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Criteria for releasing COVID-19 patients from isolation

Scientific Brief

17 June 2020

Background

On 27 May 2020, WHO published updated interim guidance on the clinical management of COVID-19,1,2 and provided updated recommendations on the criteria for discharging patients from isolation. The updated criteria reflect recent findings that patients whose symptoms have resolved may still test positive for the COVID-19 virus (SARS-CoV-2) by RT-PCR for many weeks. Despite this positive test result, these patients are not likely to be infectious and therefore are unlikely to be able to transmit the virus to another person.

This scientific brief provides the rationale for the changes made to the clinical management of COVID-19 guidance, based on recent scientific evidence.  WHO will update these criteria as more information becomes available. For more information about clinical care of COVID-19 patients, see WHO’s full guidance.1

Previous recommendation

Initial recommendation (published on 12 January 2020)

WHO’s first technical package of guidance for the clinical management of the novel coronavirus, now known as COVID-19, was published in early January 2020, shortly after a cluster of atypical pneumonia cases was first reported in Wuhan, People’s Republic of China,3 and included recommendations on when a patient with COVID-19 is no longer considered infectious.

The initial recommendation to confirm clearance of the virus, and thus allow discharge from isolation, required a patient to be clinically recovered and to have two negative RT-PCR results on sequential samples taken at least 24 hours apart.4 This recommendation was based on our knowledge and experience with similar coronaviruses, including those that cause SARS and MERS.5

Updated recommendation

New recommendation (published on 27 May 2020 as part of more comprehensive clinical care guidance1)

Within the Clinical Management of COVID-19 interim guidance published on 27 May 2020,1 WHO updated the criteria for discharge from isolation as part of the clinical care pathway of a COVID-19 patient. These criteria apply to all COVID-19 cases regardless of isolation location or disease severity.

Criteria for discharging patients from isolation (i.e., discontinuing transmission-based precautions) without requiring retesting[1]:

  • For symptomatic patients: 10 days after symptom onset, plus at least 3 additional days without symptoms (including without fever [2] and without respiratory symptoms)[3]
  • For asymptomatic cases[4]: 10 days after positive test for SARS-CoV-2

以下是2012年搞笑诺贝尔奖得奖名单,这些奖项被授予那些做出看起来愚蠢却又对世界有深度贡献的科学家、作家、和平缔造者们,或者用主办方《不可思议研究年报》的话来说就是奖励那些“乍看起来让人发笑,但是随后发人深省”的研究工作。我敢担保,这些发明绝对能使人们大笑!
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“温家宝总理强调指出,中国有效应对了全球金融危机的严重影响,经济保持稳定快速增长。因此中国成为全球第二大经济体,在五年内GDP几乎翻番。”Luis Schmidt Montes, Chilean ambassador
伊法斯夫拉腾以英国独立党(U.K. Independence Party)为例,它的官方平台力主脱欧,但是面向选民的宣传中又强调移民对经济与文化的影响,她说这是一种混合了务实与民粹的论调。
Goldman Sachs will pay out big bonuses, be publicly vilified for a month and then go quietly back to printing profits.
我叫它“万隆奖”,该奖得名于一位中国肉业大亨,人家身为CEO却无比坦诚地宣称:“我就是个杀猪卖肉的。”万隆先生一定会同意我把这个奖颁给北伯林顿铁路公司(BNSF)的一位高管,这位仁兄在一次会议上说:“我们把东西从一个地方运到另一个地方。”

*Countries may choose to continue to use testing as part of the release criteria.  If so, the initial recommendation of two negative PCR tests at least 24 hours apart can be used.

What is the reason for the change?

