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上海家居流通、网络零售领域将建市场信用平台

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 楼市导师助推行情?这其实是一群“隐形”中介 (Published 14 August 2020) Cite this as: BMJ 2020;370:m3181

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  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

2019年重庆市级重大项目名单确定 总投资2.2万亿

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.

这是第一首真正意义上的007系列电影主题曲(再说一次,詹姆斯·邦德前两部电影开场只使用了管弦乐),至今仍然是最好的一首。雪莉·巴赛得到了唱出自己心声的机会,她很乐意接下这个挑战。这首歌增添了《金手指》中反派人物奥里克的危险性(还有吸引力),但这仅仅只是雪莉·巴赛歌曲魔力的一部分。詹姆斯·邦德傲慢自大、英雄主义、诱惑人心、虚幻迷离,但谁在乎啊?这首歌就是为詹姆斯·邦德所作,歌词充满男子气概,歌手的演唱简直完美。
9.We here in the UK want nothing more than to provide you, our guests, with a fantastic experience this summer, combining the best in international sport, brilliant facilities, fantastic entertainment and a cultural legacy that draws on centuries of excellence in art and architecture. If you ended up with four tickets for the wrestling at the ExCel Centre, well, better luck next time.
金发女郎乐队《花粉传播者》
I expect more companies to develop leaders who know how to manage networks — not just the traditional internal network of employees, but more loosely connected webs of suppliers and contractors, managed remotely via the internet and social media.
这也是短信应用独有的棘手问题。在消费内容时,我们希望广告乖乖待在一边。没人想在聊天时突然有条广告蹦出来。雷表示:“人们在聊天时最不想看到的就是打断对话的广告条或弹出式广告。可能这在非个人的网络上还管用,但在短信中,人们最恼火的就是看到传统广告。”
Tsinghua University holds the No. 1 spot in both computer science and engineering. The Chinese institution overtook MIT for the top computer science rank this year.
Meanwhile, the University of Bradford School of Management and the University of Edinburgh Business School each climb 16 places, to 42nd and 55th, respectively. Judge Business School at the University of Cambridge rises 15 places to 14th.

最佳喜剧类导演:吉尔?苏洛威(Jill Soloway),《透明家庭》,“地上的人” (Transparent, "Man on the Land")
6.Miniature Human Brains
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9. The Chinese militarywill demand and receive vastly expanded investments in the form of advancedaircraft and ships.
Although the banks' dividend to shareholders is shrinking, it still accounted for half of the combined dividends of all public companies in China. The banks' earnings also made up 52% of the total profits reported by listed companies last year.

Footnotes

  • 民建联调查发现逾半受访者满意香港整体房屋政策
  • 对学习充满热情

A vibrant ETF market would depend on the evolution of fee-based distribution networks. Mark Talbot, managing director of Asia-Pacific at Fidelity International, says the distribution infrastructure is holding back retail demand.
Most common passwords of 2013:
n. 董事,经理,主管,指导者,导演
The overall 2018 ranking encompasses more schools than ever before – 1,250 universities located across 74 countries. This is an increase from the 1,000 schools in 65 countries included in last year's edition.
女士们、先生们,欢迎来到2016年没礼貌大奖颁奖典礼。
Pan Jiancheng, deputy head of the bureau's China Economic Monitoring and Analysis Center, said the increasing proportion of research and development expenditure to GDP indicates that the driving force of economic growth is transforming to innovation-focus from the traditional factors - exports and investment.

业内:预测2018年将是房地产销量的“小年”

References

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