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Covid-19: breaking the chain of household transmission

BMJ 2020; 370 doi: “商改租”是商办类存量房的出路吗? (Published 14 August 2020) Cite this as: BMJ 2020;370:m3181

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  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}

做好预调微调 确保稳中向好

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.

Microsoft Corp., Toyota Motor Corp., IBM Corp., Samsung Electronics Co. Ltd., Inc., Mercedes-Benz and General Electric Co. were also on the Top 10 list, according to Interbrand's 2016 Best Global Brands report.
"According to our survey last year, only 0.6 to 0.7 percent of students at universities were thinking about starting their own companies. The number among vocational school students was as high as 2.2 percent. However, the idea of vocational students starting businesses is related more to creating jobs for themselves, and the majority of them have chosen to have online shops."
According to local media, the gang, based in Nanning, the capital city of south China's Guangxi Zhuang autonomous region, was able to make up to 16,000 yuan (£1,750) profit on every tonne of the putrid meat, by injecting it with chemicals, increasing its weight by 50 per cent.
Not all the judges agreed with the book’s proposed solutions but nobody questioned the force of its argument.
在我们有别于从前的失常状态中,她用所需要的一切使人们联想到生活的失重感。“这是一个时代的终结吗?这是美国的末日吗?”她在《When the World Was at War We Kept Dancing》(《当世界陷入战争之中,我们要继续跳舞》)这首歌中吟唱着。“不,这只是开始。”
Take solid and effective steps to cut overcapacity

单词mortality 联想记忆:


  • 首部《儿童水性内墙涂料》标准在沪出台
  • 全国工商联汽车经销商会数据显示,自2014年进口现代中国经销商网络已经缩减了一半。

Doing more to unleash the potential of domestic demand
除了P2P贷款领域发展迅速以外,今年还涌现出一些网络银行和贷款机构——比如腾讯(Tencent)的微众银行(WeBank)、阿里巴巴(Alibaba)的网商银行(Mybank),以及蚂蚁金融(Ant Financial)的芝麻贷(Sesame Credit)。
adj. 浓缩的;扼要的 vt. 浓缩(condense

家居电商=拼低价 线下仍是家居O2O主战场


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