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惠州首个棚户区改造项目召开听证会

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 中美贸易战升级建材业吃亏 (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

北京严查在售商品房项目 哄抬房价等成为检查重点

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.

Another common path to job loss is the habitual obsession that many employees have with social media. Some companies have taken measures to monitor or limit their employees’ social media use, while others have blocked these sites completely. So beware: spending too much time on social media or other websites not related to your work can cost you your job.
Whiteness means being part of the group whose appearance, traditions, religion and even food are the default norm. It’s being a person who, by unspoken rules, was long entitled as part of “us” instead of “them.”
For decades, the language of white identity has only existed in the context of white supremacy. When that became taboo, it left white identity politics without a vocabulary.
GM is addicted to hefty sales incentives to move the cars and new CEO Ed Whitacre knows it. In 2010, he will slash incentives and end up abandoning GM's 20% U.S. market share target to find profitability. The search will prove elusive.
在过去的20年里,日本有些城市的生活成本达到过世界最高,但现在正在降低。东京和大阪分别降低了11名和14名。
“授课的是一流从业者,”该学院一名毕业生表示,“该项目为只有极少金融业工作经验的年轻专业人士量身打造,学生们毕业后马上就能投入工作。”
我国火车票购票官网12306网站已成为世界最大火车票购票网站,2017年该网站交易总量达35亿张车票。

To wish you joy at this holy season. Wishing every happiness will always be with you.
除了《地心引力》和《美国骗局》,我还选出了其他一些口碑不错的影片(按字母顺序排列):
007系列电影主题曲第二名:蒂娜·特纳--《黄金眼》
Everything Else
Job history

Footnotes

  • “红五月”开局 各地楼市销售现分化
  • slice

"Demolitions are now becoming increasingly terrible. I am willing to ask a question very seriously as a CPPCC National Committee member: Can we not pay so much attention to GDP? Can we choose to slow down the speed of economic development?" CUI YONGYUAN, member of the CPPCC National Committee and TV host
All but one of the other top 10 categories reflected public fascination with celebrities. Teen pop sensation Miley Cyrus was in third place in the search rankings and television personality Kim Kardashianwas not far behind at fourth place. They were followed by Lady Gaga at No. 5, actress Megan Fox in seventh place, with Justin Bieber, American Idol and Britney Spears completing the top 10. The iPhone stood out as the exception, coming in sixth.
adj. 年长的,高级的,资深的,地位较高的
随着经济增长放缓,中国政策制定者对银行放贷速度越来越担心。中国银行业监管机构的数据显示,去年中国银行业资产规模增加了逾72万亿元人民币(合11万亿美元)。
Fair enough. Let's put the Kings in the “maybe” file. I'll drop the Nuggets in there, as well, as they are in basically the same place as a franchise, give or take some dysfunctional elements. The Wizards have to go in there, too, much as I am down on them at the moment.
It makes piggybacks more comfortable.

李克强:过去一年扎实打好三大攻坚战 重点任务取得积极进展

References

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