Kwanan nan CDC ta ƙirƙira lambobin Rarraba Cututtuka na Duniya (ICD) don matsayin rigakafin Covid-19. Ana amfani da lambobin ICD da yawa a cikin bayanan likita, bayanan inshora na likita da bincike na kiwon lafiya don rarraba daidaitattun jihohin cututtuka da kuma raunin da ya faru daga abubuwan da ba a iya gani ba kamar hatsarori, magunguna da raunin na'urorin likita, sinadarai masu guba, da dai sauransu. Matsayin rigakafin ba cuta ba ne ko jihar rauni, duk da haka CDC ta ba da rationalized ƙirƙirar lambobin ICD don shi. An saita code ɗin zai fara aiki a ranar 1 ga Afrilu, 2023.
Kamar yadda aka bayyana ta Dr. Robert Malone, "Tsarin rarraba ICD yana gudana daga Hukumar Lafiya ta Duniya, ba gwamnatin Amurka ba." Cibiyoyin Medicare da Medicaid Services (CMS) na Amurka ne suka haɓaka lambobin ICD na rigakafin wasu watanni tara da suka gabata, kuma CDC tana aiwatar da su.
Tsarin coding, Z28.xxx, ya ƙunshi duka matsayin rigakafi da dalilai masu yuwuwar matsayin. Duk da haka, babu alama akwai lambar don "cikakken alurar riga kafi," kawai ga jihohi daban-daban na "ba a cika cikakken alurar riga kafi ba."
- Lambar Z28.0 tana nufin "ba a yi rigakafi ba saboda sabani." Z28.1 na nufin "alurar rigakafin da ba a yi ba saboda shawarar haƙuri saboda dalilai na imani ko matsin lamba."
- Z28.2 na nufin "alurar rigakafin da ba a yi ba saboda shawarar haƙuri don wani dalili da ba a bayyana ba."
- Z28.8 yana nufin "alurar rigakafi ba a aiwatar da shi ba saboda wani dalili" wanda saboda lambar Z28.2 dole ne ya koma ga dalilan da ba su da alaƙa ga yanke shawara na haƙuri.
- A ƙarshe, Z28.39 yana nufin "sauran matsayin rashin rigakafi," gami da "Matsalar rigakafin rigakafi" da "Matsalar jadawali na rigakafi."
Koyaya, mai yuwuwar sabani ya taso saboda lambar Z28.310 tana nufin "ba a yi wa COVID-19 ba."
Don daidaita wannan, lambobin Z28 a cikin sakin layi na baya dole ne su koma ga alluran rigakafi ban da na Covid-19. Wata lambar Covid-19 kawai ita ce Z28.311 wacce ke nufin "wani sashi na alurar riga kafi don COVID-19," inda "bangare" ke nufin ma'anar CDC don "cikakken alurar riga kafi" a lokacin da mai haƙuri ya ziyarci mai ba da lafiya wanda ke yin rikodin matsayin rigakafin a cikin jadawalin likita.
A bayyane yake cewa ba a kayyade cikakkun bayanai na dalilan zaɓin masu haƙuri don matsayin rigakafin ba a cikin lambobi don rigakafin Covid-19, amma CDC tana da wasu watanni biyu don gyara wannan. Babu takamaiman lambobin tukuna don “ƙi bayyana matsayin COVID-19” ko “ matsayin rigakafin COVID-19 da ba a san shi ba,” amma ana iya ƙara waɗannan lambobin a wani lokaci.
Menene amfanin da aka tsara wannan bayanin? Tabbas akwai dalili na lafiyar jama'a don hukumomi su sami damar sanya ido kan matsayin alurar riga kafi. Hukumomin kiwon lafiyar jama'a, kamfanonin inshora da masu bincike na kiwon lafiya suna nazarin bayanan lafiyar mutum akai-akai, amma a cikin tsarin da ba a bayyana sunansu ba. Ana yin rikodin bayanan da za a iya ganewa a cikin ma'ajin bayanai, duk da haka HIPAA da sauran dokoki suna ba da kariya ga bayanan lafiya da za a iya gane su kuma suna tsara yadda za a iya amfani da irin waɗannan bayanan don bincike.
