Amurka da hukunce-hukuncen jihohi 50 suna ba da gwaji na dabi'a don gwada ko za a iya danganta asarar rayuka da yawa ta hanyar aiwatar da manyan sauye-sauye na zamantakewa da tattalin arziki da aka haifar ta hanyar ba da umarnin kulle-kullen jama'a.
Jihohi goma ba su da takunkumin kulle-kulle kuma akwai nau'i-nau'i 38 na kulle-kulle / jihohin da ba na kulle-kulle ba wadanda ke raba kan iyaka. Mun gano cewa ƙayyadaddun ƙa'ida da aiwatar da matsuguni a cikin jihar baki ɗaya ko umarnin zama-a-gida yana da alaƙa da ingantaccen yanayin kiwon lafiya, ga kowa da kowa, duk abin da ke haifar da mace-mace ta jiha. Wannan sakamakon bai dace da hasashen cewa kulle-kullen ceton rayuka ba.
Gabatarwa
A ranar 11 ga Maris, 2020, Hukumar Lafiya ta Duniya ta ayyana barkewar cutar a sakamakon barkewar cutar a Wuhan, China na COVID-19 (COVID-2), cututtukan numfashi da ake zargin kwayar cutar SARS-CoV-13 ce ta haifar. A ranar 2020 ga Maris, 19 an ayyana dokar ta-baci ta kasa a Amurka game da barkewar COVID-2020. A cikin Amurka, wannan sanarwar ta haifar da martani iri-iri daga hukumomin kiwon lafiya da jami'an gwamnati a jihohi daban-daban. Daga cikin waɗancan bambance-bambancen, martanin manufofin-hikimar jiha, yawancin jihohin sun ba da mafaka-in-wuri ko odar-gida-gida a cikin Maris da Afrilu na XNUMX (wanda ake kira "kullewa").
Abin da ya sa waɗannan matakan kulle-kulle su ne don rage yaduwar COVID-19 ta hanyar iyakance hulɗar zamantakewa, a ƙarƙashin tunanin cewa cutar ta yadu ta hanyar hulɗar mutum-da-mutum. Koyaya, saboda 'yancin kai na mulkin jihohi a Amurka, matakan kulle-kulle sun sami fa'ida da aiwatarwa da yawa, tare da wasu jihohin sun yi watsi da kulle-kullen gaba daya.
Waɗannan bambance-bambance a cikin yanke shawara na jihar don ko dai a kulle ko a'a don haka kafa gwaji mai amfani don gwada hasashen cewa kulle-kullen ceton rayuka. Wannan hasashe na hasashen cewa da a samu raguwar mace-mace (kowanne mutum daya) a jihohin da suka aiwatar da dokar kulle-kulle, da yawan mace-mace a jihohin da ba su yi ba, bayan daidaitawa kan bambance-bambancen yanayin kiwon lafiyar al’ummar jihar, idan har ana kyautata zaton duk wasu abubuwan sun yi kadan. Za a iya samun bayanan da ke akwai don gwada waɗannan tsinkaya a cikin mace-mace duk-sau (ACM) ta lokaci da kuma ta jiha, CDC ta ruwaito.
Kamar yadda wasu masu bincike suka nuna (misali Rancourt, Baudin & Mercier 2021), ACM ya ja baya da matsala mai wuyar aiki na sanadin mutuwa, wanda ke cikin yanayi na siyasa, kuma a sakamakon haka mai saurin kamuwa da son zuciya (misali. Ealy et al. 2020). Ba a cika sanin ainihin abin da ke haifar da mutuwa a cikin yanayin cututtukan numfashi ba, kuma mutuwar ba ta zama ɗaya tak ba.
Fa'idar nazarin ACM shine cewa ana yin rikodin mace-mace a Amurka tare da babban aminci (babu nuna son kai ko rashin rahoto). Da zarar an yi rikodin, mutuwa mutuwa ce, ba tare da la’akari da yadda aka sanya dalilin a takardar shaidar mutuwa ba. Idan kulle-kulle yana da tasiri wajen hana mace-mace saboda yaduwar cuta yayin bala'in, to ya kamata yankunan da suka aiwatar da kulle-kullen su sami karancin mutuwar kowane mutum daga kowane dalili, idan babu wasu abubuwan da ke dagula hankali.
