Idan kun bayyana rashin fahimta game da manufofin Covid, mutane suna saurin mayar da martani: Ok, don haka menene ka mafita? Ta yaya ka shin yakamata mu magance cutar a maimakon haka? Kwararru uku sun fito da amsa, wacce suka rubuta a rubuce kuma suka sanya hannu tare a cikin garin Massachusetts na Great Barrington a ranar 4 ga Oktoba, 2020.
[Wannan wani yanki ne daga sabon littafin marubucin Makafi shine 2020, Brownstone ne ya buga.]
Babu wanda zai iya kuskuren shaidar shaidarsa. Masanin kiwon lafiyar jama'a da ke mai da hankali kan cututtuka masu yaduwa da yawan jama'a, farfesa na Jami'ar Stanford Jay Bhattacharya ya ninka a matsayin masanin tattalin arziki. Sunetra Gupta, farfesa a fannin cututtukan cututtuka a Jami'ar Oxford, ya ƙware a fannin rigakafi, haɓaka rigakafin rigakafi, da ƙirar lissafi na cututtukan cututtuka. Martin Kulldorff, masanin ilimin halittu kuma masanin cututtukan cututtuka, ya ƙare shekaru 18 a matsayin farfesa na Jami'ar Harvard a 2021.
Dabarar da suka gabatar a cikin Babban Sanarwar Barrington (GBD) ta fito ne daga keɓancewar siffa ta coronavirus: ƙayyadaddun ƙayyadaddun yanayin haɗarin sa. A ƙarshen bazara na 2020, bincike yana tabbatar da abin da ma'aikatan a kowane asibiti suka rigaya suka sani: "Haɗarin [mutuwar Covid] yana hauhawa yayin da shekaru ke ƙaruwa." CDC ta buga wani bayanin da ya sanya wannan kaifi mai kaifi cikin sauƙi: idan kun kamu da kwayar cutar a cikin shekaru 75-84, haɗarin ku na mutuwa daga gare ta ya ninka sau 3,520 fiye da idan kun kama ta tana da shekaru 5-17. Yanayi na yau da kullun kamar kiba, cututtukan zuciya, da ciwon sukari suma sun haɗu da haɗarin, kodayake ba kusan shekaru ba.
Don haka a nan muna da kwayar cutar da ke haifar da babban haɗari ga wasu mutane da ƙaramin haɗari ga wasu. A lokaci guda muna da manufofin kulle-kulle waɗanda, ga duk abin da suke yi na daidaito, sun raba mutane da kyau ta layin aji. Ga ƙwararrun ma'aurata tare da dafa abinci mai dafa abinci da biyan kuɗi zuwa sabis na yawo guda huɗu, kulle-kulle suna wakiltar damar sake haɗawa da nishaɗi cikin sauƙi na rayuwa, kamar burodin zaitun da aka gasa a gida da fina-finai Humphrey Bogart. Zuwa ga sabon ɗalibin ƙasashen waje da ya sauko, yana dimuwa da kaɗaici a ƙarƙashin rufin gininsa, ba haka ba. Ma'aikata masu mahimmanci, a nasu bangaren, ana tsammanin za su iya ɗaukar haɗarin da ajin kwamfutar tafi-da-gidanka suka yi.
Wannan rikice-rikicen yanayi ya sa ba zai yiwu a yi la'akari da tambayar: Shin za mu iya ba ƙungiyoyi masu karamin karfi su dawo da 'yancinsu yayin da muke kare mafi rauni? Wannan shine ainihin abin da GBD ya gabatar. Na sake buga shi anan a takaice:
Manufofin kulle-kulle na yanzu suna haifar da mummunan tasiri akan lafiyar jama'a na gajere da na dogon lokaci. Tsayar da waɗannan matakan har sai an sami maganin alurar riga kafi zai haifar da lalacewar da ba za a iya gyarawa ba, tare da cutar da marasa galihu.
Mun san cewa raunin mutuwa daga COVID-19 ya fi ninki dubu sama da tsofaffi da marasa ƙarfi fiye da matasa. Mun san cewa duk jama'a za su kai ga rigakafin garken garken kuma ana iya taimaka wa wannan ta hanyar (amma ba a dogara da) maganin rigakafi ba. Don haka ya kamata manufarmu ita ce rage mace-mace da cutar da jama’a har sai mun kai ga rigakafin garken shanu.
