{"id":2095,"date":"2020-06-07T18:44:05","date_gmt":"2020-06-07T17:44:05","guid":{"rendered":"http:\/\/slanedeti.sk\/cms\/?p=2095"},"modified":"2020-06-09T08:19:34","modified_gmt":"2020-06-09T07:19:34","slug":"koronavirus-covid-19-a-cysticka-fibroza","status":"publish","type":"post","link":"https:\/\/slanedeti.sk\/cms\/koronavirus-covid-19-a-cysticka-fibroza\/2095","title":{"rendered":"Koronav\u00edrus COVID-19 a cystick\u00e1 fibr\u00f3za"},"content":{"rendered":"\n

V polovici marca sme priniesli prv\u00e9 inform\u00e1cie<\/a> o tom, ako epid\u00e9mia nov\u00e9ho koronav\u00edrusu m\u00f4\u017ee\novplyvni\u0165 pacientov s cystickou fibr\u00f3zou. Odvtedy v\u010faka intenz\u00edvnemu\nmedic\u00ednskemu v\u00fdskumu prib\u00fadaj\u00fa nov\u00e9 poznatky o tomto ochoren\u00ed prakticky ka\u017ed\u00fd\nde\u0148. \u010cas\u0165 t\u00fdchto poznatkov je zhrnut\u00e1 v tomto \u010dl\u00e1nku, ktor\u00fd na minul\u00fd vo\u013ene\nnadv\u00e4zuje a dop\u013a\u0148a ho.<\/p>\n\n\n\n

COVID-19 <\/strong>pri cystickej fibr\u00f3ze<\/strong><\/h4>\n\n\n\n

V\u00edrusov\u00e9 ochorenie COVID-19 m\u00e1 \u0165a\u017e\u0161\u00ed priebeh u os\u00f4b s in\u00fdmi zdravotn\u00fdmi komplik\u00e1ciami a preto CF pacienti patria po\u010das prebiehaj\u00facej pand\u00e9mie k ohrozenej skupine obyvate\u013eov. Od marca 2020 do\u0161lo v Eur\u00f3pe (a n\u00e1sledne aj na ostatn\u00fdch kontinentoch) k r\u00fdchlemu \u0161\u00edreniu nov\u00e9ho koronav\u00edrusu SARS-Cov-2. T\u00e1to epid\u00e9mia zasiahla aj CF pacientov a dnes s\u00fa k dispoz\u00edcii prv\u00e9, aj ke\u010f zatia\u013e obmedzen\u00e9 inform\u00e1cie o priebehu tejto infekcie pri cystickej fibr\u00f3ze. Jeden z prv\u00fdch \u010dl\u00e1nkov, ktor\u00fd sa venoval tejto problematike, vy\u0161iel v polovici apr\u00edla v prest\u00ed\u017enom medic\u00ednskom \u010dasopise Lancet<\/a>. V tom \u010dase boli zn\u00e1me prv\u00e9 infekcie u CF pacientov, predov\u0161etk\u00fdm v Taliansku. Neboli tam e\u0161te inform\u00e1cie o priebehu ochorenia pri CF. V \u010dl\u00e1nku sa kon\u0161tatuje, \u017ee ve\u013ea pacientov malo zv\u00fd\u0161en\u00e9 obavy o svoje zdravie a \u017eivot. Spom\u00ednali sa v \u0148om niektor\u00e9 odpor\u00fa\u010dan\u00e9 opatrenia pre CF centr\u00e1, napr. pozastavenie prevent\u00edvnych n\u00e1v\u0161tev. <\/p>\n\n\n\n

Jedna z prv\u00fdch \u0161tatist\u00edk<\/a> bola publikovan\u00e1 vo Ve\u013ekej Brit\u00e1nii, aj ke\u010f obsahuje iba z\u00e1kladn\u00e9 inform\u00e1cie. Do 25. m\u00e1ja bolo v Brit\u00e1ni\u00ed 21 CF pacientov, ktor\u00ed sa nakazili nov\u00fdm koronav\u00edrusom. 9 z nich v \u010dase testovania nemalo pr\u00edznaky, 20 sa z COVID-19 vylie\u010dilo a 1 zomrel. Podrobnej\u0161iu \u0161tatistiku<\/a>, ktor\u00e1 je t\u00fd\u017edenne aktualizovan\u00e1, zverej\u0148uje European Cystic Fibrosis Society. K 27. m\u00e1ju 2020 uv\u00e1dza, \u017ee v Eur\u00f3pe bolo potvrden\u00fdch 79 CF pacientov s ochoren\u00edm COVID-19, pri\u010dom u 72 z nich s\u00fa zn\u00e1me \u010fal\u0161ie inform\u00e1cie o priebehu ochorenia. K poslednej aktualiz\u00e1cii registra sa 46 (64%) z nich vylie\u010dilo, 15 (20%) sa \u010falej lie\u010dilo, u 8 (11%) stav nebol zn\u00e1my a 3 (4%) zomreli. <\/p>\n\n\n\n

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Stav CF pacientov<\/figcaption><\/figure>\n\n\n\n

