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绿色建材成行业新宠 需加快标准认证体系建设

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 租房淡季 成交量却涨了 (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

深圳市将建立海域使用权出让制度

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.

近几年,得益于世界日新月异,就像保护异性夫妻一样, LGBT群体(女同性恋、男同性恋、双性恋、跨性别人士)也会得到同样的权利保障。事实上,如今60%的美国人承认同性婚姻的合法性,如果你问那剩余的40%呢?我们可以告诉你美国的其他地方以及世界的其他地方,例如俄罗斯,很快都会赶上脚步。
当城市规划部门明年初(2015年——译注)提出初步的建议方案时,布鲁克林的东纽约(East New York)地区将被列为试点。随后,重新区划进程就将在该处全市最穷社区之一内展开。而紧随其后的,将是针对皇后区的西法拉盛(Flushing)的提案。
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根据人社部、财政部近日联合下发的通知,企业和机关事业单位退休人员的月均养老金将在2016年的基础上上调约5.5%。
They say that it is especially risky to use the same password for entertainment sites as for email and social networking accounts.
The education sector has remained largely unchanged by online service delivery — but could be transformed dramatically in 2018.
室内环境:这栋砖砌结构、灰泥粉饰并铺着瓷砖屋顶的两层楼房屋由Dorr & Dorr公司设计,于1916年完工,近15年内曾经翻修。该房屋采用了半牧场、半工匠艺术的设计风格,运用了简洁的线条、开敞式空间、典雅的木制品和彩色玻璃等设计。翻修工程由明尼阿波利斯市Sala建筑公司的约瑟夫·麦茨勒(Joseph Metzler)完成。

在20世纪90年代,罗斯把它应用到如何把美国医学生分配到医院。他开发了一种新的算法被全国驻地医师匹配程序所采用,这有助于把驻院医师分配到合适的医院。
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Politics also color perceptions of the weather, the survey found. More than three-quarters of Democrats and six in 10 independents believe that the weather has become more extreme over the last few years, while less than half of Republicans say they have perceived such a shift.
喜剧类最佳男演员:杰佛里?塔博(Jeffrey Tambor),《透明家庭》(Transparent)
They say that it is especially risky to use the same password for entertainment sites as for email and social networking accounts.

Footnotes

  • 一个房产中介的自白:高息贷款业务存在即合理
  • HSBC said its private reading of China's manufacturing sector was stagnant last month, confirming a "flash" estimate already published.

最近几个月,大宗商品相关行业受到的冲击尤为严重。采矿业全年利润下降23%。石油和石化炼制企业的利润也出现下滑。尽管油价下跌,但很多炼厂仍要接受在油价暴跌之前签订的协议价格,而它们的出厂价格在下跌。
One of the more notorious incidents was when Zhu Ling, a student at the prestigious Tsinghua University, was paralyzed when her roommate allegedly poisoned her with thallium in 1994.
Wishing you a sparkling New Year and bright happy New Year! May the season bring much pleasure to you.愿你的新年光彩夺目,愿你的新年灿烂辉煌!佳节快乐!
福布斯杂志称,26岁的劳伦斯能排名榜首,大部分得益于从《饥饿游戏》系列影片的最后一部中分得的收入,以及从她参与拍摄的即将上映的太空探险影片《乘客》中所得的一大笔预付费。
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The value created by the service sector rose to 51.6 percent of GDP.

法拉第未来:获美国政府审批 FF完成20亿美元首轮融资

References

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