Bayanai da Hanyar
Manufarmu ita ce tantance ingancin kulle-kulle a cikin ceton rayuka a lokacin COVID-19 ta hanyar kwatanta adadin wadanda suka mutu daga dukkan dalilai a cikin jihohi biyu: jiha daya da ke da kulle-kulle, da kuma jihar da ba ta da kulle-kulle da ke da iyaka da jihar ta kulle. Mun kuma yi nazarin jihohin kulle-kullen da ba su da iyaka da kowace jihar da ba ta kulle-kulle ba, don cikawa.
Mun gano jihohin da ba na kulle-kulle ba ta hanyar yin nazarin umarnin gudanarwa da zartarwa da gwamnatocin jihohi suka bayar a watan Maris-Afrilun 2020 don mayar da martani ga sanarwar cutar ta WHO da na gwamnatocin tarayya da na jihohi. Yawancin waɗannan umarni an adana su a gidan yanar gizon Ballotpedia.com, kuma mun gano umarnin da hanyoyin ba su da inganci ta hanyar bincika gidajen yanar gizon gwamnatin jihar. Mun sanya makin “stringency” ga kowane odar zartarwa bisa yaren odar kullewa ga ‘yan jihar:
An yi oda/ wajabta: 3
Umarni: 2
Shawarwari/karfafawa: 1
Babu oda: 0
Mun gano cewa akwai jihohi bakwai (7) waɗanda ke da adadin 0 saboda ba su ba da umarnin zama a gida ba: North Dakota, South Dakota, Wyoming, Iowa, Oklahoma, Nebraska, da Arkansas. Akwai ƙarin jihohi uku (3) waɗanda ke da adadin 1 saboda gwamnatoci kawai sun ba da shawara ko ƙarfafa ’yan ƙasa su zauna a gida, amma ba su buƙatar yin hakan ba, kuma ba su samar da hanyoyin tilastawa: Utah, Kentucky da Tennessee.
Ma'aunin mu na kulle-kulle da jihohin da ba na kulle-kulle ba ya bambanta da nazarce-nazarcen da suka gabata a cikin saukinsa (watau mayar da hankali kan tsayayyen harshe a cikin umarnin zartarwa kawai). Amma sakamakonmu na jahohin da ba na kulle-kulle ba ya haɗa da duk jihohin bakwai da aka jera a matsayin marasa kullewa Ballotpedia, kuma ya haɗa da duk jihohi huɗu waɗanda ba na kulle-kulle ba wanda CDC ta ɗauki nauyin binciken Moreland et al. (2020).
Mun kwatanta sakamakon wadannan jihohi goma da ba na kulle-kulle ba tare da jihohin kulle-kulle da ke da iyaka, a karkashin tunanin cewa ba a hana yaduwar cutar ta iyakokin jihohi. A cikin wannan binciken mun mai da hankali kan jimlar mace-mace (ACM) a cikin ƙayyadadden lokaci a matsayin ma'auni na ingancin kullewa. Muna amfani da lokuta uku kamar yadda aka bayyana a ƙasa.
Mun zazzage fayilolin waƙafi-ƙimar (csv) masu ɗauke da ACM kowane mako ga kowace jiha daga CDC Wonder website. Mun raba bayanan ACM na mako-mako ga kowace jiha ta yawan jama'ar jihar (Cidayar Amurka, Afrilu 1, 2020), wanda ya haifar da adadin mace-mace a kowane mako, a kowane mako (D).pcw). A cikin wannan rahoto mun bayyana Dpcw kamar yadda adadin wadanda suka mutu a cikin mazauna 10,000.
Wani ƙarin matakin gyara ya zama dole don ba da izini ga ingantacciyar kwatancen mace-mace daga jiha zuwa jiha. Bambance-bambance a cikin rabon shekaru, ƙimar kiba, matakan talauci, ƙimar nakasa ta jiki da ta hankali, da sauran abubuwan tantance lafiya zasu haifar da bambance-bambance na asali a cikin D.pcw a jihohi daban-daban. Waɗannan bambance-bambancen suna bayyana gaba ɗaya a cikin koma baya a cikin Dpcw da aka gani a cikin shekarun da ba annoba ba (kafin 2020).
Misali, Hoto 1 yana nuna kwatancen Dpcw tsakanin New York da Florida a tsakanin shekarun 2014-2020. Kamar yadda yake tare da duk kwatancen-hikima na jiha, New York da Florida suna da ban mamaki iri-iri na ɗan lokaci a cikin Dpcw daga mako zuwa mako da kuma daga shekara zuwa shekara, duk da haka kuma suna da bayyane kuma kusan akai-akai.
