a cikin wata baya labarin, Na yi nazarin yanayin da ba a sani ba a bayan nadin Dr. Deborah Birx a matsayin Mai Gudanarwa na Tawagar Task Force Response na Fadar White House a ranar 27 ga Fabrairu, 2020.
Dangane da wannan jarrabawar, na ɗauka cewa Dokta Birx ba ta sami aikin ba saboda ƙwarewar likitancinta ko lafiyar jama'a - duka biyun suna da alaƙa galibi da cutar kanjamau, ƙwayar cuta gaba ɗaya ba kamar SARS-CoV-2 ba dangane da yadda take yaɗuwa, tsawon lokacin da ta fara, da kuma yadda yakamata a sarrafa ta. Haka kuma Birx ba ta da wani horo ko wallafe-wallafe a cikin cututtukan cututtukan cuta ko sarrafa cutar. Maimakon haka, kamar yadda Birx da kanta ta fada, Majalisar Tsaro ta Kasa ta dauki ma'aikata tare da nada ta aikin, ta hannun Mataimakin mai ba da shawara kan harkokin tsaro na Asiya. Matt Pottinger.
Amma me ya sa? Me yasa za a nada wani wanda ba shi da masaniyar likita ko ilimin kimiyya zuwa babban matsayi na mayar da martani ga annoba? Amsar, na yi imani, ita ce, an shigar da Birx a wannan matsayin don aiwatar da matakan da ba a gwada su ba, marasa ilimin kimiya, da matakan kawar da cutar gaba ɗaya. an kwafi kai tsaye daga China - matakan da al'ummar kare lafiyar halittu suka zaba saboda tsoro barna da koma baya na kwayar cutar da aka canza ta kwayoyin halitta. Amma hakan yayi nisa sosai a fagen hasashe.
Ɗaukar mataki baya, kafin hasashe dalilin da ya sa, bari mu bincika ƙarin kankare abin da: Wadanne irin matakan da Dr. Deborah Birx ta gindaya mana ba su da tasiri da bala'i, kuma menene dalilinta na sanya su?
Shiru Ya Fada
Duk abin da Birx ke iƙirari game da cutar ta Covid, da duk takaddun ta don rage shi, sun dogara ne akan ra'ayi ɗaya, wanda aka bayyana akai-akai a cikin littafinta, Shiru yadawo:
"Rarrabawa da yaduwar kwayar cutar zai kasance mafi girma kuma cikin sauri (fiye da kwayar cutar SARS ta 2002/3) saboda mamayewar da ba a gano ba da na yi imani da gaske tana faruwa a duk duniya." (shafi 28)
A wasu kalmomi, kamar yadda Birx ya bayyana, kwayar cutar SARS-CoV-2 ta bambanta da sauran ƙwayoyin cuta masu kama da mura da cututtukan da suka gabata saboda tana yaduwa cikin sauri, kuma ba a iya gano ta yayin da take yaduwa. Me yasa aka kasa gano shi? Domin yawancin mutanen da suka kamu da cutar suna da "rauni mai sauƙi - wata hanya ta kwatanta yaduwar shiru" (shafi na 92).
Mu sake daukar wani sakan na biyu don yin la’akari da kalaman Dr. Deborah Birx da kanta: Shiru yadawo yana nufin rashin lafiya. Da yawan yaɗuwar shiru, mutane da yawa suna kamuwa da cutar amma suna fuskantar ƙananan alamun bayyanar cututtuka.
Transmissibility da mutuwa
Idan bazuwar shiru yana nufin yawancin mutane suna da ƙarancin cuta, me yasa Birx ke tunanin SARS-CoV-2 yana da haɗari sosai har ya cancanci rufe duk duniya tare da ɗaukar matakan ragewa da ba a taɓa gani ba?
Kamar yadda ta bayyana (shafi na 18), idan muna son sanin yadda kwayar cutar ke da hatsari, dole ne mu yi la’akari da yadda take yaduwa cikin sauki da sauri, da kuma adadin mutanen da suka kamu da cutar ke mutuwa. Amma maimakon kallon kowane ɗayan waɗannan abubuwan daban, Birx ya dace da haɗa su:
"Ƙarin fallasa yana nufin ƙarin kamuwa da cuta, wanda ke nufin ƙara yawan rashin lafiya da mutuwa." (shafi na 56)
Ma’ana, da yawan mutanen da suka kamu da cutar, haka nan mutane za su yi mummunar rashin lafiya ko kuma su mutu. Amma kawai mun koya daga Birx cewa yawancin mutanen da suka kamu da cutar ta SARS-CoV-2 ta hanyar bazuwar shiru suna da laushi ko babu alamun cutar. Don haka, ta nata lissafi, ƙarin kamuwa da cuta ba dole ba ne yana nufin ƙarin rashin lafiya ko mutuwa ba.