我预计,将有更多公司培养懂得如何管理网络的领导人——不只是传统的内部员工网,还包括联系更松散的供应商和承包商网络,通过互联网和社交媒体进行远程管理。
4、慧眼识香。邦德眼光敏锐,能辨认出孰敌孰友。这种品质常见于性开放者。007很容易识出对他有意的女人,有科学证明,帅哥往往擅长于此。
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●"President Obama Confirms He Will Refuse To Leave Office If Trump Is Elected"
2013年,勇士队曾在中国与洛杉矶湖人队打过季前赛,而森林狼队则是首次来华。

小说作者安东尼·赫洛维兹(Anthony Horowitz)透露,新书《Trigger Mortis》为现代读者作了改动,包含反对吸烟的信息,而且首次有一位“直言不讳”的同性恋朋友出场。

  • Long periods of isolation for individuals with prolonged viral RNA detection after resolution of symptoms, affecting individual well-being, society ,and access to healthcare.13
  • 4.阿迪达斯。品牌喜爱度:35%/排名:25
  • Prolonged viral shedding around the limit of detection, having negative results followed by positive results, which unnecessarily challenges trust in the laboratory system.23-28

These challenges and newly available data on the risk of viral transmission over the course of the COVID-19 illness provided the framework for updating WHO’s position on the timing of discharging recovered patients from isolation in and outside health care facilities. WHO continuously reviews scientific literature on COVID-19 through its Science Division and its COVID-19 technical teams. All aspects of clinical management of COVID-19 patients and laboratory testing strategies are discussed within WHO and with Member States and WHO’s global expert networks of public health professionals, clinicians, and academics around the world. These expert networks and the Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH)7 considered the challenges and reviewed the available data in the decision process to change the initial recommendation. 

3. 经济已经在崩溃,2014年到2016年的GDP将会更加难看
The GDP of Southwest China's Chongqing Municipality grew by 10.7 percent in 2016, hitting 1.76 trillion yuan. Southwest China's Guizhou province and Tibet autonomous region posted 10.5 percent and 10 percent growth respectively.
Talk show host and comedian Ellen DeGeneres will host the Oscars ceremony for a second time.
China’s exports and imports suffered larger-than-expected drops in the first month of this year in both renminbi- and dollar-denominated terms.
One such development is 60 Water Street in Dumbo, a 290-unit rental with a 24-hour concierge and a roof deck offering Manhattan views. Leasing begins next month, with rent for a two-bedroom starting at a jaw-dropping $6,018 a month. “People want that condo-like living, even though they’re renting and not owning,” said Jodi Ann Stasse, the managing director of new developments for Citi Habitats.
国家统计局最近开始跟踪研究的大城市的房价数据就支持这种可能性。
值得一提的是,优步和特斯拉也未能上榜。“优步和特斯拉都在创新,但用专利数量、成功、全球化和影响力进行衡量,都不足以上榜,”Stembridge说道。“还有,这两家公司在2010-2014年这段时间也没有获得超过100项的专利技术,从而达到该榜单要求。”
First, says Tom Kozenski, a supply-chain expert at consulting and training firm RedPrairie, most people still think of logistics -- if they think of it at all -- as a "non-sexy" field centered on boring, low-paid warehouse work.
They need more talent. Full stop. The best avenue for attracting talent for them has always been the draft.
response

WHO encourages the scientific community to compile additional evidence to further improve isolation discharge criteria and establish the conditions under which isolation can be abbreviated or where the possible risks of the current discharge criteria require further adaptation. Better understanding of transmission risk among individuals with different clinical presentations or comorbidities and in different settings will aid further refinement of these criteria. For situations that might still require a laboratory-based approach, we encourage the further optimization of such a laboratory algorithm. WHO encourages countries to continue testing patients, if they have the capacity to do so, for systematic data collection that will enhance understanding and better guide decisions about infection prevention and control measures, especially among patients with prolonged illness or those who are immunocompromised.

Current understanding of transmission risk  

Infection with the virus causing COVID-19 (SARS-CoV-2) is confirmed by the presence of viral RNA detected by molecular testing, usually RT-PCR.  Detection of viral RNA does not necessarily mean that a person is infectious and able to transmit the virus to another person. Factors that determine transmission risk include whether a virus is still replication-competent, whether the patient has symptoms, such as a cough, which can spread infectious droplets, and the behavior and environmental factors associated with the infected individual. Usually 5-10 days after infection with SARS-CoV-2, the infected individual starts to gradually produce neutralizing antibodies. Binding of these neutralizing antibodies to the virus is expected to reduce the risk of virus transmission.10,11,29,35

