Tun daga farkon rikicin COVID-19, abubuwan haɗari don nau'ikan nau'ikan nau'ikan nau'ikan mutuwa da mutuwa daga - ko "tare da" - kwayar cutar numfashi da ake kira SARS-CoV-2 ta kasance. gano a fili: Manya-manyan tsufa, kiba, matsananciyar cututtuka na yau da kullun (wasu cututtuka, misali hauhawar jini, ciwon sukari, ciwon daji).
Ga mutanen da ba su da ɗayan waɗannan halayen, haɗarin mutuwa daga (ko ma kawai "dangane da") COVID-19 shine low low kuma kusa da 0.
Ya kamata alluran rigakafin su hana cututtuka masu tsanani da mutuwa; in ba haka ba, su - kuma a fortiori m yarda da gaggawa - zai zama mara ma'ana gaba ɗaya.
A wannan lokacin, duk da haka, har yanzu ba za mu iya sanin ko sun yi hakan ba. Martin Kulldorf yana da gaskiya gaba ɗaya lokacin da ya buƙata a cikin nasa labarin kwanan nan cewa masana'antun "suna gudanar da ingantaccen gwajin gwaji na asibiti wanda ke tabbatar da cewa alluran suna rage mace-mace."
Zane da aiwatar da irin wannan gwajin - a cikin ƙungiyar haɗari mai girma (misali> 65 shekaru, da aƙalla cuta guda ɗaya), a kan lokaci mai ma'ana (aƙalla watanni 6), kwatanta gabaɗaya (ba kawai gwajin-tabbatacce) mace-mace a cikin wuribo zuwa rukuni-rukuni - zai kasance (kuma har yanzu zai kasance) madaidaiciya kuma mafi ƙarancin rikitarwa fiye da karatun rajistar kasance a gaskiya za'ayi da wadannan kayayyakin.
Yadda aka gudanar da gwaje-gwajen an bayyana a sarari a cikin ka'idoji, wallafe-wallafe, da gabatarwar FDA: Mutanen da suka sami alamun bayyanar cututtuka (jerin waɗannan alamun sun canza kaɗan daga masana'anta zuwa wani, amma duk ba takamaiman alamun mura ko mura ba) sun yi gwajin PCR. Idan - kuma kawai idan - gwajin ya zama tabbatacce (a cikin Nazarin Pfizer, wannan lamarin ya kasance a cikin 170 kawai daga cikin sama da 3,400 marasa lafiya na alamun bayyanar cututtuka), an dauki ƙarshen "alama ta Covid-19" a matsayin wanda aka kai.
Abin da waɗannan binciken ya nuna shi ne cewa a cikin mutanen da ke nuna alamun mura ko mura, an gano kwayar cutar ta SARS-CoV-2 da yawa a cikin alurar riga kafi fiye da rukunin placebo.
Abin da aka nuna ta haka ba shi yiwuwa a rage kowane nau'in cutar da aka bayyana a asibiti kuma ana iya bambanta, amma kawai a cikin adadin ingantattun gwaje-gwaje na ƙwayar cuta guda ɗaya na da yawa waɗanda aka sani suna haifar da alamun da ba na musamman ba.
Menene ba wanda aka nuna duk da haka, an sami raguwar alamun mura da mura a kowane se. Sabanin haka.
Dukkan binciken da aka gudanar tare da allurar rigakafin Covid-19 na fama, ban da wasu sanannun sanannun. son zuciya gaba daya, daga ainihin aibi guda ɗaya: Suna nuna raguwa a cikin "Covid-19 masu alaƙa" marasa alama ko alamun bayyanar cututtuka, asibiti ko mace-mace, amma ba sa yin tambayar ko wannan raguwar marasa lafiyar gwajin ta fassara zuwa cikin overall raguwar cututtukan mura, na (na al'ada) ciwon huhu, na asibiti da mace-mace.
Koyaya, wannan ita ce tambayar da ta dace ta asibiti.
Ba shi yiwuwa a zana wani tabbataccen sakamako daga bayanan da ke kan tasirin allurar rigakafin cutar kan mace-macen gabaɗaya wanda aka buga har yanzu. Danish ɗin kwanan nan analysis, da alama an ƙaddamar da shi ga LANCET, ya sake zama daidai lokacin da yake jayayya "don yin RCTs na mRNA da maganin rigakafi na adeno-vectored… kwatanta tasirin dogon lokaci akan yawan mace-mace."
Waɗannan RCTs (Randomized Clinical Trials) suna buƙatar cikakken kuma, kuma sama da duka, sun haɗa da ƙungiyar Placebo, kuma ba kawai kwatanta alluran rigakafin da juna ba.
Mafi girman fifikon allurar DNA-vector, kamar yadda ƙungiyar Danish ta ruwaito, ya dogara ne akan ƙananan lambobi da kaɗan. abin dogara. Bugu da ƙari, mutum yana buƙatar yin taka tsantsan tare da ƙididdigar ƙididdiga na post-hoc akan ƙarshen ƙarshen asibiti waɗanda ba a riga an ayyana su don gwajin (s) da ake tambaya ba - wannan na iya zama da sauri ya zama kamar "zubar da bayanai. "
Gabaɗaya mace-mace ba ta kasance ƙarshen kowane gwaji ko nazari na Covid ba. A zahiri, kamar yadda mutuwar Covid wani bangare ne na mace-macen da ba za a iya kaucewa ba na yawan jama'a (ba mu dawwama ba ne, kuma a matsakaita). muna mutuwa a matsakaicin shekarun mutuwa), yana iya yiwuwa a iya nuna fa'idar mace-mace gabaɗaya ga allurar rigakafin Covid - har ma da yadda suke da yuwuwar. m illa.
Amma da aka gudanar da gwaje-gwaje na asibiti yadda ya kamata tare da dacewa ("wuya") wuraren ƙarshe na asibiti shine kawai hanyar ganowa da ƙarewa.
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Manfred Horst, MD, PhD, MBA, yayi karatun likitanci a Munich, Montpellier da London. Ya shafe mafi yawan aikinsa a masana'antar harhada magunguna, kwanan nan a cikin sashen bincike & ci gaba na Merck & Co/MSD. Tun daga 2017, yana aiki a matsayin mai ba da shawara mai zaman kansa don harhada magunguna, fasahar kere-kere da kamfanonin kiwon lafiya (www.manfred-horst-consulting.com).
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