(An Rubuce Rubuce-rubuce don Masu digiri a Medicine, Jami'ar Sydney, Class na 1965)
An sami barkewar annoba guda biyar a Ostiraliya.
An kare shi ta hanyar 19th Ƙarni ta wani tudu da ya ɗauki watanni ana hayewa, Annobar Bubonic na 1900 ta karya baya na tunanin cewa Ostiraliya tana da kariya ta keɓewar yanki, ladabin berayen da ke tafiya teku. Annoba a Sydney ta kafa wani tsari wanda a cikin shekaru biyun da suka gabata mun saba da shi: rudani da cin hanci da rashawa tare da wasu bayyananniyar hanya mai ma'ana ta gudanarwa.
Babban Ashburton Thompson, Shugaban Hukumar Lafiya ta NSW, ya canza tsarin gudanar da cutar ta hanyar haɓaka ƙa'idar "gwaji da ware". Wannan ya shafi kowace shekara al'ada jini daga 40-50,000 berayen da aka kama tare da gabar tekun Darling Harbor (kamar yadda Thompson ya tabbatar da cewa cuta a cikin mutum ya bi breakout epizootic cuta a cikin berayen). Wannan bidi'a a cikin lafiyar jama'a ya biyo bayan raguwar kashi 80 cikin ɗari a duka cututtukan asibiti da farashi ga al'umma.
Gudunmawar kimiyya iri ɗaya ta biyo bayan cututtukan mura guda uku a cikin 20th karni. Bayan mura na Mutanen Espanya a 1918/19, Macfarlane Burnet ya kafa cibiyar binciken mura ta duniya. Annobar cutar mura ta Asiya da Hong Kong da ta biyo baya a tsakiyar karni ta haifar da binciken kwayar cuta wanda ya ƙare a cikin kyautar Nobel ga Peter Doherty.
Mutuwar duniya daga cututtukan annoba da mura na Sipaniya, bi da bi, miliyan 15 da 50-100, suna sanya Covid-19 cikin hangen nesa. Yawan mace-mace a duniya ya kai miliyan 6. Adadin mace-mace a Ostiraliya na annoba a kashi 25 cikin ɗari da mura na Sipaniya a kashi 2.5 cikin ɗari idan aka kwatanta da adadin mutuwar Covid a ƙasa da kashi 0.1%. Bai bambanta sosai da abubuwan lura a cikin mummunan lokacin mura ba.
Shin kun taɓa tunanin cewa mun ƙaddamar da ayyukanmu na likitanci tare da cututtukan cututtuka: cutar ta 1968 Hong Kong H3N2, da kuma a cikin 2020, Covid-19? Abin sha'awa ma'aunin duka biyun bai bambanta sosai ba, duk da haka babu wanda ya tuna da cutar ta Hong Kong tare da sha'awar da muke dangantawa da kwarewar "Covid-19".
Me yasa haka? Wannan makala tana ƙoƙarin nemo amsa.
Wasu kamanceceniya gabaɗaya tsakanin “Cutar Cutar Australiya” tana wanzu duk da bambance-bambancen da ke tattare da cutar da kuma sakamako.
Da farko, wani lokaci na annoba na shekaru 2-3 ya biyo bayan shekaru masu fama da cututtuka: cutar bubonic ta ci gaba a Ostiraliya fiye da shekaru 20, cutar H1N1 (1918) ita ce keɓancewar yanayi har zuwa 1950s (da maimaita bayan-2000), yayin da H3N2 Hong Kong keɓance (wani "canzawa" ya ci gaba da mamaye H1956 daga H2. annobar yanayi. Covid ya riga ya buga rawar da yake takawa wajen haifar da dogon lokaci tare da Long Covid a cikin kashi 2 na waɗanda ke murmurewa daga kamuwa da cuta. Girman tasirin Long Covid da cututtukan endemic tambaya ce ta gaba.