Mun gyara wannan biya ta hanyar ƙididdige factor Hjihar, wanda shine matsakaicin darajar ma'auni na jihar Dpcw kuma Dpcw na jihar tunani daga Janairu 1, 2014 zuwa Disamba 31, 2020. Mun zaɓi New York a matsayin jihar tunani don lissafin Hjihar. Wannan zaɓi na jihar tunani ba bisa ka'ida ba ne, amma yawan jama'ar New York yana nufin, a mafi yawan lokuta, kuskuren a cikin H.jihar kurakurai Poisson sun mamaye shi a cikin Dpcw na yanayin sha'awa.
A cikin misalin da aka nuna a Hoto 1, yanayin gyaran yanayin lafiya na Florida shine Hjihar = 0.537, yana nuna cewa New York ta sami 53.7% ƙarancin Dpcw fiye da Florida a cikin shekarun 2014 zuwa 2020, mai yiwuwa saboda wani ɓangare na yawan tsofaffi a Florida. Ga kowane kwatankwacin hikimar jiha na Dpcw mun ɗauki wannan rabon a matsayin abin gyara don kawo jihohin biyu kan sikeli ɗaya, yana ba da damar daidaita yanayin lafiya na mace-mace a lokacin bala'in.
Wannan yanayin gyaran yanayin lafiya ya dace tunda muna yin kwatancen bambanci tsakanin jihohi tare da ba tare da kulle-kulle ba. Muna tambaya, "Bayan aiwatar da matakan kulle-kulle, menene bambancin juzu'i tsakanin daidaitawar kowane mutum ACM a kowace jihohi biyu?" Wannan yana ɗaukar cewa bayan cire bambance-bambance a cikin yanayin kiwon lafiyar al'ummomin jihohin da ke makwabtaka da su, babban tasiri a kan daidaitawar kowane mutum ACM shine kafa dokar hana fita. Wannan zato ya tabbata idan aka yi la’akari da cewa kulle-kullen zai haifar da cikas ga tattalin arzikin kasa da na yanki, tsarin kiwon lafiya, da kuma tsarin zamantakewa na gaba daya.
Hoto 1: Mutuwar kowane mutum, kowane mako (Dpcw) a Florida (blue) da New York (ja). Ƙungiyar hagu tana nuna kashewa a cikin Dpcw, wanda muke dangantawa da bambance-bambance a yanayin lafiyar kowace jiha (tsarin shekaru, matakin talauci, yawan kiba, da sauransu). Ƙungiyar da ke hannun dama tana nuna gyara Dpcw, wanda ke ba da damar kwatanta bambanci tsakanin waɗannan jihohin biyu daga 2020 zuwa gaba.
Don ƙididdige tasirin kulle-kulle akan mace-mace a lokacin COVID muna ƙididdige hadedde (jimlar) daidaitaccen yanayin lafiya-daidaita mutuwar kowane mutum, Dtot, a kan zaɓaɓɓen lokaci. Sa'an nan kuma mu ƙididdige rabon Dtot ga kowane jihohi guda biyu, wanda R ke nunawa (kulle raba ta rashin kullewa). Muna amfani da lokuta daban-daban guda uku waɗanda muke tsammanin Dtot, da R, don kama tasirin matakan kullewa:
Dzuwa, 1: Jimlar lokacin kulle-kullen jihar.
Dzuwa, 2: Takaitacciyar lokacin "COVID peak 1" (cp1) kamar yadda Rancourt et al. (2021; mako 11 zuwa mako 25 na 2020)
Dzuwa, 3Jima'i na tsawon lokaci daga Maris 11, 2020 zuwa Disamba 31, 2021
A cikin wannan takarda muna ba da rahoton tazarar amincewar kashi 95% don haɗin kai, daidaitawar yawan jama'a da daidaitaccen yanayin kiwon lafiya ga kowane kwatancen hikimar biyu na kulle-kulle da jihohin da ba na kulle-kulle ba, da kuma yanayin-daidaita-daidaita yanayin mace-macen kowane mutum da muke ba da rahoto. Ana ƙididdige waɗannan tazarar amincewa a ƙarƙashin zaton cewa babban tushen kuskure ya fito ne daga ƙididdiga.
results
An taƙaita sakamakon mu a cikin alkalumman da ke ƙasa.
