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中央经济工作会议:解决好婴幼儿照护和儿童早期教育服务问题

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 绿建无忧之旅│走进济南 共绘绿建蓝图 构建无忧生活 (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

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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.

你有翻白眼的习惯吗?握手时有气无力?不爱进行眼神交流?这些可谓是职业杀手。人们必须意识到行动大于言语,大部分的沟通是通过非语言暗示完成的。你的一些非语言习惯可能会被认为是不礼貌的,不专业的—而这些最终会严重影响你的职业发展。
无论从哪个角度看,2014年都是本田汽车公司宁愿忘却或掩盖的一年,看看本田为2015年提出的宏大口号——“本田之年”就知道了。
农村贫困人口减少1240万;
支持两国之间双向旅游的最新倡议包括以下几点:审查10年旅游签证;安排开放的航空市场服务以消除双方航空公司的所有容量限制;Qantas航空公司于1月推出北京到悉尼的新服务等。
"Pandas used to be really difficult to breed in captivity, but the Chengdu base and other zoos around the world have cracked the problem and now there are around 400 in captivity," Mr Marven said.
在香港最繁忙地带之一湾仔(Wan Chai)的中心,坐落着一幢30多层的写字楼。今年早些时候,这幢大楼的易手使其成为世界最贵楼市香港的第二贵地产项目。
中国社会科学院近日发布的《中国社会心态研究报告(2016)》显示,一线城市居民生活压力较大,不过小城市也未必是宜居地。

Influenced by the current economic situation, and resource relocation in China's financial market, the banking industry is away from the high-speed growth period, the expert added.
2005年初,斯通和其联合创始人爱丽莎卡玛赫特和朱瑞德斯贾丁斯发现,使用博客的女性规模庞大,但主流媒体却很少会引用她们的文章。于是,三人决定召开一次草根会议,并吸引了谷歌和雅虎(Yahoo)等赞助商。门票很快销售一空,不久,她们便成立了BlogHer.com。这个博客发布平台把撰写博客变成了许多女性可以用来赚钱的一项业务——2009年至2012年期间,这家公司向5,000名博主支付了超过2,500万美元。目前,这个平台的用户已经超过9,200万人。
Makers of processed food, soda and fast food see markets in the developing world as their greatest growth opportunities. At the same time, obesity rates and weight-related illnesses are on the rise in developing countries. An ongoing series of articles examined the interaction of these two trends, starting with cases in Brazil, Ghana and Colombia. Taken together, these stories reveal “a new global food order, and a new health crisis.”
英国大选就是个教训。民调也不过是戛纳的“外卖餐点”:预测是傻瓜才干的事。一整周,坊间盛传托德?海因斯的女同性恋恋爱故事《卡罗尔》将斩获金棕榈最佳影片奖,或者拉斯洛?杰莱斯László Nemes 处女作《索尔的儿子》Son of Saul将折桂。最后几天,共识则是来自台湾的导演侯孝贤(Hou Hsiao-Hsien)指导的《刺客聂隐娘》(The Assassin)将问鼎大奖。且据英国博彩分析,《龙虾》是个难缠的对手。但是,最终宣布雅克?欧迪亚Jacques Audiard's 《流浪的迪潘》Dheepan获奖时,大家一致惊讶表示:“真的吗?”所有的评论员、影评人小组、内部八卦、数据统计、上帝都知道,只是少有人提及罢了。好吧,这就是生活。
白意味着属于一个外表、传统、宗教乃至食物都符合默认常规的群体。按照不言而喻的规则,白人意味着是一个长期被称作是“我们”,而不是“他们”中的一份子的人。

Footnotes

  • 7月份上海房屋租赁市场需求旺盛 量价同步上扬
  • 居民消费价格指数(CPI)继续从8月份的低点反弹,10月份,CPI同比上涨2.1%,涨幅比上月扩大0.2个百分点,并与分析师的预期中值相符。

The Cassini spacecraft has been sending home images of Saturn, its rings and its moons since arriving at the gas giant in 2004. The mission ended in September with a planned fiery crash into Saturn’s atmosphere. While it studied the planet, Cassini explored moons — Titan and Enceladus — that could be home to extraterrestrial life. The probe also gave us great insight into our solar system, and will continue to do so for years as scientists pore over the data it collected.
So ladies, we have been warned. What would your response be?
This is all bad news for investors, just as America's 30-year bond bull is ending.
这是充满希望的春天,也是令人绝望的寒冬……
首先,正如咨询与培训机构RedPrairie公司的供应链专家汤姆?科赞斯基所言,一提到物流行业,多数人都觉得它“没有吸引力”,是一项乏味且薪水不高的仓储工作。
The capital plans to move most of its municipal departments to the suburban district of Tongzhou in 2017, the Beijing Municipal Committee announced on Wednesday.

新政后长沙频现 秒光盘购房指标被炒至10万

References

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