Umqondo we ubhubhane lwembulunga yonke Kuye kwashiswa ezinkumbulweni zethu ngemva kwe-COVID-19. Lokho okwakuzwakala njengokuthile okukude noma okuvela encwadini yomlando ngokuzumayo kwaba impilo yethu yansuku zonke: imaski, ama-ICU agcwele, amakilasi aku-inthanethi, imigwaqo engenalutho kanye nezihloko ezikhuluma ngezifo nokufa.
Ngaphandle komthelela ongokomzwelo, i-COVID-19 ibilokhu iyi- impilo kanye nenhlekelele yomphakathi ngobukhulu obukhulu: amakhulu ezigidi zamacala aqinisekisiwe, izigidi zokufa, umjaho wesayensi ongakaze ubonwe wokuthuthukisa imijovo kanye nokwelashwa, izingxoxo zobunikazi, ukungalingani kobulili okwandayo, kanye nomnotho womhlaba wonke oshaqekile. Noma kunjalo, akubanga ubhubhane lokuqala olukhulu emlandweni… futhi ngeke kube olokugcina.
Ubhubhane lwe-COVID-19: ukuthi lwaluyini, lwaqala nini nokuthi sikuphi manje
Ikholi Ubhubhane lwe-covid-19 (noma ubhubhane lwe-coronavirus) kwabangelwa yigciwane le-SARS-CoV-2. Amacala okuqala aziwayo avele ngoDisemba 2019 eWuhan, esifundazweni saseHubei eShayina, lapho kwabikwa khona iqembu leziguli ezine-pneumonia engaziwa ukuthi ivelaphi, eziningi zazo zihlobene ne-Huanan Seafood Wholesale Market.
Ngomhlaka-30 Januwari 2020, i-World Health Organization (WHO) yamemezela isimo njenge isimo esiphuthumayo sezempilo yomphakathi esikhathazayo emhlabeni jikeleleNgoMashi 11, 2020, njengoba kutholakale izinkulungwane zamacala emazweni angaphezu kwe-100, i-WHO yamemezela ngokusemthethweni lesi simo njengobhubhane. Lesi simo esiphuthumayo saqhubeka nokusebenza kwaze kwaba nguMeyi 5, 2023, lapho isimo sokuqapha samazwe ngamazwe sasuswa khona, yize igciwane laqhubeka nokusabalala.
Ngo-Agasti 2023, okungaphezu Amacala aqinisekisiwe ayizigidi ezingama-692 kanye nokufa okungaphezu kwezigidi eziyi-7 okubangelwa yi-COVID-19 ngokusemthethweni, kanti igciwane lisakazeka emazweni nasezindaweni ezingaba ngu-260. Uma kucatshangelwa ukungabikwa kahle, kulinganiselwa ukuthi okungenani u-10% wabantu bomhlaba batheleleka eminyakeni embalwa yokuqala, okuhunyushwa njengezibalo eziseduze nabantu abayizigidi ezingu-780 abathelelekile kuleso sigaba sokuqala sodwa.
Ngokuhamba kwesikhathi, ukusabalala kwegciwane kuye kwasimama, futhi namuhla ochwepheshe abaningi nohulumeni bakhuluma ngakho isigaba sokuphela kwesikhathiI-SARS-CoV-2 isekhona, kodwa ngaphandle kokwanda okukhulu komhlaba wonke eminyakeni yokuqala, kanye nengxenye enkulu yabantu abagonyiwe noma abathelelekile ngaphambilini. Noma kunjalo, kusukela ngo-Okthoba 27, 2024, i-COVID-19 yayiqongelele ukufa okuqinisekisiwe okungaphezu kwezigidi ezingu-7,07 futhi manje ibhekwa njengobhubhane lwesihlanu olubulalayo kakhulu noma ubhubhane oluqoshwe phansi.
Kusukela ku-SARS-CoV-2 kuya ku-COVID-19: igciwane, izifo kanye namagama
I-ejenti ebangela ubhubhane yi- I-SARS-CoV-2, i-RNA coronavirus enezintambo eyodwa enengqondo enhle eyingxenye yeqembu elincane le-Orthocoronavirinae. Iyigciwane le-zoonotic: kungenzeka ukuthi lagxuma lisuka kumalulwane laya kubantu, kungaba ngokuqondile noma nge-host ephakathi. I-genome yalo ihlanganisa amaprotheni amaningana esakhiwo, kufaka phakathi iphrotheni ye-S (spike), enesibopho sokubopha kwi-receptor yeseli le-ACE2 nokuqala ukungena esitokisini.
Ekuqaleni, lesi sifo sasibizwa ngokungakahleleki ngokuthi "i-Wuhan pneumonia." I-WHO yasebenzisa okwesikhashana izinkulumo ezifana nalezi: isifo sokuphefumula esibuhlungu esibangelwa yi-2019-nCoVNgomhlaka-11 kuNhlolanja 2020, kwasungulwa igama elisemthethweni elithi COVID-19, okuyigama elifingqiwe elithi isifo se-coronavirus 2019NgesiSpanishi, i-RAE kanye ne-Fundéu batusa uhlobo lwesifazane (I-COVID 19ngoba umongo “yisifo”), yize ukusetshenziswa kwansuku zonke “i-covid” yabesilisa nayo isivele isunguliwe.
