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Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 乌金木家具:价格悬殊背后的质量秘密 (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

12月南京只发了9张新房预售证 只及11月“零头”

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.

During the RoboCup 2500 contestants from 40 countries competed in 15 competitions with various types of computerized soccer robots, healthcare robots, rescue robots and dance robots.
n. 史诗,叙事诗 adj. 史诗的,叙事诗的,宏大的,
Housing started last year on a high note. It ended the year facing mounting worries about higher interest rates, supply constraints, tight credit and a host of other problems.
“我还给了他一个直言不讳的同性恋朋友,他会责备邦德,说:‘拜托,邦德,你是生活在20世纪,不是中世纪。’”
An ancient Egyptian amulet was uncovered in Jerusalem by a young girl taking part in a family dig in the capital.
When M·A·S·H first aired, the characters of Hawkeye and Trapper were meant to be equally sized roles. It was with that understanding that Wayne Rogers agreed to take the role of Trapper John. However, as Alan Alda began to make changes to the characters and have more influence on the direction of the show, Hawkeye began to seriously eclipse Trapper.
The China International Robot Industry Summit, held on Tuesday in Shanghai, said the sales and growth rate of industrial robots hit records in 2017. Among industrial robots, 37,825 were domestically manufactured, up 29.8% year-on-year.

在开放课程排行榜中,基于对参加课程高管的调查,瑞士洛桑国际管理发展学院在最重要的10项指标上得分特别高。该校在3项指标上排第一,在其他7项指标上都排前五。
这位备受欢迎的英国女孩莉莉·唐纳森曾担任过“Vogue”这类时尚杂志的封面女郎,她展示了自己性感迷人的夏装,身着一件白色半透明的抹胸连衣裙参加了此次活动。这位三十岁的模特穿着一件近乎透明的礼服,看上去漂亮极了。
尽管与普通的开瓶器并无二致,但它拥有精良的设计,是由不锈钢和实木制成的。
We will boost the development of modern agriculture.
单词manifesto 联想记忆:

Footnotes

  • 港股收盘:恒指涨逾1% 农业、资源领涨 地产超百股收涨
  • 5.Effective decision makers

stir
根据美国海洋和大气管理局的数据,美国本土今年1月至11月的气温是有史以来每年前11个月的最高记录。2012年还将超过1998年,成为美国有记录以来最热的一年。
The block chain has such rich potential that there is an initiative underway to create additional “side chains,” though there is controversy around that idea. “We don’t really want to mess with the main block chain right now,” says Adam Ludwin, CEO of Chain, a block chain API that makes it easier to create bitcoin applications. “It works, we don’t want to break it.”
The committee *bestowed the award upon Yoshinori Ohsumi of the Tokyo Institute of Technology, for his research on *autophagy, which is a self-eating process seen in cells.
In fact, one ancient saying was, "ifyou have Kucha, only one percent of the states in the Western Frontiers remain unsubmissive."
或许你会认为这个60%并不起眼,但它是很重要的一步,因为在2003年,同性婚姻在美国的任何地方都是不合法的。

“楼市去库存”2016年地方或有八大去库存底牌

References

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