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国务院常务会议落实降低社会保险费率部署 降低失业和工伤保险费率政策再延长一年

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 朝阳区长王灏:继续增加公租房供给 (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

房产公司为方便选房人停车 竟然用白纸贴住“禁停”标志

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.

“在古代,库车的名字在中国文学中叫做龟兹,是建立在西域绿洲上的一个非常强大的城邦,研究人员写到。
A powerful earthquake struck off Japan's southern coast on May 30, prompting fears in China of a catastrophe similar to the tsunami and Fukushima nuclear power plant meltdown that followed the 2011 Japanese quake. In the end, no fatalities or major damage were reported.
2. The 2012 Ig Nobel Peace Prize
It organized two large-scale inspections last year, involving more than 5,300 batches of imported consumer goods, such as air purifiers, car brake blocks, household electrical appliances and clothes, with more than 1,500 found to be substandard, Han said.
China's expenditure on technology research and development rose 10.6% to 1.57 trillion yuan in 2016, the fastest annual growth since 2014, as the nation increases its investment in new driving forces to stabilize the economy.
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Barrymore's condition was based on the real life of Michelle Philpots, who suffered head trauma in two separate motor vehicle accidents, which left her with a 24-hour memory. Rather than using Sandler's tapes, Philpots has survived for over 23 years using Post-it notes and her (amazingly modern, from her perspective) mobile phone.

Some Brexiters and Republicans believe in the ideal of absolutely free markets.
戴假牙的角色
According to Oliver Cooke, a financial-services recruiter at Selby Jennings in New York, banks have been stressing what they call “internal mobility”, or redeploying staff from one department to another. If a bank facing sluggish conditions in debt trading, for example, can convert a trader to a risk analyst or a compliance officer, it can keep people interested — and it can save a bundle on severance.
同比来看,65个城市的房价同比上涨,5个城市房价同比下跌,
The Harry Potter star Emma Watson hold fifth position in the list of ten most beautiful women of 2015. The English actress, model, and activist, Watson took the top spot on the AskMen “Top 99 Outstanding Women 2015″ list and at number 26 on the TIME 100 list of the world's most influential people.

Footnotes

  • 楼市“银十”镀金成交创新高 高库存隐忧仍存
  • 几乎所有的创业者(93%)都将获得新技能列为自己决定读EMBA的重要或非常重要的因素。“我知道自身技能的价值,而不必‘担心’没有工作,”其中一位创业者说。

他说:“目前为止,健身追踪器还不属于这类产品。但是下一代可穿戴设备有潜力跨越这个至关重要的里程碑。”
Yet when October was taken as a whole, only Shenzhen showed a real month-on-month price fall.
设计师布莱恩-卡朋特和布兰德-霍克因为酷爱户外运动而受到启发,决定想出一种创意方式,能够随处搭吊床。
James Bond Themes 8. "You Only Live Twice" by Nancy Sinatra
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1. Bubble With No Name Yet triggers the biggest crash in 30 years

国内楼市出现区域分化 去库存压力在三四线城市

References

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