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Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 知识产权保护助力家居市场更好发展 (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

“扩张有风险” 橱柜企业不能“玩心跳”

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.

Iron Man 3 is the highest-grossing movie of 2013 so far with $1.2 billion. But that’s not enough to put its star, Robert Downey Jr., on top of our list of the top-grossing actors. Dwayne “The Rock” Johnson beat him this year by working more.
“These students have absolutely no free speech rights that were violated in this context."
Agricultural raw materials, especially the so called soft commodities such as sugar, coffee and cotton, have been among the top performers this year.
不过,人们并没有对周二的峰会寄予过高期望,因为没有任何迹象表明,各国能在政治上实现突破,进而采取更有力的举措。科学家表示,要想如愿把全球变暖控制在各国五年前一致同意的上限,那么未来几年里,就必须扭转排放量上升的势头。现有的所有方案,与实现这一目标都相距甚远。
凡是这家汽车服务公司的忠实员工在效力满10年后,都可获得一份奖励:在佛罗里达州波卡拉顿的一处度假胜地欢度周末(此地距该公司总部仅15分钟车程)。这项福利此后每5年都可以享受一次。
如今,中国对西方经济体的投资重回正轨,有望在今年再度刷新纪录:今年头六周,中资集团就宣布了700亿美元的潜在交易,尽管这个数字是非常初步的,并不是所有收购最终都能完成。
去年,中国工商银行的每股盈利为0.77元人民币,低于上一年的0.78元人民币,税前每股分红为0.2333元人民币,低于上一年的0.2554元人民币。

A hilarious video showed the swaying crowds singing Can’t Take My Eyes Off You and Hey Baby to the laughing young woman in Bordeaux.
Wang studied computer programming while growing up in China. After college, she hoped to move to the U.S. to start her career. The next year, the Chinese Students Protection Act was passed and Wang got her master's in computer science at University of Houston. She worked at several Silicon Valley startups (and launched her own, iBizWomen.com) until September 11, 2001. The attack inspired her to create Binary Group, a technology consulting company that works with the Federal Government. Over the past 16 years, Binary has helped its clients save piles of money -- like the Army 20th Support Command, which cut $60 million over five years for its satellite communication bandwidth requirements.
Zhou Qunfei from Lens Technology, the major touchscreen maker, ranks third on the list with a net worth of 45 billion yuan.
Five programmes feature in the pre-experience ranking for the first time. The highest new entrant is Lee Kong Chian School of Business at Singapore Management University. The school came second in terms of the international mobility of its graduates, and is the first school to feature in both pre-experience and post-experience rankings.
中国厂商:中国汽车进军美国?巴菲特持股的比亚迪汽车公司称,它将于2015年登陆美国市场,吉利汽车也将于2016年进入美国市场。不过自2006年起,我们就一直在听说中国车企要登陆美国。中国汽车最大的硬伤是做工问题。中国有80多家汽车厂商,生产的车型多达524款,研发资金铺得太开,太单薄,以至于很难获得有意义的业绩。

Footnotes

  • 杭州发文规范商品房销售:现场须公示地下车位价格
  • Splashdata's list shows that many people use easily guessable passwords. Some other passwords in the Top Ten include "qwerty," "abc123," "111111," and "iloveyou."

However the prolonged period of contraction fits with the overall pattern of the slowing Chinese economy.
facilitate
This umbrella protects your dogs from the sun and rain.
leakage
Best chances: A best film nomination looks certain. Darkest Hour's Gary Oldman is the favorite for best actor, but if anyone can beat him it's probably Chalamet.
4、慧眼识香。邦德眼光敏锐,能辨认出孰敌孰友。这种品质常见于性开放者。007很容易识出对他有意的女人,有科学证明,帅哥往往擅长于此。

随着门窗行业的发展,电动门企业能否搭上“便车”

References

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