A cikin Figures 2, 3, da 4, y-axis ya lissafa duk nau'i-nau'i na kulle-kulle/marasa-kulle 38 na jihohin da aka yi amfani da su don kwatanta sakamakon mace-mace, tare da jihar kullewa da aka jera farko, sai kuma jihar da ba ta kulle ba. Dige-dige masu shuɗi suna nuna ƙima-ƙimar rabo, R, da sandunan kuskure masu alaƙa suna nuna tazarar amincewar 95%; layin da aka tsinke a tsaye yana nuna haɗin kai. Ƙimar hagu na layin tsaye suna nuna alƙaluman da jihar ta kulle ta sami ƙarancin yanayin kiwon lafiya da aka gyara kowane mutum fiye da jihar da ba ta kulle ba. Ƙimar da ke hannun dama na layin sun nuna cewa kulle-kullen ya sami ƙarin yanayin kiwon lafiya da aka gyara kowane mutum fiye da jihar da ba ta kulle ba.
Hoto 2: Matsakaicin-lafiya da aka daidaita ga kowane mutum ACM rabo (R) ga kowane jihohi biyu maƙwabta da aka jera akan y-axis. Adadin ya dogara ne akan taƙaita duk mace-mace a kowace jiha a tsawon lokacin da ya dace da kololuwar COVID (3/11/2020 - 6/24/2020). Sandunan kuskure suna nuna tazarar amincewar kashi 95% na kowane rabon biyu. Matsakaicin hagu na layin tsaye yana nuna cewa an sami raguwar mace-mace a cikin jihar ta kulle fiye da na jihar da ba ta kulle ba, yayin da ma'auni zuwa dama na layin tsaye ya nuna cewa jihohin da ke da kulle-kulle sun sami ƙarin mace-mace.
Hoto 3: Matsakaicin-lafiya da aka daidaita ga kowane mutum ACM rabo (R) ga kowane jihohi biyu maƙwabta da aka jera akan y-axis. Adadin ya dogara ne akan taƙaita duk mace-mace a kowace jiha a tsawon lokacin da ya yi daidai da lokacin kulle-kullen jihar. Sandunan kuskure suna nuna tazarar amincewar kashi 95% na kowane rabon biyu. Matsakaicin hagu na layin tsaye yana nuna cewa an sami raguwar mace-mace a cikin jihar ta kulle fiye da na jihar da ba ta kulle ba, yayin da ma'auni zuwa dama na layin tsaye ya nuna cewa jihohin da ke da kulle-kulle sun sami ƙarin mace-mace.
Hoto 4: Matsakaicin-lafiya da aka daidaita ga kowane mutum ACM rabo (R) ga kowane jihohi biyu maƙwabta da aka jera akan y-axis. Adadin ya dogara ne akan taƙaita duk mace-mace a kowace jiha a cikin cikakken “COVID Era” a cikin saitin bayanan mu (Maris 11, 2020 - Jan 25, 2022). Sandunan kuskure suna nuna tazarar amincewar kashi 95% na kowane rabon biyu. Matsakaicin hagu na layin tsaye yana nuna cewa an sami raguwar mace-mace a cikin jihar ta kulle fiye da na jihar da ba ta kulle ba, yayin da ma'auni zuwa dama na layin tsaye ya nuna cewa jihohin da ke da kulle-kulle sun sami ƙarin mace-mace.
Idan kulle-kulle ya ceci rayuka, to muna tsammanin yawancin rabon ACM (R) zai zama ƙasa da ɗaya. Maimakon haka, muna ganin akasin haka. Don duk lokacin haɗin kai guda uku, yawancin rabon rabon ya fi ɗaya girma. Don lokacin cp1 (kulle, cikakke), 28 (28, 21) nau'i-nau'i suna da ma'aunin ACM (R) mafi girma fiye da ɗaya, yayin da 0 (0, 9) nau'i-nau'i suna da rabo kasa da ɗaya, kuma sauran 10 (10, 8) nau'i-nau'i suna da R wanda ba a iya bambanta da haɗin kai a 95% amincewa.
