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警方扫黑除恶端掉“小区服务队” 业主:解气!

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 央视解读财政部部长提房地产税:论证必须慎之又慎 (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.

● “佛罗里达一男子在毒品实验室放屁引发火灾,后死于爆炸”
At the start of the year, the ruling Communist party set a target of 6 per cent growth in trade for this year but total trade has now fallen by just over 8 per cent in the first ten months of 2015 compared with the same period a year earlier.
由于预算充足,该公司的部门经理们可以用独一无二的个性化方式来奖励自己的下属。以下是两个曾给出的奖励:免费在马术训练场驰骋、附带套索和马术表演课程的烤肉野餐。
以下是第68届年度黄金时段艾美奖的主要获奖者名单,请登陆emmys.com浏览获奖名单完整版。
13. “Girlhood” (Céline Sciamma)
There are 15 Chinese brands in the top 100, one more than last year and a sharp rise on a decade ago, when China Mobile was the only Chinese brand.
The paperpot transplanter allows a single person to transplant 264 plants covering over 85ft in just minutes. What used to take hours, now takes minutes. Allowing you to spend less time transplanting crops, and more time doing other things like farm improvements, marketing, sales, or just taking some time off.

The potential impact of any surprise move in Fed policy was clear in the “taper tantrum” of 2013, when just the suggestion that the Fed might soon rein in its ultra-loose monetary policies was enough to provoke a wave of global panic.
明星大撞衫 看谁更好看(二)
adj. 暴露的,无掩蔽的,暴露于风雨中的 v. 暴露,
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Footnotes

  • 资本“转战”:从炒房价到炒房租
  • 这与上月制造业采购经理人指数(PMI)的表现相一致,PMI显示制造业活动有所扩张。

该部门期望今年消费增长仍然能够强有力地带动经济增长。
北京、上海等城市都存在严重的空气污染问题。北京1月份爆发了近期最为严重的雾霾,而去年12月上海空气污染指数一度爆表。严重的空气污染问题显然无助于吸引更多外国游客前来旅游。
28 June
A Florida teen is causing strangers to freeze and stare because of her uncanny likeness to Queen Elsa from the Disney movie Frozen.
To wish you joy at this holy season. Wishing every happiness will always be with you.
Striking a balance may take a while, but working toward this list as a goal for starting your company will make the difference. How an owner feels about progress and how quickly a business can be up and running — and feeding that bottom line — will swiftly feel the impact.

海珠今年已拆违230万平方米

References

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