Hanya mafi tausayi ita ce ba da damar waɗanda ke cikin haɗarin mutuwa su yi rayuwarsu ta yau da kullun don haɓaka rigakafi ga ƙwayar cuta ta hanyar kamuwa da cuta ta dabi'a, tare da kare waɗanda ke cikin haɗari mafi girma. Muna kiran wannan Kariyar Mayar da hankali. Za a iya aiwatar da cikakken jerin matakan matakan, gami da hanyoyin da za a bi don tsara gidaje da yawa, kuma yana cikin iyaka da iyawar ƙwararrun kiwon lafiyar jama'a.
Wadanda ba su da rauni ya kamata a ba su nan da nan a bar su su ci gaba da rayuwa kamar yadda aka saba. Ya kamata a ci gaba da ayyukan fasaha, kiɗa, wasanni da sauran ayyukan al'adu. Mutanen da suka fi fuskantar haɗari za su iya shiga idan sun ga dama, yayin da al'umma gaba ɗaya ke jin daɗin kariyar da waɗanda suka gina garken garken garken garken garken garken ke bayarwa ga masu rauni.
A wajen mahallin Covid, babu wani abu mai tsauri game da shawarar. Ya yi daidai da jagorar cutar ta pre-Covid daga irin waɗannan kungiyoyi kamar WHO da CDC, waɗanda suka ba da shawarar hana hana bargo tare da ba da fifiko kan rage ɓarnawar zamantakewa. Hakanan ya kawo karshen tashin hankali a duk lokacin bazara na 2020, lokacin da gungun masana a cikin ƙasashe da yawa suka fara yin kira da a samar da ƙarancin ra'ayi game da Covid-daga Balanced Response a Kanada zuwa New Zealand's Covid Plan B - tare da gargaɗin gwamnatocinsu da su maido da rayuwa ta yau da kullun ga mafi ƙarancin haɗari. GBD ta fito a matsayin ƙarshen waɗannan jita-jita, roƙon hana kulle-kulle wanda a ƙarshe ya ɗauki hankalin duniya. Masana ilimin natsuwa a jajibirin kaddamar da shi, Bhattacharya, Gupta da Kulldorff yanzu sun haskaka fuskarsu a duniya.
Lokacin da 'yan ukun suka buga daftarin a kan layi, sun gayyaci magoya bayan su don su sanya hannu a kan ta. Ƙididdigar sa hannun ya ƙaru da sauri na ƴan kwanaki-Na sani, saboda na kalli canjin lambobi-sannan na tsaya. Tashin hankali ya fara ne kwanaki hudu bayan GBD ta fito, lokacin da Francis Collins, darektan Cibiyar Kiwon Lafiya ta Kasa, ya kira shi aikin "masu cutar cututtukan fata guda uku" a cikin imel zuwa Fauci da sauran manyan abokan aiki. Da alama ya damu game da kutsewar kafofin watsa labarai da ke kewaye da sanarwar, ya nemi a yi “sauri da ɓarna [sic] na wurarenta.”
Collins ya sami burinsa lokacin da wata kasida ta jami'ar Yale masanin cututtukan cututtuka Gregg Gonsalves ta bayyana a ciki The Nation a wannan ranar. Ba za mu bi “wasu ra’ayi na rayuwar matasa da mafifici ba,” Gonsalves ya rubuta—fassarar madaidaicin “kare masu rauni.” Bayan 'yan kwanaki, da Lancet ya buga wata sanarwa ta kin amincewa da GBD da aka sani da John Snow Memorandum. Fauci da kansa ya bayyana GBD a matsayin "marasa hankali" da "mai haɗari."