Ba kimiyyar roka ba ce. Ba ma Epidemiology 101. Ma'ana ce kawai.
Gimbiya Diamond
Yanzu bari mu ce ba ma son yin amfani da dabaru kawai don karyata ma'anar Birx mara tushe cewa yaduwar shiru yana sa SARS-CoV-2 ke da haɗari sosai. A ce mun kalli abin da mashahurin masanin cututtukan cututtukan duniya ya ce a cikin Maris 2020 game da abin da bazuwar shiru ke nufi dangane da haɗarin gaba ɗaya daga sabon coronavirus.
John Ioannidis farfesa ne na Stanford kuma jagoran ƙwararrun ƙwararrun duniya a fannin cututtukan cututtukan dabbobi, ƙididdiga da bayanan ilimin halittu, tare da ɗaruruwan wallafe-wallafe da ƙwarewa a daidai wuraren da ke da mahimmanci don fahimtar cutar ta bulla. Shi ne kawai irin mutumin da kuke so ya ba ku shawara kan yadda za ku kimanta barazanar da wata novel virus ke haifarwa.
a wani An buga labarin Maris 17, 2020, Ioannidis ya bayyana cewa don gano yadda cutar ta kamu da cutar, kuna buƙatar ƙididdige kusan adadin mutanen da suka kamu da cutar za su mutu.
Ioannidis ya yi amfani da jirgin ruwa mai saukar ungulu na Gimbiya Diamond don ƙididdige ƙimar kisa (yawan mutanen da suka kamu da cutar kuma suka mutu) don SARS-CoV-2. Ya yi amfani da jirgin ruwan ne saboda an keɓe fasinjojin na dogon lokaci don ba da damar cutar ta yadu a tsakanin su, kuma waɗanda ke da alamun an gwada su ga Covid. Mutane bakwai daga cikin 700 da suka gwada inganci sun mutu. Wannan adadin mutuwa ne na 1% (7/700).
Koyaya, kamar yadda Birx kanta ta lura: "Bayanin da aka rubuta ya yi zafi sosai, daga 1 zuwa 691 sun tabbatar da inganci a cikin makonni uku kawai - kuma waɗannan sune kawai mutanen da ke da alamun cutar. Idan sun kasance suna yin gwajin ko'ina, tsakanin mutanen asymptomatic, ainihin adadin zai iya girma sau biyu zuwa uku: cututtukan 1,200 zuwa 1,800." (shafi na 46)
Ioannidis ya kuma yi tunanin cewa mutane da yawa da ba a gwada su ba za su iya kamuwa da cutar. A wannan yanayin, a ce alal misali akwai mutane 1,400 da ba a gwada su ba amma masu kamuwa da cutar, adadin masu mutuwa zai ragu zuwa 0.33% (7/2,100). Kuma idan akwai mutane 2,800 da ba a gwada su ba amma masu kamuwa da cutar, adadin masu mutuwa zai zama 0.2% (7/3,500). Da sauransu.
Wannan shine abin da yaduwar shiru ke nufi ga yawan mace-mace: yayin da kwayar cutar ke kamuwa da mutane ba tare da kashe su ba, ba ta da kisa. Wanne, a cikin duniyar hankali, mai yiwuwa yana nufin za mu buƙaci ƙananan matakan ragewa.
Birx, duk da haka, a cikin ɗayan manyan ayyukanta na ɓarnatar da hankali, ta ƙarasa da cewa, saboda matakan da take ganin sune mabuɗin don dakatar da yaɗuwar (mask da nisantar da su) a zahiri ba sa aiki don dakatar da yaduwar cutar, a fili kwayar cutar tana yaduwa cikin nutsuwa, wanda ke nufin muna buƙatar ɗaukar ƙarin waɗannan matakan:
"Duk da matakan da ma'aikatar kiwon lafiya ta Japan ta sanya, wannan haɓakar fashewar wata shaida ce ta bazuwar shiru." (shafi na 46)
Bugu da ƙari, yana da ma'ana sosai don zama tushen duk mahaukatan manufofin Covid, amma akwai shi. Kuma, ba shakka, Birx ba ta taɓa bin hujjarta ba zuwa ga ƙarshe na ma'ana wanda shine:
- Idan rufe fuska da nisantar da kai ba su hana yaduwar shiru ba, me yasa muke sanya su?
