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传化涂料2016全国客户峰会在杭隆重召开

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 中国三大一线城市二手房价增幅连续4个月下滑 (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

陶瓷卫浴行业潜规则揭秘

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.

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Pyongyang, which refers to Park as "human scum' has long condemned the balloon launches and in recen onths has stepped up its demands for Seoul to ban them.
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今年3月,福特以16亿美元将沃尔沃卖给中国吉利汽车,从此退出豪华汽车市场。虽然这是一个巨大损失——福特11年前购买沃尔沃这家瑞典汽车制造商花了60亿美元——但2009年福特实现了27亿美元的利润,是2005年以来首次盈利。受惠于“旧车换现金”计划(更不要说丰田的加速器问题了),今年2月福特重新占据了美国最大汽车制造商的宝座。这也是为什么福特首席执行官阿兰?穆拉里能够将目光投向国外,如印度这样的大市场,在印度推出了紧凑车型Figo。
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这项测试的答案没有对错,只要对自己诚实即可。

Comic skit “Big City Small Life”(Wang Ning, Chang Yuan and Ailun)
一些科学家说,2014年成为创下气温纪录的一年,最值得注意的一点是该年度并没有发生强大的厄尔尼诺现象,一种由于太平洋将巨大的热量输送到大气层所造成的大尺度天气模式。
根据《中国社会保险发展年度报告2015》显示,全国城镇职工与城乡居民养老保险累计结余近4万亿元。
在许多情况下,这种做法已经渐渐从政界边缘进入主流。比如说,英国的执政党保守党立场是中间偏右,它曾经推进英国脱欧,公投之后,新的保守党首相特丽莎?梅(Theresa May)表现出对白人身份政治的同情。
An industry insider said the survey indicated that China was in the process of an industrial upgrade and a high value-added service sector was on the rise. This is leading to a thriving Internet industry, which needs science and engineering professionals, and a booming finance industry, which requires finance and economics professionals.

Footnotes

  • 传统涂料企业发力“互联网+”谋转型 焕新服务迎来快速增长?
  • 2. Shanghai, China-The enormous metropolis of Shanghai—China's most populous city—has an historic urban core which sits alongside its status as a contemporary, global financial hub.

‘Jeopardy!’ This game show celebrated the 50th anniversary of its debut (broadcast on March 30, 1964), and proved it can still not only stump viewers but also surprise them. That’s not just because the host, Alex Trebek, briefly regrew a mustache after 13 clean-shaven years, but also because some contestants showed they could still rile an audience. This year, it was Arthur Chu, who introduced a blitzkrieg style of gamesmanship that provoked a cyber hate-fest. His strategy was thrilling and certainly effective: he came in second in the Tournament of Champions. (Ben Ingram, the nice guy, finished first.)
NATO’s bombing campaign began on March 24 1999 after peace talks meant to stop the persecution of ethnic Albanians in Kosovo collapsed. Targets in both Yugoslavia and Kosovo were struck—first the Serb air defense network that opposed NATO planes then a broader target array including Yugoslav army forces said to be directly involved in the persecution of Kosovars. The target list also included political-military targets inside the Yugoslav capital of Belgrade itself.
n. 离开,出发,分歧
Shortly after Cook's op-ed, the Senate voted to approve the Employment Non-Discrimination Act, which would make it illegal to discriminate against LGBT employees in the workplace. The legislation will now be sent to the House for consideration.
China's tourism officials are looking to reverse the trend of declining inbound visitors in 2014--possible, experts say, if it revamps its outdated tour packages and lowers ticket prices.
陈女士说:“所有这些搜索项综合反映了2010年的许多方面,还反映了这一年政治和技术领域的变革。”

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References

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