We report a family cluster of coronavirus disease 2019 (COVID-19) caused by a presymptomatic case. There were 9 family members, including 8 laboratory-confirmed with COVID-19, and a 6-year-old child had no evidence of infection. Among the 8 patients, 1 adult and a 13-month-old infant were asymptomatic, and 1 adult was diagnosed as having severe pneumonia.

Abstract Background Recent studies have focused on initial clinical and epidemiological characteristics of the coronavirus disease 2019 (COVID-19), which is the mainly revealing situation in Wuhan, Hubei. Aim This study aims to reveal more data on the epidemiological and clinical characteristics of COVID-19 patients outside of Wuhan, Zhejiang, China. Design This study was a retrospective case series. Methods Eighty-eight cases of laboratory-confirmed and three cases of clinically confirmed COVID-19 were admitted to five hospitals in Zhejiang province, China. Data were collected from 20 January 2020 to 11 February 2020. Results and discussion Of all 91 patients, 88 (96.70%) were laboratory-confirmed COVID-19 with throat swab samples that tested positive for SARS-Cov-2, three (3.30%) cases were clinically diagnosed. The median age of the patients was 50 (36.5–57) years, and female accounted for 59.34%. In this sample, 40 (43.96%) patients had contracted the disease from local cases, 31 (34.07%) patients had been to Wuhan/Hubei, eight (8.79%) patients had contacted with people from Wuhan, and 11 (12.09%) patients were diagnosed after having flown together in the same flight with no passenger that could later be identified as the source of infection. In particular within the city of Ningbo, 60.52% cases can be traced back to an event held in a temple. The most common symptoms were fever (71.43%), cough (60.44%) and fatigue (43.96%). The median of incubation period was 6 (interquartile range 3–8) days and the median time from the first visit to a doctor to the confirmed diagnosis was 1 (1–2) days. According to the chest computed tomography scans, 67.03% cases had bilateral pneumonia. Conclusions Social activity cluster, family cluster and flying alongside with persons already infected with COVID-19 were how people got infected with COVID-19 in Zhejiang.

The UK National Health Service introduced a pay for performance scheme for primary care providers in 2004/5. The scheme rewarded providers for the proportion of eligible patients who received appropriate treatment. Eligible patients were those who had been reported by the provider as having the relevant disease minus those they exception reported as not suitable for treatment. Using rich provider level data, we find that differences in reported disease rates between providers, and differences in exception rates both between and within providers, suggest gaming. Faced with ratio performance indicators, providers acted on denominators as well as numerators. Copyright � The Author(s). Journal compilation � Royal Economic Society 2010.

This article examines the effects of housing tenure on individuals' job and unemployment durations in the UK. We examine job to job transitions and transitions from unemployment. We take account of whether or not the arrival of a job was synonymous with a non-local residential move, tenure endogeneity and unobserved heterogeneity. We find that home-ownership is a constraint for the employed and public renting is more of a constraint for the unemployed. Employed home-owners have a lower transition into employment with a distant move and unemployed public renters have a lower probability of gaining employment in more distant labour markets. Copyright � 2008 The Author(s).

OBJECTIVE To reveal more data on the epidemiologic and clinical characteristics of coronavirus disease 2019 (COVID-19) patients outside of Wuhan, from five hospitals in east of Zhejiang province, China. DESIGN Retrospective case series. SETTING Five hospitals in east of Zhejiang province, China. PARTICIPANTS 88 cases of laboratory-confirmed and 3 cases of clinical-confirmed COVID-19 were : medRxiv preprint RESULTSOf all 91 patients, 88 (96.70%) were laboratory-confirmed COVID-19 pneumonia with throat swab samples that tested positive for SARS-Cov-2 while 3 (3.30%) were clinical-diagnosed COVID-19 pneumonia cases. The median age of the patients was 50 (36.5-57) years, and female accounted for 59.34%. In this sample 40 (43.96%) patients had contracted the diseases from local cases, 31 (34.07%) patients had been to Wuhan/Hubei, 8 (8.79%) cases had contacted with people from Wuhan, 11 (12.09%) cases were confirmed aircraft transmission.In particular within the city of Ningbo, 60.52% cases can be traced back to an event held in a temple.The most common symptoms were fever (71.43%), cough (60.44%) and fatigue (43.96%).The median of incubation period was 6 (IQR, 3-8) days and the median time from first visit to a doctor to confirmed diagnosis was 1 (1-2) days. According to the Chest computed tomography scans, 67.03% cases had bilateral pneumonia, and 27.47% cases showed unilateral pneumonia. CONCLUSIONSocial activity cluster, family cluster and travel by airplane were how COVID-19 patients get transmitted and could be rapidly diagnosed COVID-19 in Zhejiang.

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SummaryObjective Consultants employed by the NHS in England are allowed to undertake private practice to supplement their NHS income. Until the introduction of a new contract from October 2003, those employed on full-time contracts were allowed to earn private incomes no greater than 10% of their NHS income. In this paper we investigate the magnitude and determinants of consultants' NHS and private incomes. Design Quantitative analysis of financial data.Setting A unique, anonymized, non-disclosive dataset derived from tax returns for a sample of 24,407 consultants (92.3% of the total) in England for the financial year 2003/4. Main outcome methodsThe conditional mean total, NHS and private incomes earned by age group, type of contract, specialty and region of place of work. ResultsThe mean annual total, NHS and private incomes across all consultants in 2003/4 were £110,773, £76,628 and £34,144, respectively. Incomes varied by age, type of contract, specialty and region of place of work.The ratio of mean private to NHS income for consultants employed on a full-time contract was 0.26.The mean private income across specialties ranged from £5,144 (for paediatric neurology) to £142,723 (plastic surgery). There was a positive association between mean private income and NHS waiting lists across specialties.

Background: No data is available about in-flight transmission of SARS-CoV-2. Here, we report an in-flight transmission cluster of COVID-19 and describe the clinical characteristics of these patients. Methods: After a flight, laboratory-confirmed COVID-19 was reported in 12 patients. Ten patients were admitted to the designated hospital. Data was collected from 25th January to 28th February 2020. Clinical information was retrospectively collected. Results: All patients were passengers, and none were flight attendants. The median age was 33 years, and 70% were females. None was admitted to intensive care unit, and no patients died up to 28th February. The median incubation period was 3.0 days and time from onset of illness to hospital admission was 2 days. The most common symptom was fever. Two patients were asymptomatic and had normal chest CT scan during hospital stay. On admission, initial RT-PCR was positive in 9 patients, and initial chest CT was positive in half of the patients. The median lung 'total severity score' of chest CT was 6. 'Crazy-paving' pattern, pleural effusion, and ground-glass nodules were seen. Conclusion: There is potential for COVID-19 transmission in aeroplanes, but the symptoms were mild in our patients. Passengers and attendants must be protected during flights.