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京藏协作项目拉萨市综合交通体系规划获阶段性成果

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 南京一楼盘推出1成首付:名额有限 余款限期补齐 (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

市场发展空间巨大 企业疯狂抢食智能家居市场

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.

狄更斯在《双城记》中描写法国大革命时,距离事件发生已有近一个世纪。而我则是在今年12月就回顾盘点这一年。因此,我在此描述的某些趋势,可能将在可预见的未来继续存在,而另一些趋势则可能已经开始减弱。作为当今时代“最哗众取宠的权威人士”之一,我只要求各位在阅读这篇评论文章时记住一点:过去的业绩并不能保证将来的表现。
来自5个不同国家的5所商学院今年首次进入排行榜。新加坡李光前商学院(Lee Kong Chian School of Business)是新进入者中排名最高的,直接跃居第36位。加拿大女王大学史密斯商学院(Queen’s Smith School of Business)的排名提高最大,跃升32位至第67名。
导演贝尼特·米勒(Bennett Miller)认为卡瑞尔是饰演杜邦的合适人选,但不想让观众一眼就认出他来。他要求造型师比尔·科森(Bill Corso)改变卡瑞尔的外貌。
扎克伯格还协助成立了一个名为FWD.us的游说团体,旨在推动美国的移民和教育改革。
The stomach-churning finding is not the first to be exposed in the area. Police in Guangxi, along China's border with Vietnam, have stepped up anti-smuggling operations over the last year and have raided seven illegal food processors.
《南华早报》援引当地公安局李剑敏告诉新华社记者的消息:“整个加工车间里又腥又臭,人进去待一两分钟就受不了。”
While organizers of the show attempt to get it back on track following a string of problems obtaining visas for models and performers such as Gigi Hadid and Katy Perry, now they're also claiming that their e-mails are being intercepted by Chinese authorities.

它还体现在詹巴蒂斯塔·瓦利(Giambattista Valli)最近的秋冬时装秀上,那场时装秀中充满泡泡袖印花长款衬衫和配套裤子,以及低腰直筒女学生连衣裙;还体现在麦丝玛拉(MaxMara)向乔治·巴里斯(George Barris)1962年为玛丽莲·梦露(Marilyn Monroe)拍摄的照片致敬的系列。
[.ent?'teinm?nt]
美国品牌如Chipotle、德克萨斯仪器公司和通用动力第一次出现在了该榜单上。
Brazilian soccer fan Joedir Sancho Belmonte missed the 1950 World Cup final to stay home with his sick mother. Sixty-four years later, Belmonte exchanged his original unused ticket for three new tickets to the 2014 final.
Sorry, folks, but if you're an investor hoping America's political internecine wars will improve in the near future, just don't invest. The war between Congress with it's abysmal 10% approval rating and the president, the war between the Dems, GOP and the tea party, is going to get even worse, upsetting markets and the economy even more.

Footnotes

  • 家居电商消费今年或超2000亿元
  • 人类活动造成的这些气体及其他气体的增加,导致地球温度与前工业化时代相比,上升了大约1.5华氏度(约合0.8摄氏度),造成全球陆冰融化。海平面上升的速度似乎正在加快,热浪和暴雨天气越来越多。

补救办法: 做预算。 如果你不能估算需要多少钱才能过上令你感到舒适的生活,你就无法确切地知道为了1万美元薪水而换工作是否真的划算。在比较新、旧工作时,列出各自的优缺点,这会对你很有帮助。如果新工作只是薪水更高一点,那么你可以比较下这个工作是否要求更长的工作时间和完成更多的工作任务。请记住,调查表明:年收入在7.5万美元以内,幸福感会随着薪水的增加而增加,但是一旦薪水超过这个水平,幸福感的增加便不再明显。因此,如果你认为薪水增加到8.5万或9万美元会使你更加快乐,这时你或许应该着手解决生活中那些与金钱无关而引起的不快乐。
在弗丽达·詹尼尼(Frida Giannini)为古驰(Gucci)设计的很多时装秀上都可以看到这种理念,包括2014年秋冬的台布渐变色和A字皮裙;2013年春夏的粉色长款衬衫和褶饰女主人连衣裙;2009年春夏的披头士风格鲜艳裤套装和宽松束腰长裙。
求职者犯的错,他们:
许多管理者提到了一些极其失礼的情况。求职者:
Against: Opening so early in the year outside of awards season could hinder its chances.
赫洛维兹承认,他这样做时不得不小心翼翼,以保存这部间谍小说的首位作者伊恩·弗莱明(Ian Fleming)所创造的007的个性和态度。弗莱明于1964年逝世。

超七成受访者看跌未来房价 仅9%近期打算购房

References

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