SARS-CoV-2 RNA has been detected in patients 1-3 days before symptom onset, and viral load in the upper respiratory tract peaks within the first week of infection, followed by a gradual decline over time.10,12,15,19,21,22,36-39  In the feces and lower respiratory tract, this viral load seems to peak in the second week of illness.19 Viral RNA has been detected in upper respiratory tract (URT) and lower respiratory tract (LRT) and feces, regardless of severity of disease.19 There seems to be a trend in longer detection of viral RNA in more severely ill patients.10,14,15,18,19,41-43  Studies of viral RNA detection in immunocompromised patients are limited, but one study suggested prolonged detection of viral RNA in renal transplant patients.33 Some studies analyzed the risk of transmission related to symptom of onset, and the estimated risk of transmission was highest at or around the time of symptom onset and in the first 5 days of illness.13,15

The ability of the virus to replicate in cultured cells serves as a surrogate marker of infectivity but requires special laboratory capabilities and may not be as sensitive as PCR.10,20 Animal models can aid understanding of transmission risk. In a study by Sia, et al., hamsters infected with SARS-CoV-2 were housed with healthy hamsters on either day 1 or day 6 after infection. Transmission to healthy hamsters occurred in the day 1 group, but not in those exposed 6 days after inoculation. In this model, the timing of transmission correlated with the detection of virus using cell culture, but not with detection of viral RNA in donor nasal washes.31

Studies using viral culture of patient samples to assess the presence of infectious SARS-CoV-2 are limited.8-10,21,29,30,34   Viable virus has been isolated from an asymptomatic case.9 A study of 9  COVID-19 patients with mild to moderate disease found no SARS-CoV-2 virus able to be cultured from respiratory samples after day 8 of symptom onset.10 Three studies of patients with undisclosed or variable degree of illness showed an inability to culture virus after days 7-9 of symptom onset.8,29,30  Patients who were RT-PCR positive on retesting after an initial negative RT-PCR on discharge from isolation were also studied, and none of these patients yielded positive viral cultures.29 One possible outlier is a case report of a patient with mild COVID-19 who remained PCR-positive for 63 days after symptom onset. In this patient, viral cultures were positive from upper respiratory tract specimens only on the day of symptom onset, but were culture-positive from sputum samples until day 18.22 It is unclear whether this posed a transmission risk as the patient had no respiratory symptoms. In a hospital-based study of 129 patients severely or critically ill with  COVID-19, 23 patients yielded at least one positive viral culture. This study included 30 patients who were immunocompromised. The median duration of viral shedding as measured by culture was 8 days post onset, the interquartile range was 5-11, and the range was 0-20 days.11 The probability of detecting virus in culture dropped below 5% after 15.2 days after of symptoms. In this study, patients testing positive by viral culture were still experiencing symptoms at the time of sample collection.11 This and other studies have described the correlation between reduced infectivity with the decrease in viral loads10,11,29,34 and a rise in neutralizing antibodies.10,11,29 Although viral RNA can be detected by PCR even after the resolution of symptoms, the amount of detected viral RNA is substantially reduced over time and generally below the threshold where replication competent virus can be isolated. Therefore, the combination of time after onset of symptoms and the clearance of symptoms seems to be a generally safe approach based on current data.  

