{"id":45690,"date":"2020-07-27T14:08:20","date_gmt":"2020-07-27T11:08:20","guid":{"rendered":"https:\/\/bilimvegelecek.com.tr\/?p=45690"},"modified":"2020-07-27T14:08:20","modified_gmt":"2020-07-27T11:08:20","slug":"isvecin-suru-bagisikligi-politikasi-ne-sonuc-verdi","status":"publish","type":"post","link":"https:\/\/bilimvegelecek.com.tr\/index.php\/2020\/07\/27\/isvecin-suru-bagisikligi-politikasi-ne-sonuc-verdi","title":{"rendered":"\u0130sve\u00e7\u2019in \u2018s\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131\u2019 politikas\u0131 ne sonu\u00e7 verdi?"},"content":{"rendered":"

Neredeyse b\u00fct\u00fcn d\u00fcnya, Avrupa ve kom\u015fular\u0131 s\u0131n\u0131rlar\u0131 kapat\u0131p, i\u00e7erde s\u0131k\u0131 karantina \u00f6nlemleri al\u0131rken \u0130sve\u00e7 h\u00fck\u00fcmeti tamamen farkl\u0131 bir \u015fey yapt\u0131. Dan\u0131\u015fmanlar\u0131 olan salg\u0131n hastal\u0131klar uzman\u0131 Dr. Anders Tegnell\u2019in m\u00fccadele plan\u0131n\u0131 izleyerek, kafe, bar, lokanta, spor salonlar\u0131 dahil t\u00fcm i\u015fyerlerini ve ibadethaneleri a\u00e7\u0131k tuttu. Elli ki\u015fiden az gruplar\u0131n toplanmas\u0131n\u0131 serbest b\u0131rakt\u0131 (ilk aylarda bu say\u0131 500 idi). Yerle\u015fim yerleri karantinaya al\u0131n\u0131p, d\u0131\u015far\u0131yla ili\u015fkileri kesilmedi. Lise ve \u00fcniversiteler do\u011frudan e\u011fitime ara verirken 16 ya\u015f alt\u0131 \u00f6\u011frencilerin gitti\u011fi okullar kapat\u0131lmad\u0131. Daha da \u00f6nemlisi, yak\u0131n zamana kadar, hastaneler ve huzurevleri gibi riskli yerler d\u0131\u015f\u0131nda COVID-19 test taramas\u0131 da yap\u0131lm\u0131yordu. Dr. Tegnell tan\u0131nm\u0131\u015f bilim dergisi Nature<\/em>\u2019\u0131n kendisiyle yapt\u0131\u011f\u0131 s\u00f6yle\u015fide yakla\u015f\u0131m\u0131n\u0131, \u00f6zg\u00fcrl\u00fc\u011fe sayg\u0131 ve \u0130sve\u00e7lilerin sosyal ve bireysel sorumluluk anlay\u0131\u015f\u0131na g\u00fcven olarak ifade ediyor.(1) El ve y\u00fcz temizli\u011fi, evden \u00e7al\u0131\u015fma, sosyal mesafenin korunmas\u0131, ya\u015fl\u0131lar\u0131n kalabal\u0131ktan ka\u00e7\u0131nmalar\u0131 uyar\u0131lar\u0131 ise h\u0131z kesmeden s\u00fcrd\u00fcr\u00fcl\u00fcyor. Dr. Tegnell\u2019e g\u00f6re, koronavir\u00fcs yay\u0131l\u0131m\u0131 ve ya\u015fam kayb\u0131 sa\u011fl\u0131k sistemini \u00e7\u00f6kertmeyecek d\u00fczeyde kald\u0131\u011f\u0131 s\u00fcrece endi\u015feye gerek yok. Vir\u00fcs Avrupa\u2019n\u0131n her yerine eri\u015ftikten sonra art\u0131k s\u0131n\u0131rlar\u0131, okullar\u0131, i\u015fyerlerini kapatmak komik bir \u015fey ona g\u00f6re. \u00d6zellikle gen\u00e7lerin g\u00fcndelik ya\u015fam\u0131n i\u00e7inde aktif olarak tutulmas\u0131 onlar\u0131n ak\u0131l ve beden sa\u011fl\u0131\u011f\u0131 i\u00e7in \u00f6nemli diyor Dr. Tegnell.<\/p>\n

 <\/p>\n

\u201cS\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131\u201d<\/strong><\/p>\n