A ka'idar, matsayin rigakafin ba zai iya bambanta ba. Bayanan likita sun riga sun san shekarunku, jinsi da launin fata, inda kuke zama, game da kiba, ciwon sukari, shan taba da barasa da kuma matsayin ku na HIV. Wasu daga cikin waɗannan bayanan na iya zama abin ƙyama idan aka fitar da su a bainar jama'a, amma a halin yanzu babu wani yanayi na siyasa ko wasu yanayi da zai tilasta zaɓin da ba a so a kan jama'a dangane da wannan bayanan sirri da aka tattara.
Sai dai ka yi tunanin cewa wata rana jami’an gwamnati suna bubbuga kofarka da karfe 6 na safe, suna gaya maka cewa ana bukatar ka sha magungunan daina shan taba, a karkashin hukuncin zama na tilas a “otal-otal mai shan taba” har sai ka mika wuya ga abin da gwamnati ta bukata.
Magungunan sun gina masu watsawa waɗanda aka kunna lokacin da aka fallasa su zuwa acid ɗin ciki, don haka ana yin rikodin ɗaukar su. Bayan haka, Amurkawa 500,000 ne ke mutuwa a duk shekara sakamakon cututtukan da ke da alaƙa da shan taba kuma kulawar jinya ta ƙarshen rayuwa wani kuɗaɗe ne wanda gwamnati ba ta son biyansa. Shan taba ku yana cutar da tattalin arziƙin kula da lafiyar da kakata ke buƙata. Ko wani abu.
Amma Covid-19 da allurar sa sun bambanta. An ƙirƙiri allurar rigakafin Covid da masu haɓaka su a ƙarƙashin ka'idojin amfani da gaggawa (EUA) kuma ba su da cikakken lasisi. Sigar Aikace-aikacen Lasisi na Halittu (BLA), misali, Comirnaty, ba a gabaɗaya a cikin Amurka. Jama'ar Amurka ba su lura da wannan sana'ar chicanery ba kuma ɗimbin ɓangarorin mutane suna ganin cewa maganin yana da cece-kuce.
Mutane da yawa sun ga abokansu da danginsu da aka yi wa allurar rigakafi da yawa suna samun Covid, wasu lokuta da yawa. Mutane da yawa sun kuma ga abokai da dangi sun cutar da alurar riga kafi, kuma yawancin mutane sun san mutuwar yau da kullun na ’yan wasa masu lafiya, mutuwar da aka tattauna kamar yadda “kwatsam.” Mutane sun ga allurar rigakafin a matsayin mafita ga cutar, amma duk da haka sun gaza gaba ɗaya a duk faɗin jama'a don hana yaduwar cutar.
Kuma, an cika mutane da labarun yau da kullun na tsawon shekaru biyu masu ƙarfi cewa alluran rigakafin “amintattu ne kuma masu tasiri” kuma dole ne a sha, kuma mutanen da ba a yi musu allurar ba “mugaye ne,” “masu son kai,” aljanu suna lalata al’umma, kuma ya kamata a guje su.
Wato matsayin rigakafin mutum a yau shine mafi girman bayanan mutum na zamani, wanda ya zarce ciwon AIDS. Don haka, duk wani aikin gwamnati dole ne ya zama “hacking” daga hacking da rashin amfani. Hakanan, dole ne a amince da gwamnati don kiyaye bayanan don amfani kawai kamar yadda aka yi amfani da wasu bayanan likita na sirri.
Ganin tsawon shekaru biyu da manyan farfagandar gwamnati game da alluran rigakafin, game da illolinsu, game da Covid, game da farkon jiyya na Covid, da haɗin gwiwar gwamnati tare da kamfanonin kafofin watsa labarun don murkushe ingantattun ra'ayoyin likita da na kimiyya da bayanai, babu wani dalili mai ƙarfi don tallafawa amincewa da gwamnati da irin wannan bayanan.
Babu wani dalili da za a yi imani da cewa gwamnati ba za ta ba da bayanin matsayin ga kamfanonin inshora ko wasu kamfanonin da ke yin manyan kasuwanci tare da jama'ar Amurka ba. Har ila yau, babu wata hanyar da gwamnati za ta fitar da irin waɗannan bayanan sirri. Don haka, babu wani abu da zai iya hana irin waɗannan kamfanoni hana ayyukan bisa ga bayanan da aka lalata. Misali, ana iya toshe tafiye-tafiyen jama'a; za a iya toshe asusun banki; ana iya toshe sayayya.