Conclusion

"If reform implemented 30 years ago solved the problem of ideology, then, at present, reform is to solve the problem of interests. Reform at present is actually like cutting our own with a knife, and we all need to be determined and must strengthen our confidence." WANG YANG, NPC deputy and member of the Political Bureau of the Communist Party of China Central Committee
“我们会根据天气谨慎考虑投送的时间和地点,但这些都不会公开,”脱北者Park Sang-Hak说道,他曾经领导过一系列的气球投送运动。
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Economic forecasters are counting on 2014 to be a breakout year. But whether the economy finally moves past its sluggish growth will rest on several forces playing out differently than they have since the recovery began. Some of the key questions:
If you've got children, I understand that this isn't always possible. Children should always come first. But if you don't show up for your classes, you're not getting that education we discussed in No. 1.
Yao has been at the center of a hostile takeover battle for China's largest real estate developer China Vanke Co Ltd (000002.SZ).
在纽约市许多公寓楼的大门背后,充斥着居民们不协调的抱怨声。从我的“房地产答疑”(Ask Real Estate)专栏所收到的抱怨信中,我们可以一窥居民们是如何应对生活在拥挤、昂贵的住房中的种种不顺心的。比方说,有个合作公寓的股东被邻居家的老鼠窝吓坏了;有一对父母被禁止将婴儿车推进楼内的电梯;有个租户厨房里的橱柜从墙壁上掉了下来。
另外两个在2014年表现上佳的行业可谓风马牛不相及:高科技(上涨16%)和必需消费品(上涨13.2%)。市场上最激进与最保守的两大投资领域前后脚撞线,留下困惑的旁观者们不知该如何解释这一现象。2014年,美国失业率大幅下降,GDP呈增长势头,为何领跑市场的却是医疗保健、必需消费品、公用事业等周期性最不明显的行业?令专家们懊恼的是,有些时候就是没有令人满意的答案。美国作家库尔特o冯内古特曾写道:
8. You left your résumé in the freaking printer!
boring
中国官方国内生产总值(GDP)增速会超过6.5%吗?

These modifications to the criteria for discharge from isolation (in a health facility or elsewhere) balance the understanding of infectious risk and the practicality of requiring repeated negative PCR testing, especially in settings of intense transmission or limited testing supplies. Although the risk of transmission after symptom resolution is likely to be minimal based on what is currently known, it cannot be completely ruled out. However, there is no zero-risk approach, and strict reliance on PCR confirmation of viral RNA clearance creates other risks (e.g. straining resources and limiting access to health care for new patients with acute disease). In patients with severe disease who are symptomatic for prolonged periods of time, a laboratory-based approach might also aid decision-making on the need for prolonged isolation. Such a laboratory-based approach can include measuring viral load and neutralizing antibody (or proven equivalent antibody) levels.10,11,29 More research is needed to further validate such an approach.   

WHO will update these criteria as more information becomes available. For more information about clinical care of COVID-19 patients, see WHO’s full guidance.1


[1] Countries can choose to continue to use a laboratory testing algorithm as part of the release criteria in (a subset of) infected individuals if their risk assessment gives reason to do so. 

[2] Without the use of any antipyretics.

[3] Some patients may experience symptoms (such as post viral cough) beyond the period of infectivity. Further research is needed. For more information about clinical care of COVID-19 patients, see our Clinical Management Guidance.1

[4] An asymptomatic case is an individual who has a laboratory confirmed positive test and who has no symptoms during the complete course of infection.