\u0130sve\u00e7\u2019in uygulamas\u0131yla birlikte \u201cs\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131\u201d olgusu da g\u00fcndeme geldi. Bu kavram, bireysel olarak kazan\u0131lan ba\u011f\u0131\u015f\u0131kl\u0131ktan farkl\u0131 olarak toplumsal \u00f6l\u00e7ekteki ba\u011f\u0131\u015f\u0131kl\u0131k i\u00e7in kullan\u0131l\u0131yor ve halk\u0131n b\u00fcy\u00fck b\u00f6l\u00fcm\u00fcnde infeksiyona kar\u015f\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k geli\u015fmesini ifade ediyor. S\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131, infeksiyona neden olan etmenin (\u00f6r. vir\u00fcs, bakteri) insanlar aras\u0131nda b\u00fcy\u00fck oranda yay\u0131lmas\u0131yla ya da a\u015f\u0131lama yoluyla sa\u011flan\u0131r. Bu olguyu belirleyen en \u00f6nemli say\u0131sal de\u011fer \u201cs\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131k e\u015fi\u011fi\u201d<\/strong>dir. Bu de\u011fer ise tek bir \u00f6l\u00e7\u00fcte yani \u201ctemel \u00e7o\u011falma ya da bula\u015fma say\u0131s\u0131\u201d<\/strong>na (R0) ba\u011fl\u0131d\u0131r.<\/p>\n

\"\"
\u0130sve\u00e7 h\u00fck\u00fcmeti dan\u0131\u015fmanlar\u0131 olan salg\u0131n hastal\u0131klar uzman\u0131 Dr. Anders Tegnell\u2019in m\u00fccadele plan\u0131n\u0131 kabul ederek bir t\u00fcr \u201cs\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131\u201d y\u00f6ntemini izledi. Sonu\u00e7 pek ba\u015far\u0131l\u0131 de\u011fil.<\/figcaption><\/figure>\n

Konu basit\u00e7e \u015f\u00f6yle a\u00e7\u0131klanabilir: S\u00f6zgelimi, salg\u0131n\u0131n ba\u015flad\u0131\u011f\u0131 bir toplumda SARS-CoV-2 vir\u00fcs\u00fc ile infekte olmu\u015f bir ki\u015finin vir\u00fcs\u00fc \u00fc\u00e7 insana daha bula\u015ft\u0131rd\u0131\u011f\u0131 farz edilsin (\u015eekil 1). Bu durumda temel bula\u015fma say\u0131s\u0131= R0 = 3 olacakt\u0131r ve buradan, basit bir form\u00fcl kullan\u0131larak, bu topluluktaki s\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131k e\u015fi\u011finin 0,67 oldu\u011fu hesaplan\u0131r. Bunun anlam\u0131 \u015fudur: Vir\u00fcs\u00fcn bu h\u0131zda yay\u0131ld\u0131\u011f\u0131 b\u00f6yle bir toplulu\u011fun en az % 67\u2019si vir\u00fcs al\u0131p, ona kar\u015f\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k kazand\u0131ktan sonra ancak vaka say\u0131s\u0131nda d\u00fc\u015fme ba\u015flayacakt\u0131r.(2) Fakat a\u015f\u0131 yoklu\u011funda, \u015fu anda baz\u0131 \u00fclkelerin yapt\u0131\u011f\u0131 gibi, ilk yola yani do\u011fal infeksiyona ge\u00e7it verildi\u011finde bunun ya\u015fam kayb\u0131 a\u00e7\u0131s\u0131ndan topluma \u00e7\u0131kard\u0131\u011f\u0131 maliyet a\u011f\u0131r olacakt\u0131r. Dr. Tegnell, SARS-CoV-2 vir\u00fcs\u00fcn\u00fc alan ki\u015filerde bir ba\u011f\u0131\u015f\u0131kl\u0131k yan\u0131t\u0131n\u0131n olu\u015ftu\u011funu ama bunun ne kadar s\u00fcreyle etkili olaca\u011f\u0131n\u0131n bilinmedi\u011fini dile getirmekte. \u00c7\u00fcnk\u00fc az da olsa, hastal\u0131\u011fa yakalanm\u0131\u015f baz\u0131 insanlar\u0131n tekrar infekte oldu\u011fu y\u00f6n\u00fcnde d\u00fcnyan\u0131n farkl\u0131 yerlerinden haberler gelmeye devam ediyor.<\/p>\n