Neman farin ciki kyauta yana kunshe a cikin ayyana 'yancin kai. Gwamnati ba za ta iya tsoma baki bisa doka ba tare da ma'amaloli na yau da kullun na yau da kullun. Amma kamfanoni masu zaman kansu da ke aiki bisa ga umarnin gwamnati, tare da bayanan matsayin gwamnati da gwamnati ta kawo, za su iya yin hakan sosai.
Kamar yadda aka gani daga takardun FOIA, ɗaruruwan ma'aikatan gwamnati sun kwashe shekaru ana fama da bala'in suna yin daidai wannan ɗabi'ar da ta sabawa tsarin mulki wajen sa kamfanonin kafofin watsa labarun su murkushe 'yancin fadin albarkacin baki na Amurkawa.
Bugu da ƙari, a yanzu babu wata fa'ida ta gwamnati ta tattara matsayin rigakafin kwata-kwata. A lokacin da ake tunanin allurar rigakafi gabaɗaya (ba daidai ba) don rage yaduwar Covid-19 a cikin jama'a, wataƙila an sami dalilin yin hakan.
Koyaya, a ranar 11 ga Agusta, 2022, CDC ya bayyana a bainar jama'a cewa allurar rigakafin Covid-19 ba sa aiki a matsayin ma'aunin lafiyar jama'a don sarrafa yaduwar cutar. Sun ce, "karɓan jerin firamare kaɗai, in babu sabuntar allurar rigakafi* ta hanyar karɓar duk allurai masu ƙarfafawa, yana ba da ƙaramin kariya daga kamuwa da cuta da watsawa (3,6)." "Kasancewar zamani tare da allurar rigakafin yana ba da lokaci na wucin gadi na ƙarin kariya daga kamuwa da cuta da watsawa bayan kashi na baya-bayan nan, kodayake kariya na iya raguwa cikin lokaci."
Gaskiyar cewa irin wannan fa'idar "mai wucewa ce" kuma ta ragu yana nuna cewa bayan ɗan gajeren lokaci, masu haɓakawa sun kasa rage haɗarin watsawa don haka umarnin rigakafin ba su da inganci.
Abinda kawai gwamnati ke sha'awar aiwatar da allurar rigakafin Covid, don haka a cikin tattara bayanan sirri game da matsayin rigakafin, shine cewa alluran sun rage watsawa. Ba su yi ba.
Na biyu, CDC ta Agusta 11th Jagoran manufofin ba ya bambanta tsakanin mutanen da aka yi wa alurar riga kafi da marasa rigakafi ta kowace hanya don kowace manufa. Don haka babu wani tursasashen manufar gwamnati wajen ayyana mutane a matsayin masu allurar rigakafi ko kuma ba a yi musu allurar ba. Zai zama kamar gwamnati ta tattara bayanan sirri game da launin gashi, sai dai launin gashi ba abin kunya ba ne kuma matsayin rigakafin yana da matukar damuwa.
Gwamnati da kanta - ta CDC - ta ƙaddara cewa matsayin rigakafin ba shi da mahimmancin manufofin. Don haka ba za a iya samun wani abin sha'awa ga gwamnati ta tilastawa ta tattara waɗannan bayanai ba tare da son ran jama'a ba, ko da kuwa ba zagi ba ne. Haka kuma bayan da gwamnati ta kwashe shekaru biyu da suka gabata a bainar jama'a tana yi wa mutanen da ba a yi musu allurar rigakafi ba saboda zabin lafiyarsu na hankali da halal.
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Harvey Risch, Babban Masanin Kimiyya a Cibiyar Brownstone, likita ne kuma Farfesa Emeritus na Epidemiology a Makarantar Yale na Kiwon Lafiyar Jama'a da Makarantar Magungunan Yale. Babban sha'awar bincikensa shine ilimin ilimin ciwon daji, rigakafi da ganewar asali, da kuma hanyoyin cututtukan cututtuka.
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