U uveden\u00fdch 72 pacientov\nnie s\u00fa zn\u00e1me v\u0161etky charakteristiky, napr\u00edklad d\u00f4le\u017eit\u00e1 inform\u00e1cia o priebehu\nochorenia je zn\u00e1ma u 37 pacientov. Z \u00fadajov vypl\u00fdva, \u017ee ochorenie malo u nich\nv\u00e4\u010d\u0161inou mierny priebeh (27 pacientov, 73%), u siedmych \u0165a\u017ek\u00fd a u troch\nkritick\u00fd.<\/p>\n\n\n\n

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Priebeh COVID-19 u CF pacientov<\/figcaption><\/figure>\n\n\n\n

\u010ealej 16 pacientov potrebovalo podanie kysl\u00edku a dvaja respira\u010dn\u00fa podporu\n(p\u013e\u00facnu ventil\u00e1ciu), aj ke\u010f sa neuv\u00e1dza, ku ktorej skupine (ak\u00e9mu po\u010dtu)\npacientov sa to vz\u0165ahuje. Z \u00fadajov z registra tie\u017e vypl\u00fdva, \u017ee medzi CF\npacientmi, ktor\u00ed ochoreli na COVID-19, s\u00fa \u010dastej\u0161ie zast\u00fapen\u00ed dospel\u00ed. Najviac\nzast\u00fapenou vekovou skupinou boli \u013eudia od 30 do 49 rokov a u mlad\u0161\u00edch \u013eud\u00ed pod\n20 rokov bol v\u00fdskyt ni\u017e\u0161\u00ed. To m\u00f4\u017ee nasved\u010dova\u0165 tomu, \u017ee star\u0161\u00ed pacienti maj\u00fa\nmen\u0161ie mo\u017enosti izol\u00e1cie, ale m\u00f4\u017ee to tie\u017e s\u00favisie\u0165 so zn\u00e1mou skuto\u010dnos\u0165ou o\nmiernej\u0161om priebehu u det\u00ed.<\/p>\n\n\n\n

Doteraz najpodrobnej\u0161ie klinick\u00e9 zhodnotenie<\/a> bolo publikovan\u00e9 koncom apr\u00edla v Journal of Cystic Fibrosis. T\u00e1to anal\u00fdza \u010derpala \u00fadaje z CF registrov \u00f4smych kraj\u00edn (vr\u00e1tane mimoeur\u00f3pskych), pri\u010dom zahrnula 40 pacientov. Taktie\u017e v tejto skupine boli v\u00fdrazne zast\u00fapen\u00ed star\u0161\u00ed pacienti \u2013 medi\u00e1nov\u00fd vek bol 33 rokov. S t\u00fdm s\u00favis\u00ed aj vy\u0161\u0161\u00ed po\u010det zdravotn\u00fdch komplik\u00e1ci\u00ed \u2013 15 z nich malo diabetes a 11 transplantovan\u00e9 p\u013e\u00faca (pr\u00edpadne aj \u010fal\u0161\u00ed org\u00e1n ako pe\u010de\u0148, alebo obli\u010dky). 28 (70%) pacientov sa do ukon\u010denia sledovania vylie\u010dilo, 12 (30%) pokra\u010dovalo v lie\u010dbe a nebolo zaznamenan\u00e9 \u017eiadne \u00famrtie. 13 (33%) pacientov potrebovalo lie\u010dbu kysl\u00edkom a jeden (2,5%) podporn\u00fa p\u013e\u00facnu ventil\u00e1ciu. \u0160tyria (10%) pacienti boli na jednotke intenz\u00edvnej starostlivosti. \u0160t\u00fadia odhaduje v\u00fdskyt COVID-19 v CF popul\u00e1ci\u00e1ch z\u00fa\u010dastnen\u00fdch kraj\u00edn na 0,07%, \u010do je pribli\u017ene polovi\u010dn\u00fd v\u00fdskyt oproti celkovej popul\u00e1ci\u00ed. Vysvet\u013euje to zv\u00fd\u0161enou izol\u00e1ciou CF pacientov, ke\u010f\u017ee si dobre uvedomuj\u00fa rizik\u00e1 spojen\u00e9 s infekciou. <\/p>\n\n\n\n

