"Idan kuna da tabarau ko garkuwar ido, ya kamata ku yi amfani da shi." ~ Anthony Fauci, Yuli 30th, 2020
Mun ji isasshe daga Fauci a lokacin da aka yi wannan sharhi a tsakiyar 2020 don fara daidaita shawararsa ta sabani akai-akai. Idan da mun ba da nauyi ga wannan sharhi kuma mun bincika dalilin da ya sa ya fara ba da shawarar tabarau (har yanzu bai taba ba da su da kansa ba)?
Duk da yake ban yi mamakin cewa yanayin jikin fuska na ciki da ya haɗa da bututun ido da haɗin kai a cikin tsarin ba ilimin gama gari bane, Ina tsammanin ƙarin martani daga ƙungiyar likitocin game da turawar Fauci don kariyar ido. Ba wai kawai ƙwararrun likitocin ke ɗaukar babban kwas kan ilimin jikin ɗan adam ba - ana buƙatar su hadu kowace shekara tare da Masanin Tsaftar Masana'antu don dacewa da gwajin da ya dace, takamaiman kayan haɗari ga kowane saitin fallasa, gami da kariyar ido. Wannan tsarin gwaji yana buƙatar yin daki-daki game da kowane saitin fallasa da ake buƙata donning da ayyukan doffing a cikin iyakar ayyukansu na ƙwararru.
Maimakon yin karin haske kan shawarar nasa, Fauci ya yi shiru a bainar jama'a game da batun kuma jama'a sun ci gaba, cikin biyayyar rufe fuska duk da haka gaba daya sun yi sakaci da hanyoyin nasolacrimal. Abin kunya, kunya.
Waɗannan su ne tsarin na'urar lacrimal da ke haɗa hanyoyin ido da hanci. Ainihin, ido yana matsewa cikin kogon hanci. Babu wani daga cikin shugabannin da ke magana na ƙungiyar likitocin da ya taɓa kawo cewa waɗannan sassan jikin suna haɗuwa da juna, kuma yayin da muke jin labarin abin rufe fuska ad tashin hankali shekaru uku bayan barkewar cutar ta SARS-CoV-2, babu wanda ke jayayya da baƙi akan intanet game da tabarau.
Bernie Sanders kwanan nan aka yaba don kasancewa shi kaɗai ne mutum a watan Fabrairu, 2023 State of the Union wanda ke ba da gudummawar na'urar numfashi (ƙananan aji, ba mai ragewa) ba, amma ido leƙen asiri wani abu mai kifi. An lura da cewa ya ci gaba da cire gilashin sa, yayin da suke cikin hazo.
Wadanda suka ba da gudummawar na'urorin numfashi sun fuskanci cewa fitar da hayaki gabaɗaya ana jujjuya su daga gadar hanci (ko kuma daga gibin gefe idan an rufe shi da kyau). Wannan ita ce fitar da hayakin fitar da na'urar numfashi ta N95 mara inganci, wanda ke haifar da shi:
Wannan ɗumi mai ɗanɗanon hayaƙin numfashi shine ke haifar da hazo. Wannan shi ne ainihin dalilin da ya sa na ci gaba da jayayya da cewa abin rufe fuska BABU sarrafa tushe don iska mai iska, saboda waɗannan na'urorin ba a ƙirƙira su ba ko kuma an yi nufin su kare wasu daga hayakin ku, amma don kare mai sawa kawai. ASTM ta yarda da ni a kan wannan batu:
Ƙungiyar Gwaji da Kayan Aiki ta Amurka (ASTM) Ƙimar Ƙimar Ƙimar Fuskar F3502-21 Bayanin kula na 2 ya ce, "A halin yanzu babu wasu hanyoyin da aka kafa don auna zubewar waje daga abin rufe fuska, abin rufe fuska, ko na numfashi. Babu wani abu a cikin wannan daidaitattun adireshi ko yana nuna ƙima na ƙima na waje kuma ba za a iya yin da'awar game da matakin da fuskar rufe fuska ke rage fitar da barbashi da mutum ya haifar."
