{"id":6327,"date":"2024-03-11T18:00:37","date_gmt":"2024-03-11T15:00:37","guid":{"rendered":"https:\/\/www.klimik.org.tr\/koronavirus\/?p=6327"},"modified":"2024-03-12T09:42:03","modified_gmt":"2024-03-12T06:42:03","slug":"covid-19-pandemisinin-besinci-yilina-girerken-ne-durumdayiz-ne-yapmaliyiz","status":"publish","type":"post","link":"https:\/\/www.klimik.org.tr\/koronavirus\/covid-19-pandemisinin-besinci-yilina-girerken-ne-durumdayiz-ne-yapmaliyiz\/","title":{"rendered":"COVID-19 Pandemisinin Be\u015finci Y\u0131l\u0131na Girerken Ne Durumday\u0131z? Ne Yapmal\u0131y\u0131z?"},"content":{"rendered":"<p>Bundan tam d\u00f6rt y\u0131l \u00f6nce, COVID-19, \u00fclkemizde de ilk vakan\u0131n g\u00f6r\u00fcld\u00fc\u011f\u00fc 11 Mart 2020 tarihinde D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) taraf\u0131ndan pandemi ilan edilmi\u015ftir. Ge\u00e7en d\u00f6rt y\u0131l i\u00e7inde sistem kay\u0131tlar\u0131nda COVID-19\u2019a ba\u011fl\u0131 t\u00fcm d\u00fcnyada 800 milyon, \u00fclkemizde 20 milyon kadar ki\u015finin hastaland\u0131\u011f\u0131 ve d\u00fcnyada 7 milyon, \u00fclkemizdeyse 100 bin ki\u015finin \u00f6ld\u00fc\u011f\u00fc bildirilse de \u00a0ger\u00e7ekte COVID-19\u2019a ba\u011fl\u0131 \u00f6l\u00fcmlerin d\u00fcnyada 17 milyonu, \u00fclkemizdeyse 300 bini \u00a0buldu\u011fu tahmin edilmekte ve hastal\u0131\u011f\u0131n d\u00fcnyaya maliyetinin 2024 itibariyle 12.5 trilyon US$ oldu\u011fu hesaplanmaktad\u0131r. DS\u00d6\u2019n\u00fcn \u015eubat 2024\u2019teki son raporunda son bir ayda COVID-19\u2019a ba\u011fl\u0131 503 000 yeni olgu, 10 bin yeni \u00f6l\u00fcm oldu\u011fu bildirilmi\u015f, ancak t\u00fcm d\u00fcnyada COVID-19 surveyans \u00e7al\u0131\u015fmalar\u0131n\u0131n \u00e7ok azalm\u0131\u015f olmas\u0131 nedeniyle g\u00fcncel rakamlar\u0131 tam olarak tahmin etmenin m\u00fcmk\u00fcn olmad\u0131\u011f\u0131 ve at\u0131k su surveyanslar\u0131 gibi sistemlerden gelen verilerle birlikte de\u011ferlendirildi\u011finde ger\u00e7ek rakamlar\u0131n bildirilenlerin 2-19 kat\u0131 kadar oldu\u011fu ifade edilmi\u015ftir.<\/p>\n<p>Ge\u00e7en d\u00f6rt y\u0131lda yap\u0131lm\u0131\u015f \u00e7ok yo\u011fun ve g\u00fc\u00e7l\u00fc bilimsel \u00e7al\u0131\u015fmalar sayesinde hastal\u0131kla ilgili bilinmeyen bir\u00e7ok konu a\u00e7\u0131kl\u0131\u011fa kavu\u015fturulmu\u015ftur. Korunmada etkili olan a\u015f\u0131lar\u0131n bir y\u0131l i\u00e7inde, tedavide etkili antivirallerinse iki y\u0131l i\u00e7inde bulunmas\u0131 ve kullan\u0131ma sunulmas\u0131 sayesinde ve bunlara ek olarak d\u00f6rt y\u0131l boyunca toplumda hastal\u0131\u011f\u0131 ge\u00e7iren ki\u015fi say\u0131s\u0131n\u0131n, dolay\u0131s\u0131yla ba\u011f\u0131\u015f\u0131kl\u0131k seviyesinin artmas\u0131yla hastal\u0131\u011f\u0131n neden oldu\u011fu morbidite ve mortalite oranlar\u0131 \u00f6nemli \u00f6l\u00e7\u00fcde azalm\u0131\u015ft\u0131r.