Tieto poznatky potvrdzuj\u00fa z\u00e1va\u017enej\u0161\u00ed priebeh koronav\u00edrusovej infekcie pri CF oproti ostatnej popul\u00e1ci\u00ed. Skuto\u010dnos\u0165, \u017ee tretina pacientov potrebovala kysl\u00edk znamen\u00e1 aj potrebu kvalitnej zdravotnej starostlivosti. Tieto \u00fadaje poch\u00e1dzaj\u00fa z kraj\u00edn kde m\u00e1 CF starostlivos\u0165 vysok\u00fa \u00farove\u0148, napr\u00edklad 14 pacientov zo 40 v spom\u00ednanej \u0161t\u00fadii bolo nastaven\u00fdch na lie\u010dbu CFTR modul\u00e1tormi. Preto v podmienkach menej kvalitn\u00e9ho zdravotn\u00e9ho syst\u00e9mu m\u00f4\u017eu by\u0165 v\u00fdsledky hor\u0161ie. Okrem n\u00edzkeho po\u010dtu pacientov v t\u00fdchto \u0161tatistik\u00e1ch, \u0161t\u00fadi\u00e1ch je potrebn\u00e1 opatrnos\u0165 pri ich interpret\u00e1ci\u00ed, preto\u017ee je v nich viac pacientov, ktor\u00ed sa k ukon\u010deniu \u0161t\u00fadie \u010falej lie\u010dili, alebo nebol zn\u00e1my ich stav a spr\u00e1vnej\u0161\u00ed postup je hodnoti\u0165 uzavret\u00e9 pr\u00edpady (\u010do je ale v podmienkach prebiehaj\u00facej epid\u00e9mie zlo\u017eitej\u0161ie). Pozit\u00edvne m\u00f4\u017ee by\u0165 hodnoten\u00e9, \u017ee po\u010det \u00famrt\u00ed nie je pr\u00edli\u0161 vysok\u00fd a nenaplnili sa najhor\u0161ie o\u010dak\u00e1vania.<\/p>\n\n\n\n

V\u00fdskum COVID-19<\/strong><\/h4>\n\n\n\n

Od za\u010diatku epid\u00e9mie v \u010c\u00edne sa vedelo, \u017ee \u010das\u0165 infikovan\u00fdch nemus\u00ed ma\u0165 \u017eiadne pr\u00edznaky (s\u00fa asymptomatick\u00fd). Podrobnej\u0161\u00ed obraz o tom priniesli a\u017e rozsiahle testovania popul\u00e1cie na Islande a v Taliansku, pod\u013ea ktor\u00fdch je 20 a\u017e 50% infikovan\u00fdch asymtomatick\u00fdch. Jedn\u00fdm z d\u00f4vodov, pre\u010do je \u0161\u00edrenie v\u00edrusu tak r\u00fdchle, je pr\u00e1ve probl\u00e9m zachyti\u0165 asymptomatick\u00fdch nosi\u010dov. Pri sp\u00e4tnej anal\u00fdze archivovan\u00fdch biologick\u00fdch vzoriek sa tie\u017e zistilo, \u017ee v\u00edrus sa dostal do Eur\u00f3py sk\u00f4r ako sa p\u00f4vodne predpokladalo. Bol dok\u00e1zan\u00fd<\/a> vo vzorke u pacienta z Franc\u00fazska z konca decembra 2019 a v tom obdob\u00ed je pravdepodobne za\u010diatok jeho komunitn\u00e9ho \u0161\u00edrenia vo Franc\u00fazsku. To, \u017ee infekcia prebieha \u010dasto asymptomaticky m\u00e1 d\u00f4sledky aj na \u010fal\u0161ie epidemiologick\u00e9 a klinick\u00e9 parametre, ako napr\u00edklad smrtnos\u0165. Anal\u00fdza rozsiahleho s\u00faboru<\/a> \u00fadajov odhadla smrtnos\u0165 v celkovej popul\u00e1cii meran\u00fa ako Case fatality ratio medzi 1,38% a 3,67% (pod\u013ea r\u00f4znych met\u00f3d v\u00fdpo\u010dtu). Zaviedla aj kateg\u00f3riu Infection fatality ratio, zah\u0155\u0148aj\u00facu aj \u013eud\u00ed s asymptomatick\u00fdm priebehom, pri ktorej odhaduje smrtnos\u0165 na 0,66%, \u010do je menej ako sa p\u00f4vodne predpokladalo. V \u00famrtnosti s\u00fa ale pozorovan\u00e9 medzi krajinami ve\u013ek\u00e9 rozdiely. Vysok\u00e1 \u00famrtnos\u0165 v severnom Taliansku s\u00favis\u00ed so zast\u00fapen\u00edm \u013eud\u00ed vo vy\u0161\u0161om veku a pre\u0165a\u017een\u00edm zdravotn\u00edctva. Naopak, v krajin\u00e1ch kde sa podarilo v\u00edrus zachyti\u0165 u mlad\u0161\u00edch \u013eud\u00ed, ako napr\u00edklad v Nemecku ale aj na Slovensku, s\u00fa \u0161tatistiky priaznivej\u0161ie. Na Slovensku<\/a> sa podarilo ve\u013ek\u00fa \u010das\u0165 pr\u00edpadov zachyti\u0165 v karant\u00e9ne, preva\u017ene u mlad\u00fdch \u013eud\u00ed vracaj\u00facich sa zo zahrani\u010dia a zatia\u013e nedo\u0161lo k masov\u00e9mu komunitn\u00e9mu \u0161\u00edreniu epid\u00e9mie ako v z\u00e1padoeur\u00f3pskych krajin\u00e1ch.  <\/p>\n\n\n\n