Bugu da ƙari, bayanin kula na 5 ya ce, "A halin yanzu babu takamaiman hanyoyin da aka yarda da su waɗanda ke da su don auna ɗigogi na waje daga abin rufe fuska ko wasu samfuran. Don haka, ba za a iya yin da'awar game da matakin sarrafa tushen tushen abin rufe fuska mai shinge bisa la'akari da ƙima.
Don haka shin yana da mahimmanci idan fitar da fitar da makwabcin ku ya kasance a fuskar ku na tsawon lokacin jirgin ku na awa 6?
Lallai. Ka yi tunanin zama a tsakanin waɗannan ɓangarorin biyu masu kyau tare da buɗe idanunka, kuma fitowar su ta kai tsaye a fuskarka.
A cikin rage haɗarin iska, kariyar ido wani ma'auni ne na kit ɗin da ake buƙata, saboda waɗanda daga daidaitaccen yanki na gwaninta, Tsaftar masana'antu, sun san isashen yanayin jikin ɗan adam don tunawa da haɗin kai na tsarin fuska.
Yaduwar ido na SARS-CoV-2
An mai da hankali sosai kan kariyar numfashi tun farkon barkewar cutar, amma An riga an kafa watsawar ido don SARS-CoV-1.
"An nuna SARS-CoV-1 ana watsa shi ta hanyar tuntuɓar kai tsaye ko tare da digo ko iska mai iska tare da mucosa na idanu, hanci da baki. Lallai, a lokacin barkewar cutar SARS-CoV-2003 ta 1 a Toronto, ma'aikatan kiwon lafiya waɗanda suka kasa sanya kariya ta ido wajen kula da marasa lafiya da suka kamu da cutar ta SARS-CoV-1 sun sami mafi girman adadin seroconversion."
Mun fara ganin haɓaka bincike kan watsawar ido don SARS-CoV-2 yana fitowa, haka nan, yana tafiya ta hanyar nasolacrimal daga ido, yana matsewa cikin rami na sinus.
"Akwai shaida cewa SARS-CoV-2 na iya ko dai kai tsaye cutar da kwayoyin halitta a saman ido, ko kuma za a iya ɗaukar kwayar cutar ta hanyar hawaye ta hanyar hancin hanci don cutar da hanci ko epithelium na ciki."
"Tsarin nasolacrimal yana samar da haɗin jiki tsakanin fuskar ido da na numfashi na sama. Lokacin da aka cusa digo a cikin ido, duk da cewa wasu daga cikin su suna shanye shi da cornea da conjunctiva, yawancinsa ana zubar da shi zuwa cikin kogin hanci ta hanyar nasolacrimal canal kuma daga bisani a canza shi zuwa ga numfashi na sama ko kuma na gastrointestinal."
"SARS-CoV-2 akan saman ido ana iya canza shi zuwa tsarin daban-daban tare da hawaye ta hanyar nasolacrimal."
Ba kasafai ba ya haifar da bayyanar ido a cikin kamuwa da ido, yayin da cututtukan tsarin ke faruwa akai-akai. Ba za a iya tantance bayyanar ido koyaushe a matsayin wurin tuntuɓar wannan dalili ba, saboda ciwon ido ba koyaushe ya zo daidai da kamuwa da cuta ba.
Ana tattauna bututun nasolacrimal sau da yawa a cikin binciken watsawar ido, amma wannan ba shine kawai hanyar watsa ido da aka tattauna ba.
"Akwai hanyoyi guda biyu da bayyanar ido zai iya haifar da kwayar cutar ta SARS-CoV-2.
Bugu da ƙari, bincike ana gudanar da shi ta hanyar amfani da sifofin ido a ciki watsa SARS-CoV-2.
"Sa'an nan a nan tambaya ta zo, ko SARS-CoV-2 gano a conjunctival secretions da hawaye ne mai kamuwa da cuta? Kwayar cutar daga wani samfurin nasopharyngeal da kuma swab na majinyacin COVID-6 ba wai kawai ya kamu da kwayar cutar ta mutum ba amma kuma ya kamu da cutar sosai kuma ya kai ga kamuwa da kwayar cutar kwayar cuta fiye da SARS-CoV.