Ngokombono wezokwelapha, I-COVID-19 Kungukutheleleka kwe-SARS-CoV-2 okungasukela ezimweni ezingenazimpawu kuya kwi-pneumonia enzima, i-acute respiratory distress syndrome, i-sepsis, kanye nokwehluleka kwezitho eziningi. Izinga lokufa kwalesi sifo elilinganiswe yi-WHO ngo-2020 lalicishe libe ngu-0,5-1%, kodwa ngomehluko omkhulu kuye ngobudala, izifo ezihambisana nalesi sifo, ukufinyelela ohlelweni lwezempilo, kanye nesigaba sobhubhane.
I-SARS-CoV-2 idluliselwa kanjani futhi yiziphi izimpawu zayo?
I-SARS-CoV-2 idluliselwa kakhulu kusuka ku- umuntu nomuntu emoyeniLawa amaconsi okuphefumula kanye nama-aerosol esiwakhiphayo lapho sikhuluma, siphefumula, sikhwehlela, sithimula, simemeza, noma sihlabelela. Lawa maconsi amancane angaphefumulwa ngqo eduze noma ahlale emoyeni ezindaweni ezingenawo umoya ohlanzekile, ezivalekile.
Kukhona futhi ukutheleleka nge- ukuthintana ngokungaqondileAmaconsi awela ezindaweni, umuntu uthinta leyo ndawo, bese ethinta amehlo akhe, impumulo, noma umlomo. Kodwa-ke, ngokuhamba kwesikhathi kwatholakala ukuthi ama-fomite (izindawo ezingcolile) adlala indima encane ekudluliseleni uma kuqhathaniswa nokudluliswa emoyeni. Noma kunjalo, igciwane lingahlala ezintweni ezifana [nezingachazwanga] amahora noma izinsuku. ipulasitiki, insimbi, ikhadibhodi, imali yamaphepha noma ingilazi, kuye ngokushisa kanye nomswakama.
Isikhathi se-incubation ngokuvamile siseduze Izinsuku ze-5ngezinsuku ezi-2 kuya kweziyi-14. Kunobufakazi bokudluliswa kosuku olulodwa noma ezimbili ngaphambi kokuqala kwezimpawu, okuhambisana nomthamo wegciwane ophakeme. Lokhu kulawula okunzima kakhulu esigabeni sokuqala, ngoba abantu ababonakala bephilile babengadlulisela igciwane ngenkuthalo.
Izimpawu ezivame kakhulu zihlanganisa umkhuhlane, ukukhwehlela okomile, ukukhathala, kanye nobunzima bokuphefumulaEqenjini elikhulu laseShayina elinamacala aqinisekisiwe angaba ngu-56,000, u-87,9% wavezwa umkhuhlane, u-67,7% wavezwa ukukhwehlela okomile, u-38,1% wavezwa ukukhathala, kanti u-19% wavezwa ukuphelelwa umoya. I-Myalgia, ikhanda elibuhlungu, umphimbo obuhlungu, isifo sohudo, ukuminyana kwamakhala, kanye, okumangalisayo ekuqaleni, ukwehla kwesisindo ngokuzumayo nakho kwachazwa. iphunga nokunambitha engxenyeni enkulu yeziguli.
Ezimweni ezimbi kakhulu, i-bilateral pneumonia, i-acute respiratory distress syndrome, i-shock (ngokuvamile i-septic), izehlakalo ze-thromboembolic (i-deep vein thrombosis, i-pulmonary embolism, i-stroke), kanye nezinkinga zezinso nezenhliziyo zingase zenzeke. I-Lymphopenia, izimpawu zokuvuvukala eziphakeme, nezinye izimo zivame ukuchazwa emayunithi okunakekelwa okujulile. isiphepho se-cytokineOkungukuthi, impendulo yokuvuvukala engalawuleki elimaza izicubu ngokwazo.
Amacala, ukufa, kanye nomehluko phakathi kwamazwe namaqembu abantu
Izibalo zomhlaba wonke ziyamangaza: kusukela ngoNovemba 2023, kwakukhulunywa cishe ngokuthi Amacala aqinisekisiwe ayizigidi ezingama-700 futhi cishe abantu abayizigidi eziyi-7 babike ukufa. Kodwa kusukela ekuqaleni kwakunenkinga enkulu: amandla okuxilonga, incazelo yamacala, kanye nezindlela zokubala ukufa kwahlukahluka kakhulu phakathi kwamazwe.
Ezinyangeni ezimbalwa zokuqala, amazwe afana neNingizimu Korea akwenzile ukuhlolwa kwabantu abaningiukufinyelela izivivinyo ze-PCR eziyi-10,000 ngosuku ekuqaleni kukaMashi 2020, okwavumela ukutholakala kwamacala amaningi amancane kanye namazinga angokoqobo futhi aphansi okufa kwamacala. Ngakolunye uhlangothi, iJapan, i-United Kingdom, kanye ne-United States ekuqaleni zenze izivivinyo ezimbalwa, kanti iSpain ne-Italy nazo zazinqunyelwe ukuntuleka kwama-reagents kanye nama-laboratory ahlomile.