Don haka, bincikenmu na ƙimar R na tsawon lokaci uku yayin da ake tsammanin kulle-kulle zai yi tasiri ya nuna cewa bayanan ACM daga shekaru biyu da suka gabata bai dace da hasashen cewa kulle-kullen ceton rayuka ba. A gefe guda, sakamakonmu ya yi daidai da ƙarshen Rancourt et al. (2021) cewa yawan mace-mace a cikin lokacin COVID a cikin Amurka yana faruwa ne ta hanyar gwamnati da matakan likita, da kuma martani ga ayyana cutar.
Hoto na 4 yana nuna adadin mace-mace da aka daidaita-daidaitacce ga kowane mutum na mako 15 na "COVID peak 1" na tsawon mako 1 (cp11; makonni 25 zuwa 2020 na 15) ga duk jihohi daban-daban (ja) da kuma taga haɗin sati 2019 iri ɗaya a cikin 2018 (blue) da 0 (kore). Anan, ana ba da odar jahohin, daga sama zuwa kasa, a cikin raguwar matsakaicin yawan jama'ar jihar, wanda galibi ana kyautata zaton shi ne sanadin yaduwar cututtuka masu yaduwa. Sunayen jaha a magenta sun yi daidai da jihohin mu goma da ba na kulle-kulle ba suna da maki 1 ko XNUMX. Sunayen jaha a cikin cyan sune jihohin kulle-kullen da ke da iyaka da jihar da ba ta kulle ba, wanda muka yi amfani da shi a lissafin mu na R.
Matsakaicin daidaitaccen yanayin kiwon lafiya hadedde duk abin da ke haifar da mace-mace a cikin makonni 15 na “cp1” na 2019 da 2018 an tauye su sosai ga duk jihohi zuwa ƙimar kusan mutuwar 14 a cikin 10,000 (Hoto na 5), yayin da madaidaicin dabi'u a cikin lokacin COVID 2019, ya bambanta daga tushe zuwa jiha. 25 a cikin 10,000 na New Jersey, kuma yawanci ya kai 15 zuwa 21 a cikin 10,000. Jihohin da ba a kulle ba suna da sunaye akan magenta masu launin y-axis, yayin da jihohin kulle-kullen da aka yi amfani da su azaman kwatancenmu wajen ƙididdige R suna cyan masu launi.
Hoto na 5 ya nuna cewa galibin jihohin mu goma da ba na kulle-kulle ba suna da ingantaccen yanayin kiwon lafiya da ke haifar da mace-mace a cikin sati 15 na cp1 akan ƙimar asali na pre-COVID (2018 da 2019) kusan 14 a cikin 10,000, yayin da mafi yawan jihohin da ke da ƙimar kullewa sama da ƙimar mutuwa-2.
Hoto 5: Haɗaɗɗen yanayin kiwon lafiya da aka gyara ACM akan lokacin cp1 (Maris 11-Yuni 29 2020; ja) idan aka kwatanta da lokaci guda a cikin 2019 (blue) da 2018 (kore). Jihohi sun ba da umarnin daga sama zuwa kasa wajen rage yawan jama'a. Magenta yana nuna jihohin da ba a kulle ba cyan yana nuna jihohin kulle-kulle da ke da iyaka da jihohin da ba na kulle-kulle ba.
Yayin da madaidaicin ƙima na yawan mace-mace saboda kulle-kulle ya wuce iyakar wannan takarda, za mu iya yin ƙayyadaddun ƙididdiga bisa Hoto 5. Jihohi uku mafi yawan jama'a (California, Texas, Florida) suna da sama-sama na COVID-lokaci na ƙaruwa na kusan 1 a cikin 10,000. Dangane da shekara guda na kalanda (makonni 52), kuma ga yawan jama'a daidai da na Amurka duka, wannan zai yi daidai da mutuwar kusan 110,000, wanda za a iya danganta shi kai tsaye ga tasirin ba da umarnin kulle-kullen kuma wanda ba zai faru ba idan ba a aiwatar da kulle-kulle ba. Wannan ƙimar ta yi daidai da kiyasin adadin mace-mace na kulle-kulle na 97,000/shekara ta Mulligan & Arnot (2022).
Tattaunawa da Kammalawa
Amfani da kulle-kulle don “keɓe” yawan jama'ar Amurka don shawo kan yaduwar cutar ba ta da wani misali a tarihin ƙasar. A lokacin cututtukan cututtukan da suka gabata, marasa lafiya da marasa lafiya ne kawai aka keɓe yayin da sauran jama'a ke ci gaba ko kaɗan kamar yadda aka saba.