Bisa ga wannan binciken, ɓoyayyun ido suna da saurin kamuwa da cuta.
"Sashin ido na iya zama tafki da tushen yaduwa ga SARS-CoV-2. Ana iya yada SARS-CoV-2 zuwa saman ido ta hanyar ido da iska, sannan kuma canjawa zuwa wasu tsarin ta hanyar nasolacrimal da metastasis na hematogenous. Ba za a iya watsi da yiwuwar watsa ido na SARS-CoV-2."
Wannan takarda kuma tana da mai da hankali kan iskar da ke shigowa cikin mucosa na ido.
"Da zarar aerosols ya fito, SARS-CoV-2 na iya ɗaure zuwa ACE2 akan mucosa na ido da aka fallasa don haifar da kamuwa da cuta.
Wani ƙarin yanki da aka bincika a cikin wannan bincike yayi magana game da rhesus macaques inda waɗanda kawai aka yi wa maganin ta hanyar ido suka kamu da cutar.
"Idan fuskar ido ita ce tashar tashar SARS-CoV-2 don shiga, a ina kwayar cutar ke canjawa bayan shiga? Gwajin dabba ya nuna yiwuwar hanyoyin nasolacrimal na SARS-CoV-2 canja wuri daga saman ido. Macaques inoculated ta hanyar conjunctival za a iya gano SARS-CoV-1 conjunctival swabs na rhesus macaques da aka allura ta hanyar intragastric ko intracheal kwanaki uku bayan conjunctival inoculation, rhesus macaques ya nuna m nasolacrimal tsarin kyallen takarda, ciki har da lacrimal gland, conjunctiva, hanci rami, da makogwaro, wanda ya haɗa idanu da kuma numfashi fili a kan jikin mutum."
An ƙarin nazarin macaque yana da irin wannan binciken.
"Deng et al. ya nuna cewa kamuwa da cuta na SARS-CoV-2 na iya haifar da kamuwa da cuta ta hanyar inoculation na ido a cikin samfurin dabba na gwaji ta amfani da macaques. Sun euthanized da necropsied daya daga cikin conjunctival inoculated-dabbobi da kuma gano cewa kwayar cutar ta yadu zuwa ga nasolacrimal tsarin da ido nama, hanci kogon, pharynx, trachea, kyallen takarda a cikin na baka, kyallen takarda a cikin ƙananan-hagu lobe na huhu, inalguide ciki da kuma na ciki na ciki, na ciki da kuma na ciki. Sun kuma sami takamaiman maganin rigakafin IgG, wanda ke nuna cewa dabbar ta kamu da SARS-CoV-1 ta hanyar saman ido. ”
Yayin da hanyar nasolacrimal ita ce farkon mayar da hankali a mafi yawan bincike na yanzu, an kuma tattauna shingen jini-retinal (BRB) a matsayin hanya mai yiwuwa.
"Da zarar ya isa saman ido, SARS-CoV-2 na iya mamaye conjunctiva da iris a karkashin sulhu na ACE2 da CD147, wani mai yuwuwar mai karɓar SARS-CoV-2 akan sel masu masaukin baki. CD2 a cikin kwayoyin epithelial pigment na retinal pigment da sel endothelial na jini.
RSV
An yi wani yunƙuri kwanan nan don dawo da abin rufe fuska don ƙwayar cuta ta Syncytial (RSV), musamman a cikin makarantu, saboda wannan ƙwayar cuta ta fi shafar yawan matasa, duk da haka watsawar ido wata hanya ce ta kamuwa da cuta ga RSV.
A cikin wannan takarda, yin amfani da kwayar cutar ta cikin hanci ta haifar da farawar rashin lafiya ga kusan dukkanin cututtukan numfashi da aka yi nazari. Yana bitar hanyoyin watsawa da ƙaramin ƙwayar cuta don mura, Rhinovirus, Coxsackievirus, Adenovirus, RSV, Viruses Enteric, Rotavirus, Norovirus, da Echovirus, gami da watsa ido.