Lokhu kusho ukuthi inani langempela labantu abangenwe yileli gciwane laliphezulu kakhulu kunenani elibhalwe ngokusemthethweni. ESpain, ekupheleni kukaMashi 2020, kwalinganiselwa ukuthi kungenzeka ukuthi kwakukhona amacala angempela aphakathi kuka-300,000 no-900,000 uma kuqhathaniswa namacala angu-39,000 atholakale. EShayina, amacala angenazimpawu ahlolwe ukuthi analeli gciwane awazange abikwe njengaqinisekisiwe ekuqaleni, okwaphinde kwanciphisa izinga langempela lokuqubuka kwaleli gciwane.
Ngakolunye uhlangothi, lapho umthamo we-PCR wanda kakhulu, kwaphakanyiswa ukuthi kungaba khona ukulinganisa ngokweqile yamacala asebenzayo, ngoba ukuhlolwa kuthole izingcezu ze-RNA yegciwane engasasebenzi emavikini ngemva kokudlula kokutheleleka. Kwenzeka into efanayo ngenani labashonile: I-Italy, isibonelo, ibale kuphela labo abahlolwe batholakala bene-COVID-19 abashonile, ishiya ngaphandle abantu abaningi asebekhulile abashone emakhaya asebekhulile ngaphandle kokuhlolwa. IBelgium, ngakolunye uhlangothi, ifake ezibalweni zayo zokufa okungenzeka ukuthi labo abashone emakhaya asebekhulile abanezimpawu ezihambisanayo noma ngabe babengahlolwanga.
ESpain kwatholakala ukuthi ukufa okungaphezu kwamandla omuntu Inani eliphelele lokufa elidlula okulindelwe ngesikhathi samagagasi obhubhane laliphakathi kuka-50% no-70% ngaphezu kokufa okubangelwe ngokusemthethweni yi-COVID-19 ngokuhlolwa kwe-PCR, okunikeza umbono womthelela wangempela. Futhi uma sikubheka ngamaqembu, ubudala buyisici esibalulekile: iminyaka emaphakathi yalabo abashona e-Italy yayicishe ibe ngu-79, futhi cishe bonke babenezimo ezazikhona ngaphambili (umfutho wegazi ophakeme, isifo sikashukela, isifo senhliziyo, i-COPD, umdlavuza, njll.).
Ukungalingani okusekelwe ocansini, ubulili kanye namaqembu asengozini
Nakuba igciwane lingathelela noma ubani, idatha yabonakala kusenesikhathi ukungalingani okukhulu ngokobulili nangobuliliEmazweni amaningi, ukufa kwakuphezulu kwabesilisa kunakwabesifazane (isibonelo, u-4,7% uma kuqhathaniswa no-2,8% eShayina). Izimbangela zezinto eziphilayo (umehluko wama-hormone, impendulo yomzimba, ukwanda kokubhema kanye nezifo ezingamahlalakhona kwabesilisa) kanye nezici zokuziphatha kuye kwatholakala.
Kodwa-ke, lapho bebheka ngale kwengozi yokufa, abesifazane baye babhekana nobunzima obukhulu. umthelela onzima kakhulu Kwezinye izingxenye, emakethe yezabasebenzi, imithwalo yemfanelo yokunakekela, ukusebenza ekhaya nezingane, umnotho ongakahleleki, kanye nodlame olusekelwe kubulili, ubhubhane luye lwandisa ukungalingani okukhulu Abesifazane sebevele bakhona. Ngokwesilinganiso, abesifazane benza amahora amaningi engeziwe omsebenzi wasekhaya nowokunakekelwa ongakhokhelwa, futhi emikhakheni efana nokunakekelwa kwempilo bamele iningi labahlengikazi kanye nabasebenzi abasizayo, ngakho-ke ukuchayeka kwabo kuleli gciwane kwakukhulu.
ESpain, isibonelo, cishe ama-75% abasebenzi bezempilo abangenwe yileli gciwane babenegciwane. abesifazaneNgaphezu kwalokhu kukhona abasebenzi basekhaya kanye nabanakekeli, abaningi abasemnothweni ongakahleleki, abalahlekelwe yimisebenzi yabo ngesikhathi sokuvalelwa ekhaya futhi, ngenxa yokuthi abazange banikele ekuvikelekeni komphakathi, bakhishwa emzamweni wosizo lukahulumeni. ELatin America naseCaribbean, cishe ingxenye yalabo abasebenza ngaphandle kwezinkontileka ngabesifazane, abamele ingxenye enkulu yomkhakha wokunakekelwa ongakhokhelwa.
