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李克强开会研究整治“奇葩证明”

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 中国9个热点城市2017年末房价同比下跌 (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

(两会受权发布)李克强说,过去一年统筹城乡区域发展,良性互动格局加快形成

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.

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'We are quite confident that it should sell towards the high end of the estimate or above.'
电视剧版《三生三世十里桃花》于1月30日首播,由人气女演员杨幂和迪丽热巴主演。该剧讲述了一个小仙女和一位神仙的三世情缘。
'In the meantime, the U.S. continues to grow its own domestic production both in oil and gas. I think, for us, it's less about where the actual price is going--it's more about how much more growth is left in North American oil sands, shale gas, shale oil,' as well as shale exploration elsewhere, he said.
波多黎各人自前任总督的过去4年受到了几十项新税收的影响,还增加了水电费。加西亚·帕迪利亚设法为政府创造更多的收入,他说资金正在用尽。尽管有某些和那些措施,岛上政府已经违约上百万美元的债券付款,数个机构宣布进入紧急状态。
British business schools make up ground on their French counterparts in the revamped Financial Times ranking of masters in management degrees.

9.千万别相信民调
Though she says 'women have a tight to be angry', McGowan says #MeToo activists have 'sold themselves a fiction' rather than face up to the true nature of Hollywood.
“Thutmose III was one of the most important pharaohs in Egypt’s New Kingdom and is credited with establishing the Egyptian imperial province in Canaan,” said Gabriel Barkay, the co-founder and director of the Temple Mount Sifting Project.
20. Best Advice for Movie Lovers In August, the scholar Wheeler Winston Dixon sounded an alarm: “If you go on Amazon and you see some great black-and-white film, and it’s going for $3, or any kind of foreign or obscure film, buy it, because it’s going out of print, and they’re not going to put them back into print.” Tens of thousands of films that were on VHS never made the jump to DVD or to Blu-ray, Mr. Dixon warns. And the brave new world of downloads (a.k.a. electronic sell-through) — well, tune in next year.
英国新人结婚模仿“怪物史瑞克”(图)

Footnotes

  • 家居业海外市场需求下滑 转为依靠内需拉动
  • A robust LinkedIn presence is crucial to any job search. You know that. Your manager knows that. And your manager probably knows that you know that – so she'll be concerned when you go from having a bare-bones profile on Monday to one jacked with additional work history, new connections, status updates and recommendations by Friday. "Don't go from zero to 500 overnight, because that can be quite obvious," Foss cautions。

On the sales front, General Motors and Ford F -0.13% lost market share to Chrysler, which leveraged its Jeep brand to previously unimagined heights – and then, metaphorically left its heritage behind when it established legal domicile in the Netherlands and changed its name to FCA US LLC.
[ri'membr?ns]
Among the top 50 richest women in the world, entrepreneurs from the Chinese mainland account for 56%.
在本届戛纳电影节上,女性电影制作人以及相关女性话题曾广受关注成为宣传主题。28年来,戛纳首次以女导演拍摄的电影拉开序幕,伊莎贝拉?罗西里尼(Isabella Rossellini)成为“一种关注”单元评审团主席,莎尔玛?海雅克(Salma Hayek)主持讨论会高调探讨女性角色在电影中的意义。可以讨论的话题有许多,但是真的有何改变吗?数字似乎更能说明问题,主竞赛单元的19部入围作品仅有2部来自女性导演。而后发生的“高跟鞋门”,更有.....面对外界对于影展涉嫌性别歧视的负面消息,艺术总监蒂埃里?弗雷莫(Thierry Frémaux)一点儿反应都没。他只是说,戛纳电影节的举办有着及其不公平的高标准,参展影片不能申请其他诸如威尼斯或柏林电影节。这难道是建议人们去“攻击奥斯卡”?
单词portion 联想记忆:
7. Amy Adams - $13.5 million

成都卖场顽疾众多生存堪忧 居家综合体是新方向

References

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