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门窗市场竞争形势或两极分化

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 宜家IWAY准则倒逼“浙江制造” 跟不上就淘汰 (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

央行:北京共有产权住房贷款最低首付比例不低于30%

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.

Be Professional
adj. 准确的,精确的
单词creative 联想记忆:
该王储称,当局可通过和解收回多达1000亿美元。
Song “Chang’er”(Li Yugang and three Chinese astronauts)
两队将于10月5日抵达深圳并将在深圳大运中心进行比赛。
['k?:p?rit]

总的来说,在选择就读EMBA的原因中,创业排在最末(10分中得5.5分)。学员的主要动机是学习管理(9.1分)、拓宽人脉(8.3分)及增加收入(8.1分)。
但是,斯蒂文森称“这或许反映出美国在保护本国钢铁制造商方面比欧盟更大胆”。
Seoul insists the activists have a democratic right to send the leaflets, but has appealed for restraint to avoid overly provoking the North.
n. 火焰,热情
If you have a question, come to my office. Don't corner me in the bathroom.

Footnotes

  • 发改委:下决心解决好房地产问题 坚决遏制房价上涨
  • [di'str?kt]

Stand: Wal-Mart U.S. President and CEO Bill Simon pledged to hire veterans
adj. 透视的
8."Homeland" (2.4 million)
5.电子烟
《哈利·波特》粉们,福利来啦!该片是《哈利·波特》前传,讲述了纽特·斯卡曼德在老纽约的冒险经历。该片根据《哈利·波特》中霍格沃兹学院的同名教科书改编而成。
两个抢手在讽刺杂志查理周刊屠杀了12个人,谢里夫库阿奇和他的兄弟塞得,他们可能就是出国“接受屠杀训练并散播恐怖”的人中的两个。

一线楼市国庆节成交量同比上涨 难掩整体低迷走势

References

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