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前8月龙头房企增速放缓

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: “大学生八折买房” 助力武汉临空港发展 (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

学区房“折腾”记:从大房子蜗居进“鸽子笼”

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.

单词response 联想记忆:
"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
安联:小奥运会
A moment of panic followed, before the teenager decided to take matters into his own hands and find a way out.
此器于2012年由考古学家发掘出土,此后一直保存在仪征博物馆,未向对外展示。
n. 设计者
“Selling out!” “Pandering to the Americans!” The cries went up immediately when the official selection was announced. The list of directors crossing over to make films in English was a long one including the Italians Matteo Garrone and Paolo Sorrentino, Yorgos Lanthimos of Greece, Norway's Joachim Trier and even Guillaume Nicloux of France, a country whose cultural establishment is highly sensitive to the creeping Anglophone menace. The argument goes that Cannes is supposed to be a haven for world cinema; for English, there is Hollywood. But does it really matter? Films at Cannes in languages other than French or English play with subtitles in both languages – and that's a lot of text to deal with.

节目11 歌曲《我心永恒》,席琳-迪翁
The nearest star, Proxima Centauri, has a planet orbiting it not much bigger than Earth. Its "year" is only 11 days. But it's in the habitable zone because Proxima Centauri is a red dwarf star about 100 times fainter than the sun. And there's hot news that a similar star, 40 light years away, may have three planets in its habitable zone.
《风流医生俏护士》首播时,鹰眼和诱捕者这两个角色原本同等重要,也正是在这样的条件下,韦恩·罗杰斯才同意扮演诱捕者约翰。然而,当艾伦·艾尔达开始对这个角色进行改动并对整个剧情走向产生更大影响时,鹰眼使诱捕者这一角色黯然失色。
bene好,fit做-做事后的好处
我预计,将有更多公司培养懂得如何管理网络的领导人——不只是传统的内部员工网,还包括联系更松散的供应商和承包商网络,通过互联网和社交媒体进行远程管理。

Footnotes

  • 本周国常会:加大对民营经济和中小企业支持 完善普惠金融定向降准政策
  • It is the first time in five years that a single programme broke into the top five, so strong was the hold of the main five global EMBAs.

吉尔伯特说:“我们很容易看到,在当下的市场中,领头羊们都处在相当脆弱危险的地位。看看他们在每款新设备上做出创新的速度,我们可以很明显地发现这一点。”
之后,女孩回头并踮起脚尖轻轻亲吻了男子的脸颊,旁边的人群顿时高声欢呼起来。
我们总会不断地去思考着NBA一个赛季接着一个赛季的时间流逝,原因也很明显。在流逝的过程中,每一项事物都是有联系的,整个过程就是一个连续体。这就是我们记住在一个赛季当中所发生事情的方式。当我们翻看日历,从1月1日到12月31日,回顾一下我们在这个过程中学到了什么,对我们来说是很有好处的。而且,很多人说NBA赛季的“非正式开端”是圣诞节,也正是因为新年很快就要开始了。下面是我们在2017年里所学到的关于nba的经验教训。
cheerfulness
Neighborhoods
Fidget Spinner

全国百城楼价涨幅无锡居首 二线城市成上涨主力

References

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