Ke\u010f \u010c\u00edna koncom decembra 2019 prv\u00fd kr\u00e1t informovala WHO o novom ochoren\u00ed, bolo ozna\u010den\u00e9 ako \u201epneum\u00f3nia nezn\u00e1meho p\u00f4vodu\u201c. \u010c\u00edm \u010falej, t\u00fdm viac je ale zrejm\u00e9, \u017ee COVID-19 nepostihuje iba respira\u010dn\u00fd syst\u00e9m. Podobne ako s\u00fa ve\u013ek\u00e9 individu\u00e1lne rozdiely v z\u00e1va\u017enosti ochorenia, bola pozorovan\u00e1 aj zna\u010dn\u00e1 variabilita pr\u00edznakov a boli op\u00edsan\u00e9 nov\u00e9 sympt\u00f3my s\u00favisiace s t\u00fdmto ochoren\u00edm. Postihnut\u00fd m\u00f4\u017ee by\u0165 kariodovaskul\u00e1rny syst\u00e9m, obli\u010dky, pe\u010de\u0148 aj nervov\u00fd syst\u00e9m. Je tie\u017e viac inform\u00e1ci\u00ed o reakci\u00e1ch imunitn\u00e9ho syst\u00e9mu, ked\u017ee ochorenie \u010dasto vedie k siln\u00fdm prejavom z\u00e1palu. Na jednej strane s\u00fa viac ohrozen\u00ed pacienti s oslabenou imunitou, ale na druhej prehnan\u00e1 reakcia imunitn\u00e9ho syst\u00e9mu tie\u017e vedie k zhor\u0161eniu ochorenia. Patofyziologick\u00fdm mechanizmom, ktor\u00fd vedie k org\u00e1nov\u00e9mu po\u0161kodeniu, je tvorba krvn\u00fdch zrazen\u00edn. N\u00e1sledkom m\u00f4\u017ee by\u0165 napr\u00edklad m\u0155tvica aj u mlad\u00fdch pacientov. Tie\u017e bol op\u00edsan\u00fd zriedkav\u00fd, ale z\u00e1va\u017en\u00fd z\u00e1palov\u00fd syndr\u00f3m u det\u00ed<\/a>, ktor\u00e9 prekonali koronav\u00edrusov\u00fa infekciu a pripom\u00edna Kawasakiho chorobu.<\/p>\n\n\n\n

Potvrdzuje sa, \u017ee u \u010dasti pacientov sa niektor\u00e9 pr\u00edznaky objavuj\u00fa aj po vylie\u010den\u00ed. Pacienti sa \u010dasto s\u0165a\u017euj\u00fa napr\u00edklad na chronick\u00fa \u00fanavu. S\u00fa zn\u00e1me aj in\u00e9 z\u00e1va\u017enej\u0161ie pr\u00edznaky (spomenut\u00e9 v marcovom \u010dl\u00e1nku), ako zn\u00ed\u017een\u00fd p\u013e\u00facny objem, po\u0161kodenie obli\u010diek. Pacienti, ktor\u00ed boli vo v\u00e1\u017enom stave a trpeli nedostatkom kysl\u00edka, m\u00f4\u017eu ma\u0165 aj po\u0161kodenie mozgu, ke\u010f\u017ee nervov\u00e9 bunky s\u00fa ve\u013emi citliv\u00e9 na z\u00e1sobovanie kysl\u00edkom. Predbe\u017ene sa predpoklad\u00e1, \u017ee trval\u00e9 po\u0161kodenie po prekonan\u00ed COVID-19 nie je be\u017en\u00e9 a v\u00e4\u010d\u0161ina \u013eud\u00ed sa plne zostav\u00ed. Niektor\u00e9 odhady hovoria o trval\u00fdch n\u00e1sledkoch u 10% pacientov, ale komplexnej\u0161ie zhodnotenie bude mo\u017en\u00e9 a\u017e na z\u00e1klade \u010fal\u0161ieho v\u00fdskumu.<\/p>\n\n\n\n

Okam\u017eite po vypuknut\u00ed epid\u00e9mie za\u010dali vedci intenz\u00edvne pracova\u0165 na v\u00fdvoji mo\u017enej vakc\u00edny a v s\u00fa\u010dasnosti je vo v\u00fdvoji okolo 100 projektov, pri\u010dom ned\u00e1vno boli zverejnen\u00e9 v\u00fdsledky<\/a> prv\u00fdch klinick\u00fdch sk\u00fa\u0161ok. Jedn\u00e1 sa zatia\u013e o prv\u00fa f\u00e1zu a najoptimistickej\u0161ie odhady hovoria o vakc\u00edne, ktor\u00e1 by mohla by\u0165 schv\u00e1len\u00e1 koncom tohto roka. Zatia\u013e dve sk\u00faman\u00e9 vakc\u00edny, u ktor\u00fdch boli zverejnen\u00e9 v\u00fdsledky, viedli u \u013eud\u00ed v klinickej \u0161t\u00fadii k imunitnej odpovedi \u2013 tvorbe protil\u00e1tok, \u010do je z\u00e1kladn\u00fd predpoklad ich \u00fa\u010dinnosti. Aj preto prevl\u00e1da optimizmus, \u017ee sa vakc\u00ednu podar\u00ed vyvin\u00fa\u0165. V\u00fdvoj novej vakc\u00edny je ale v\u017edy komplikovan\u00fd proces<\/a>, ktor\u00fd za norm\u00e1lnych okolnost\u00ed trv\u00e1 okolo 5 rokov a jeho ur\u00fdchlenie si vy\u017eaduje mimoriadne nasadenie. V priebehu apr\u00edla sa dostali na trh aj s\u00e9rologick\u00e9 testy detekuj\u00face protil\u00e1tky proti SARS-CoV-2 v\u00edrusu, ktor\u00fdch zmyslom je ur\u010di\u0165, \u010di vy\u0161etrovan\u00e1 osoba v minulosti prekonala ochorenie (napr\u00edklad asymptomaticky). Tieto testy za\u010dalo pon\u00faka\u0165 mno\u017estvo v\u00fdrobcov, pri\u010dom ich kvalita resp. senzitivita sa stala ter\u010dom kritiky a americk\u00e1 FDA z d\u00f4vodu nedostato\u010dnej kvality niektor\u00fdm v\u00fdrobcom predaj t\u00fdchto testov zak\u00e1zala<\/a>. <\/p>\n\n\n\n