\"\"<\/p>\n

\u0130sve\u00e7 ve kom\u015fular\u0131ndaki durum<\/strong>
\nPeki, t\u00fcm bunlardan sonra neler oldu? Ya\u015fl\u0131 huzurevlerinin salg\u0131ndan korunmas\u0131 h\u00fck\u00fcmet politikas\u0131n\u0131n temel ama\u00e7lar\u0131ndand\u0131 ama \u00fclkede ya\u015fam\u0131n\u0131 kaybeden her \u00fc\u00e7 ki\u015fiden \u201cen az\u201d biri huzurevi sakini. D\u0131\u015farda buralara vir\u00fcs ta\u015f\u0131nmas\u0131n\u0131n \u00f6n\u00fcne ge\u00e7ilemedi\u011fi ger\u00e7e\u011fini Dr. Tegnell de kabul ediyor ve neyin yanl\u0131\u015f gitti\u011finin ara\u015ft\u0131r\u0131ld\u0131\u011f\u0131n\u0131 s\u00f6yl\u00fcyor.<\/p>\n

Kom\u015fular\u0131, Finlandiya, Norve\u00e7 ve Danimarka\u2019da hem vaka say\u0131s\u0131 hem de ya\u015fam kayb\u0131n\u0131n \u0130sve\u00e7\u2019ten d\u00fc\u015f\u00fck olmas\u0131 uygulaman\u0131n onlara g\u00f6re olduk\u00e7a ba\u015far\u0131s\u0131z kald\u0131\u011f\u0131n\u0131 g\u00f6steriyor (Tablo 1). Say\u0131larla ifade etmek gerekirse, bu \u00fc\u00e7 kom\u015fu \u00fclkenin n\u00fcfuslar\u0131n\u0131n toplam\u0131 \u0130sve\u00e7\u2019inkinden sadece 1,6 kat fazla, fakat onlardaki toplam COVID-19 vaka say\u0131s\u0131 (29.630), \u0130sve\u00e7\u2019tekinin (78.048 hasta) yar\u0131s\u0131ndan da az. Bu arada \u0130sve\u00e7\u2019te yap\u0131lan test say\u0131s\u0131n\u0131n \u00f6teki \u00fclkelere g\u00f6re daha s\u0131n\u0131rl\u0131 oldu\u011fu da ak\u0131lda tutulmal\u0131. \u0130\u015fyerlerini kapatan bu \u00fclkelerin vir\u00fcs yay\u0131l\u0131m\u0131n\u0131 daha iyi \u00f6nledi\u011fi a\u00e7\u0131k.<\/p>\n

COVID-19 hastalar\u0131 aras\u0131nda ya\u015fam kayb\u0131na gelince, \u0130sve\u00e7\u2019te bu say\u0131 5639 ki\u015fi iken, \u00fc\u00e7 kom\u015fu \u00fclkedeki toplam ya\u015fam kayb\u0131 say\u0131s\u0131 sadece 1194, yani \u0130sve\u00e7\u2019tekinden neredeyse be\u015f kat daha az. Yani ciddi karantina \u00f6nlemleri ve k\u0131s\u0131tlamalar\u0131n her a\u00e7\u0131dan daha etkili bir koruma y\u00f6ntemi oldu\u011fu g\u00f6r\u00fcl\u00fcyor. Bu arada ba\u015fkent Stockholm\u2019\u00fcn g\u00f6\u00e7menlerin ya\u015fad\u0131\u011f\u0131 varo\u015flar\u0131nda SARS-CoV-2\u2019nin yay\u0131lma h\u0131z\u0131n\u0131n \u015fehrin geri kalan\u0131ndan 3 kat daha y\u00fcksek olmas\u0131 da salg\u0131n\u0131n nihayette yoksullar\u0131 vurdu\u011fu ger\u00e7e\u011fiyle uyu\u015fuyor.(3)<\/p>\n

Farkl\u0131 d\u00fc\u015f\u00fcnenler de var<\/strong><\/p>\n

\"\"
\u0130sve\u00e7 h\u00fck\u00fcmeti ya\u015fl\u0131 huzurevlerinin salg\u0131ndan korunmas\u0131n\u0131 ama\u00e7lam\u0131\u015ft\u0131, ama \u00fclkede ya\u015fam\u0131n\u0131 kaybeden her \u00fc\u00e7 ki\u015fiden \u201cen az\u201d biri huzurevi sakini.<\/figcaption><\/figure>\n