Tare da albarkar Fauci don lalata GBD, ƙwararrun kafofin watsa labaru da mayaƙan kan layi sun wajaba cikin farin ciki. An fusata a cikin bugu da kuma a shafukan sada zumunta: Masu kisan kai! Masu musun Covid! Ba su damu da masu rauni ba! (Kada ku manta cewa dukan dabarun sun ta'allaka ne da kare masu rauni.) "Na fara samun kira daga 'yan jarida suna tambayar ni dalilin da yasa nake son 'bar kwayar cutar,' lokacin da ban ba da shawarar komai ba. Ni ne harin wariyar launin fata da barazanar kisa," in ji Bhattacharya. Jita-jita cewa Cibiyar Nazarin Tattalin Arziki ta Amirka (AIER) tana amfani da GBD guda uku don ciyar da tsarin 'yanci ya fara yaduwa. A zahiri, "AIER ya kasance mai kirki don samar da wurin taron wanda ya kai ga Babban Sanarwar Barrington, amma bai taka rawar gani ba wajen tsara abubuwan da ke ciki."
Jeffrey Tucker, babban editan AIER a lokacin (kuma wanda ya kafa Cibiyar Brownstone), ya bayyana mani cewa kungiyar tana fatan "tabbatar da tattaunawa game da manufofin Covid. Ba mu da masaniyar inda za ta je ko girman girmanta."
Kalmar "kariya ga garken" ta sami duhu mai duhu, tare da kowa ya manta cewa cututtukan numfashi sun ƙare tare da rigakafin garken garken a cikin tarihi. Rashin karanta kalmar a matsayin ra'ayi mai ban tsoro da son kai ya ci gaba da damun Gupta, wanda ya lura cewa "kariya ga garken a zahiri ra'ayi ne mai zurfi" saboda babban rigakafin al'umma "shine abin da ke kare masu rauni."
Nan da nan mutum ba gratae, abokan GBD sun nemi banza don kare kansu ga masu sauraron da suka riga sun toshe kunnuwansa. Gupta, mai ci gaba na rayuwa, ta koma buga tunaninta a gidajen labarai masu ra'ayin mazan jiya. "Ba zan iya ba, ya dace a ce, a koyaushe ina daidaita kaina da Daily Mail," in ji ta a cikin wata kasida da ta rubuta wa jaridar jim kadan bayan da GBD ta fito, ta kara da cewa "ba ta shirya tsaf don harin zagi, zargi na sirri, tsoratarwa da barazanar da suka cika shawararmu ba."
Na sami damar yin hira da duka membobin ƙungiyar GBD guda uku akan kiran bidiyo na rukuni daban. Ga tarihin, ba zan iya tunanin wani mutum uku mai gaskiya da alheri ba—irin mutanen da mahaifiyata ta rasu za ta kira. mazan jiya. Da masu sukar su sun shafe sa'a guda tare da su akan nachos da giya, ina da yakinin yakin cin mutuncin da ake musu da ya kaure kai tsaye.
Wani lokaci, kalma ɗaya na iya sa komai ya faɗi cikin wuri. Kalmar "marasa waƙa," wadda Gupta ya yi amfani da ita don kwatanta martanin Covid, ta yi tasiri a kaina. Ita ce kalmar da nake nema tun dazu, mabuɗin abin da mutanen zama-gida-ceto-rayuka suka ɓace. Wataƙila ba daidaituwa ba ne cewa Gupta ta sanya hula ta biyu a matsayin marubucin da ta lashe lambar yabo, tana ba ta hankali daga ra'ayin duniya.
"Rikicin cuta ne," in ji ta lokacin da na tambaye ta da ta yi karin bayani. "Martani ne mai fuska daya ga rikicin da ya shafi bangarori daban-daban, na kira shi da martani mara waka domin yana kewar ruhin rayuwa, abubuwan da ke ba da ma'ana."
Idan Gupta ta sami rashin amsawar cutar a cikin waƙa, ita ma ta ƙi ta kayan ado. Zaune a teburin cin abinci, kuna karya biredi tare da abokanka waɗanda ba a rufe su ba yayin da uwar garken abin rufe fuska ke niƙa barkono a kan yaren ku… "bangaren ɓacin rai da ba za a iya jurewa ba" ya ɓata mata hankali na daidaito. "Ya yi daidai da tsarin kabilanci, [tare da] kowane nau'i na dokoki game da wanda zai iya shan ruwa daga wurin wane - duk waɗannan ƙa'idodi marasa ma'ana da ƙa'idodi marasa kyau waɗanda ke wurin don lalata mutuncin mutane."