Ikholi “ubhubhane wesithunzi” Lokhu kubhekisela ekwandeni okukhulu kobudlova obusekelwe kubulili ngesikhathi sokuvalelwa endlini. Ukuvalwa kwezikole, ukulahlekelwa yimisebenzi, kanye nokuvalelwa endlini nomhlukumezi kwaholela ekwandeni kwezingcingo eziya ezingcingweni zokusiza, amacala obudlova basekhaya, kanye nesidingo sezindawo zokukhosela, kwaze kwaba yilapho lezi zinsizakalo zincipha. Ngaphansi kuka-40% wezisulu ezifuna usizo olusemthethweni, kanti u-10% kuphela obika ukuhlukunyezwa emaphoyiseni, okwenza kube nomthelela ekungabonakalini kwakho.
Umphakathi we-LGBTI nawo uthinteke kakhulu: ukulahleka kwemali engenayo Ezingxenyeni ezisengozini kakade, kube nokuvalwa kwezindawo eziphephile zokuhlalisana nabantu, ukwanda kobudlova basekhaya kubantu okwadingeka babuyele emakhaya angawamukeli, futhi ubhubhane luye lwasetshenziswa njengezaba zezepolitiki kwamanye amazwe ukuze kugxekwe abantu abancane ngokobulili noma kubambezelwe ukuthuthuka kwezomthetho kwamalungelo.
Eminye imiphumela yezempilo: ngale kwegciwane
Ukunakwa okukhulu kwe-COVID-19 nakho kube nakho imiphumela emibi izinkinga ezinkulu ngezinye izifo. Izinhlelo eziningi zokuvimbela, zokuhlola, kanye nezokwelapha zaphazamiseka noma zancishiswa, futhi ukutholakala komdlavuza, isifo senhliziyo, izifo ezingamahlalakhona, kanye nezinye izifo kwabambezeleka. I-WHO ilinganisela, isibonelo, ukuthi ngo-2020 cishe abantu abangu-500,000 abengeziwe bafa ngenxa yofuba ngenxa yokuphazamiseka kokutholwa nokwelashwa.
Ngokumangalisayo, kwaba nokwehla komlando kwezinye izifo zokuphefumula ezifana umkhuhlane wesizini kanye negciwane lokuphefumula elihambisana nokuxhumana, ikakhulukazi ebusika baseNingizimu Yenkabazwe ka-2020. Kungenzeka ukuthi ukwehla kokuhamba kwamanye amazwe, ukusetshenziswa kwemaski, ukuvalwa kwezikole, kanye nokuqhelelana nabantu kunciphise ukusabalala kwala magciwane ngempumelelo enkulu.
Kwabasebenzi bezempilo, ubhubhane lusho ukuthi ukucindezeleka okungakaze kubonwe ngaphambiliEmazweni afana neSpain, amaYunithi Okunakekelwa Okujulile andise kathathu umthamo wawo wemibhede yokunakekelwa okubucayi, okwenza kube lula ukuthola ama-ICU emakamelweni okuhlinzwa, amakamelo okululama, nakwezinye izindawo. Ama-ventilator amadala kanye nemishini yokubulala izinzwa kwasetshenziswa kabusha, futhi kwaqanjwa nezixazululo eziphuthumayo ngenxa yokuntuleka kwama-ventilator emhlabeni wonke kanye nemishini yokuzivikela.
Ngaphezu kokukhathala ngokomzimba, ochwepheshe abaningi bahlushwa ukucindezeleka kokuziphatha Lokhu kwakubangelwa ukubeka phambili izinsiza ezinganele (imibhede ye-ICU, ama-ventilator, ama-sedative) kanye nokusebenza ngemishini yokuzivikela enganele ngezinye izikhathi. Akuyona into engaqondakali ukuthi ingxenye enkulu kakhulu yabasebenzi bezempilo yatheleleka: eSpain, izibalo eziseduze ne-14% yamacala aphelele zabikwa ezindaweni ezithile.
Ukuhlolwa kokuxilonga, i-serology kanye namacala angenazimpawu
Ukuqinisekisa ukutheleleka okusebenzayo, ithuluzi elijwayelekile legolide libe yi- Ukuhlolwa kwe-PCRLezi zivivinyo zibona izingcezu ze-RNA yegciwane. Ziyazwela kakhulu, kodwa lokhu kunemiphumela emibili ebalulekile: zivumela igciwane ukuthi litholakale ngisho noma kunemithwalo yegciwane ephansi kakhulu, futhi zingaqhubeka nokunikeza umphumela omuhle lapho umuntu engasathelelani ngoba kusele izinsalela ze-RNA engaphili.
Ngesikhathi esifanayo, amazwe amaningi akwenzile izifundo ze-serological ngokuhlolwa kwama-antibody ukulinganisa ukuthi yiliphi iphesenti labantu abathelelekile ezinyangeni ezedlule, noma ngabe babengasenalo igciwane elitholakalayo. Eminye imiphumela ekhombisayo: esifundazweni sase-Italy iBergamo, ukusabalala kwegciwane kufinyelele ku-57%, eGeneva kwakucishe kube ngu-11%, eSpain cishe ku-10% ngoDisemba 2020, kanti eNew York City kudlule ku-22% ngemuva kwegagasi lokuqala.