Na biyu, alluran rigakafi masu ban mamaki da rikice-rikice sun mamaye tunanin likitanci a duk annoba. Abin sha'awa duka sun yi ikirarin kariya kusan kashi 50 daga mutuwa. Waldemar Mordecai Haffkine daga Cibiyar Pasteur ya samar da maganin kashe kwayoyin cuta shekaru biyar bayan Alexandre Yersin ya gano kwayoyin cutar a 1894; an yi amfani da maganin rigakafi na polybacterial a cikin Burtaniya da Ostiraliya a cikin mura na Sipaniya (da'awar rage mutuwa a cikin matasa daga ciwon huhu na staphylococcal); a shekara ta 1968 an sami allurar rigakafin cutar H3N2 na zamani a cikin watanni biyar da fara bullar cutar mura ta Hong Kong. A cikin bala'in Covid-19 na mu na yanzu an samar da sabon sabon gwajin kwayoyin halittar ''alurar rigakafi'' na Covid-19 watanni 12 bayan gano kwayar cutar wacce ta zama cibiyar kula da cutar.
Abin mamaki ba cutar ba ce, amma sanadin ta. Coronaviruses wani bangare ne na rayuwa tare da cututtukan cututtuka masu sauƙi na yau da kullun. Wataƙila ya kamata mu kasance cikin faɗakarwa, saboda SARS da MERS sun kasance masu maye gurbin coronaviruses.
Mun yi tsammanin-har ma an horar da mu- annoba ta mura ta gaba. Kwayar ƙwayar cuta ta numfashi tana haifar da annoba lokacin da maye gurbi ya ba ta damar tserewa daga bronchus zuwa sararin alveolar. A cikin bronchus, ƙwayar cuta tana ƙunshe da tsarin garkuwar jikin mucosal mara kumburi. Duk da haka, sararin alveolar yana da kariya ta tsarin na'urar rigakafi, wanda ta yanayinsa shine pro-mai kumburi kamar yadda ake nufi, kuma dole ne, don haifar da rigakafi.
A cikin kamuwa da cuta na Covid ƙwayar cuta na iya mamaye sararin alveolar, ta fara mayar da martani mai ƙarfi, kuma ta bayyana a asibiti azaman cutar huhu. Ƙwararrun ƙwayoyin cuta na Spike wanda ke manne da masu karɓar ACE-2 a cikin nama na huhu yana ƙara lalacewa ta hanyar guba na ciki.
Allurar rigakafi, kasancewa na gargajiya na antigen kamar yadda aka yi amfani da su a cikin kariya ta mura, ko kuma allurar rigakafin da ake amfani da su don kariya daga Covid-19, suna motsa IgG antibody kawai wanda ke iyakance ga sashin tsarin. Wannan yana kare kariya daga lalacewar sararin samaniya na alveolar amma ba shi da tasiri akan kamuwa da mucosal. Daidai abin da aka samo a asibiti: kariya daga cututtuka masu tsanani tare da ƙarancin shiga asibiti da mace-mace, amma kadan zuwa wani tasiri akan kamuwa da cutar, cututtuka na gida ko yada cututtuka zuwa wasu.
Daga ina cutar Covid-19 ta fito? Ma'auni na shaida yana ba da damar yin amfani da dakin gwaje-gwaje don haɓaka cututtukan cututtuka maimakon "gujewa" daga mai masaukin baki wanda ba ɗan adam ba a kasuwannin rigar Wuhan. Tsarin kwayoyin halitta ya gano “tsalle” da ba zato ba tsammani don tsarin juyin halitta, kuma an gano jerin tushe da ke da alaƙar shigar da wucin gadi.
Wataƙila ba za mu taɓa sanin gaskiya ba.
Ragewar kamuwa da cuta yana da alaƙa da drift na antigenic, kamar yadda aka gani tare da sauran ƙwayoyin cuta na RNA. Ya zuwa yau ƙwanƙolin da aka samo asali suna da alaƙa da babban kamuwa da cuta, tare da ƙarancin ƙwayoyin cuta. Asalin kwayoyin halitta na bambance-bambancen yanzu ya bambanta da juna kamar yadda suke daga iyayen Wuhan keɓe. Wannan ya haifar da gazawar rigakafin ci gaba wanda ba abin mamaki bane idan aka yi la'akari da kamuwa da mura.
Ta yaya muka magance cutar? Amsar ita ce da mun yi kyau. Mafi kyau.
