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Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 家电行业首个七星服务标准出台 (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

家居业已成买方市场 行业营销需“组合拳”出击

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.

3.3 进一步释放国内需求潜力
Sylvan Esso “Coffee” (Partisan)
As well as dancing, she has her eye on singing and acting - she has already acted in the TV shows Drop Dead Diva and Austin & Ally.
But the 3D version of the mascot image failed to dodge bullets, as critical netizens sneered at this version: "Reminds me of green and red lights." "Lost all the flair of that ink painting" "What are those balls under its ears?" "It is so ugly that I just want to cry."
待售房产:一栋带有三间卧室和三间半浴室的河滨当代住宅
豆瓣网友“Weishenmeyaoxuefa”称:“这部剧中的武术场景很抢眼,演员们表演的是真功夫。”
The list also has some movies that earned awards at the 67th Berlin International Film Festival in February, such as the best movie winner On Body and Soul and best director winner The Other Side of Hope, by Aki Kaurismaki of Finland.

He then pressed all the buttons in the hope to get the elevator to work again, but to no avail. Sun then punched the "stop" button, to lock the elevator and secure it won't move.
n. 码,密码,法规,准则
同时,11月服务业PMI指数是51.2。此前的10月份该指数为52。本周早些时候报出的11月份制造业PMI指数为48.6,高于48.3的预期。10月份该指数则为48.3。
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n. 奇思妙想,一段楼

Footnotes

  • 上半年东莞出口木家具6.93万批次 出口额增长15.42%
  • 艾伦·狄珍妮丝:

By March, there's a real chance two or three of these prospects stick out as franchise players.
iPhone X
Given that every single Wall Street economist had called for higher rates at the start of this year and 67 of 67 economists surveyed by Bloomberg concurred, the rate-sensitive utilities industry would have been the last sector a rational person would want to overweight. Bets on the financial sector were slow to pay off while wagers on “cheap” energy stocks demolished portfolio performance in the third and fourth quarters, just as they had elevated it during the first and second.
7. Flying Lotus “You’re Dead” (Warp) The new fusion makes no apologies for the old fusion, just a series of upgrades. As a producer, Flying Lotus values continuity as much as disruption, hazy beauty as well as jump-cut clamor. His suitelike reflection on death leaves room for irreverent wit — and, on “Never Catch Me,” one of the year’s best verses by Kendrick Lamar.
Believe it or not, this prize went to the US Government General Accountability Office (GAO) for issuing a report that recommended a report about another report of reports recommending reports... or something like that.
"I'm excited about the opportunity to return to China, enjoy the country's culture, and bring the excitement of live NBA games directly to Chinese fans," he added.

北京10住房租赁企业承诺不涨房租

References

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