Lolu lwazi luqinisekisile ukuthi Ukutheleleka kwangempela kwakungcono kakhulu. Inani langempela lamacala laliphezulu kunalelo eliboniswe ezibalweni ezibikiwe, ngenxa yenani elikhulu lamacala athambile futhi angenazimpawu kanye nokulinganiselwa kokuhlolwa kokuqala. Ngaphezu kwalokho, idatha ibonise umehluko omkhulu wezindawo kuye ngokuthi amagagasi anamandla kangakanani kanye nezinyathelo ezithathiwe.
Izindlela zokuvimbela: kusukela ekugezeni izandla kuya ekuvalelweni
Izincomo eziyisisekelo zokunciphisa ukudluliselwa kwegciwane zigxile ezindaweni ezintathu eziyinhloko: inhlanzeko, imaski kanye nebangaUkugeza izandla ngensipho namanzi okungenani imizuzwana engama-20, ukusebenzisa i-sanitizer yezandla uma lokho kungenzeki, ukugwema ukuthinta ubuso bakho ngezandla ezingcolile, ukumboza umlomo nekhala lakho lapho ukhwehlela noma uthimula (ikakhulukazi ngaphakathi kwendololwane yakho), kanye nokufaka umoya ezindaweni ezivalekile kwaba yizenzo zansuku zonke.
Ukusetshenziswa kwe imaski Lokhu kube ngenye yezingxoxo ezibonakala kakhulu. Ekuqaleni, i-WHO yancoma imaski kubantu abaningi, kodwa ngobufakazi bokusabalala kwezimpawu kanye ne-aerosol, amazwe amaningi aqala ukuyincoma noma ukuyiyala ngaphakathi nasezimweni eziyingozi kakhulu. Imaski yokuhlinzwa neyendwangu inciphisa ukukhishwa kwamaconsi endaweni ezungezile, kuyilapho i-N95/FFP2 respirators nayo ihlinzeka ngesivikelo kumuntu ogqokile.
Enye imininingwane engaxoxwa ngayo kancane ukuthi izifihla-buso eziningi kanye nemishini yokuphefumula yaklanywa ngokwe- amaphethini obuso besilisaLokhu kuzenza zilingane kahle nabesifazane futhi kwandisa ingozi yokuvuza. Ngaphezu kwalokho, amamodeli ane-valve yokukhipha umoya awafaneleki ukulawula ubhubhane: enza ukuphefumula kube lula kumsebenzisi, kodwa akhipha umoya ongahlungiwe, okungathi uma umsebenzisi ethelelekile, usakaze igciwane.
Ngaphezu kwezinyathelo zomuntu ngamunye, ohulumeni basebenzise amasu okusebenza ukusebenza kahle ekulawuleni ubungozi y ukuziqhelelanisa nomphakathi kanye nokuncipha kokuhamba: ukuvalwa kwemingcele, imikhawulo yokuhamba, imikhawulo yamandla, ukumiswa kwemicimbi emikhulu, ukuvalwa kwezikole namanyuvesi, ukusebenza ngocingo kanye, ezimweni eziningi, ukuvalelwa ekhaya okuqinile.
Le mikhawulo yehlise kakhulu inani lokuzala eliyisisekelo (R0). ESpain, isibonelo, kulinganiselwa ukuthi lehle lisuka kumanani angaphezu kuka-2 ngaphambi kwesimo esiphuthumayo laya cishe ku-0,98 ngo-Ephreli 2020, kanye nokwehla kwezinga lokukhula kokutheleleka lisuka ku-40% laya cishe ku-3%. Kodwa-ke, izindleko zomnotho nezengqondo zazinkulu kakhulu: ukuwohloka komsebenzi, ukwanda kokungasebenzi, kanye ukuwohloka kwempilo yengqondo engxenyeni enkulu yabantu, okunomthelela omkhulu kubantu abasha, abesifazane kanye namaqembu asengozini.
Imithi yokugoma, amalungelo obunikazi kanye nokungalingani komhlaba wonke
Ukuthuthukiswa kwemithi yokugomela i-COVID-19 bekulokhu ngokushesha okukhuluEsikhathini esingaphansi konyaka kusukela igciwane lahlukaniswa, imithi yokugoma eminingana yayisivele igunyaziwe: i-messenger RNA (Pfizer-BioNTech, Moderna), i-viral vector (AstraZeneca, Janssen, Sputnik V), i-virus engasebenzi (Sinopharm, Sinovac) kanye nemijovo ye-protein subunit, phakathi kwezinye.
Le mithi yokugoma iyahlukahluka ngobuchwepheshe bayo kanye Uchungechunge olubandayo Okudingekayo: Imithi yokugomela i-messenger RNA idinga ukubanda ku--20 °C (Moderna) noma cishe ku--70 °C (Pfizer) ukuze igcinwe isikhathi eside, kuyilapho imithi eminingi yokugomela i-adenovirus noma igciwane elingasebenzi igcinwa ngaphansi kwefriji ejwayelekile. Le mfuneko yempahla yenza kwaba nzima ukusatshalaliswa kwayo emazweni anengqalasizinda ebuthakathaka.
