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国家税务总局召开个人所得税改革动员部署会议

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 张家口家居市场“外在”热闹难掩“实质”低迷 (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

一二手房价格倒挂 长沙楼市库存真的告急?

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.

adj. 保守的,守旧的
n.
No one since Michael Haneke has enjoyed cinematically dissecting social conventions as much as Greek film-maker Yorgos Lanthimos. His The Lobster took Cannes by storm two years ago with its scathing look at a society that turns adults into animals if they cannot find a romantic partner within 45 days – it was our world but pushed toward the outermost limits of groupthink and conformity. Now he’s back with The Killing of a Sacred Deer, a domestic thriller about a surgeon (Colin Farrell) and his wife (Nicole Kidman), also a doctor, who befriends a fatherless teen named Martin. The boy seems determined to expose the family’s secrets and unmask a terrible trauma from their past. Is this film about how domestic (and perhaps societal) tranquility sometimes depends on shared, agreed-upon lies? Either way, prepare to be unnerved. Released November 9 in Denmark, November 16 in Russia and November 30 in China's Hong Kong. (Credit: A24)
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LeBron is invulnerable to age
LEAST LADYLIKE

THE NIGHTLY SHOW WITH LARRY WILMORE (Comedy Central, Jan. 19) Mr. Wilmore’s topical comedy show replaces “The Colbert Report” at 11:30 p.m. and represents the latest opportunity to introduce some diversity to late-night programming. No pressure there!
有史以来第1个真正有用的机器宠物
6. 谷歌搜索广告关键词规划工具
曾发明Chapul蟋蟀蛋白棒的创业家帕特o克劳雷通过Bigcommerce来验证产品的早期市场兴趣,积攒市场人气,并且与健康食品商店和超市协商达成交易。虽然该团队有机会能以低得多的价格转至Shopify平台,但最近选择又一次与Bigcommerce续签。“我们认为,短期内我们的增长速度不会超过Bigcommerce,”他说。
Investors have noticed Honda’s troubles. The automaker was one of the very few worldwide to avoid deep losses during the global financial crisis. Still, its common shares are down 17.2% over the past year, while the Nikkei 225 Index is up 7.4% and Toyota Motor shares are up 19.5%.

Footnotes

  • 国家发改委:五年内增加百万养老床位
  • 单词discourse 联想记忆:

Honestly if you want to laugh your way through a Netflix original movie, please just watch The Incredible Jessica James because it's a delightful romantic comedy that blows everything else out of the water.
May the glow of New Year candle fill your heart with peace and pleasure and make your New Year bright.Have a love filled New Year!愿新年的烛光带给你祥和与喜悦,祝你新年充满爱。
为了让世界都关注濒危物种和中国成都大熊猫基地,演出者们全力表演,节目精彩令人难以忘怀。他们不仅给伦敦市民带去了乐趣,还与基地大使、自然主义者奈杰尔-马文一同去学校向孩子们宣扬熊猫保护的理念。
(实际上,在过去三年的节日假期里,捷蓝航空公司绝对不是航班起飞延误最糟糕的航空公司。这项殊荣要授予Comair公司,这是达美航空公司经营地区航线的公司。不过该公司在2012年假日季节开始前停业,因此我们没有让这家公司上榜。)
Best of luck in the year to come.愿你在未来的一年里,吉星高照。
Someone might tell you to ‘Be yourself' in the interview. Don't be yourself. That's the worst advice ever. We don't want people who are neurotic and quirky and whatever else. All we care about is your skill and experience.

西宁跻身营商环境上升最快榜单前十

References

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