ƙwararrun likitoci sun ba da shawarar wannan hanyar "kariyar da aka mayar da hankali" a cikin Babban Sanarwa na Barrington a cikin 2020, yana nuna cewa akwai wasu zaɓuɓɓuka don kulle-kulle kuma an fahimce su sosai a cikin ƙungiyar likitocin. Kwanan nan kamar yadda 2019 Hukumar Lafiya ta Duniya ta ba da shawarar irin wannan hanyar a cikin shawarwarin ta don rage haɗarin kamuwa da cutar mura yayin da ba ta ambaci matakan kulle-kulle ga jama'a ba.WHO 2019). Tabbas, rahoton na WHO ya bayyana musamman cewa keɓe mutane da aka fallasa ba a ba da shawarar ba "ba a ba da shawarar ba saboda babu wani takamaiman dalili game da wannan matakin" (duba Tables 1 da 4). Hakazalika, da Shirin shirye-shiryen rigakafin cutar mura ga Amurka bai ambaci kulle-kulle ba kuma ya bayyana cewa "…matakan gargajiya da aka tsara don rage haɗarin gabatarwa da watsa wasu cututtukan, kamar gwajin asibiti da keɓewa a tashar jiragen ruwa, ba zai yi tasiri ba" (Strikas et al. 2002).
A cikin nazarin da suka yi na wallafe-wallafen da ake da su game da ayyukan cutar mura, Inglesby et al. (2006) ba da shawarar kai tsaye game da matakan keɓancewa yayin kamuwa da cutar mura, ga marasa lafiya da masu lafiya duka, saboda ana sa ran farashin al'umma zai fi fa'ida. Sun kammala, "Kwarewar [E] ta nuna cewa al'ummomin da ke fuskantar annoba ko wasu abubuwan da ba su da kyau suna ba da amsa mafi kyau kuma tare da ƙarancin damuwa lokacin da aikin zamantakewa na al'umma ya ragu." Waɗannan shawarwarin sun wuce shiryawa da kuma ba da amsa ga cututtukan mura. A cikin wani rahoto mai taken Shirye-shirye don Cutar Cutar Cutar Kwalara mai Tasiri, marubutan sun kammala cewa keɓewa yana cikin mafi ƙarancin ingantattun matakan da ba na magunguna ba wajen ɗaukar yaduwar cututtuka (Cibiyar Johns Hopkins don Tsaron Lafiya 2019).
Don haka, matakan kulle-kullen da aka aiwatar a cikin 2020 da yawancin jihohin Amurka, da kuma ƙasashe da yawa a duk duniya, sun wakilci wani babban gwaji da ba a taɓa gani ba a cikin rigakafin cututtuka. Dukkanin bayanan mace-mace da muka tantance suna ba mu damar gwada hasashen cewa kulle-kullen ceton rayuka yayin cutar ta COVID. Mun ga cewa waɗannan bayanan ba su dace da wannan hasashe ba; Jihohin da ke da kulle-kulle sun sami ƙarin asarar rayuka fiye da jihohin makwabta ba tare da kulle-kulle ba. Don haka mun kammala cewa wannan gwajin gazawar manufofin kiwon lafiyar jama'a ne kuma bai kamata a yi amfani da matakan kulle-kulle ba yayin barkewar cutar nan gaba.
Binciken da muka gano cewa duk- sanadin mace-mace ya karu a jihohin da ke da kulle-kulle ya yi daidai da sakamakon binciken Agrawal et al. (2021) wanda ya sami karuwar ƙididdiga a cikin yawan mace-mace saboda odar wurin zama a Amurka da a cikin ƙasashe 43. Hakazalika, Mulligan & Arnot (2022) an kiyasta cewa an sami asarar rayuka sama da 97,000 a cikin shekara sakamakon kulle-kulle, tare da raba mace-mace daidai-wa-daida a tsakanin duk kungiyoyin da suka manyanta, sabanin mutuwar COVID da aka fi dangantawa tsakanin tsofaffi.
Idan aka yi la’akari da ƙaƙƙarfan alaƙa tsakanin takunkumin kulle-kullen jama’a da ƙara yawan mace-mace, wanda aka nuna a sama (Hoto na 2-5), ya dace a ƙirƙiri hasashe don sanadin ko musabbabin wannan ƙungiyar.