Ekuqaleni kuka-2022, okungaphezu Amadosi ayizigidigidi ezingu-9.37Lokhu kwakumele cishe ama-59% abantu bomhlaba abanesilinganiso okungenani esisodwa ngaleso sikhathi. NgoJanuwari 2023, inani labantu abagonywe okungenani esisodwa lalicishe libe yizigidigidi ezingu-5.294, cishe izingxenye ezimbili kwezintathu zabantu bomhlaba wonke.
Kodwa-ke, ukusatshalaliswa kwakungalingani kakhulu. Amazwe anemali engenayo ephezulu, amele cishe u-14% wabantu bomhlaba, alawula cishe i-14% yabantu. ingxenye yemithamo ethengiwe ngaphambilini (kugcinwe imali engaphezu kwezigidigidi eziyi-10 kusengaphambili ngoDisemba 2020). I-India neNingizimu Afrika bahole isiphakamiso e-WTO sokumisa okwesikhashana amalungelo obunikazi emithini yokugoma, imithi, kanye nobuchwepheshe obuhlobene ne-COVID-19 ngesikhathi sobhubhane, ngokusekelwa amazwe angaphezu kwe-000 kanye nezinhlangano eziningi ezizimele.
Iningi lamazwe acebile—kufaka phakathi amazwe amaningana e-European Union, i-United States (ekuqaleni), i-United Kingdom, ne-Brazil—ekuqaleni aphikisana nalesi sinyathelo, evikela uhlaka lwempahla yobuhlakani. NgoMeyi 2021, i-United States yamangaza abaningi ngokusekela ukukhululwa okulinganiselwe okugxile emithini yokugoma, kodwa izingxoxo zaqhubeka futhi umphumela waba buthaka impela.
Imithi yokugoma yayingeyona nje ithuluzi lezempilo, kodwa futhi yayiyithuluzi ibhizinisi elikhuluUmuthi wokugomela i-Pfizer-BioNTech wephule amarekhodi okuthengisa, wakhiqiza cishe ama-€70 billion phakathi kuka-2021 no-2022, kanti iModerna ithole imali engaphezu kwama-€34 billion ngemithi yokugomela ngesikhathi esifanayo. Ngesikhathi esifanayo, kwavela inqwaba yemithamo kusukela ngasekupheleni kuka-2022, futhi kwavela izingxabano mayelana nokulahla amaqoqo aseduze nokuphelelwa yisikhathi.
Ukungavikeleki komzimba, ukutheleleka kabusha, kanye ne-COVID ende
Ngemva kokutheleleka, umzimba ukhiqiza i- amasosha omzimba ngokuhlanganisa ama-antibodies namaseli e-T kanye nama-B enkumbulo. Izifundo eziningana zikhombisile ukuthi, kubantu abaningi, ukuba ne-COVID-19 kunciphisa kakhulu ingozi yokutheleleka kabusha ezinyangeni ezilandelayo futhi, uma kwenzeka, kwenza ukugula kube lula futhi kungenzeki ukuthi kudingeke ukuthi kulaliswe esibhedlela.
Isibonelo, ukuhlaziywa okwenziwe ngo-2021 kuphakamise ukuthi labo asebevele belulame ekuthelelekeni babene-avareji engaba ngu-1. Ingozi engaphansi ngo-80% kokutheleleka kabusha okungenani izinyanga eziyisithupha, kanye namathuba angaphansi kuka-94% okuthola izimpawu, kanti amazinga okutheleleka kabusha aqinisekisiwe acishe abe ngu-0,6%. Ucwaningo olulandelayo lubonisa ukuthi ukuzivikela kwemvelo, kuhlanganiswe noma kungenawo umuthi wokugoma, kungahlala isikhathi eside ngenxa yamaseli enkumbulo B kanye namaseli e-plasma aphile isikhathi eside emnkantsheni wamathambo.
Ngesikhathi esifanayo, lokho okubizwa ngokuthi I-COVID eqhubekayo noma “i-COVID ende”: isethi yezimpawu eziqhubekayo noma ezibonakala emavikini noma ezinyangeni ngemuva kokutheleleka okukhulu (ukukhathala, ukuphefumula kanzima, inkungu yobuchopho, ubuhlungu bemisipha, ukuphazamiseka kokulala, ukushintsha kokunambitha noma iphunga, njll.). Lesi sifo sivame kakhulu kwabesifazane nakubantu ababenezimo zokuqala eziphakathi noma ezinzima, kodwa singathinta nentsha enempilo ngaphambili.
Ukutheleleka kwangaphambilini noma ukugoma akuqinisekisi ukuvikeleka okuphelele ekuthelelekeni okusha; abakwenzayo ukunciphisa amathuba okugula nokufa okukhuluNgakho-ke, nakuba imikhawulo eminingi isisusiwe, iziphathimandla zincoma ukuthi kuqashwe ngokucophelela ezindaweni ezisengozini enkulu, kuvikelwe abantu abasengozini, futhi kubuyekezwe imithamo yokuqinisa emaqenjini asengozini enkulu (asebekhulile, amasosha omzimba abuthakathaka, kanye nabantu abanezifo ezihambisana nalesi sifo ezingathi sína).