Da farko, irin yanayin da ake gani a cikin bala'in rikice-rikice, bureaucratic bungling da tsadar tattalin arziki suna nan don kowa ya gani. Muna rufe shekaru uku ba tare da ƙarshen ganin cutar ta barke ba, ko ga rashin fahimta. Cutar sankarau da ta gabata ta ɗauki kimanin shekaru biyu kafin ta koma cikin ƙaramin matakin endemic. Tare da 5,500 lokuta a kowace rana a halin yanzu a yawan mace-mace na kashi 0.2%, cutar ta bunƙasa a Ostiraliya (ko da yake ƙasa da 110,000 lokuta a kowace rana a cikin Janairu 2022, tare da irin wannan mace-mace).
An zaɓi raƙuman ruwa na takamaiman nau'in antigen ta allurar rigakafi masu iyaka? Alamun dogon lokaci na "Long Covid" a cikin kusan kashi 20 na waɗanda ke murmurewa daga kamuwa da cuta, wanda allurar rigakafi ba ta shafa ba, suna ba da hoto na dogon lokaci ga mutane da yawa. Rashin yin allurar rigakafi don kawo ƙarshen cutar, da bayyanar ƙarin kamuwa da cuta, ƙarin mace-mace da kamuwa da cuta a cikin batutuwa masu yawa, ya sa wasu ke kiran Covid a "annoba na masu allurar rigakafin sau uku. "
“Bugu da ƙari” na cutar ta kasance alluran rigakafi. Ba za a taɓa cimma alƙawarin bakarawa da rigakafin garken garken ba—wannan ba hanyar allurar rigakafin da ake amfani da ita ba ce don magance cututtukan mucosal. Abubuwan da suka kamu da cutar suna ci gaba da yada ƙwayoyin cuta, ba tare da la'akari da allurar rigakafi ba-hakika waɗanda ke da abubuwan haɓakawa suna ɓoye ƙarin ƙwayoyin cuta na tsawon lokaci. Maimaita maganin alurar riga kafi a cikin gajeren lokaci yana ba da fa'ida a hankali, kuma na ɗan gajeren lokaci, saboda haɓakar ƙwayoyin T reg (mai hanawa). Danne martani mara tsari ga ɗimbin antigens suna wanka saman mucosal shine ma'anar ma'anar rigakafi ta mucosal. Kwarewa tare da allurar maganin “rashin hankali” don rashin lafiyan cututtukan antigens (daidaitaccen daidai da masu haɓaka masu maimaitawa don kamuwa da ƙwayoyin cuta) yana nuna ragewar net ɗin na iya dawwama na tsawon shekaru (Biomechanics da Ingantattun allurar rigakafin covid. Quantum 20.3.2022)
Na biyu, sakamakon da masana'antun harhada magunguna suka yi iƙirari, da kuma kawar da tasiri, arha, aminci da hanyoyin warkewa, sun kasance ne ta hanyar "labari" wanda masu yin alluran rigakafi suka samo asali (da dala biliyan 100 a kowace shekara). Alkawarin labarin ya dauki hankulan hukumomi da 'yan siyasa. Manufarta ita ce ta mayar da hankali kan alluran rigakafi kawai, ban da duk wasu matsalolin da za su iya rage jin daɗin jama'arsu.
Na uku, sarrafawa ta hanyar masana'antu da ma'aikata ya yiwu saboda tsarin magani ya daina tallafawa ko sarrafa aikin magani. Dokokin kimiyya a likitanci da dangantakar likita da haƙuri-ginshiƙi duwatsun yi- sun kasance cikin haɗarin sasantawa.
Fourth, "labarin" da ke sarrafa sarrafa Covid yana da lahani a kimiyya. Covid kamuwa da cuta ne na sashin mucosal kuma don haka ana sarrafa shi ta hanyar amsawar rigakafin gida. Babban halayyar rigakafin mucosal ita ce maƙarƙashiya mai ƙarfi na rigakafi, wanda aka tattauna a sama.
biyar, haɗarin allurar mRNA. mRNA yana yaduwa a cikin jiki. Ana iya gano shi a cikin jini na tsawon makonni yayin da furotin Spike ke samuwa a cikin tasoshin jini da ke hade da "autoimmune" T-cell suna kutsawa cikin mutuwar mutum bayan mutuwar bazata. Hakanan alama ce a cikin biopsies na endocardial na batutuwa tare da myocarditis bayan allurar rigakafi. Rahotannin da ba a taɓa ganin irinsu ba na munanan abubuwan da suka faru a cikin dukkan rajistar jami'an Yammacin Turai, gami da mace-mace, sun tafi ba tare da wani sharhi ba. VAERS ita ce hukumar bayar da rahoto ta Amurka. Tsakanin Disamba 14, 2020 da Agusta 8, 2022, an sami rahotanni sama da 250,000 munanan abubuwan da suka faru, tare da mutuwar sama da 30,000. Alamar damuwa. Waɗannan alkaluma sun haɗa da tattara rahotanni na duk sauran alluran rigakafi sama da shekaru 20.