\u00a0 Ancak COVID-19 Pandemisi be\u015finci y\u0131l\u0131na girerken, a\u015fa\u011f\u0131da s\u0131ralanm\u0131\u015f \u00e7ok farkl\u0131 sorunlarla ve boyutlarda t\u00fcm d\u00fcnyay\u0131 etkilemeye devam etmektedir:<\/p>\n<p><strong>1)<\/strong> COVID-19 pandemisi beklentilerin aksine ge\u00e7ti\u011fimiz y\u0131l da mevsimsel bir \u00f6zellik kazanmam\u0131\u015f, y\u0131lda 2-3 kez dalga \u015feklinde seyretmeye devam etmi\u015ftir. COVID-19 2023 y\u0131l\u0131nda ABD\u2019de gribe g\u00f6re 6 kat daha fazla hastane ba\u015fvurusuna, 5 kat daha fazla hastane yat\u0131\u015f\u0131na ve 3 kat daha fazla \u00f6l\u00fcme yol a\u00e7m\u0131\u015f, toplam 75.000 ki\u015finin hayat\u0131n\u0131 kaybetmesine neden olmu\u015ftur. \u00dclkemizde COVID-19 izlemi sonland\u0131r\u0131ld\u0131\u011f\u0131 ve test yapma olanaklar\u0131 \u00e7ok s\u0131n\u0131rland\u0131r\u0131ld\u0131\u011f\u0131 i\u00e7in ger\u00e7ek durumu tam olarak bilmek m\u00fcmk\u00fcn olmasa da g\u00f6zlemlerimiz bizdeki durumun da ABD ile \u00f6rt\u00fc\u015ft\u00fc\u011f\u00fcn\u00fc, 2023 y\u0131l\u0131 i\u00e7in sonuncusu ve en \u015fiddetlisi Aral\u0131k ay\u0131nda ba\u015flamak \u00fczere en az 3 dalga ya\u015fand\u0131\u011f\u0131n\u0131 ve Aral\u0131k 2023 dalgas\u0131n\u0131n yo\u011fun bak\u0131m \u00fcnitelerinde t\u0131kanmalara yol a\u00e7acak kadar etkili oldu\u011funu, \u00f6nemli say\u0131da can kayb\u0131na yol a\u00e7t\u0131\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnd\u00fcrmektedir. Hem \u00fclkemizde hem de d\u00fcnyada bir\u00e7ok \u00fclkede hasta ki\u015filerin izole edilmesi uygulamalar\u0131ndan da b\u00fcy\u00fck oranda vazge\u00e7ilmi\u015ftir. T\u00fcm bunlar virusun kontrols\u00fcz bir \u015fekilde yay\u0131lmas\u0131n\u0131 ve mutasyonlarla evrimine devam etmesini kolayla\u015ft\u0131rmaktad\u0131r. 2023 y\u0131l\u0131 sonlar\u0131ndan itibaren etkili olmaya ba\u015flayan ve ilk su\u015ftan \u00e7ok belirgin olarak farkl\u0131la\u015fm\u0131\u015f olan omikron alt varyant\u0131 JN.1 \u015fu anda t\u00fcm d\u00fcnyada bask\u0131n su\u015f haline gelmi\u015ftir.<\/p>\n<p><strong>2)<\/strong> \u00dclkemizde \u015fu anda COVID-19\u2019a kar\u015f\u0131 uygulanabilecek bir a\u015f\u0131 yoktur. Orijinal su\u015f i\u00e7eren a\u015f\u0131lar uygulamadan kald\u0131r\u0131lm\u0131\u015f, y\u00fcksek gelirli \u00fclkelerde 2023 sonbahar\u0131ndan itibaren kullan\u0131m\u0131na ba\u015flanm\u0131\u015f ve mevcut su\u015flara kar\u015f\u0131 da etkili olabildi\u011fi g\u00f6r\u00fclm\u00fc\u015f tek de\u011ferli g\u00fcncellenmi\u015f a\u015f\u0131 da \u00fclkemize hi\u00e7 getirilmemi\u015ftir.<\/p>\n<p><strong>3)<\/strong> Hastal\u0131\u011f\u0131n tedavisinde etkili olan antivirallerden remdesivir ve nirmaltrelvir-ritonavir \u00fclkemize hi\u00e7 getirilmemi\u015f, \u00fclkemizde \u00fcretilerek 2022 y\u0131l\u0131ndan beri kullan\u0131lmakta olan molnupiravirin ise \u00fcretimine devam edilip edilmeyece\u011fi ve \u00f6n\u00fcm\u00fczdeki g\u00fcnlerde sa\u011flan\u0131p sa\u011flanamayaca\u011f\u0131 konusunda net bir bilgiye ula\u015f\u0131lamam\u0131\u015ft\u0131r.