Babu shakka, Amurkawa masu gata daga babba-tsakiya da ƙwararrun azuzuwan ba su mutu daga zama a gida ba. Koyaya, ba ma'ana ba ne a fitar da cewa ka'idojin kulle-kullen jama'a da umarni duk da haka wakilai ne ko alamomin doka na matakin tashin hankali (ciki har da watsi) wanda cibiyoyin jama'a a cikin jihar suka amsa ko kuma suka mayar da martani game da barkewar cutar. Waɗannan cibiyoyi za su haɗa da makarantu, gidajen kulawa, asibitoci, dakunan shan magani, sabis na naƙasassu, wuraren kulawa da rana, sabis na 'yan sanda, sabis na iyali da zamantakewa, da sauransu.
Muna ci gaba da hakan da gangan saboda yana da yuwuwa yawan adadin mutuwar da ke da alaƙa da kulle-kulle daga wuraren tafkunan mutane ne musamman waɗanda ke cikin haɗarin fuskantar kisa daga manyan rugujewar rayuwarsu da hanyoyin sadarwar tallafi. Wannan zai zama gaskiya ba tare da la'akari da ainihin abin da ke haifar da mutuwa ba, da aka ba da haɗin gwiwar da aka sani tsakanin damuwa da damuwa da keɓancewa na zamantakewa da rashin lafiya da mace-mace, ta hanyar tasiri akan tsarin rigakafi (Ader da Cohen 1993; Cohen et al. 1991; Cohen et al. 1997; Cohen et al. 2007; Sapolsky 2005; Prenderville et al., 2015; Shekarar 2014; Rancourt et al. 2021). Lallai, akwai isassun shaida cewa kulle-kullen suna da alaƙa da haɓakar haɓakawa da yawa rashin aikin yi da kuma rashin lafiyar kwakwalwa gaba ɗaya (misali Jewell et al. 2020, Czeisler et al. 2020).
Bayanan ACM da ke samuwa ta hanyar gidan yanar gizon CDC Wonder ba a rarraba su ta jihohi da alƙaluma, don haka ba mu sami damar bincika ƙungiyoyin alƙaluma ke mutuwa ba, da kuma yadda suke mutuwa, a kowace jiha. Koyaya, bayanan alƙaluma suna samuwa akan matakin ƙasa, kuma Mulligan & Arnot (2022) ya sami karuwa mai yawa a cikin yawan mace-mace a tsakanin mutane masu shekaru 18-65, wanda adadi ne wanda ba shi da babban haɗari daga COVID.
Hakazalika, Rancourt et al. (2021) ya gano cewa rarraba na ɗan lokaci da sararin samaniya na duk abubuwan da ke haifar da mace-mace a cikin lokacin bala'i bai dace da tasirin cutar numfashi ta hoto ba. Sun sami shaidar cewa adadin mace-mace da yawa a lokacin bala'in an yi kuskuren gano cututtukan cututtukan huhu, mai yuwuwa ya tsananta ta hanyar rushewar tsarin kiwon lafiyar Amurka.
Don haka, akwai ƙaƙƙarfan shaida da ke tallafawa hasashen cewa kulle-kulle ya sanya nauyin damuwa kwatsam ga masu rauni a cikin Amurka, wanda ke haifar da hauhawar mutuwa a cikin waɗannan jihohin da suka yi amfani da kulle-kulle azaman matakan sarrafa cuta.
An zana wannan taƙaitaccen bayani daga babban binciken marubuta.
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John Johnson Farfesa ne na ilimin taurari a Cibiyar Astrophysics | Harvard da Smithsonian. Tarihin bincike na John ya ƙunshi ganowa da lura da sararin samaniya, tattara bayanai, da ƙira da gina kayan aikin da ake amfani da su wajen farautar duniyar da ta wuce tsarin hasken rana.
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Denis Rancourt farfesa ne a fannin kimiyyar lissafi kuma shugaban masana kimiyya a Jami'ar Ottawa tsawon shekaru 23. Yanzu yana rubutu game da magani, COVID-19, lafiyar mutum, canjin yanayi, yanayin siyasa, 'yancin ɗan adam, ka'idar siyasa, da ilimin zamantakewa. Denis ya rubuta fiye da 100 labaran-jarida da aka bita a cikin fasaha na kimiyya da fasaha.
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