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八成大宗“信用贷”用于购房 空手套白狼还在玩

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 东莞治理工业“二房东” (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.

James Bond is one of the few constants that movie lovers have in this crazy world of ours. We seem to know that, no matter what, a new Bond movie is always on the way.
他表示那个时候的人有另外一种浪漫,人们没有电脑,所以交流都是通过信件,这样其实更浪漫。
“Why did this happen to my daughter?” she said. “There’s been so many deaths because of the guns. I don’t know how many people have to die.”
我的核心价值观是什么?作为一个人,对你来说什么是重要的?家庭、健康、信仰、工作还是其他?确保在你的生活中,你追寻了自己最在乎的东西。
源于:metal(n 金属),因为奖牌是金属做的
7.Do not ask a policeman the best way to get to the West End or how to use an Oyster card. He wants to help, but he's from the West Midlands.
Chen Yu, vice-president of the China Association for Employment Promotion, said a startup may be meaningful, but one should not expect too much from it.

添加方式2.搜索微信号ikekenet添加即可。
Swyft works with 50 different messaging partners, including Kakao Talk, Facebook Messenger, BlackBerry Messenger, and Line. The partnerships give the 11-person company access to 2.5 billion registered users. As the strategies for monetizing messaging apps evolve, the young startup has carved out a way for brands to inject themselves into the conversation.
You might think that our love of lists could be pinned on the Ten Commandments, but Umberto Eco says otherwise. “The list is the origin of the culture,” he once said on a subject he knows well, having written a book titled “The Infinity of Lists.” And culture wants “to make infinity comprehensible” and “to create order — not always, but often,” hence Homer’s catalogs in “The Iliad” and the roll call of never-completed household chores on my fridge. “We like lists because we don’t want to die,” Mr. Eco also said, which is the best explanation of the listicle that I’ve yet read.
在讲故事的时候,历史片和故事片各有所长,不过,时不时也会出现无法归入其中任何一类的电影。这些故事十分离奇,但字里行间又透着现实。这些电影非常有趣,观众却常常完全不知道,他们正在看的情节真的发生过。好啦,别猜了!读下去,你就能认识几个好莱坞的古怪剧本,都是受到狗血现实生活的启发。
尽管中国在设计制造能与波音737或空客A320媲美的大飞机上仍有很长的路要走,但发展趋势很显著。中国航空工业正走向一个崭新的发展阶段并不断迈向成熟。The first flight of the Comac C919. Credit: Comac

Footnotes

  • 多家银行推出公积金或工资等多种形式办无抵押贷款
  • 7. MonPère

China’s forex reserves — the world’s largest — have long been seen as the ultimate guarantor of financial stability, since they can be used to hedge against capital flight or to bail out domestic financial institutions struggling with a rise in bad debts.
获奖者:金·卡戴珊
? Ten of a reported 33 fatalities occured in New York City, and that number was expected to rise, according to Mayor Michael Bloomberg. Deaths in New York were attributed to falling trees, electrocution and drowning.
[k?n'tein]
As China gains ground, its best frenemy – the United States – account for the other half of the top 10 spots. Berkshire Hathaway and Wells Fargo WFC -both move up four spots to No.5 and No. 9, respectively.
Developer: Supermassive Games, Sony Computer Entertainment

重庆:洋品牌败走,本土建材超市逆势崛起

References

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