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房地产行业出现拐点 城市间分化将加剧

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 轨道交通产业将成广州新的千亿产业 (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

产能过剩等问题突出 我国建材业转型遇四大良机

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.

库迪斯和沃斯在孜孜不倦分析荷兰金融记录的过程中得出了结论,悲观者和乐观者之间真正的区别在于他们是否亲身经历过这样的痛苦过程。库迪斯认为,可以类比的是那些经历过大萧条的人们的行为:这些人在大萧条梦魇过去后的几十年里,一直回避金融风险。
根据花旗居屋(Citi Habitats)提供的数据,在布鲁克林拟于明年投放市场的6527套新出租屋中,有1442套分布在贝德福德-斯图文森(Bedford-Stuyvesant)、布什维克(Bushwick)和克林顿山(Clinton Hill)。就在不久前,这些社区都还被视为不热门的地区。
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Those born after 1995 tend to make more varied choices and are likely to combine work with their hobbies.
9. 设身处地也能提高记忆力
Like air, blue skies treat everyone equally.
亚太地区是地区国家共有的家园,我们不希望、也不愿意看到冷战思维下所谓“选边站队”的事情发生。

Footnotes

  • 陕西:预计今年全省新建改建重大文旅项目1300个 总投资1500亿元
  • The future is always bright if you are an entrepreneur, and the opportunities to create new ventures based on the digitisation of age-old services has a long way to run.

“一带一路”战略:“丝绸之路经济带”和“21世纪海上丝绸之路”
smart
在苹果(Apple)的蒂姆库克(Tim Cook)支持AR后,该技术可能是更大的机遇。苹果最新操作系统及新款手机iPhone X纳入了AR技术。
以下国家在“2017年最佳国家“整体排名中相当亮眼 。这份排名意在衡量全球最大经济体。
Time Management
10. Drawing Words Helps Your Brain Recall Them

二手房交易纠纷报告:中介隐瞒实情易发购房纠纷

References

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