<\/p>\n<p><strong>4)<\/strong> Pandeminin be\u015finci y\u0131l\u0131na girerken en \u00f6nemli sorunlardan biri de salg\u0131nlar, bula\u015f\u0131c\u0131 hastal\u0131klar bunlar\u0131n kontrol\u00fc ve a\u015f\u0131larla ilgili giderek artan ak\u0131l\/bilim d\u0131\u015f\u0131 yakla\u015f\u0131mlar, a\u015f\u0131 teredd\u00fcd\u00fc \/kar\u015f\u0131tl\u0131\u011f\u0131 ve infodemidir. Bu t\u00fcr hareketler, m\u00fcsamaha g\u00f6sterilmesi, g\u00f6rmezden gelinmesi veya bunlarla aktif ve planl\u0131 bir \u015fekilde m\u00fccadele edilmemesi nedeniyle infeksiyon hastal\u0131klar\u0131n\u0131n tan\u0131s\u0131, tedavisi, \u00f6nlenmesi anlam\u0131nda onlarca y\u0131ld\u0131r b\u00fcy\u00fck emeklerle elde edilmi\u015f bir\u00e7ok kazan\u0131m\u0131n kaybedilmesine yol a\u00e7makta ve halk sa\u011fl\u0131\u011f\u0131na ciddi zarar vermektedir.<\/p>\n<p><strong>5)<\/strong> Pandemi s\u00fcrecinde ba\u015fta \u00e7ocukluk \u00e7a\u011f\u0131 a\u015f\u0131lamalar\u0131, ak\u0131lc\u0131 antimikrobiyal kullan\u0131m\u0131, infeksiyon kontrol ve zoonotik hastal\u0131klar m\u00fccadelesi olmak \u00fczere infeksiyon hastal\u0131klar\u0131n\u0131n kontrol\u00fc ve y\u00f6netiminde ortaya \u00e7\u0131kan aksamalar k\u0131zam\u0131k, bruselloz, K\u0131r\u0131m-Kongo kanamal\u0131 ate\u015fi ve antimikrobiyallere diren\u00e7li patojenlerin neden oldu\u011fu infeksiyonlar gibi \u00e7ok say\u0131da infeksiyon hastal\u0131\u011f\u0131n\u0131n artmas\u0131na yol a\u00e7m\u0131\u015ft\u0131r.<\/p>\n<p>Yap\u0131lmas\u0131 gerekenler;<\/p>\n<ul>\n<li>Pandeminin be\u015finci y\u0131l\u0131na girerken COVID-19\u2019un halen gripten daha ciddi bir hastal\u0131k oldu\u011fu, \u00f6ncelikle &gt;65 ya\u015f, \u00e7oklu komorbiditesi olanlar, organ veya hematopoetik k\u00f6k h\u00fccre nakli yap\u0131lm\u0131\u015f veya aktif kanser tedavisi alanlar, ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 bask\u0131lay\u0131c\u0131 ila\u00e7 kullananlar ve gebeler olmak \u00fczere riskli gruplarda \u00f6nemli say\u0131da morbiditeye ve \u00f6l\u00fcme yol a\u00e7t\u0131\u011f\u0131 bir ger\u00e7ektir. Bu nedenle \u00f6n\u00fcm\u00fczdeki s\u00fcre\u00e7te, \u00fclkemizdeki mevcut grip surveyans sistemine COVID-19\u2019un da dahil edilerek hastal\u0131\u011f\u0131n molek\u00fcler dahil surveyans\u0131n\u0131n yeniden yap\u0131lmas\u0131 gerekmektedir. G\u00fcncellenmi\u015f COVID-19 a\u015f\u0131lar\u0131n\u0131n da yine ayn\u0131 grip a\u015f\u0131lar\u0131nda oldu\u011fu gibi \u00fclkemize d\u00fczenli bir \u015fekilde getirilerek risk gruplar\u0131na uygulanmas\u0131 sa\u011flanmal\u0131d\u0131r. Ek olarak \u00fclkemizde bulunmayan SARS-CoV-2\u2019ye etkili antiviraller remdesivir ve nirmatrelvir\/ritonavirin de getirilmesi ve var olan molnupiravirin tedari\u011fine devam edilmesi de \u00f6nemlidir.<\/li>\n<li>Pandemiyle birlikte ivmelenen bilim\/a\u015f\u0131 kar\u015f\u0131tl\u0131\u011f\u0131, infodemiyle m\u00fccadele i\u00e7in bu t\u00fcr eylemleri yapan hekim dahil t\u00fcm ki\u015fi ve gruplara kar\u015f\u0131 gerek uzmanl\u0131k dernekleri gerek TTB gerekse Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 acilen eyleme ge\u00e7meli, halk sa\u011fl\u0131\u011f\u0131n\u0131 b\u00fcy\u00fck \u00f6l\u00e7\u00fcde tehdit eden bu yanl\u0131\u015f\/uydurma\/\u00e7arp\u0131tma bilgilerin do\u011frular\u0131n\u0131n t\u00fcm vatanda\u015flara iletilmesi sa\u011flanmal\u0131d\u0131r.