- Idan yawancin mutane suna kamuwa da ƙananan cututtuka, me yasa muke buƙatar matakan rage girman duniya tun da farko?
Testing
Dagewar rashin hankali na Birx na cewa bazuwar shiru yana sa kwayar cutar ta fi haɗari tana kai ta zuwa wani mahimmin mai da hankali kan gwaji da lambobi.
Domin, a cewar Birx, idan bazuwar shiru ba laifi ce a kanta, hanyar da za a iya magance ta ita ce a rage shiru ta hanyar gwaji. Kuma yawancin lokuta da ake samu, komai laushi ko asymptomatic, ƙarin haɗarin da ake zaton kwayar cutar ta haifar. Wannan zato mai sauƙi mai ƙarfi, duk da rashin ma'ana a cikin mahallin yaɗuwar shiru, ya kasance ɗaya daga cikin dalilai masu ban tsoro don ƙuntatawa mara ƙarewa waɗanda ke ci gaba har zuwa yau.
A bayyane yake, Birx bai san cewa Hukumar Lafiya ta Duniya, a cikin ta jagororin don matakan da ba na magunguna ba (NPIs) don kamuwa da mura, ya bayyana a sarari cewa:
"Shaidu da gogewa sun ba da shawarar cewa a cikin lokaci na 6 na annoba (ƙara da ci gaba da yaduwa a cikin jama'a), tsauraran matakai don ware marasa lafiya da keɓancewar hulɗa, koda kuwa su ne marasa lafiya na farko da aka gano a cikin al'umma, wataƙila ba su da tasiri, ba kyakkyawan amfani da ƙarancin albarkatun kiwon lafiya ba, da kuma lalata zamantakewa."
A takaice dai, gwada mutanen asymptomatic da keɓe su don dakatarwa ko sassauta yaduwar cutar ƙwayar cuta ta numfashi da ta riga ta yaɗu ga sauran jama'a ba kawai mara ma'ana ba ne amma mai iya cutarwa. Haka kuma, yayin da kwayar cutar ta yadu cikin sauri da kuma shiru, gwajin da ba a yi amfani da shi ba ya zama ƙasa da keɓewa, saboda kwayar cutar ta fi yaɗuwa a cikin yawan jama'a.
Kuma, kamar yadda Birx da kanta ta kasance cikin fargaba don gargaɗi kowa da kowa, gami da Shugaba Trump, a cikin Maris 2020 lokacin da ta fara ba da shawarar yin gwaji mai yawa, "ba shakka kwayar cutar ta riga ta yadu sosai, a ƙarƙashin radar, a cikin Amurka" (shafi na 3).
Masking da nisantar da jama'a
To yaya game da sauran matakan? Kamar yadda aka tattauna a sama, Gimbiya Diamond ta bayyana wa Birx cewa rufe fuska da nisantar da jama'a ba za su iya dakatar da yaduwar "shiru ba." Amma duk da haka ko ta yaya waɗannan suna cikin manyan dabarun rage mata.
Birx ta ce tabbacinta game da ingancin abin rufe fuska da nisantar da kai ya zo ne daga lokacinta a Asiya yayin barkewar cutar SARS 2002-2004.
"Ina aiki a Asiya a cikin 2002 lokacin da aka fara barkewar cutar sankara ta numfashi (SARS)" (shafi na 9), ta tuna. [NOTE: SARS a zahiri yana nufin mai tsanani Cutar cututtuka mai saurin numfashi, amma a nan Birx ya maye gurbin "mai tsanani" da "kwatsam" - wani ɗan ƙaramin alamar cewa amincin kimiyya ba shine farkon abin da littafin ya fi mayar da hankali ba.]
Abin da ya dace ta kasa gaya mana, shi ne, ba ta cikin kasar Sin, inda barkewar cutar ta samo asali, kuma ba ta cikin kasashen Asiya da ke fama da cutar sosai. Maimakon haka, ta kasance a Tailandia, tana aikin rigakafin cutar kanjamau. Ita kuma ta watsar da abin jin dadin hakan an sami kamuwa da cuta 9 da mutuwar 2 a duk Thailand daga cutar SARS.
Duk da haka, duk da haka nesa ba kusa ba ta kasance daga farkon barkewar annobar 2002-2004, Birx ta dage da cewa:
"Daya daga cikin abubuwan da suka hana yawan mace-macen cutar ta SARS ya zama mafi muni shine, a Asiya, yawan jama'a (matasa da tsofaffi) sun rungumi sanya abin rufe fuska akai-akai…
[WATA BAYANI AKAN KUSKUREN MAGANAR KIMIYYA: ba abin rufe fuska ba kuma ba a taɓa danganta shi da rage yawan mace-mace (CFR) na kowace cuta ba. CFR shine mutane nawa ke mutuwa da zarar sun kamu da rashin lafiya. Ana rage CFR ta hanyar jiyya waɗanda ke hana marasa lafiya mutuwa. Masks, bisa ka'ida, na iya hana mutane kamuwa da cuta. Ba za su iya hana mutuwa a cikin marasa lafiya da suka rigaya ba.]