Haɓaka kashi 15 cikin ɗari na “mutuwar da ba zato ba tsammani” lokacin shirye-shiryen rigakafi a duk faɗin duniya, bai ja hankalin hukuma ba. Bayanan hukuma na Burtaniya da aka fitar a ranar 6 ga Yuli, 2022 wakilci ne na abubuwan ban tsoro da ake fuskanta yanzu: adadin mace-mace (daidaitacce a cikin shekaru 100,000 na mutum na tsawon watan Fabrairu 2021 zuwa Mayu 2022), duk suna haifar da mace-mace ga “alurar rigakafi/ba allurar rigakafi ba” shine 6.37 (P<0.0001) don wadanda ba na Covid-7.25 sun mutu 0.0001 (P <2.06); kuma ga masu mutuwa daga Covid 3 (NS). Binciken bayanan Mataki na XNUMX na Pfizer da ke nuna yawan mace-mace ya fi girma a cikin allurar idan aka kwatanta da sarrafawa, wanda yakamata ya harba harbin gargadi.
An yi rikodin myocarditis bayan-alurar riga kafi a cikin mazan matasa kamar 1 cikin 5-10,000 da aka yi wa alurar riga kafi: duk da haka karatu mai yiwuwa a Thailand auna matakan troponin da yin amfani da duban dan tayi an gano kashi 2-3% na yaran makarantar sakandaren da aka yi wa alurar riga kafi tare da myocarditis.
Ina Duk Wannan Ke Tafiya?
An kulle mu cikin labari ba tare da wata bayyananniyar hanyar fita ba. Cin zarafi, maganganun maganganu da soke rajista kayan aikin ne da ake amfani da su don sarrafa likitocin da ke ƙalubalantar shirye-shiryen ƙarfafawa mara kyau, ko kuma waɗanda ke nuna damuwa game da lalacewa ta hanyar rigakafin ƙwayoyin cuta. Ko ma wadanda suka kuskura su tallafawa arha, lafiyayye da ingantaccen magani na magani wanda zai iya rage cutar. Abu mafi ban tsoro shine likitocin da ke cikin haɗari sune waɗanda suka dage kan tabbatar da cewa marasa lafiya sun ba da cikakken izini bayan la'akari da haɗarin rigakafin. Wannan shi ne ainihin abin da ake buƙata na dangantakar likita da haƙuri, kuma bisa ƙa'ida ta dagewa daga hukumomi guda waɗanda suka soke rajista don yin hakan!
Covid ya fito fili aikin likita ba tare da shigarwa cikin manufofin kiwon lafiya ba. Sha'awar kuɗi tana tasiri ga yanke shawara da ma'aikatan gwamnati suka zartar, waɗanda masana'antar harhada magunguna ke motsa su, kuma waɗanda aka saƙa cikin manufofin siyasa. Makantar al'adu ga haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin haƙƙin al'ada na al'ada yana farawa tare da mujallolin likitanci sun kasa buga kowane labarin a waje da labarin.
The New England Journal of Medicine da kuma Lancet dukkansu an tilasta musu janye gurbatattun labaran da ke kunshe da “labaran karya” da nufin bata sunan magunguna masu arha, aminci da inganci. Hukumomin gwamnati, ƙungiyoyin ƙwararru da jami'o'i sun hana 'yancin faɗar albarkacin baki yayin da suke ƙaga bayanan da ba daidai ba. Duk a ƙarƙashin inuwar kariya ta "Trusted News Initiative," tsarin haɗin gwiwar duniya wanda kawai "labarin" ke ciyarwa a cikin manyan labaran labarai.
