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抑制房租病态上涨需多措并举

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 家居卖场无条件退货藏“猫腻” (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

绿色建材满天飞 装修市场多李鬼

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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Aaron Hernandez
居民消费价格涨幅3%左右;
2. 在原来工作岗位上呆太久了
数百所国内高校的2017届、2015届和2013届毕业生、共281万人参与了这项调查。
我是否有从一天当中能抽出时间来给自己?我们都需要一点“自我时间”。每天留出一些时间放松一下,做你喜欢做的事情——阅读、冥想、看电视、烹饪、跟你爱的人共享黄金时光等等。
fatigue

On the occasion of the New Year, may my wife and I extend to you and yours our warmest greetings, wishing you a happy New Year, your career greater success and your family happiness.
这张专辑贯穿了新浪潮音乐、电子舞曲和流行舞曲,是清新悦耳又充满乐趣的流行音乐珍品。
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While not a low rating when compared to the other four dramas, it was still criticized by many audience members.
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Footnotes

  • 涂料企业化压力为动力 “链条合作”是关键
  • ……声称自己之所以迟到是因为迷路了,但我们的接待员却说她刚刚看到这位求职者在咖啡店里玩。

Best Car Brand: Mazda
物理学界这一开拓性的发现已经点燃科学研究的星星之火,而他们的这项研究发展为前沿科技,也不过是时间早晚的事罢了,就像100年前我们无法想象今天的激光和电脑芯片那样,美国物理学会候选会长劳拉?H?格林在接受《纽约时报》采访时表示。
Chinese industrial profits slumped by a record 8 per cent last month, as Beijing’s targeted stimulus efforts failed to arrest a slowdown in the key driver of China’s economy.
大小:5003平方英尺(约465平方米)
This year's new college grads entering the workforce are being offered an average monthly salary of 4,014 yuan ($582), and about one-third of them chose to work in first-tier cities, according to survey results released by zhaopin.com, a Chinese online recruitment service provider.
rough

家居电商化须探“特色”之路

References

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