Birx yana nuna tabbaci iri ɗaya game da nisantar da jama'a:
"Wata dabarar da ta dakile barkewar cutar ta SARS ta 2003 ita ce jagororin nisantar da jama'a - iyakance kusancin ku da sauran mutane, musamman a cikin gida… (shafi na 37)
Birx ba ta bayar da bayanan ƙafafu, nassoshi, ko wata shaidar kimiyya kwata-kwata don waɗannan ikirari ko, don wannan al'amari, ga duk wani iƙirarin ta na ilimin kimiyya. Kamar yadda aka ambata a cikin Babban bita na Jeffrey Tucker of Shiru yadawo, akwai ba ko ɗaya tak a cikin littafin duka ba.
Amma duk da haka, idan muka kalli wallafe-wallafen kimiyya, mun gano cewa waɗanda suka yi nazarin NPI a lokacin barkewar cutar SARS ta 2002-2004 sun zo daidai da akasin ƙarshe. Kungiyar Aiki ta WHO akan watsawar SARS ta Duniya da Al'umma kammala cewa:
"Barkewar cutar ta 2003 mai tsanani na numfashi mai tsanani (SARS) ta ƙunshi ta hanyar ayyukan kiwon lafiyar jama'a na gargajiya, kamar ganowa da ware marasa lafiya, keɓe abokan hulɗa, da haɓaka kamuwa da cuta. Tasiri mai zaman kansa na matakan 'ƙaratar zamantakewa' da sanya abin rufe fuska a wuraren jama'a yana buƙatar ƙarin kimantawa."
A wasu kalmomin, rufe fuska da nisantar da jama'a su ne mafi ƙarancin tabbatar da shisshigi don shafar yaduwar ko sakamakon cutar SARS da Birx ke ikirarin kafa manufofinta.
Ƙarfafa wannan ƙaddamarwa, a Binciken WHO na 2006 na NPIs don cututtukan mura, shawarwarin sun bayyana a sarari cewa:
"Ba a sa ran sanya abin rufe fuska da jama'a zai yi tasiri mai tasiri kan watsawa, amma ya kamata a ba da izini, domin wannan yana iya faruwa ba tare da bata lokaci ba."
Duk wasu hujjojin da aka samo ko aka ƙirƙira don rufe fuska yayin Covid bayan nadin Birx a Rundunar Task Force ta Fadar White House, waɗanda ta yi iƙirarin kafa manufofinta na bogi ne daga tafiya.
Wannan ba shakka babu damuwa ga Birx, wanda manufarsa a ciki Shiru yadawo a fili ba don isar da ingantattun ka'idodin kimiyya ko lafiyar jama'a ba. Ta fi damuwa da nuna yadda ita da maƙarƙashiyarta ta kulle-kulle, Mataimakin mai ba da shawara kan Tsaron ƙasa Matt Pottinger, suka yi yarjejeniya gaba ɗaya game da duk matakan rage ilimin kimiyya ba tare da juna ba:
Birx ya ce "Ba tare da ni ba, Matt ya zama annabin fadar White House da kansa ya naɗa abin rufe fuska," in ji Birx. Amma, ga damuwarta, "a Fadar White House, sakon Matt game da sanya abin rufe fuska don hana yaduwar shuru ya fada kan kunnuwa." (shafi na 36)
Wanne ya sa mutum ya yi mamaki: a ina Pottinger, ɗan jarida mai zaman kansa wakilin leken asiri, ya sami ra'ayinsa mai ƙarfi game da amfanin abin rufe fuska don rage cututtukan cututtukan ƙwayar cuta gabaɗaya, musamman cutar ta Covid?
Bisa lafazin Lawrence Wright's wanda ba na kimiyya ba, labarin da aka fi sani a ciki The New Yorker a watan Disambar 2020, Pottinger ya sami ra'ayin ne yayin da yake tuƙi motar motsa jiki, yana magana da likita a China, da kuma rubuta bayanai a bayan ambulaf (duk a lokaci guda!):
"A ranar 4 ga Maris, yayin da Matt Pottinger ke tuki zuwa Fadar White House, yana waya da wani likita a kasar Sin, yana daukar bayanai a bayan ambulan yayin da yake kewaya zirga-zirga, yana ji. sabon bayani mai mahimmanci game da yadda ake dauke da kwayar cutar a China. Likitan… ya jaddada hakan masks sun kasance masu tasiri sosai tare da Covid, fiye da kamuwa da mura. "Yana da kyau a ɗauka a kusa da na'urar tsabtace hannu," in ji likitan. "Amma masks za su yi nasara a ranar."