Epidemiologick\u00e1 situ\u00e1cia<\/strong><\/h4>\n\n\n\n

Pod\u013ea s\u00fa\u010dasn\u00fdch poznatkov sa v\u00edrus SARS-CoV-2 prv\u00fd kr\u00e1t objavil v okt\u00f3bri alebo v novembri 2019 v \u010d\u00ednskom meste Wuhan, odkia\u013e sa r\u00fdchlo roz\u0161\u00edril do viacer\u00fdch kraj\u00edn. V Eur\u00f3pe sa za\u010dal komunitne \u0161\u00edri\u0165 pravdepodobne koncom decembra 2019. Po\u010das nasleduj\u00facich dvoch mesiacov \u2013 do konca febru\u00e1ra 2020, pri\u0161lo do Eur\u00f3py mno\u017estvo cestuj\u00facich z \u00c1zie, \u010do podporovalo neust\u00e1ly import nov\u00fdch pr\u00edpadov. Taliansko bolo koncom janu\u00e1ra 2020 medzi prv\u00fdmi krajinami, ktor\u00e9 pozastavili lety z \u010c\u00edny. V tom \u010dase u\u017e vzniklo v severnom Taliansku ohnisko n\u00e1kazy, o ktorom vtedy e\u0161te nikto nevedel. Ohnisk\u00e1 v severnom Taliansku, spolu so susedn\u00fdm Tirolskom, boli miestami, odkia\u013e sa za\u010dala najm\u00e4 v\u010faka cestovn\u00e9mu ruchu n\u00e1kaza \u0161\u00edri\u0165 do mnoh\u00fdch nov\u00fdch oblast\u00ed. \u00darady predpokladali mo\u017en\u00fd v\u00fdskyt iba u cestuj\u00facich z rizikov\u00fdch oblast\u00ed (juhov\u00fdchodnej \u00c1zie) a ani netestovali \u013eud\u00ed s pr\u00edznakmi, ak nemali cestovate\u013esk\u00fa anamn\u00e9zu. Ke\u010f 13.febru\u00e1ra zomrel prv\u00fd \u0161paniel na COVID-19, tak o jeho skuto\u010dnej pr\u00ed\u010dine smrti nikto nevedel a jeho diagn\u00f3za bola ur\u010den\u00e1 a\u017e post-mortem o mesiac nesk\u00f4r. A\u017e po prv\u00fdch \u00famrtiach koncom febru\u00e1ra sa v Taliansku roz\u0161\u00edrilo testovanie a behom t\u00fd\u017ed\u0148a odhalilo tis\u00edce pr\u00edpadov. Po\u010det m\u0155tvych v tom \u010dase u\u017e narastal geometrick\u00fdm radom. Vznik prv\u00e9ho ve\u013ek\u00e9ho ohniska mimo \u010c\u00ednu zastihol taliansku vl\u00e1du nepripraven\u00fa. Po nieko\u013ekod\u0148ovom v\u00e1han\u00ed vyhl\u00e1sila od 10. marca tzv. \u201elockdown\u201c – obmedzenie pohybu a ekonomickej aktivity v celej krajine. Tieto udalosti povzbudili testovanie v celej Eur\u00f3pe a a\u017e vtedy, pri desa\u0165tis\u00edcoch pr\u00edpadov, za\u010d\u00ednal by\u0165 rozsah epid\u00e9mie vidite\u013enej\u0161\u00ed. Postupne v\u0161etky eur\u00f3pske \u0161t\u00e1ty prijali skuto\u010dn\u00e9 (a nie len symbolick\u00e9) protiepidemick\u00e9 opatrenia. <\/p>\n\n\n\n

