Ni izihe mpamvu z'amateka zatumye abantu barwanya kwanduza ikirere mu gihe cy'icyorezo cya COVID-19?

Ikibazo cyo kumenya niba SARS-CoV-2 yanduzwa cyane nigitonyanga cyangwa aerosole ntivugwaho rumwe.Twashatse gusobanura aya makimbirane dukoresheje isesengura ryamateka yubushakashatsi bwanduye mu zindi ndwara.Kubenshi mumateka yabantu, paradigima yiganje nuko indwara nyinshi zaterwaga numwuka, akenshi zigeze kure kandi muburyo bwa fantasmagorical.Iyi paradisme ya miasmatique yamaganwe hagati yikinyejana cya 19 na nyuma yikigereranyo cya mikorobe, kandi nkuko indwara nka kolera, umuriro wa puerperal, na malariya wasangaga zandura mubundi buryo.Abitewe n'ibitekerezo bye ku kamaro ko kwandura / gutonyanga, ndetse no guhangana n’ingaruka yahuye n’igitekerezo gisigaye cya tewolojiya ya miasma, umuyobozi w’ubuzima rusange w’ubuzima rusange, Charles Chapin mu 1910, yafashije mu gutangiza ihinduka ry’imiterere, abona ko kwanduza ikirere bidashoboka.Iyi paradigmme nshya yabaye yiganje.Ariko, kudasobanukirwa na aerosole byatumye habaho amakosa atunganijwe mugusobanura ibimenyetso byubushakashatsi kumihanda.Mu myaka mirongo itanu yakurikiyeho, kwanduza ikirere byafatwaga nk’ingirakamaro cyane cyangwa bito ku ndwara zose z’ubuhumekero, kugeza igihe hagaragajwe kwandura igituntu (cyatekerezaga ko cyandujwe n’ibitonyanga) mu 1962. Paradigma yo guhuza / ibitonyanga yagumyeho yiganje, kandi indwara nke gusa nizo zemewe cyane nko mu kirere mbere ya COVID-19: izo zanduye neza abantu batari mucyumba kimwe.Kwihuta kw’ubushakashatsi butandukanye bwatewe nicyorezo cya COVID-19 bwerekanye ko kwanduza ikirere ari uburyo bukomeye bwo kwanduza iyi ndwara, kandi bikaba bishoboka ko ari ingirakamaro ku ndwara nyinshi zandurira mu myanya y'ubuhumekero.

Ingero zifatika

Kuva mu ntangiriro z'ikinyejana cya 20, habayeho kurwanya ko indwara zandurira mu kirere, zangiza cyane mu gihe cy'icyorezo cya COVID-19.Impamvu nyamukuru yiyi myigaragambyo iri mumateka yubumenyi bwa siyanse yerekeye kwandura indwara: Gutekereza ko kwanduza ikirere byatekerezaga ko byiganje mu mateka menshi y’abantu, ariko pendulum yageze kure cyane mu ntangiriro z'ikinyejana cya 20.Mu myaka ibarirwa muri za mirongo, nta ndwara ikomeye yatekerezaga ko ituruka mu kirere.Mugusobanura aya mateka namakosa yashinze imizi bikomeje, turizera ko byoroshya iterambere muriki gice mugihe kizaza.

Icyorezo cya COVID-19 cyateje impaka zikomeye ku buryo bwo kwanduza virusi ya SARS-CoV-2, irimo uburyo butatu: Icya mbere, ingaruka z’ibitonyanga “sprayborne” ku maso, ku mazuru, cyangwa ku munwa, bitabaye ibyo bikagwa hasi. hafi yuwanduye.Icya kabiri, mukoraho, haba muburyo butaziguye numuntu wanduye, cyangwa muburyo butaziguye no guhura nubutaka bwanduye (“fomite”) hagakurikiraho kwikingira ukoraho imbere mumaso, izuru, cyangwa umunwa.Icya gatatu, iyo uhumeka aerosole, bimwe muribyo bishobora kuguma bihagarikwa mukirere amasaha (“kwanduza ikirere”).1,2

