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首家涂料工程学院成立 全球涂料产业向前迈进

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 小长假二手房市场活跃 多数二手房未因新政加价 (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

午间地产股持续下跌 新城控股、保利地产等领跌

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.

[d?'mestik]
此外,广电总局还透露,虽然今年的票房增长受人民币贬值影响要稍低于35%,但是电影市场增长势头依旧强劲。
Bangkok's 2014-15 fall from the top was largely put down to political instability in recent years.
自从该调查首次面世以来,香港已经连续第七年高居榜首了。
而中国工商银行排在榜单的第十位,是该榜单上排名最高的中国企业。
While Cousins' volatile personality and high-usage tendencies present challenges, there are numerous justifications for rolling the dice:
Entrepreneurs are movers and shakers. They can’t afford to analyze every detail or they’d never get anywhere. There is no place for procrastination in a startup. It’s a 24/7, no-vacation-or-sick-days kind of job that demands constant forward momentum. Make a brief assessment at every step and move on it. Trust your instincts.

Indeed. That's an understated benefit of Philly tanking so hard in recent years: they are so bad it disincentives other clubs from tanking because they'll struggle to be as bad as the Sixers. The Mavericks are in the mix, at least.
单词charming 联想记忆:
她是头号权势女性:过去10年里,德国总理默克尔八度上榜——其中七次都荣登榜首。
Yes, some molds cause allergic reactions and respiratory problems. And a few molds, in the right conditions, produce "mycotoxins," poisonous substances that can make you sick.
charity

Footnotes

  • 全球避暑城市名城百佳榜单出炉 贵阳昆明入前十
  • adj. 人口统计学的

We will ensure that foreign trade continues to pick up and register steady growth.
About 60 per cent have not yet worked and a further 30 per cent have less than two years’ experience.
你咋不上天呢?
立场:承诺聘用老兵
['pr?p?ti]
6. Miranda Kerr

京“金九”难现 房企对市场预期高但定价难

References

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