S odstupom \u010dasu je zrejm\u00e9, \u017ee lep\u0161ie dopadli tie krajiny, ktor\u00e9 konali r\u00fdchlo, \u010do bol aj pr\u00edpad strednej Eur\u00f3py. V niektor\u00fdch krajin\u00e1ch (napr. Brit\u00e1nia, Holandsko, \u0160v\u00e9dsko) prebiehala diskusia o tzv. \u201eskupinovej imunite\u201c, \u010do bola predstava, pod\u013ea ktorej je mo\u017en\u00e9 cielene nakazi\u0165 v\u00e4\u010d\u0161inu obyvate\u013estva, ktor\u00e1 by n\u00e1sledne zabezpe\u010dila imunitu pre zranite\u013enej\u0161ie skupiny. Proti takejto predstave sa postavila v\u00e4\u010d\u0161ina odborn\u00edkov a jej nere\u00e1lnos\u0165 nazna\u010dili aj vplyvn\u00e9 matematick\u00e9 modely<\/a> vypracovan\u00e9 na Imperial College London. Pod vplyvom poznania a v\u00fdvoja, v\u0161etky krajiny okrem \u0160v\u00e9dska od tejto koncepcie upustili. \u0160v\u00e9dsko sa stalo koncom m\u00e1ja krajinou s najvy\u0161\u0161\u00edm po\u010dtom nov\u00fdch \u00famrt\u00ed na po\u010det obyvate\u013eov v Eur\u00f3pe. <\/p>\n\n\n\n

Na druhej strane stoja chudobnej\u0161ie krajiny, pre ktor\u00e9 s\u00edce \u201eskupinov\u00e1 imunita\u201c nie je cie\u013eom, ale ke\u010f\u017ee nie s\u00fa re\u00e1lne schopn\u00e9 epid\u00e9miu zastavi\u0165, tak k nej (za cenu obrovsk\u00e9ho po\u010dtu m\u0155tvych) smeruj\u00fa. V takej situ\u00e1cii je napr. Ir\u00e1n a v s\u00fa\u010dasnosti zrejme u\u017e aj Latinsk\u00e1 Amerika. Lockdown viedol prakticky vo v\u0161etk\u00fdch eur\u00f3pskych krajin\u00e1ch k postupnej stabiliz\u00e1cii a poklesu po\u010dtu nov\u00fdch pr\u00edpadov. Matematicky vyjadren\u00e9, zn\u00ed\u017eilo sa reproduk\u010dn\u00e9 \u010d\u00edslo R0 z \u00farovne okolo 3 bez opatren\u00ed na 0,5 \u2013 0,7 pod\u013ea rozsahu obmedzen\u00ed. Pod\u013ea odhadov z \u010c\u00edny lockdown vo Wuhane, ktor\u00fd bol mimoriadne pr\u00edsny, viedol k hodnot\u00e1m R0 0,2. Prim\u00e1rnym cie\u013eom lockdownov bolo zabr\u00e1ni\u0165 kolapsu zdravotn\u00edckeho syst\u00e9mu. To sa v podstate v\u0161ade v Eur\u00f3pe podarilo (okrem kritickej situ\u00e1cie na prelome marca a apr\u00edla v severnom Taliansku, v Madride a pr\u00edpadne v Belgicku). V niektor\u00fdch krajin\u00e1ch boli opatrenia tak\u00e9 \u00fa\u010dinn\u00e9, \u017ee priniesli pr\u00edle\u017eitos\u0165 dosta\u0165 epid\u00e9miu op\u00e4\u0165 pod kontrolu. Teda mo\u017enos\u0165 podchyti\u0165 v\u0161etky pr\u00edpady, epidemiologick\u00fdmi met\u00f3dami doh\u013ead\u00e1va\u0165 ich kontakty a izolova\u0165 ich z komunity. Vzh\u013eadom na vysok\u00fa ekonomick\u00fa cena lockdownov, zlep\u0161uj\u00facu sa epidemiologick\u00e1 situ\u00e1cia a nespokojnos\u0165 \u010dasti obyvate\u013estva s obmedzeniami, za\u010dali vl\u00e1dy opatrenia pribli\u017ene od polovice apr\u00edla postupne uvo\u013e\u0148ova\u0165. Toto uvo\u013e\u0148ovanie zatia\u013e neviedlo v \u017eiadnej eur\u00f3pskej krajine k s\u00fastavn\u00e9mu zvy\u0161ovaniu po\u010dtu nov\u00fdch pr\u00edpadov \u2013 trend je bu\u010f stabilizovan\u00fd, alebo pokra\u010duje mierny pokles.<\/p>\n\n\n\n

