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Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 个人信息泄露频发 凸显企业数据安全短板 (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

深圳今年将新增人才房安居房公租房11万余套

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.

据国际足联秘书长杰罗姆·瓦尔克说,贝老爷子的1950年版门票将在苏黎世的一家博物馆展出,展览定于2015年开放。他还说:“这版球票很稀有,我们希望博物馆能够珍藏。”
维尔德斯在周一晚上的电视辩论中呼吁荷兰将土耳其大使驱逐出境。
With very best wishes for your happiness in the New Year.
Fortunately for Honda, it benefits from a deep reservoir of customer goodwill and loyalty in the U.S., as well as a reputation for building high-quality vehicles that are rated highly by objective third parties for their low cost of ownership. The reservoir was drained somewhat by a product defect controversy resulting from airbag deployments that scattered shrapnel on its victims.
Rossi, 31, spends his days calculating the future costs of the Pentagon's pension, health and education benefits, but says his job involves more than just crunching numbers for spreadsheets. He communicates with other government agencies and brainstorms with colleagues about financial models.
剑桥大学佳奇管理学院也以优异表现结束今年,它首次出现在开放招生和定制高管教育榜单上,而且在MBA榜单上的排名上升3位,在EMBA榜单上的排名上升12位。
没有比5个月前林赛·罗韩贴子中的麻木不仁和无动于衷更过分的了。

n. 联合,结合,交往,协会,社团,联想
本文为与《时代》杂志的合作内容。
但是,房地产经纪公司世邦魏理仕(CBRE)香港机构投资团队主管约翰?戴维斯(John Davies)说,价格下降应会让香港房地产市场变得更加可靠。“这个市场正在显示出机构投资者更了解的成熟市场的特征,”他说。
在过去的12个月里,这位22岁的T台女王兼真人秀明星赚得2200万美元,首次登顶福布斯模特收入榜。
Written instructions apparently issued by China’s tourism administration, shown to the FT by one Beijing travel agent, order agencies to cancel group tours to South Korea booked for after March 15 and add that companies not in compliance could be fined or have their licences revoked. The tourism administration was not immediately available for comment.

Footnotes

  • 特价家具定制产品不退换 商场先行赔付是噱头
  • 节目13 歌曲《嫦娥》,李玉刚 景海鹏 刘旺 刘洋

《王冠》
(传说中的中心对称!!!!)不过Illuminati的对称文已经遗失,下面的对称文是Dan Brown在写《天使与魔鬼》的时候找朋友设计的。 就《天使与魔鬼》一书描述,尽管很多人怀疑该组织的真实性,但光照派的确存在,至今如此,并且已经渗入了当今各个领域,尤其是很多共济会成员都在其中。
"The only thing she's got is the woman card," Trump said. "I'd love to see a woman president, but she's the wrong person. She's a disaster."
I may say "I'm terminating you because you didn't meet performance measures." I'm not going to say it's because you're a pain in the butt and piss people off every time you interact with them.
人类在过去50年的平均寿命比人类存在的20万年中的平均寿命要长的多。目前,人类的平均寿命是70岁,1950年的平均寿命是47岁,两者存在很大的差异。
Some 150,000 rural residents in southwest China's Tibet Autonomous Region escaped poverty last year, according to the Tibet Poverty Alleviation Office.

央行“双降”后 二手房房贷咨询量不升反跌

References

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