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Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 定制家具 O2O模式迎合消费习惯 (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

价格高销量差 进口建材遭遇信任危机

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.

They also arrived 40 minutes late for the official welcome and were running late to an event in Vancouver, too.
6. Now, like an addict who can't stop, Gross writes in his Tipping Point blog that QE will run to 2015. Earlier it seemed like the Bubble With No Name Yet should be renamed the Bernanke Bubble. But now, with Gross and Pimco's $2 trillion at stake here, maybe we should call it The Gross Bubble.
Canada, the second largest country in the world in terms of landmass, ranks No. 2 overall. It takes top spots in Quality of Life and Best Countries for Education.
But the declines continued, and now it’s all over, red rover.
现今和未来的科技都基于多重技术,而每一种技术都在发生着改变、并和其他技术交互。这让我们的科技产品,像是互联网的东西、电话、笔记本等等变得不稳定,这同时也让消费者感到厌恶。就说说你们手机里的应用,有多少你是真正在用的?又有多少真正能让你的生活变简单、变快捷、变得更有趣?我认为消费者对此的嘲讽情绪会上升,科技带给他们的愉悦感会被失望所取代。这会给硬件和软件的开发者造成压力,从而让他们追求最无趣的产品品质:稳定性。
综合考虑,这些事实与战略规划凸显了中国航天工业的认知——为了成为有竞争力的全球飞机制造商,中国需要拓宽行业的广度与深度。在他们掌握了价值链的两端——飞机设计与集成组装后,中国意识到长期处于价值链中游的组装和子系统地位将摧毁他们的航空业。这就是为什么中国雄心勃勃地与波音、空客等飞机制造商以及美国通用电气公司、劳斯莱斯等发动制造商竞争,形式前所未有地激烈。
成功的CEO都保持着都极有规律的生活,他们每天早起,锻炼身体,身边会放一些点心补充能量,每周拿出几个晚上进行社交。

工作经历
12. Zoho CRM
相比之下,十年前名列榜单前20的城市中有6个亚洲城市、10个欧洲城市和4个美国城市。这项调查计算了93个国家的131个城市的生活成本,研究结果用于企业计算转移员工的成本。
The show’s sense of humor remains keen without relying on nudity, swearing and sexting. This gives the show a refreshing aura in an age where shows are constantly trying to push the envelope in terms of racy content.
最近,无人驾驶汽车的新闻屡见报端,它也叫做自动驾驶汽车。谷歌的自动驾驶汽车是此行业的领头羊,已行驶48万千米(30万英里),仅发生过两次交通事故,还都是人为因素造成的。事实上,无人驾驶汽车并不是新奇事物,早在达·芬奇发明以弹簧发条作驱动带内置预设程序的马车时,自动驾驶的概念便名噪一时。

Footnotes

  • 京别墅成交创30个月新高 800万以内成“香饽饽”
  • 该网站声称,“越喝,你(和酒瓶)就越聪明,但实际上你喝得越多,你就越醉,脑海中保留的信息也更少。

就在整场比赛即将结束时,荷兰队射入一球再次追平比分,双方进入加时赛。最终中国队射入第三球,赢得2013年机器人世界杯足球比赛冠军。
Celebrity Latin tattoos may be fuelling a revival of the ancient language in schools, it emerged today。  明星们的拉丁语纹身引发了一阵学习拉丁语的热潮。
After the success of The Conjuring, Ed Warren and Lorraine Warren are back to kick some ghost butts. Conjuring 2 is based on the Enfield Poltergeist, which is apparently a true event that took place in London in 1977.
adj. 不稳定的,易变的
For the first time in six years, a new challenger has topped the FT’s ranking of executive MBA programmes.
中国富豪的账面财富突然暴涨,乃至此前不为人知的大亨一跃成名,都不是什么稀罕事,在股市上市和其他公开投资会将他们一下子推到聚光灯下。

热门区域哑火 三四线城楼市不会“雨露均沾”

References

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