Amashyirahamwe y’ubuzima rusange harimo n’umuryango w’ubuzima ku isi (OMS) yabanje gutangaza ko virusi yandurira mu bitonyanga binini byaguye hasi hafi y’uwanduye, ndetse no gukora ku butaka bwanduye.OMS yatangaje ashimangiye ku ya 28 Werurwe 2020, ko SARS-CoV-2 itari mu kirere (usibye ku bijyanye n’uburyo bwihariye bw’ubuvuzi butanga aerosol)) kandi ko ari “amakuru atari yo” kuvuga ukundi.3Izi nama zivuguruzanya n’abahanga benshi bavuze ko kwanduza ikirere bishoboka ko byagira uruhare runini.urugero Ref.4-9Nyuma yigihe, OMS yoroheje buhoro buhoro iyi myifatire: icya mbere, yemera ko kwanduza ikirere bishoboka ariko bidashoboka;10hanyuma, nta bisobanuro, guteza imbere uruhare rwo guhumeka mu Gushyingo 2020 kugenzura ikwirakwizwa rya virusi (ifite akamaro gusa mu kurwanya indwara ziterwa na virusi);11noneho gutangaza ku ya 30 Mata 2021, ko kwanduza SARS-CoV-2 binyuze muri aerosole ari ngombwa (mugihe udakoresheje ijambo "ikirere").12N'ubwo umuyobozi wo mu rwego rwo hejuru wa OMS yemeye mu kiganiro n'abanyamakuru muri kiriya gihe ko "impamvu duteza imbere guhumeka ari uko iyi virusi ishobora kwanduzwa n'umwuka," bavuze kandi ko birinze gukoresha ijambo "ikirere."13Amaherezo, mu Kuboza 2021, OMS yavuguruye urupapuro rumwe kurubuga rwayo kugira ngo isobanure neza ko kwanduza ikirere kigufi kandi kirekire cyane ari ngombwa, mu gihe kandi byerekana neza ko "kwanduza aerosol" no "kwanduza ikirere" ari kimwe.14Ariko, usibye urwo rupapuro, ibisobanuro bya virusi nk "ikirere" bikomeje kutagaragara rwose mu itumanaho rusange rya OMS guhera muri Werurwe 2022.

Ibigo bishinzwe kurwanya no gukumira indwara (CDC) muri Amerika byakurikiranye inzira ibangikanye: icya mbere, kivuga akamaro ko kwanduza ibitonyanga;hanyuma, muri Nzeri 2020, kohereza muri make kurubuga rwayo kwemerera kwanduza ikirere byafashwe nyuma yiminsi itatu;15hanyuma, ku ya 7 Gicurasi 2021, yemera ko guhumeka aerosol ari ngombwa mu kwanduza.16Ariko, CDC yakunze gukoresha ijambo "igitonyanga cyubuhumekero," mubisanzwe bifitanye isano nigitonyanga kinini kigwa hasi vuba,17Kuri Kuri Indege,18guteza urujijo rukomeye.19Nta shyirahamwe ryagaragaje impinduka mu kiganiro n'abanyamakuru cyangwa ubukangurambaga bukomeye bw'itumanaho.20Mugihe ibyo byemezo bike byakorwaga n’imiryango yombi, ibimenyetso byo kwanduza ikirere byari bimaze kwegeranya, kandi abahanga n’abaganga benshi b’ubuvuzi bavugaga ko kwanduza ikirere atari uburyo bwo kwanduza gusa, ariko ko bishoboka koyiganjeuburyo.21Muri Kanama 2021, CDC yavuze ko kwanduza verisiyo ya delta SARS-CoV-2 yegereye iy'inkoko, virusi yandurira mu kirere cyane.22Impinduka ya omicron yagaragaye mu mpera za 2021 yasaga nkaho ari virusi ikwirakwira vuba, yerekana umubare munini w’imyororokere hamwe n’igihe gito.23