Bayan haka, bayan samun wannan sabon sabon bayani mai mahimmanci daga wani "likita a China" wanda ba a bayyana sunansa ba, ko da motarsa da ke fakin tana komawa baya cikin bishiya (da alama ya manta birki na gaggawa), Pottinger "ya ci gaba da tunanin abin rufe fuska." A bayyane yake, ra'ayin ya ruɗe shi. Me yasa? Domin ya yi tunanin cewa a bayyane yake cewa, duk inda akasarin mutane suka sanya abin rufe fuska, an dakatar da kamuwa da cutar 'mutuwa a cikin sa'.
Wannan shi ne kyakkyawa da yawa. Matt ya yi tunanin cewa a bayyane yake cewa abin rufe fuska ya dakatar da yaduwa a Hong Kong da Taiwan - bisa ga irin shaidar da wataƙila ba za mu taɓa sani ba - don haka dole ne a aiwatar da shi a ko'ina.
KAMMALAWA & AL'AMURAN DA BA'A WARWARE
A cikin ta"labari mai ban tsoro" na annoba, Shiru yadawo, Deborah Birx ba ta ma ƙoƙarin yin mahawara mai ma'ana ta kimiyya ko kiwon lafiyar jama'a don goyon bayan matakan kama-karya irin na Sinawa da ta ba da shawarar. Madadin haka, ta bayar da maganganun marasa ma'ana, masu cin karo da juna - wasu karya ce wasu kuma an dade ana karyata su a cikin adabin kimiyya.
Ina shakka Birx ta gaskanta duk wani ikirarin kimiyya na karya da aka yi a littafinta. Maimakon haka, kamar yadda yake tare da batun yadda aka nada ta tun farko, labarin gaba ɗaya shine allon hayaƙi ko karkatarwa, wanda aka yi niyya don jawo hankali daga wanda a zahiri ya naɗa ta da kuma dalilin da ya sa.
Idan mun san amsoshin waɗannan tambayoyin guda biyu (ta wanene kuma dalilin da yasa aka nada Birx), na yi imani za mu sami cewa:
- Dukkanin tsauraran matakan kulle-kulle irin na kasar Sin an sanya su ne a kan Amurka da duniya ta hanyar jami'an gwamnati wadanda ba su da masaniyar barkewar cutar amma yawancin sojoji da hadin gwiwar tsaron kasa, musamman shigar da kwayar cutar.
- Ba kwayar cutar ta SARS-CoV-2 da tasirinta a duniyar gaske ta shafi Birx, Pottinger da shugabanninsu da takwarorinsu na wasu ƙasashe ba. Damuwa ne ko sanin cewa an kirkiri kwayar cutar ne a cikin shirin bincike na sirri mai cike da cece-kuce. Tun da yawan al'ummar duniya ba a taɓa fuskantar wani injiniyan injiniyan "ƙarfafa yiwuwar kamuwa da cutar ba", kuma tun da China ta yi iƙirarin manufofinta na aiki, sun dage cewa lamarin yana buƙatar matakan tsauraran matakan da ba a taɓa amfani da su ba.
- Hukumomin kiwon lafiyar jama'a da shuwagabanni a yawancin ƙasashe jami'an tsaro / tsaro na rayuwa sun mamaye su, saboda wani ɓangare na matsanancin haɗarin da kwayar cutar za ta iya haifarwa, amma kuma saboda sojoji da hukumomin tsaron ƙasa suna da mafita da yawa suna jiran irin wannan matsalar. Misali daya shine dandamalin rigakafin mRNA waɗanda aka yi amfani da su don haɓaka rigakafi na Covid a cikin Operation Warp Speed - aikin da yawancin shugabannin Ma'aikatar Tsaro ke ɗaukar aiki [ref]. Wani misali shi ne na Ingila rigima amma mai matukar riba "nufa naúrar. "
Ana ci gaba da binciken duk waɗannan tambayoyi masu mahimmanci.
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Debbie Lerman, 2023 Brownstone Fellow, yana da digiri a Turanci daga Harvard. Ita marubuciyar kimiyya ce mai ritaya kuma ƙwararren mai fasaha a Philadelphia, PA.
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