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中国发布人权白皮书:人均消费支出40年增18倍

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 发改委:五一放假调整 将落实免收小型客车通行费政策 (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.

相比之下,巴西雷亚尔升值促使咖啡和糖价格飙升,因为该国是这两种商品的最大生产国。
人力资源和社会保障部的一位官员称:“根据往年的经验,在报名窗口快关闭时,报名人数会剧增,尤其是在最后三天。”
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That comes in spite of official figures released on Tuesday showing China’s exports had contracted for a second straight month in October, suggesting domestic demand is the main driver of price gains for producers.
2.《活力王子》中的王子几乎破产
Big banks have more or less given up on trying to retain people with higher pay. Ever since the financial crisis it has been clear that if you want to get seriously rich, you go to Silicon Valley. Ruth Porat laid down a big marker in 2015, swapping an annual $13m or so salary as CFO of Morgan Stanley for a package at Google (now Alphabet) about five times bigger.
While not a low rating when compared to the other four dramas, it was still criticized by many audience members.

11. Our gut bacteria are messing with us in ways we could never have imagined. New research has revealed that neurodegenerative diseases like Parkinson's might actually start out in the gut, rather than the brain, and there's mounting evidence that the human microbiome could be to blame for chronic fatigue syndrome. With gut bacteria showing signs of controlling our appetite, changing our brain structure, and triggering brain lesions that could lead to strokes, our tiny passengers are a force to be reckoned with.
谎言4:太感谢了!我很喜欢!说谎原因:告诉别人他们送的礼物一团糟会让我看起来像是冷血的混蛋。
一家国际医学杂志撤销了107篇中国学术论文,由此引发了人们对中国学术诚信的关注。被撤稿的作者多数是临床医生。
46岁的姚振华以深圳为大本营,在房地产上赚取了第一桶金。但他的净财富之所以能在一年内增长约8倍,凭借的是他旗下的宝能集团(Baoneng Group)进军保险业和随后对房地产业竞争对手万科(Vanke)展开“突袭”。万科在中国多座城市拥有业务。
单词campaign 联想记忆:

Footnotes

  • 房地产投资增速创新高 粤鲁浙闽拉动全国4成增长
  • 《王冠》

May the season\'s joy fill you all the year round.
1. glitterati / n . 知名人 士,国际上层社会人士。
Figures released by the International Society of Aesthetic Plastic Surgery (ISAPS), suggest that when population is taken into account, South Korea is now the world's largest market for cosmetic procedures.
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凯投宏观(Capital Economics)首席亚洲经济学家马克?威廉姆斯(Mark Williams)补充道:“我们预计,2017年新兴市场出口的表现将继续改善,出口值会同比温和增长。”
“悲观、消极”的小说家阿斯利·埃尔多安正在努力加工处理自己的可怕经历:数月的牢狱生活。

家居企业淡化长假营销

References

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