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房地产基建投资稳健增长 或推高三月投资数据

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 北京今年138个棚改项目公布 涉及11500户 (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

成都家居商圈 掀起体量之战

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.

medal
Yesterday, Industrial and Commercial Bank of China and Bank of China — two of the Big Four state-owned banks — both reported that full-year net profits had risen by less than 2 per cent in 2015.
Mr Baweja agrees with this conclusion, noting that both South Korea and India, another net commodity importer, are exporters of refined oil products, the dollar value of which should rise this year.
“中国银行业面临的逆风将延续很长时间,”他说。“除了盈利来源减少,它们还将不得不为坏账带来的亏损做好准备。”
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。
The ranking rates the best 100 programmes worldwide for working senior executives.
Foreigners with permanent residence enjoy the same rights as Chinese citizens, such as in investment, housing purchases and schooling, among other rights.

Promoting social development to ensure and improve the wellbeing of our people
由于新出口订单增幅与上月基本持平,新订单总量增长趋缓。但就业流失加速,投入品价格增幅收窄,企业对客户收取的价格略有回升。
The latest survey also showed the country had a narrower gap between genders in 2015. As to the structure of genders, the male-to-female ratio last year was 105.02, lower than the 2010 ratio of 105.2.
因此,他在福布斯的该榜单上排名下滑了220位,与其他19名富豪并列第544位。
4. Jennifer Aniston - $21 million

Footnotes

  • 北师大教授钟伟:一二线楼市火热 全国楼市平平
  • China's Booming Cyberstar Economy Might Hit $8.7b in 2016

……带着狗来面试。
“One employee’s parents contacted the company to let us know their son was resigning.
n. 身份,一致,特征
During your early years wasthere anything that inspired or sparked your imagination to start writing theway that you have done so far?
fare
At the end of a politically charged ceremony in which Donald Trump was the subject of frequent jokes by host Jimmy Kimmel, Warren Beatty and Faye Dunaway announced that La La Land had won. But as the producers and cast of Damien Chazelle’s modern musical were on stage giving emotional thank you speeches, they were told that Moonlight was the real winner.

山东家具产业:实现由大到强需要创新驱动

References

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