Kwakira buhoro kandi bidatinze ibimenyetso byerekana ko SARS-CoV-2 yanduye mu kirere n’imiryango minini y’ubuzima rusange yagize uruhare mu kurwanya iki cyorezo, mu gihe inyungu z’ingamba zo gukingira ikwirakwizwa rya aerosol zigenda zigaragara neza.24-26Kwemera vuba ibi bimenyetso byashishikarizaga umurongo ngenderwaho utandukanya amategeko yo murugo no hanze, kwibanda cyane kubikorwa byo hanze, ibyifuzo byambere bya masike, cyane cyane gushimangira mask nziza kandi ikayungurura, kimwe namategeko yo kwambara masike mumazu niyo yabikora intera mbonezamubano irashobora gukomeza, guhumeka, no kuyungurura.Kwemererwa mbere byari gutuma hibandwa cyane kuri izi ngamba, kandi bikagabanya igihe n’amafaranga arenze urugero mu ngamba nko kwanduza indwara hamwe n’inzitizi za plexiglass, ariko bikaba bitagira ingaruka ku kwanduza ikirere kandi, ku byanyuma, bishobora no kutabyara inyungu.29,30

Kuki ayo mashyirahamwe yatinze cyane, kandi ni ukubera iki habayeho kurwanya cyane impinduka?Urupapuro rwabanje rwasuzumye ikibazo cy’imari shingiro (inyungu zishingiye ku nyungu) duhereye ku mibereho.31Kwirinda ibiciro bijyanye ningamba zikenewe mu kugenzura kwanduza ikirere, nk'ibikoresho byiza byo kurinda umuntu (PPE) ku bakozi bashinzwe ubuzima32no kunoza umwuka33hashobora kuba hari uruhare.Abandi basobanuye gutinda mubijyanye no kumva ingaruka ziterwa nubuhumekero bwa N9532ariko, bagiye impaka34cyangwa kubera imicungire mibi yububiko bwihutirwa biganisha kubura hakiri kare icyorezo.urugero Ref.35

Ibisobanuro by'inyongera bitatanzwe n'ibyo bitabo, ariko bikaba bihuye rwose n'ibyo babonye, ​​ni uko gutinyuka gutekereza cyangwa kwemeza igitekerezo cyo kwanduza indwara zandurira mu kirere, igice, byatewe n'ikosa ry'ibitekerezo ryatangijwe mu binyejana byashize kandi yarashinze imizi mubuzima rusange no gukumira indwara: dogma ivuga ko kwanduza indwara zubuhumekero biterwa nigitonyanga kinini, bityo, ingamba zo kugabanya ibitonyanga byaba byiza bihagije.Izi nzego kandi zagaragaje ubushake bwo guhindura nubwo haba hari ibimenyetso, bijyanye n’imyumvire ya sociologie na epistemologie yukuntu abantu bagenzura ibigo bashobora kurwanya impinduka, cyane cyane niba bigaragara ko bibangamiye imyanya yabo;uburyo gutekerezaho bishobora gukora, cyane cyane iyo abantu birwanaho imbere yikibazo cyo hanze;nuburyo ubwihindurize bwa siyansi bushobora kubaho binyuze muri paradigmme, nubwo abunganira paradigima ishaje barwanya kwemera ko ubundi buryo bushyigikiwe neza nibimenyetso bihari.36-38Rero, kugirango twumve ko iri kosa rikomeje kubaho, twashatse gucukumbura amateka yarwo, ndetse no kwanduza indwara zo mu kirere muri rusange, tunagaragaza inzira zingenzi zatumye inyigisho zitonyanga ziganje.

Uzaze kuri https://www.safetyandquality.gov.au/sub-brand/covid-19-icon