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全球格局生变 热水器市场步入中国时代

Editorials

Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: 以次充好、虚高价格成为卫浴行业常见乱象 (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

报告称楼市只是“弱复苏” 后市不宜盲目乐观

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.

当然,这得取决于苹果是否能设法用更便宜的零部件、更慢的处理器、分辨率更低的屏幕、以及也许是塑料机身来造出一部330美元的iPhone。而用蒂姆?库克上周在高盛公司(Goldman Sachs)一次会议上的话说,它决不能是个“低劣产品”。
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年少轻狂时,我们事事都乐于尝试。因为觉得自己一无所有而不惧怕失去。也正因如此,我们有时会在不知不觉中走上一条不归路。   WE want to try a little of everything
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IE’s online MBA consistently attracts high-calibre students. Half of IE’s alumni were senior managers when they enrolled, the highest proportion among ranked schools at that stage. Three years after graduation they were earning the highest average salary at $179,000, about $30,000 more than the next highest earners — alumni from Olin Graduate School of Business at Babson College.
I said it last year - and I'll say it again. There is only one activity more thankless than predicting the future - and that is publicly sharing your predictions.
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他表示:“这当然与中国近年来我们所看到的发展是分不开的,其中包括中国经济从‘中国制造’到‘中国创造’的转型当中,对创新的高度强调就是其中的重要内容。”
制造业及休闲和酒店服务业应会继续创造就业岗位。美国的工厂是复苏早期的推动者,尽管增长放缓,工厂应该会继续有选择地扩员。继2010年每月增加约9,000个就业岗位之后,今年以来制造业每月增加约1.6万个就业岗位。欧洲、日本和中国经济增长放缓损害了全球贸易流。但最近,更多公司高管开始意识到,在美国制造比在中国等地制造好处更多。与此同时,包括酒店在内的休闲服务业整年都是就业岗位增长的一个可靠来源。[qh]
今年9月,该指数曾跌至48这个创纪录低点,10月份该读数则为49.9。
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Footnotes

  • 24个月后 北京再供纯商品住宅地块
  • 新加坡已经连续三次被列为世界上生活成本最贵的城市,但是这一年中城市生活成本在世界范围内的分布有了显著的变化。

中国国家统计局(NBS)周四表示,最新房地产价格指数显示,11月新房价格同比下跌3.7%,为连续第三个月同比下跌,10月和9月分别同比下跌2.6%和1.3%。
“This has been a miserable year for EM,” said Paul McNamara, investment director of emerging markets at GAM, the Swiss fund house. “There has been a steady bleed out of assets and no one is certain what shape the market might be in this time next week.”
无论你相信与否,今年的搞笑文学奖被授予美国政府审计总署(GAO),以表彰他们发表的有关如何准备一份报告的报告的报告的报告……
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References

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