Pre zhodnotenie doteraj\u0161ieho priebehu epid\u00e9mie maj\u00fa v\u00fdznam \u010fal\u0161ie dva d\u00f4le\u017eit\u00e9 zdroje \u00fadajov. Prvou je \u0161tatistika celkovej \u00famrtnosti. Na eur\u00f3pskej \u00farovni sa \u0148ou zaober\u00e1 projekt Euromomo<\/a>. \u00damrtnos\u0165 v marci 2020 bola najvy\u0161\u0161ia od za\u010diatku sledovania (2016) a je tie\u017e vy\u0161\u0161ia ako ofici\u00e1lne \u0161tatistiky \u00famrt\u00ed na COVID-19. Aj na z\u00e1klade toho sa predpoklad\u00e1, \u017ee \u010das\u0165 zomrel\u00fdch nebola spr\u00e1vne diagnostikovan\u00e1, ale tie\u017e to m\u00f4\u017ee s\u00favisie\u0165 so zn\u00ed\u017een\u00edm dostupnosti zdravotnej starostlivosti (\u010do je predmetom prebiehaj\u00faceho v\u00fdskumu). Druh\u00fdm zdrojom \u00fadajov s\u00fa s\u00e9roprevalen\u010dn\u00e9 \u0161t\u00fadie protil\u00e1tok, ktor\u00e9 maj\u00fa odhali\u0165 ak\u00e1 \u010das\u0165 popul\u00e1cie bola skuto\u010dne infikovan\u00e1 (a predpoklad\u00e1 sa, \u017ee m\u00e1 imunitu). V\u00fdsledky t\u00fdchto \u0161t\u00fadi\u00ed sa z viacer\u00fdch d\u00f4vodov nepova\u017euj\u00fa za dostato\u010dne presn\u00e9, ale maj\u00fa ur\u010dit\u00fd v\u00fdznam napr\u00edklad pre vytvorenie perspekt\u00edvy o bud\u00facom \u0161\u00edren\u00ed epid\u00e9mie. Prv\u00fd d\u00f4vod bol u\u017e uveden\u00fd vy\u0161\u0161ie \u2013 samotn\u00e9 testy maj\u00fa pomerne n\u00edzku presnos\u0165. \u010ealej je probl\u00e9m pri takejto epid\u00e9mi\u00ed z\u00edska\u0165 reprezentat\u00edvnu vzorku obyvate\u013estva a v neposlednom rade, ak je zisten\u00fd po\u010det pr\u00edpadov ve\u013emi n\u00edzky, narast\u00e1 aj mo\u017enos\u0165 \u0161tatistickej chyby. Niektor\u00e9 v\u00fdsledky s\u00e9roprevalen\u010dn\u00fdch \u0161t\u00fadi\u00ed s\u00fa zhrnut\u00e9 v tabu\u013eke ni\u017e\u0161ie a vypl\u00fdva z nich, \u017ee aj v najviac postihnut\u00fdch oblastiach, kde zaznamenali desa\u0165tis\u00edce m\u0155tvych, ochorenie prekonala iba pomerne mal\u00e1 \u010das\u0165 obyvate\u013eov. <\/p>\n\n\n\n
\n Oblas\u0165<\/strong>\n <\/td>\n S\u00e9roprevalencia (%)<\/strong>\n <\/td><\/tr>
\n \u010cesk\u00e1 republika\n <\/td>\n 0,4\n <\/td><\/tr>
\n Lond\u00fdn\n <\/td>\n 17,5\n <\/td><\/tr>
\n New York City\n <\/td>\n 19,9\n <\/td><\/tr>
\n Santa Clara, California\n <\/td>\n 2,8\n <\/td><\/tr>
\n \u0160panielsko\n <\/td>\n 5,0\n <\/td><\/tr>
\n \u0160tokholm\n <\/td>\n 7,3\n <\/td><\/tr><\/tbody><\/table>\n\n\n\n

<\/p>\n\n\n\n

\u010co vieme na z\u00e1klade doteraj\u0161\u00edch poznatkov poveda\u0165 o bud\u00facom priebehu epid\u00e9mie? Ka\u017ed\u00e1 epid\u00e9mia m\u00e1 tendenciu exponenci\u00e1lneho \u0161\u00edrenia a\u017e do bodu, ke\u010f m\u00e1 tak ve\u013ek\u00e1 \u010das\u0165 popul\u00e1cie imunitu a v\u00edrus nem\u00e1 mo\u017enos\u0165 efekt\u00edvne infikova\u0165 dostatok nov\u00fdch \u013eud\u00ed. Pri R0 hodnote 3 (ktor\u00e1 sa odhaduje pre SARS-CoV-2 bez protiepidemick\u00fdch opatren\u00ed) je teoretick\u00e1 \u00farove\u0148 ak\u00e1 \u010das\u0165 popul\u00e1cie by musela by\u0165 im\u00fanna 66%. Po tom by nasledoval v\u00fdrazn\u00fd pokles cirkul\u00e1cie v\u00edrusu, aj ke\u010f nie \u00fapln\u00e9 zastavenie. Dnes nie je zn\u00e1me ako dlho pretrv\u00e1va imunita po infekcii, ale je nepravdepodobn\u00e9, \u017ee dlh\u0161ie ako 2-3 roky. Pod\u013ea s\u00fa\u010dasn\u00fdch \u00fadajov prekonalo (do konca m\u00e1ja) ochorenie COVID-19 menej ako 1% svetovej popul\u00e1cie, pri\u010dom po\u010det m\u0155tvych je ofici\u00e1lne nad 370-tis. (v skuto\u010dnosti ove\u013ea viac, ke\u010f\u017ee najm\u00e4 v rozvojov\u00fdch krajin\u00e1ch mnoho \u013eud\u00ed zomrelo bez potvrdenia diagn\u00f3zy). Na \u017eiadnom mieste nie je popul\u00e1cia bl\u00edzko \u00farovne<\/a> 66% imunity a (tam kde sa chc\u00fa pred n\u00e1kazou chr\u00e1ni\u0165) s\u00fa potrebn\u00e9 r\u00f4zne protiepidemick\u00e9 opatrenia. Uvo\u013e\u0148ovanie lockdownu vyvol\u00e1va v Eur\u00f3pe obavy z tzv. druhej vlny, podobnej ako po\u010das \u0161panielskej chr\u00edpky pred 100 rokmi. Na druhej strane s\u00fa pr\u00edklady kraj\u00edn, ktor\u00e9 nikdy ve\u013emi pr\u00edsne opatrenia nezaviedli a napriek tomu sa vyhli masov\u00e9mu roz\u0161\u00edreniu epid\u00e9mie \u2013 osobitne Hong Kong a Taiwan. Varuj\u00facim pr\u00edkladom je Singapur, zatia\u013e jedin\u00e1 vyspel\u00e1 krajina, kde jednozna\u010dne m\u00f4\u017eeme hovori\u0165 o druhej vlne epid\u00e9mie.<\/p>\n\n\n\n