<\/li>\n<li>Ba\u015fta \u00e7ocukluk \u00e7a\u011f\u0131 a\u015f\u0131lamalar\u0131, ak\u0131lc\u0131 antimikrobiyal kullan\u0131m\u0131, sa\u011fl\u0131k bak\u0131m\u0131yla ili\u015fkili infeksiyonlar ve \u00fclkemizde endemik olan veya olma potansiyeli bulunan zoonozlar\u0131n kontrol\u00fc olmak \u00fczere pandemi nedeniyle aksam\u0131\u015f t\u00fcm infeksiyon hastal\u0131klar\u0131 kontrol m\u00fccadelelerine, bilimsel ger\u00e7eklere dayan\u0131larak haz\u0131rlanm\u0131\u015f yeni planlamalar ve y\u00f6ntemlerle devam etmek de zorunludur.<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-135780\" src=\"https:\/\/www.klimik.org.tr\/wp-content\/uploads\/2023\/10\/klimik.logo_.amblem_V2_logo-629x53.png\" alt=\"\" width=\"356\" height=\"30\" \/><\/p>\n<p><strong>Kaynaklar\u00a0\u00a0<\/strong><\/p>\n<ol>\n<li>https:\/\/www.who.int\/publications\/m\/item\/covid-19-epidemiological-update-16-february-2024<\/li>\n<li>Hodson R. Nature 2022; 610: S33. doi: https:\/\/doi.org\/10.1038\/d41586-022-03353-9<\/li>\n<li>Kopel H. Diseases 2024; 12: 16. https:\/\/doi.org\/10.3390\/ diseases12010016<\/li>\n<li>https:\/\/www.cdc.gov\/flu\/about\/burden\/index.html<\/li>\n<li>https:\/\/covid.cdc.gov\/covid-data-tracker\/#trends_cumulativehospitalizations_select_00<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bundan tam d\u00f6rt y\u0131l \u00f6nce, COVID-19, \u00fclkemizde de ilk vakan\u0131n g\u00f6r\u00fcld\u00fc\u011f\u00fc 11 Mart 2020 tarihinde D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) taraf\u0131ndan pandemi ilan edilmi\u015ftir. Ge\u00e7en d\u00f6rt y\u0131l i\u00e7inde sistem kay\u0131tlar\u0131nda COVID-19\u2019a ba\u011fl\u0131 t\u00fcm d\u00fcnyada 800 milyon, \u00fclkemizde 20 milyon kadar ki\u015finin hastaland\u0131\u011f\u0131 ve d\u00fcnyada 7 milyon, \u00fclkemizdeyse 100 bin ki\u015finin \u00f6ld\u00fc\u011f\u00fc bildirilse de \u00a0ger\u00e7ekte COVID-19\u2019a ba\u011fl\u0131 \u00f6l\u00fcmlerin d\u00fcnyada 17 milyonu, \u00fclkemizdeyse 300 bini \u00a0buldu\u011fu tahmin edilmekte ve hastal\u0131\u011f\u0131n d\u00fcnyaya maliyetinin 2024 itibariyle 12.5 trilyon US$ oldu\u011fu hesaplanmaktad\u0131r. DS\u00d6\u2019n\u00fcn \u015eubat 2024\u2019teki son raporunda son bir ayda COVID-19\u2019a ba\u011fl\u0131 503 000 yeni olgu, 10 bin yeni \u00f6l\u00fcm oldu\u011fu bildirilmi\u015f, ancak t\u00fcm d\u00fcnyada COVID-19 [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":6238,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5],"tags":[],"_links":{"self":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts\/6327"}],"collection":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/comments?post=6327"}],"version-history":[{"count":1,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts\/6327\/revisions"}],"predecessor-version":[{"id":6328,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts\/6327\/revisions\/6328"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/media\/6238"}],"wp:attachment":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/media?parent=6327"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/categories?post=6327"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/tags?post=6327"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}