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减负政策 要“实打实、硬碰硬”

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 松下关闭在华工厂 转型B2B能否挽救颓势 (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

广东省鼓励建设租赁住房和人才公寓

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.

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众所周知中国一直在雄心勃勃地推进航天商业化,最近中国取得的进展正在将这一梦想转为现实。
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According to a 2014 survey it conducted, 86 per cent of respondents who finished the two years said they were taking action to end educational in-equality through their work and 65 per cent outside of their work.
Yes — by an eyelash. Democrats will need to win an additional 24 seats, meaning they will have to hold on to all 12 Democratic districts that Mr Trump won last year and pick up the 23 Republican districts that voted for Hillary Clinton, plus one or two more for good measure. The math is not on the Democrats’ side, but history is. The president’s party almost always loses some House seats in the midterms, and sometimes loses big, especially when the president has an approval rating below 50 per cent. See Barack Obama in 2010.
Take targeted and powerful measures to strengthen areas of weakness.
林怡仲预测道,下半年A股IPO的数量或将维持与上半年相当,预计2016年全年A股IPO为120宗左右,融资规模在600-800亿元人民币左右。

《速度与激情6》帮助其另外两位男演员在我们榜单中获得较高的排名:范·迪塞尔(Vin Diesel)和已故的保罗·沃克(Paul Walker)。迪塞尔以8.87亿美元位居我们榜单第四。《速度与激情6》在全球斩获7.89亿美元的票房。仅仅几个月之前,他出演的《星际传奇3》(Riddick)在各大影院上映,仅收入9,800万美元票房,不过,这也足以使迪塞尔的排名领先于他的搭档沃克。
Exports shrank 6.1 per cent year on year in dollar terms to $209.42bn in December, according to figures from the General Administration of Customs. That fall was 2.1 percentage points more severe than a median of economist estimates and worse than a revised drop of 1.6 per cent (previously 0.1 per cent growth) in November.
今年临近尾声之际,欧洲央行在12月3日投票削减其存款利率至负0.3%,并扩大资产购买,使量化宽松计划的规模达到1.46万亿欧元。此举出炉十几天后,美联储(Federal Reserve)自2006年以来首次提高利率,突显大西洋两岸正在推行的货币政策截然不同。
1.Nepal
It was therapeutic for Warriors fans after enduring the agony of the worst collapse in Finals history the year before, but even then, the whole thing felt like "yup, this is what's supposed to happen." There was very little drama, very little debate, and in the end, the result everyone was sure of happened. That doesn't generate a lot of conversation or interest. It just kind of is what it is.

Footnotes

  • 半年LED企业两成亏损 浙江亏损企业最多
  • Russian and English fans may have dominated headlines during this month's Euro 2016 football championships for their boorish, thuggish behavior.

单词compromise 联想记忆:
How do you feel about workingwith Ei Aoki again in Aldnoah?
China’s largest online peer-to-peer lender, Lufax, is seeking $1bn in new funding at a valuation of $15bn-$20bn, as growth continues to surge across the internet finance sector.
女学员开始攻读EMBA课程的年龄(36岁)较男性年轻两岁左右,但高级职位上的男女比例基本平衡,担任较初级职位的女性略多一些——26%的女学员担任专业职位,男学员的这一比例为24%。
这种成功的感觉本身也可以带来一种身份认同。
In that meeting, he told Jacobs that such problems would decrease, as China is reforming its management system in science and technology, according to a statement by the association on Friday.

建材行业数据点评:需求端显企稳供给端改革需亟待加速

References

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