Ukwelashwa kanye nokwelashwa okusathuthukiswayo
Ezinyangeni ezimbalwa zokuqala, ukwelashwa kwe-COVID-19 kwakugxile kakhulu ukwesekwaKwanikezwa umoya-mpilo, umoya ongangenisi noma ongangenisi, ukulawula umkhuhlane, ukuphathwa kwezinkinga, kanye nokuvimbela i-thrombosis. Kwahlolwa imithi eminingi (i-hydroxychloroquine, i-lopinavir/ritonavir, i-interferons, i-colchicine, i-ivermectin, njll.), kwatholakala imiphumela eyayivame ukudumaza noma ngisho nokulimaza.
Ngokuhamba kwesikhathi, ezinye sezizinzile izindlela zokwelapha eziwusizo Ezimweni ezithile: ama-corticosteroids asebenza kahle (njenge-dexamethasone) ezigulini ezihilelekile emaphashini kanye nesidingo somoya-mpilo, imithi ethile yokulwa namagciwane efana ne-remdesivir ezigabeni zokuqala kubantu abasengozini, inhlanganisela efana ne-nirmatrelvir/ritonavir (Paxlovid) ngomlomo, kanye nokusetshenziswa kwama-antibodies e-monoclonal ngokumelene nezinhlobo ezithile, yize eziningi zalahlekelwa ukusebenza njengoba igciwane lashintsha.
Enye indlela kube ukusetshenziswa kwe- i-plasma yokwelapha (i-plasma evela kubantu abalulame abane-antibody titers ephezulu) ezigabeni zokuqala kakhulu, kanti ezinye izifundo zibonisa ukwehla kokuqhubekela phambili kwesifo esibi uma kunikezwa kusenesikhathi emaqenjini athile. Ezingeni lokuhlola kakhulu, imigomo efana ne-IL-6 (tocilizumab) iye yahlolwa ezimweni zesiphepho se-cytokine, futhi ezimweni ezimbi kakhulu, ukufakelwa kwamaphaphu kwenziwe ezigulini ezinomonakalo wamaphaphu ongapheli ngemva kwe-COVID enzima.
Uphenyo luyaqhubeka: ukuhlolwa kuyaqhubeka ama-antiviral amasha, ama-immune modulator kanye nokuhlanganiswa kwezindlela zokwelapha, kanye nemiphumela yesikhathi esimaphakathi neyesikhathi eside, kokubili engokwemvelo kanye neye-neuropsychiatric, kufundwa ngokujulile.
Ubukhulu bezomnotho nezenhlalo kanye nabezindaba bobhubhane lomhlaba wonke
Ngaphandle kwezokwelapha, i-COVID-19 ibilokhu iyi- inkinga yezenhlalo-zomnotho kanye neyezepolitiki emhlabeni wonke. Ukuvalwa kwamabhizinisi, ukuphazamiseka kwe-supply chain, ukuwa kwezokuvakasha, ukuqhuma komsebenzi osebenza kude, imfundo ephoqelelwe ku-inthanethi, nokunye okuningi kuye kwashintsha impilo yansuku zonke futhi kwasheshisa izitayela ezazivele ziqhubeka, okuthinta izitayela zohwebo lwamazwe ngamazwe.
Cishe ingxenye yesithathu yabantu emhlabeni yaba kuvaliwe Ngesinye isikhathi ngo-2020, ngemikhawulo enzima yenkululeko yokuhamba, umsebenzi wezomnotho wehliswa kakhulu futhi ukungasebenzi kwanda kakhulu, yize kwaholela nasekuweni kwesikhashana kokukhishwa kwegesi kanye nokungcola okungcolisayo emadolobheni amaningi amakhulu.
Ngesikhathi esifanayo, iqiniso eliyiqiniso ubhubhane, eyodwa inkinga yolwaziUkhukhulelangoqo wolwazi, amanga, kanye nemibono yozungu mayelana nomsuka wegciwane, imigomo, ukwelashwa okuyisimangaliso, njalo njalo. Imithombo yezokuxhumana, abezindaba zikahulumeni, kanye nabadlali bezepolitiki basebenzisa ubhubhane ukuphikisana nezindaba, ukukhombisa amandla athambile, futhi, kwezinye izimo, ukufihla amaphutha okuphatha. Kwakukhona ukusolwa okuphambene kokusebenzisa abantu, ukufihla, i-propaganda, kanye nemikhankaso yolwazi olungalungile ehlelekile.
Isibonelo, iShayina yagxekwa ngokubambezeleka kokwabelana ngemininingwane ephelele ekuqaleni, ukungabaza ngenani langempela lamacala nokufa, kanye nokusebenzisa ukuthunyelwa kwezinsiza zezokwelapha kanye nemijovo kwamanye amazwe njengoba ithuluzi lokuthonyaKhonamanjalo, izikhulu zaseNtshonalanga eziphezulu kanye nemithombo yezindaba basolwa ngokusebenzisa kabi ubhubhane ngezinjongo zezwe, kungaba ukuhlasela uhulumeni waseShayina noma ukuphonsela inselelo indaba mayelana nokusebenza kahle kwezinhlelo zobushiqela uma kuqhathaniswa nentando yeningi yenkululeko.