References

  1. World Health Organization. Clinical management of COVID-19 (Interim Guidance) Potus v Korus, published 27 May 2020.
  2. World Health Organization. Coronavirus disease (COVID-19) Situation Report – 129. 28 May 2020. Available at: Steven Spielberg directs Meryl Streep and Tom Hanks in The Post, a thrilling drama about the unlikely partnership between The Washington Post's Katharine Graham (Streep), the first female publisher of a major American newspaper, and editor Ben Bradlee (Hanks), as they race to catch up with The New York Times to expose a massive cover-up of government secrets that spanned three decades and four U.S. Presidents. The two must overcome their differences as they risk their careers - and their very freedom - to help bring long-buried truths to light.
    “The First Amendment’s Free Speech protections apply only to violations by public entities, and since Harvard is a private university the First Amendment does not apply,” she said.
  3. ProMED International Society for Infectious Disease. 30 December 2019. (绿色装修评价标准实施 助推良心地板企业更上层楼 )
  4. World Health Organization. Laboratory testing of human suspected cases of novel coronavirus (nCOV) infection (Interim Guidance) (2015年风头最劲的品牌:在新款切诺基的拉动下,Jeep在2014年的销量惊人地拉高了44%,而斯巴鲁的销量则静悄悄地提高了21%,现已成为美国第十大最受欢迎的汽车品牌。 10 January 2020)
  5. World Health Organization. Technical guidance laboratory Middle East Respiratory syndrome coronavirus (MERS-CoV) (她还表示,从较长期来看,另一个让她担心的“R”是“重置”(reset),她解释称,全球各地的货币和财政政策在回归正常之前还有很长的路要走。她补充称:“最终的重置是那些在全球各地都有必要实施的结构性改革。”)
  6. World Health Organization. Global surveillance for COVID-19 caused by human infection with COVID-19 virus. (Interim Guidance) (One might expect that online programmes would appeal proportionately more to women than full-time programmes due to their flexibility. How-ever, data from the 2016 rankings show that women account for 30 per cent of enrolled students compared with 35 per cent for full-time programmes.
    Last year was the hottest on earth since record-keeping began in 1880, scientists reported on Friday, underscoring warnings about the risks of runaway greenhouse gas emissions and undermining claims by climate change contrarians that global warming had somehow stopped.
    , 20 April 2020)
  7. World Health Organization. Strategic and Technical Advisory Group for Infectious Hazards (STAG IH)  (加快改善生态环境特别是空气质量,是人民群众的迫切愿望,是可持续发展的内在要求。必须科学施策、标本兼治、铁腕治理,努力向人民群众交出合格答卷。)
  8. Bullard J, Dusk K, Funk D, et al. Predicting infectious SARS-CoV-2 from diagnostic samples, Clin Infect Dis. 2020 doi: 10.1093/cid/ciaa638.
  9. We learned that we could see a source of ripples in space-time.
    Cross-cultural Instrumental performance (Yanni, USA, and Chang Jing)
  10. 但是,这些进展也指向美国和欧盟在利用此类案件上的巨大差异,欧盟目前正在讨论是否要赋予中国世界贸易组织(WTO)框架下的“市场经济”地位——这一让步会使对中国提起反倾销案变难。
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  11. 在领英平台上高频出现是找工作的关键。你知道这点,你们经理也知道这点。你的经理兴许还知道你知道这点。所以她会从开始关注周一你的个人简介只是有个大概框架,到周五你增加了工作经历,新人脉,状态更新,推荐信慢慢被顶起,别一夜之间从0涨到500那样太明显了Foss提醒道。
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    “One person said he was going to the men’s room and didn’t return.”
  12. 女子200米蝶泳——刘子歌、焦刘洋
    “This could be just the beginning,” said Michael Na, a strategist in Seoul with Nomura.?“They have so many options to punish Korean businesses.”
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    I can't stop thinking that these children are my age, that it makes a tremendous difference where you are born, that I could be one of those children living in the Favellas of Rio; I could be a child starving in Somalia; a victim of war in the Middle East or a beggar in India. 我永远不能忘记这些和我同龄的孩子,当你出生的时候,他和我们真的很不相同,我也许生活在贫民窟,也可能是终日饿着肚子的小孩,也可能是中东战争的牺牲品,或者印度的小乞丐。
  13. 而新上榜的中国公司则包括万科、中铁公司和中国太平保险。
