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警惕首付贷换“马甲”

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 河北各市均启动数字城市基础建设工作 (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

连天红雷人营销改写红木家具行情

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.

5. Sunset
Bad news for newspaper reporters: Your job has been named the worst in the U.S. for 2015, according to rankings released by job search site CareerCast.com. Two other media positions are also high on the list, along with professions that are physically taxing.
Oops. Better luck in 2015, everybody.
凯特·温斯莱特(Kate Winslet)是另一位将其最佳女演员奖杯置于洗手间的英国演员。她因在2008年一部改编自本哈德·施林克(Bernhard Schlink)的小说《生死朗读》(The Reader)的同名影片中扮演一位集中营的看守而获此殊荣。
5. Broadcaster
No Bad Manners Awards could be complete without a mention of a Kardashian, could it?
Guangdong has cemented its position as the country's largest provincial economy for the 28th consecutive year, with its gross domestic product (GDP) exceeding 7.9 trillion yuan in 2016.

日前,美国民主党候选人希拉里·克林顿承诺,如果她在总统竞选中获胜,那么她的内阁将有半数成员是女性。
But a friend saw a TV report about it and contacted the sorting office. Mr Siddeeq, 74, says he is still eager to read it, despite now being divorced。
n. 平台,站台,月台,讲台,(政党的)政纲
哈佛大学位居榜首,紧随其后的是麻省理工学院和斯坦福大学。
Apple CEO Steve Jobs poses with the new iPhone 4 during the Apple Worldwide Developers Conference in San Francisco, California in this June 7, 2010

Footnotes

  • 人民日报评论员:美国不应将世界经济拖入“衰退陷阱”
  • Sometimes Anna’s hair, which is lighter than Ms. Chastain’s natural color, is pulled back, creating layers and a bit of playfulness, but still maintaining authority.

A devastating financial crisis led business owners and corporate executives to be especially wary about adding staff or investing in new equipment. Some worry about risks from Washington or overseas. Others are seeing consumers maintain their slow-but-steady spending, providing little incentive to deploy their cash stockpiles.
玛蒂的知名度如此之高,以致于她在Topshop(服饰店)被尖叫的青少年粉丝们围堵了,小粉丝们激动地要求和偶像自拍合影,这对于玛蒂来说有点难以适应。
[spred]
Caveat Lector! Ten Predictions for 2010
我们对已经达成或者希望达成的一些区域贸易安排一直持开放态度,也乐见其成。只要是有利于贸易自由化的,我们都会去参与、去推进。
“Thutmose III was one of the most important pharaohs in Egypt’s New Kingdom and is credited with establishing the Egyptian imperial province in Canaan,” said Gabriel Barkay, the co-founder and director of the Temple Mount Sifting Project.

楼市部分回暖 上下游行业有所上涨

References

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