Kulesi simo, i-WHO yahlolwa kakhulu: yasolwa ngokuhlonipha kakhulu iShayina kanye nokuba kancane noma ukungacaci kwezinye izincomo, futhi ithonya lezintshisekelo zezepolitiki ezinqumweni zayo labuzwa. Ngesikhathi esifanayo, indima yayo ekuhlanganiseni ulwazi lwesayensi, izincomo zobuchwepheshe, kanye nemizamo yokugoma ibe yinto ebalulekile naphezu kwemikhawulo yayo.
Ubhubhane emlandweni: ukuqhathanisa ukuze uqonde kangcono
I-COVID-19 akuyona into engavamile: iyingxenye yohlu olude lwezifo ubhubhane lomlando eziye zaphawula isintu. Phakathi kwezifo ezaziwa kakhulu yi-Plague of Justinian (yekhulu lesi-6) kanye ne-Black Death yangenkathi ephakathi, kokubili okubangelwe yi- Yersinia pestis, okwabulala amashumi ezigidi zabantu; ubhubhane lwekholera olulandelanayo ngekhulu le-19 nelama-20; umkhuhlane wango-1918 (owaqanjwa ngokungeyikho ngokuthi umkhuhlane waseSpain), kanye nokufa okulinganiselwa ezigidini ezingama-50; ubhubhane lwe-H1N1 oluncane kakhulu lwango-2009-2010; noma i-HIV/AIDS, olusalokhu luwubhubhane olusebenzayo olunamashumi ezigidi zabantu abafayo.
Ababhali abafana no URobin Marantz Henig (I-Matrix Yokudansa), uLaurie Garrett (Ubhubhane Oluzayonoma uRichard Preston (Indawo EshisayoBebelokhu bexwayisa amashumi eminyaka ukuthi inhlanganisela yokwanda komhlaba wonke, ukubhujiswa kwemvelo, ukusabalala kwamadolobha kanye nokuxhumana kakhulu nezilwane zasendle kuzokwenza ukuvela kwezidakamizwa ezintsha ezingabangela ubhubhane olubhubhisayo kube nokwenzeka kakhulu.
Ngo-2015, i-TED Talk yasungulwa yi- Bill Gates Umbiko ngokuntuleka kokulungela komhlaba wonke ubhubhane olukhulu wasakazeka eminyakeni eminingi kamuva njengokungathi uyisiprofetho esigcwalisekile: wachaza ngokucacile ukuthi umhlaba utshale imali enkulu ekuzivikeleni kwezempi, kodwa kuncane kakhulu ezinhlelweni zokuxwayisa, ucwaningo kanye namandla okuphendula ezifweni ezisafufusa.
Uma ubheka ukulandelana kwezinkinga ezinkulu zobhubhane, umuntu uthola umbono wokuthi kukhona "ubhubhane njalo eminyakeni eyikhulu"Izincwadi zezokwelapha zichaza lo mbono: ubhubhane olukhulu luvame kakhulu kunalokho okubonakala sengathi lukhona (i-SARS, i-MERS, umkhuhlane wezinyoni, umkhuhlane wezingulube, i-Ebola…), kanye nokushintsha kwesimo sezulu, ukulahleka kwezinhlobonhlobo zezinto eziphilayo kanye nobuningi babantu emadolobheni amakhulu kwandisa ingozi yokuvela nokusabalala kwazo.
Kulesi simo, i-COVID-19 ibilokhu iyindlela yokuzijwayeza, eyesabekayo kodwa efanekisayo, yokuthi kusho ukuthini ukuphatha ubhubhane ezweni elixhumene kakhulu: kusukela endimeni ebalulekile kodwa engaphelele yezinhlangano ezifana ne-WHO kuya esidingweni sokuqinisa. impilo yomphakathi, isayensi, ukubambisana kwamazwe ngamazwe kanye nezinhlelo zokuphepha komphakathi. Lokho esikubonile kukwenza kucace ukuthi umbuzo awukhona ukuthi kuzoba nolunye ubhubhane lomhlaba wonke, kodwa ukuthi sizobe sikulungele nini futhi kanjani ngesikhathi esizayo.
Konke okwenzekile nge-COVID-19—kusukela ekuqubukeni kwe-SARS-CoV-2 eWuhan kuya esigabeni samanje sobhubhane, okuhlanganisa izibalo ezinonya zokutheleleka nokufa, umjaho wemithi yokugoma, ukuwa kohlelo lwezempilo, ukwanda kobudlova obusekelwe kubulili, igebe phakathi kwamazwe acebile nampofu, kanye nemikhankaso yolwazi olungesilo iqiniso—kuveza isithombe esicacile salokho ubhubhane lwembulunga yonke Ekhulwini lama-21: isenzakalo sebhayoloji esinemiphumela ebanzi kwezepolitiki, kwezomnotho, nakwezenhlalo esisiphoqa ukuthi sicabange kabusha ngendlela esiphila ngayo, indlela esizinakekela ngayo, nokuthi impilo ehlangene ithatha indawo enjani ohlelweni lomhlaba wonke, okuhlanganisa Izinjongo Zokuthuthukiswa Okusimeme.