Wannan kalma ɗaya, feudal, tana ƙarfafa nazarin Tucker na rufe gidan abincin na Covid. A cikin ɗaya daga cikin kasidunsa masu yawa, ya lura cewa “gidan abinci, gidan kofi, da gidan abinci suna da muhimmiyar rawa wajen yaɗa ra’ayin ‘yancin duniya.” Rufe gidan abincin yana wakiltar "komawa zuwa zamanin zamani wanda manyan mutane ne kawai ke jin daɗin samun mafi kyawun abubuwa" - abin da Tucker ya kira "sabon feudalism."
Yayin da cutar ta ci gaba, Gupta ta ci gaba da faranta min rai da fahimtarta-kamar ra'ayi na haɗin gwiwar watsa kwayar cutar. "Ba shi da amfani a gano tushen kamuwa da cuta zuwa wani lamari guda," in ji ta The tangarahu. "A rayuwarmu ta yau da kullun, da yawa suna mutuwa da kamuwa da cuta amma muna ɗaukar laifin kamuwa da su gaba ɗaya. Ba za mu iya yin aiki a matsayin al'umma in ba haka ba."
Irin wannan kyakkyawar hanyar sanya shi: mu tare muna danne laifin. Babu wanda zai damu da "kashe kakar" saboda babu kowa is kashe kaka. Kwayar cuta ta shiga cikin duniyarmu kuma muna raba nauyin ruhinta a tsakaninmu, nauyin ya yi sauƙi don rabawa. (Ba tare da faɗi cewa cutar da wani da gangan ya faɗi cikin wani nau'i na daban ba, kodayake har yanzu ban ji labarin duk wanda ke neman yin hakan ba.) Amma al'adun Covid "ya maida hankali kan laifin da yakamata a warwatsa cikin al'umma akan mutum," in ji Gupta. Kuma ga mutane kamar Gupta, waɗanda suka yi magana a bainar jama'a game da dabarun da aka sayar wa (da kuma siye ta) jama'a kamar yadda ya cancanta, zargi da al'adar kunya ba su san tausayi ba.
Ina da wani ra'ayi game da abin da Gupta da abokan aikinta na GBD ke ciki, bayan sun sami rabona na invective lokacin da suke tattaunawa kan manufofin Covid akan layi: Jeka lasa sanda ka kama kwayar cutar. Yi farin ciki da shake ruwan naku a cikin ICU. Sunan ƙaunatattun uku da kuka shirya don sadaukarwa ga Covid-yi shi yanzu, matsoraci. Ji daɗin zamantakewar ku.
Babu daya daga cikin wadannan missives da ya fito daga duk wanda ya san ni da kaina, amma bayan samun isasshen su na fara tunanin ko masu kunya sun san wani abu da ban sani ba.
"Idan masu kulle-kulle sun yi daidai?" Na tambayi Dr. Zoom lokaci guda. "Idan na am Sociopath?"
"Ba ku ba sociopath."
"Ta yaya ka sani?"
"Mai sociopath ba zai yi tambayar ba - da kuma sociopaths ba sa introspects kuma ba ku yin komai sai introspect. Ke ce Sarauniyar introspection."
"Me ya sa nake yin haka? Shin tsarin tsaro ne ko wani abu?
"Duba? Kuna sake yi."
Na rubuta wata kasida game da gogewata da masu shamers na Covid, wanda ya sa mutane daga ko'ina cikin duniya yin imel da nasu labaran. Yawancin su sun fi muni fiye da na yi, ra'ayoyinsu na heterodox sun kashe su ayyuka da abokantaka (kuma a cikin wani hali, aure). Kulldorff ya wallafa hanyar haɗin yanar gizo zuwa labarin tare da wata hujja mai raɗaɗi cewa "abin kunya ba ya wanzu, ba a taɓa kasancewa ba, kuma ba zai taɓa kasancewa cikin kyakkyawan aikin kiwon lafiyar jama'a ba."