\u0130sve\u00e7 10 milyonluk n\u00fcfusuna kar\u015f\u0131n, d\u00fcnyan\u0131n en fazla say\u0131da COVID-19 vakas\u0131na sahip ilk 20 \u00fclkesi aras\u0131nda yer al\u0131yor ama kamuoyu yoklamalar\u0131 Dr. Tegnell\u2019in halk i\u00e7indeki pop\u00fcleritesinin h\u00e2l\u00e2 y\u00fcksek oldu\u011funu g\u00f6stermekte. Fakat buna bak\u0131p her \u015feyin yolunda oldu\u011fu da d\u00fc\u015f\u00fcn\u00fclmemeli \u00e7\u00fcnk\u00fc onunla ayn\u0131 fikirde olmayan bilimciler var. \u00d6rne\u011fin infeksiyon hastal\u0131klar\u0131 uzman\u0131 Dr. Stefan Hanson\u2019un liderlik yapt\u0131\u011f\u0131 \u00f6nde gelen 22 \u0130sve\u00e7li t\u0131p ara\u015ft\u0131rmac\u0131s\u0131 y\u00fcr\u00fct\u00fclen uygulamalar\u0131n mevcut bilimsel bilgilere ayk\u0131r\u0131 oldu\u011funu savunan bir bildiri yay\u0131mlad\u0131 gazetede. Dr. Hanson, g\u00f6\u00e7men semtlerinde bulunan al\u0131\u015fveri\u015f merkezlerinde \u00fcniversiteden sa\u011flad\u0131\u011f\u0131 s\u0131n\u0131rl\u0131 say\u0131da vir\u00fcs test kitleriyle insanlar\u0131 taray\u0131p, yol g\u00f6stermeye \u00e7abal\u0131yor. \u00d6n\u00fcm\u00fczdeki aylar hangi yakla\u015f\u0131m\u0131n daha do\u011fru oldu\u011funu g\u00f6sterecek olsa da \u015fu ana kadarki say\u0131lar, \u0130sve\u00e7 toplumu \u201cs\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131\u201d kazanana kadar, \u00f6nemli b\u00f6l\u00fcm\u00fc ya\u015fl\u0131, on binlerce insan\u0131n ya\u015fam\u0131n\u0131 kaybedebilece\u011fini i\u015faret ediyor. Buna dayanabilirler mi, zaman onu da g\u00f6sterecek.<\/p>\n

Ekonomiye gelince<\/strong>
\nDr. Tegnell\u2019in her yeri a\u00e7\u0131k tutma uygulamas\u0131n\u0131n bir ba\u015fka gerek\u00e7esi bu yolla ekonominin ayakta kalaca\u011f\u0131 d\u00fc\u015f\u00fcncesiydi. Fakat bu y\u0131l i\u00e7inde Gayri Safi Yurt \u0130\u00e7i Has\u0131la\u2019da (GDP) % 7\u2019lik d\u00fc\u015f\u00fc\u015f beklentisi, Britanya ve \u0130talya\u2019ya g\u00f6re daha iyi ama kom\u015fulardan daha k\u00f6t\u00fc durumda oldu\u011funu g\u00f6steriyor.(4) \u00dcrettiklerini sataca\u011f\u0131n devletlerde halk can derdindeyse senin ekonominin \u00e7al\u0131\u015f\u0131r olmas\u0131 pek anlam ifade etmiyor.<\/p>\n

S\u00fcr\u00fc, ba\u011f\u0131\u015f\u0131kl\u0131k kazanmay\u0131 beklerken!<\/strong>
\nGer\u00e7ekte bilindik koruma \u00f6nlemlerini erken alan ve bunlar\u0131 kararl\u0131 olarak s\u00fcrd\u00fcren \u00fclkeler (\u00f6r., Tablo 1\u2019de, koyu bantla i\u015faretlenenler), \u201cs\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131n\u0131\u201d beklemeden, yay\u0131lman\u0131n ve ya\u015fam kay\u0131plar\u0131n\u0131n azalt\u0131labilece\u011fini a\u00e7\u0131k\u00e7a g\u00f6sterdi.(5,6) Fakat toplumsal ve bireysel faaliyetleri ciddi \u015fekilde k\u0131s\u0131tlayan \u00f6nleyici tedbirlerinin \u00f6nemli sosyal ve ekonomik sorunlar yaratt\u0131\u011f\u0131 da bir ger\u00e7ek. K\u0131s\u0131tlamalarla bunlar\u0131n yarataca\u011f\u0131 bedelleri dengeleyecek zeki ve bilgili siyasi liderlere gereksinim var. \u015eu anda d\u00fcnyada hi\u00e7bir \u00fclke, salg\u0131n\u0131n birinci yay\u0131lma dalgas\u0131yla, ikinci dalgay\u0131 \u00f6nleyecek \u201cs\u00fcr\u00fc ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131n\u0131\u201d kazanm\u0131\u015f de\u011fil.(5) Bu nedenle tedbirlerin erkenden suland\u0131r\u0131l\u0131p, salg\u0131n \u00f6ncesi ya\u015fama d\u00f6n\u00fclme uygulamalar\u0131 daha ciddi bir y\u0131k\u0131ma yol a\u00e7abilecektir.(2,7)<\/p>\n