    6.杰克·谢帕德差点在第一集中死去
    “An employee sent his boss a text message to say he was leaving.”
    “理查三世研究小组”的成员菲利帕?朗丽说,她希望能重塑理查三世的形象,都铎王朝的继任者塑造出来的片面形象将不复存在。她负责协调研究工作以及筹款。
  14. And this year, the Nobel Prize has defied the convention of celebrating big by presenting the biggest prizes to discoveries on the smallest scales.
    In the next few years, by 2018, theincrease to $1.3 trillion will be due to about $100 billion on hepatitis Cdrugs, the same sums spent on cancer treatment, and $78 billion on diabetescare.
  15. 中国的商业银行是金融体系的控制中心,为实体经济提供的融资占总量的近70%。
    这是中国首次占据榜单前三甲以及在前10强中占了5名。中国工商银行连续两年占据第1名的宝座,中国建设银行次之,而且中国农业银行向上移动了5名成为第3名。这三大银行与排在第9名的中国银行一起跻身前10强,中国银行是“四大国有银行”中的另一个成员。
  16. 单词discourse 联想记忆:
    项目总成本:17.66万美元
    "I am a doctor and I prefer to speak frankly. A person's health is related first to eating, drinking and air. Any kind of development will be nothing if the quality of food, water and air is not good." ZHONG NANSHAN, NPC deputy and academic with the Chinese Academy of Engineering
    adj. 突出的,显著的,未支付的
  17. The 2014 ranking of 100 programmes for working senior executives is headed by Trium, runby HEC Paris, the London School of Economics and Stern School of Business at New York University. The top five places continue to be dominated by intercontinental EMBAs.
    来源:前十网
  18. 年龄:33岁
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  19. 那些具有3年驾驶经历,无重大交通事故、危险驾驶、吸毒、酒驾记录的司机将可参加网约车考试。
    9、《神奇动物在哪里》
  20. World Health Organization. Laboratory biosafety guidance related to coronavirus disease (COVID-19) (The runner-up was Lucy Kay, with Bars and Melody in third place.
    Britney Spears continued her fall in the standings, after being knocked down from number 1 to number 5 in 2009, only to land at number 10 in 2010 as rising stars such as Lady Gaga and Justin Bieber become more prominent.
  21. I did not create the characters inAldnoah. I made the mainframe of the story until the preliminary version. Butin fact Inaho's character is different than what I wrote. I don't really have aconnection with this character, so this is an exception.
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    盖尔 加朵
  22. This journey into the mind and feelings of an 11-year-old-girl may be Pixar’s wildest adventure yet. It’s a very funny workplace sitcom (with exuberant, touching performances from Amy Poehler, Phyllis Smith, Mindy Kaling and others), an ingenious allegory of psychological development, and an almost unbearably moving and honest defense of the role of sadness in our lives. (Read the review.)
    Gitanjali向《商业内幕》透露,她的发明是受到了密歇根弗林特市丑闻的启发,该地的官员们正面临着指控。
  23. Yuan J, Kou S, Liang Y, et al. PCR Assays Turned Positive in 25 Discharged COVID-19 Patients. Clin Infect Dis. 2020 doi: 10.1093/cid/ciaa398.
  24. Tang X, Zhao S, He D, et al. Positive RT-PCR tests among discharged COVID-19 patients in Shenzhen, China. Infect Control Hosp Epidemiol. 2020 doi: 10.1017/ice.2020.134.
  25. Qu YM, Kang EM, Cong HY. Positive result of Sars-Cov-2 in sputum from a cured patient with COVID-19. Travel Med Infect Dis. 2020; 34: p101619. doi: 10.1016/j.tmaid.2020.101619.
  26. Maria Rios
    The world's second-largest economy is catching up to traditional innovation front-runners, who were led again this year by Switzerland, Sweden, Britain and the United States, said the annual report by the U.N.'s World Intellectual Property Organization (WIPO), INSEAD Business School and Cornell University.
  27. 美国则在2016年下降为德国的第三大贸易伙伴。
    当你在求职布告栏比如Monster或者Indeed发布你的简历时,你现在的雇主是可有机会看到你的简历的。Foss说很多人事和经理经常在求职栏搜索职工的名字看他们是不是在找工作。
  28. 由西班牙IQS商学院、台湾辅仁大学(Fu Jen Catholic University)和旧金山大学(University of San Francisco)三家合办的管理学硕士项目排名升幅最大。其全球创业管理硕士项目的排名上升34位,至第43位,逆转了去年下滑19名的势头。这是唯一一个在三大洲授课的项目,其在国际课程体验方面排名第一。
    infinite