Hakanan: ba ya aiki. Kiran wani troglodyte don adawa da umarnin abin rufe fuska baya kawo canjin zuciya. Yana kawai gayyatar juriya-ko kuma yana motsa mutane a ƙarƙashin ƙasa, kamar yadda masanin cututtukan Harvard Julia Marcus ya nuna: “Kunya da zargi mutane ba ita ce hanya mafi kyau da za a sa su canza halayensu ba kuma a zahiri na iya zama mai amfani domin yana sa mutane su so su ɓoye halayensu.”
A cikin duk ihun da abin kunya, wasu masana kiwon lafiyar jama'a sun yi tambayoyi masu ma'ana game da yadda masu ginin GBD suka ba da shawarar kare masu rauni daga kwayar cutar da aka bari ta yadu cikin walwala a cikin al'umma. Bhattacharya, Gupta da Kulldorff sun sami amsoshi akan hakan, amma lokacin sauraron shari'a ya zo ya tafi. Tagan damar bincika dabarun kariya da aka mayar da hankali, wanda sanarwar ta buɗe na mako ɗaya ko biyu, ta sake rufewa. Ba a daɗe ba Facebook ya cece ta ambaci daftarin.
Wannan ba yanayin lafiya ba ne. Kamar yadda Harry Truman ya fada a cikin 1950, "sau daya a gwamnati ta himmatu wajen ganin an toshe muryar ‘yan adawa, hanya daya ce kawai ta bi, kuma wanda ke kan hanyar da ake kara danniya.” Hakazalika, korar GBD a matsayin "ra'ayi mai haɗari" ba zai burge Alkalin Kotun Koli Louis Brandeis ba, wanda ya rubuta cewa "muhimmin halayen al'ummar siyasa duka an bayyana da kuma ayyana su ta yadda take amsa ƙalubalen ra'ayoyin barazana" da kuma "tsoron mummunan rauni shi kaɗai ba zai iya tabbatar da zalunci na 'yancin magana ba." Ni ne kawai, ko kuwa masu yanke shawara sun fi wayo a lokacin?
Ba tare da wani Truman ko Brandeis da zai kare su ba, masu yin GBD sun daina tsayawa dama a fagen jama'a. Bhattacharya da Gupta sun mai da hankalinsu ga Collateral Global, wata ƙungiyar agaji ta Burtaniya da ta keɓe don yin rikodin illolin manufofin kulle-kullen, kuma Kulldorff ya shiga Cibiyar Brownstone a matsayin babban malami. Wanda hakan baya nufin sun manta da abinda ya faru. A cikin watan Agusta 2022, Bhattacharya da Kulldorff, tare da wasu likitoci biyu, sun shiga ƙarar Jihar Missouri a kan gwamnatin tarayya don murƙushe muhawara game da manufofin Covid. A cikin daftarin kotun, wacce ta fara da gargadin George Washington game da yin katsalandan, masu shigar da kara sun zargi gwamnatin Amurka da "budaddiyar hada baki da kamfanonin sadarwar zamani don murkushe masu magana, ra'ayoyi, da abubuwan da ba su so." Tare da kowane sa'a, shari'ar za ta ruguza wasu kofofin kabad.
A farkon watannin cutar, masana kimiyya sun damu game da kulle-kulle suna tsoron "fitowa" a bainar jama'a. Abokan GBD sun ɗauki ɗaya don ƙungiyar B kuma sun yi aikin ƙazanta. Sun biya farashi mai yawa, har da asarar wasu abokantaka, amma sun yi tsayin daka. A cikin bugawa, ta iska, da kuma kan kafofin watsa labarun, Bhattacharya ya ci gaba da bayyana kulle-kulle a matsayin "kuskuren kiwon lafiyar jama'a mafi muni a cikin shekaru 100 da suka gabata," tare da bala'in lafiya da lahani na tunani da za su yi ga tsararraki.