Yay\u0131lman\u0131n kontrol alt\u0131na al\u0131nd\u0131\u011f\u0131 \u00fclkelerin bize g\u00f6sterdi\u011fi iki alt\u0131n uygulama var: Hastal\u0131k \u015f\u00fcphesi ta\u015f\u0131yan ve riskli gruba giren, ne kadar fazla say\u0131da insan (G\u00fcney Kore\u2019nin yapt\u0131\u011f\u0131 gibi) vir\u00fcs tan\u0131 testinden ge\u00e7irilirse ve ne kadar \u00e7ok insan, ne kadar uzun s\u00fcre evde kal\u0131rsa salg\u0131n o kadar \u00e7abuk kontrol alt\u0131na al\u0131n\u0131yor.<\/strong> Bilin\u00e7li ve kurallara uygun davrananlar\u0131, en sorumsuzlar\u0131n kurban\u0131 olmaktan korumak gerekiyor.<\/p>\n

\"\"NOT:<\/strong> Haluk Ertan\u2019\u0131n Covid-19 salg\u0131n\u0131 konusundaki son durumu ve gelecekteki olas\u0131 geli\u015fmeleri b\u00fct\u00fcn boyutlar\u0131yla ele alan geni\u015f yaz\u0131s\u0131 Bilim ve Gelecek<\/em>\u2019in A\u011fustos say\u0131s\u0131nda yay\u0131nlanacak.<\/p>\n

KAYNAKLAR:<\/strong>
\n1) https:\/\/www.nature.com\/articles\/d4158-020-01098-x
\n2) Randolph, HE ve Barreiro, LB., (2020). Immunity. 52, 737-741.
\n3) Finch, W.H. ve Finch, E.H., (2020). Frontiers in Sociology. 5, 47.
\n4) https:\/\/www.abc.net.au\/news\/2020-06-30\/anders-tegnell-architect-of-the-swedish-model-coronavirus\/12384966. (Eri\u015fim 16\/07\/2020)
\n5) Okell, L.C. ve ark., (2020). The Lancet. 395, e110-111.
\n6) Inglesby, T.V., (2020). JAMA. 323(21), 2186-2197.
\n7) Sanju\u00e1n, R. ve ark., (2020). Journal of Virology. 84, 9733-9748.<\/p>\n","protected":false},"excerpt":{"rendered":"

Neredeyse b\u00fct\u00fcn d\u00fcnya, Avrupa ve kom\u015fular\u0131 s\u0131n\u0131rlar\u0131 kapat\u0131p, i\u00e7erde s\u0131k\u0131 karantina \u00f6nlemleri al\u0131rken \u0130sve\u00e7 h\u00fck\u00fcmeti tamamen farkl\u0131 bir \u015fey yapt\u0131. Dan\u0131\u015fmanlar\u0131 olan salg\u0131n hastal\u0131klar uzman\u0131 Dr. Anders Tegnell\u2019in m\u00fccadele plan\u0131n\u0131 izleyerek, kafe, bar, lokanta, spor salonlar\u0131 dahil t\u00fcm i\u015fyerlerini ve ibadethaneleri a\u00e7\u0131k tuttu. Elli ki\u015fiden az gruplar\u0131n toplanmas\u0131n\u0131 serbest b\u0131rakt\u0131 (ilk aylarda bu say\u0131 500 […]<\/p>\n","protected":false},"author":479,"featured_media":45693,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[19],"tags":[],"class_list":["post-45690","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bilim-gundemi"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t