    弗兰西斯麦克多蒙德在这个黑色喜剧故事中扮演一位悲伤的母亲,展现了出色的核心表演。
    今年剩余时间将是大西洋两岸首次公开发行(IPO)的繁忙季节,意大利倍耐力(Pirelli)(见题图)、阿里巴巴(Alibaba)支持的百世物流(Best Logistics)和视频流媒体平台Roku等公司都将上市。
  29. cast
  30. Centers for Disease Control and Prevention, 深圳房价为何任性上涨 常住人口中70%无房. Symptom-Based Strategy to Discontinue Isolation for Persons with COVID-19.  Website, accessed on 12 June 2020. Best Companies rank: 7
  31. Sia SF, Yan LM, Chin AWH et al. Pathogenesis and transmission of SARS-CoV-2 in golden hamsters. Nature. 2020 doi: 10.1038/s41586-020-2342-5.
  32.  Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA. 2020; 323(18): 1843-4. doi:10.1001/jama.2020.3786.
  33. Company: Binary Group
    Promote all-round economic, political, cultural, social, and ecological progress
    2.“老爹身材”受热捧
  34. 英国
    2015年最需要迎头赶上的品牌:由于产品线陈旧,大众今年的销量下降了11%,影响了费迪南德o皮切的“称霸全球”计划。沃尔沃的销量则下跌了17%,自从被中国车企收购后,该公司至今还没有任何进步。
    But with Jrue Holiday back and Anthony Davis putting up historic numbers, they aren't going to be bad enough to get a Fultz or Jackson. Why couldn't last year's draft class be this good?
  35. Despite the breakthrough, Jack Ma, chairman of Alibaba Group, said there was no need for human beings to fear machines.
  36. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020; 382(12): p.1177-9.
  37. An iPhone displays an image of Steve Jobs as it sits with a memorial to the Apple founder and former CEO outside an Apple Store, Wednesday, Oct. 5, 2011 in New York. Jobs passed away Wednesday at the age of 56
    关注规模较小和私营制造企业的财新制造业PMI下降,而主要关注规模较大和国有企业的官方制造业PMI指数同期出现上升。这种分歧可能表明,比起规模较大和国营的企业,较小的企业受污染限制和其他监管收紧的冲击更为严重。前者还享受国有银行的优惠待遇。
    收集了一些明星们挑选南瓜的相片。看看这些照片,然后告诉我们:你准备好庆祝周三的万圣节了吗
  38. The paper quoted a number of students from the incoming class, who had a range of responses, including two who said it was the right approach to withdraw the offers. "I do not know how those offensive images could be defended," one student said.
    本文作者为卡内基国际和平基金会(Carnegie Endowment)高级研究员、世界银行(World Bank)中国业务局前局长,译者/何黎
    冲击奖项:自从在特莱瑞德电影节首映以来,奥德曼一直就是最佳男主角奖项的宠儿。
  39.  Pan Y, Zhang D, Yang P, Poon LLM, Wang Q. Viral load of SARS-CoV-2 in clinical samples. Lancet Infect Dis. 2020; 20(4): p. 411-2. doi: 10.1016/S1473-3099(20)30113-4.
  40. Stand: Starbucks CEO Howard Schultz urged the end of government shutdown
    Japan, ranked No. 5 overall, is the top performing Asian country. It ranks No. 5 in Movers and No. 1 as the most forward-looking country.
    麻省理工学院(MIT)最近发表了一份白皮书。虽然该报告的题目听起来不免有些不吉利——《你是否已为供应链人才危机做好准备?》(Are You Prepared for the Supply Chain Talent Crisis?),却一语中的。这项研究表明,供应链经理需要掌握先进的技术技能,同时还得具备“高度的外交手腕”,精通总体业务战略,能娴熟地解决各类问题,要能在混沌状态中求生存。
  41. “尽管我本质上是一名工程师和分析人员,但迄今为止我所做过的最重要的决定都与此无关,它们永远是基于直觉,”他去年在曾就读MBA的杜克大学(Duke University)对一名采访者表示。
    If you do much hiring of freelancers, you’ve probably considered outsourcing the outsourcing. There are several great services that can help, each with varying business models. For example, Bolton Remotewill build your team with vetted, offshore contractors. Another provider,Hubstaff, starts with your project in mind and then matches you with project specialists. Using an outsourcing placement service will save time instead of trying to do the recruiting yourself. These firms typically offer free recruiting and placement services but take a cut of the hourly rate.
    3.视频编辑:增长了19.2%
  42. Xu K, Chen Y, Yuan J, et al. Factors associated with prolonged viral RNA shedding in patients with COVID-19. Clin Infect Dis. 2020 doi: 10.1093/cid/ciaa351.
  43. Qi L, Yang Y, Jiang D, et al. Factors associated with duration of viral shedding in adults with COVID-19 outside of Wuhan, China: A retrospective cohort study. Int J Infect Dis. 2020 doi: 10.1016/j.ijid.2020.05.045.

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