Za a iya taƙaita ƙwarewarmu ta yanzu a cikin tambaya mai zuwa:
Shin muna ganin yanayin rikice-rikicen yanayin kowace cuta tun daga Mutuwar Baƙar fata a 1347 ciki har da waɗanda aka samu a cikin 20th karni na Ostiraliya, ko martanin kasa da kasa ga Covid ya fi dystopian - har ma da Orwellian - a cikin matsawa zuwa yanayin juriya na duniya? "
Kula da shirin "Babban Sake saitin" don farfadowar tattalin arzikin duniya bayan Covid-19, tare da WHO ta tsakiya tana sarrafa ƙalubalen kiwon lafiya na gaba. Ita ma WHO da ta fito daga cutar ta Covid ta lalace kuma ta lalace ta hanyar tasirin gwamnatoci, masana'antu da mutane masu ƙarfi.
Wannan hoton hoto na annoba a Ostiraliya sama da shekaru 120 yana nuna kamanceceniya da bambance-bambance. Bambanci mai mahimmanci tsakanin cututtukan cututtukan guda biyar da suka shafi Ostiraliya ta wannan lokacin yana da alaƙa da daidaito tsakanin labari da kimiyya.
Ga cututtukan cututtukan da suka faru kafin Covid, a ƙarshe kimiyya ta yi nasara tare da ƙwararrun jagoranci na ƙwararru, gudummawar bincike mai mahimmanci na duniya da ingantacciyar lafiyar jama'a da cibiyoyin gwamnati.
Covid baya bin wannan hanya - tsarin iko a waje da tsarin kula da lafiya na gargajiya yana sarrafa labarin neman kai wanda ya gaza sarrafa cutar. Yanke shawara sun kasa mutunta kimiyya. Sakamakon ya hada da bullar kwayar cutar mutant da kuma bala'in cutar sankara, ƙuntatawa kan ingantattun jiyya masu arha waɗanda za su iya kawo ƙarshen cutar, gazawar yin tambayoyi game da abubuwan da suka faru na mRNA, da gazawar mutunta sana'ar likita da ke fuskantar kula da marasa lafiya na Covid.
Likitan iyali zai iya cewa kawai "Idan ba za ku iya numfashi ba ku je asibiti" (ko, kwanan nan ƙara "Muna da 'yan tsiraru, wasu magungunan da za su kashe gwamnati (watau ku) sama da $1,000"). A matakin al'umma, Mirko Bagaric, Dean of Law a Jami'ar Swinburne, yana ba da gudummawar hujja mai ƙarfi game da kula da 'yancin da muke ɗauka. Ya bayyana halayen gwamnati ta hanyar barkewar cutar a matsayin “da mafi munin cin zarafin dokar laifuka a cikin tsarin dimokraɗiyya a cikin ƙwaƙwalwar ajiyar kwanan nan," yana lura a matsayin misali "fiye da 'yan Victoria masu bin doka 50,000 waɗanda ke fuskantar takunkumin aikata laifuka."
Me za mu iya yi? Fahimtar yanayin meme na rashin fahimta wanda ya mamaye mutane da yawa a cikin sana'ar mu don karɓar ba tare da gardama ba, "labarin labari" na kantin magani/siyasa, ya yi mini wuya. A aikace, dole ne mu dawo da ikon aikinmu kuma mu dawo da matsayin da muka taɓa yin tasiri ga lafiyar majinyatan mu, bisa kimiyya ba labari ba.
Idan sana'ar likitanci ta kasa maido da ingantaccen tsarin tushen shaida, jikokinmu waɗanda ke zaɓar aikin likitanci suna fuskantar makomar dystopian da masu aikin hukuma ke gudanarwa don abubuwan duniya waɗanda kwaɗayi ke motsawa. Za a ƙara cire yanke shawara na kiwon lafiya daga mafi kyawun ƙa'idodin aiki da muka ɗauka a banza.
Idan ta ɗauki cutar ta Covid don haskaka hanyar da ta kasance ƙasa da radar, sanin yanayin sa da duk wata dama ta magance tasirinta na iya zama kyakkyawan sakamako ga Covid da muka samu tsammanin annoba a Ostiraliya, cikin shekaru 120 da suka gabata.
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Robert Clancy shine Farfesa Emeritus na Jami'ar Newcastle Makarantar Magunguna da Lafiyar Jama'a. Shi kwararre ne na Immunologist, Farfesa Farfesa Pathology, Jami'ar Newcastle kuma tsohon Shugaban Kungiyar Mucosal Immunology na Newcastle.
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