"Kwayoyin cuta na rhinoviruses a cikin hanci da idanu ana tsammanin sun yi kama da juna saboda kwayar cutar ba ta cutar da idanu amma tana kama da tafiya daga idanu zuwa mucosa na hanci ta hanyar zubar hawaye."
"Hall et al. (1981) sun bincikar cutar ta nau'in RSV A2 da hanci, ido, da baki ke gudanarwa a cikin masu aikin sa kai na manya. Sun ruwaito cewa kwayar cutar na iya kamuwa da ido ko hanci kuma dukkanin hanyoyin biyu suna da mahimmanci. A kashi na 1.6 × 105 TCID50 sun kamu da uku daga cikin masu aikin sa kai hudu da aka ba su ko dai a cikin idanu kawai ko kuma ba tare da tunanin takwas ba. saboda yaduwar cutar ta biyu."
"RSV A2 yana da mummunan kamuwa da cuta lokacin da aka gudanar da shi ta baki amma an nuna shi yana kamuwa da ido da hanci kuma dukkanin hanyoyin biyu suna kama da kwayar cutar."
"Bynoe et al. (1961) sun gano cewa ana iya samar da mura kamar yadda ya dace ta hanyar amfani da kwayar cutar ta hanci da kuma swabs na conjunctival kamar ta hanyar ba wa masu aikin sa kai a hanci."
Shin abin rufe fuska zai ceci makarantu daga yawowar RSV? Yawancin yara suna da tsarin rigakafi mai ƙarfi, tare da ƙanƙanta, ƙaramin kaso na yawan matasan da ke fuskantar chemotherapy ko shan maganin rigakafi, waɗanda yawanci ba sa zuwa harabar don koyo na mutum-mutumi. Amma ga waɗanda ke neman kariya da koyarwa ta cikin mutum, ba dole ne mu sanya su don bama-bamai na rigakafi ta hanyar ba da ma'anar tsaro ta ƙarya tare da nuna jahilci na sauran hanyoyin watsawa. Masks ba shine amsar ba.
Summary
Watsawar ido na ƙwayoyin cuta na numfashi ba shine tushen binciken ba, amma tare da sauran ƙwayoyin cuta da haɓaka bincike akan SARS-CoV-2 yana nuna sauƙin farawa na tsarin don wannan hanyar watsawa, ya kamata a ba da ƙarin hankali ga wannan yanki na bincike.
Yi la'akari da duk mutanen da kuka gani suna ba da gudummawar abin rufe fuska ko na'urorin numfashi a cikin waɗannan shekaru uku da suka gabata, an tabbatar da ingancinsu. Har yanzu nawa ne suka kamu da rashin lafiya? Shin kun taɓa ganin wani yana ba da gudummawar tabarau? Shin za mu taɓa yin magana game da gajiyawar matsayi na sarrafawa, ko matakan rage girman matakan da aka haramta, kuma sun yi yawa?
TLDR: Watsawar ido hanya ce mai yuwuwar watsawa don SARS-CoV-2. Masks ba sarrafa tushe ba ne. Ko N95s ba za su gyara wannan ba. Kuma duk abin rufe fuska na yara ba a ka'ida ba, ba a gwada shi ba, rashin da'a, da rashin tsaro, tare da ƙarancin inganci, dacewa, lokacin lalacewa, ko ƙa'idodin izinin likita, kuma tare da watsawar ido kasancewar ingantaccen hanyar watsawa don RSV, abin rufe fuska ba zai gyara wannan batun ba, ko dai.
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Megan Mansell tsohon darektan ilimi na gundumomi ne kan haɗakar jama'a na musamman, yana hidima ga ɗaliban da ke da naƙasa sosai, marasa lafiya, marasa doka, autistic, da ƙalubalen ɗabi'a; Hakanan tana da asali a cikin aikace-aikacen PPE masu haɗari. Tana da gogewa a rubuce da kuma sa ido kan aiwatar da ƙa'idar don samun damar shiga sassan jama'a da ke da rauni a ƙarƙashin cikakken ADA/OSHA/IDEA. Ana iya samun ta a MeganKristenMansell@Gmail.com.
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