社会科学院近日发布的《中国社会心态研究报告(2016)》显示,一线城市居民生活压力较大,不过小城市也未必是宜居地。
n. 非法移民
2. Organize
安德鲁希尔(Andrew Hill)是管理主编

北京天通东苑二区固定车位空闲 业主回家却无处停

References

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