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实木家具成为卖场“新主角”

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 藤制家具标准将在2015年制订完成 (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.

底特律三巨头:另两家底特律车企仍会遇到一些磕磕绊绊。通用还要继续应对“点火门”事件的余波,而福特将进入该公司有史以来最激进的产品发布期。
安德烈?艾席蒙2007年的小说改编成的这部电影是今年最受赞誉的电影之一。刚刚崭露头角的21岁演员蒂莫西?柴勒梅德饰演一个住在意大利的年轻人,他和比他年长的艾米?汉莫饰演的大学生发生了一段火热的恋情。这部电影今年一月份在圣丹斯电影节上首映后,BBC文化评论员山姆?亚当斯就给该电影打了五星,并盛赞了柴勒梅德和汉莫之间的“火花”,摄影师镜头下阳光灿烂的意大利美景,微妙的细节和剧本的深度。该片将是最有希望争夺奥斯卡奖的电影之一,定于11月24日在美国上映。(资料来源:索尼经典电影公司)
The recovery may help allay some of the gloom around emerging market countries, many of which used strong export growth as a springboard for rapid economic advancement in the early years of this century, before the export boom turned to bust.
德拉吉在12月投票表决的次日作出回击,称欧元区政策制定者在动用政策工具推动通胀达标方面“是没有限度的”。
7.Morocco
7.狱警
Arriving at the stage, he said: "What an incredible honour, that meant a lot. Two years ago we found ourselves submerged deep in nature with all its complications and all the beauty that it gave us cinematically.

同行评审指由一个或多个与论文作者业务能力相当的人进行评估,这有助于对研究进行验证。
截至2016年底,中国仍有4300万农村地区的人口生活在贫困状态下。中国的目标是在2020年时帮助他们脱贫。
The area is close to the city centre and the demolition contractors had to make sure that when they brought down the buildings they did not damage a light rail viaduct nearby or a shopping mall and electricity sub-station.
Those in third-tier cities are under relatively low financial stress and human relations stress, and enjoy better social and natural environments, and infrastructure.
社交网络公司Facebook 、电子商务巨头亚马逊和玩具公司乐高则是品牌价值增幅最大的企业。

Footnotes

  • 行业竞争加剧 家居企业如何培养麾下大军迎战?
  • 《楚乔传》

但是,贝克?麦坚时律所并购业务主席迈克尔?德佛朗哥(Michael DeFranco)对中国企业在发达经济体投资表示赞赏。
3.Sit in the Front Row
这些排行榜是基于某个特定学科的研究能力而做出评价,与综合榜单评价方式不同。
中国迅猛发展的网红经济历经了3个阶段——第一阶段基于语言文字,第二阶段是文字加图片,现在由于宽带网络的可获得性,第三阶段就是视频。
Lecent was with an unknown number of other youth when she was killed by a single bullet inside a home in a public-housing complex near Martin Grove Rd. and Finch Ave W.
It was also the "most liked" tweet of the year, with 4.59 million likes.

房贷收紧房价将迎长周期拐点吗?专家:影响有限

References

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