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富安娜家居2015年营收21亿 净利润4.36亿

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 北京西城区居民院腾退不需要全部户主同意 (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

规范民宿应多一些“网约”思维

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.

May the coming New Year bring you joy, love and peace.
Mr Cook’s lack of showmanship has not always been seen as an asset.
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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.
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单词qualified 联想记忆:
Paris (AFP) - Some 1,400 people living in France have either joined the jihadist cause in Syria and Iraq or are planning to do so, Prime Minister Manuel Valls said Monday.
这就真相了,我同意。
现在是时候制订新年旅游计划了!有“背包客圣经”之称的《孤独星球》于近日向寻找地美价廉好去处的人们推荐了2017年性价比最高的旅游胜地清单。让我们一起来看看吧。
“还有人在视频会议上宣布辞职。”

Footnotes

  • (两会受权发布)李克强谈2019年经济社会发展总体要求
  • 联合国下属的国际农业发展基金会(IFAD)上周三表示,2016年,约有2亿名打工人员--其中一半是女性--向他们在亚洲、拉美和非洲的家人汇款4450亿美元。

据BT下载网站TorrentFreak数据显示,《权力的游戏》每集平均下载人数有590万。这个数字还不包括在线视频和cyberlocker的下载方式,如果算上这种方式,数据将会更高。而《权力的游戏》每一集的平均收视人数才550万。
但煽动家利用此类抱怨的做法威胁到了民主。
在谷歌和苹果之后的品牌包括亚马逊以及微软公司等。
In a vote by Sina Weibo,China's Twitter-like website, 58.5 percent of people "liked" the ink painting version of the monkey, only 14.4 percent like the front view of the 3D version, while 12.5 percent want to "change its clothes", supposedly meaning they don't like the colors.
布雷克·格里芬的高中样子和现在相差不大。只要在高中版的格里芬上加一些头发,再增大他的肌肉,就变成了如今的格里芬。
Loyal employees of this auto services company are rewarded on their 10th anniversary -- and every five years after --with a weekend getaway at a resort in Boca Raton, Fla. (The company is headquartered just 15 minutes away.)

4月建材家居景气指数破百 环比上升10.95点

References

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