Ya daina zama rashin tsari don yarda da su. A National Post labarin da manyan likitocin Kanada huɗu suka rubuta a ƙarshen 2022 sun tabbatar da cewa "matakan draconian Covid kuskure ne." Binciken baya a cikin The Guardian yana ba da shawarar cewa, maimakon ci gaba da jajircewa kan dabarun kulle-kulle, "ya kamata mu kara himma wajen kare masu rauni." Hatta mai hankali Nature ya yarda cewa kulle-kulle "yana kara rashin daidaiton da ke wanzuwa a cikin al'umma. Wadanda suka rigaya suna rayuwa cikin talauci da rashin tsaro sun fi fuskantar wahala" - daidai mabuɗin ɗaukar hoto daga rahoton Layin Laifin Australiya da aka fitar a watan Oktoba 2022.
Kulldorff ya ɗauki wannan canjin teku a cikin ɗaya daga cikin tweets: "A cikin 2020 ni murya ce kaɗai a cikin jejin Twitter, ina adawa da kulle-kulle tare da ƴan warwatse abokai. [Yanzu] Ina wa'azi ga ƙungiyar mawaƙa; mawaƙa mai ban mamaki, kyakkyawar murya." Hakanan yanayin yanayin ya zama mafi kyawun karimci ga Bhattacharya, wanda a cikin Satumba 2022 ya karɓi lambar yabo ta Doshi Bridgebuilder Jami'ar Loyola Marymount, wanda aka ba kowace shekara ga daidaikun mutane ko ƙungiyoyin da aka sadaukar don haɓaka fahimta tsakanin al'adu da horo.
Wataƙila manufar kariyar mai da hankali ta zo da wuri don jama'a da suka firgita su daidaita ta. Amma ra'ayin bai taɓa mutuwa gaba ɗaya ba, kuma bayan paroxysms na fushin ɗabi'a ya ci gaba da tafiya, sannu a hankali ya girma fata ta biyu. Ya zuwa Satumba 2022, jimillar abokan haɗin gwiwar GBD sun haura 932,000, tare da sama da 60,000 daga cikinsu daga likitoci da masana kiwon lafiyar jama'a. Ba mummuna ba ga takarda mai haɗari ta wasu masanan cututtukan cuta guda uku. Kuma zai zama abin ban sha'awa a nuna cewa Memorandum na John Snow ya cika kusan sa hannun kwararru 7,000?1
GBD ba ta sami cikakkun bayanai daidai ba, ba shakka. Babu wanda zai yi tsammani, a cikin faɗuwar 2020, duk abubuwan mamakin da kwayar cutar ta tanadar mana. Duk da yake m a lokacin, amincewar sanarwar game da rigakafin garken ya nuna girman kai. Yanzu mun san cewa ba kamuwa da cuta ko alurar riga kafi yana ba da rigakafi mai dorewa daga Covid, yana barin mutane masu saurin kamuwa da cututtukan na biyu (da na biyar). Kuma duk tasirinsu akan tsananin cutar, alluran rigakafin ba su daina yaɗuwa ba, suna tura garkuwar garken har yanzu ba a isa ba.
Ko ta yaya, masu yin GBD sun rubuta babi mai mahimmanci a cikin labarin cutar. Sun shuka tsaba na shakka a cikin labari mai kulle-kulle. Bayan duk zagin da aka jefa, tsaba sun sami tushe a cikin wayewarmu kuma wataƙila sun tsara manufofin a kaikaice. Kuma yayin da bincike ke ci gaba da tattara fa'idodi masu banƙyama da babban lahani na mafi girman dabarun murkushewa, masu ɓarna da izgili na jiya suna komawa kan tambayar: Shin za mu iya yin ta wata hanya? Wataƙila kariyar da aka mayar da hankali ta yi aiki daidai, ko mafi kyau, kuma tare da ƙarancin lalacewa?
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Gabrielle Bauer marubuciya ce ta kiwon lafiya da likita ta Toronto wacce ta sami lambobin yabo na kasa guda shida don aikin jarida. Ta rubuta litattafai guda uku: Tokyo, My Everest, wanda ya ci kyautar Littafin Kanada-Japan, Waltzing The Tango, wanda ya zo na karshe a lambar yabo ta Edna Staebler, kuma mafi kwanan nan, littafin annoba BLINDSIGHT IS 2020, wanda Cibiyar Brownstone ta buga a 2023.
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