Pand\u00e9mia koronav\u00edrusu sa neskon\u010d\u00ed, pokia\u013e nebude k dispoz\u00edcii vakc\u00edna. Racion\u00e1lne funguj\u00faca spolo\u010dnos\u0165 zabezpe\u010d\u00ed skupinov\u00fa imunitu vakcin\u00e1ciou a nie \u0161\u00edren\u00edm infek\u010dn\u00e9ho ochorenia. Uvo\u013e\u0148ovanie opatren\u00ed \u010di u\u017e v Eur\u00f3pe alebo inde, bude nevyhnutne vies\u0165 k vzniku nov\u00fdch ohn\u00edsk n\u00e1kazy a vlastne k tomu u\u017e aj doch\u00e1dza (\u010desk\u00e1 ba\u0148a Darkov, bit\u00fanky v Nemecku, nemeck\u00fd sklad Amazonu, at\u010f.). \u00dalohou vl\u00e1d je teraz nahradi\u0165 mimoriadne re\u0161trikt\u00edvne opatrenia lockdownu viac cielen\u00fdmi a menej obmedzuj\u00facimi. Z\u00e1klad tejto strat\u00e9gie by sa mal opiera\u0165 o rozsiahle pokra\u010duj\u00face testovanie, aby bolo mo\u017en\u00e9 nov\u00e9 ohnisk\u00e1 r\u00fdchlo odhali\u0165 a izolova\u0165. Samotn\u00e9 testovanie ale ur\u010dite sta\u010di\u0165 nebude, kvalitn\u00e1 epidemiologick\u00e1 slu\u017eba, vyu\u017eite big data anal\u00fdz a umelej inteligencie, dodr\u017eiavanie vysok\u00fdch hygienick\u00fdch noriem a \u010fal\u0161ie, maj\u00fa svoje opodstatnenie. Masov\u00e9 podujatia (\u0161portov\u00e9 z\u00e1pasy, koncerty, festivaly) sa uk\u00e1zali ako udalosti najviac podporuj\u00face \u0161\u00edrenie infekcie, \u010do je dostato\u010dn\u00fd d\u00f4vod necha\u0165 ich pozastaven\u00e9 do bezpe\u010dn\u00e9ho obdobia (t.j. do pr\u00edchodu vakc\u00edny). S viac sk\u00fasenos\u0165ami sa teraz po\u010dtom nov\u00fdch pr\u00edpadov Eur\u00f3pa po lockdowne vr\u00e1tila niekde na za\u010diatok marca a m\u00e1 \u0161ancu, ale nie z\u00e1ruku, to na druh\u00fd pokus zvl\u00e1dnu\u0165.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Reakcia spolo\u010dnosti na pand\u00e9miu<\/strong><\/h4>\n\n\n\n

Ke\u010f 31.12.2019 \u010c\u00edna prv\u00fd kr\u00e1t ofici\u00e1lne ozn\u00e1mila v\u00fdskyt \u201epneum\u00f3nie nezn\u00e1meho p\u00f4vodu\u201c, \u013eudia oslavuj\u00faci silvester o\u010dak\u00e1vali od nov\u00e9ho roku ur\u010dite nie\u010do in\u00e9 ako pand\u00e9miu, ktor\u00e1 nejak\u00fdm sp\u00f4sobom zasiahne \u017eivot ka\u017ed\u00e9ho \u010dloveka na na\u0161ej plan\u00e9te. S\u00fa ve\u013ek\u00e9 rozdiely jednak v tom, ako epid\u00e9mia zasiahla krajiny, ako aj v tom, ako sa jednotliv\u00e9 spolo\u010dnosti k epid\u00e9mi\u00ed postavili. V z\u00e1plave hr\u00f4zostra\u0161n\u00fdch spr\u00e1v niekedy prehliadame, \u010do v\u0161etko sa deje spr\u00e1vne, ko\u013eko \u013eud\u00ed sa usiluje stara\u0165 o zdravie a bezpe\u010dnos\u0165 ostatn\u00fdch. Epid\u00e9mia n\u00e1s obmedzuje, ale vid\u00edme v\u00e4\u010d\u0161ie utrpenie t\u00fdch, ktor\u00ed s\u00fa chor\u00ed, alebo pri\u0161li o \u010dlenov rodiny a c\u00edtime s nimi. Nezabudneme na dobrovo\u013en\u00edkov<\/a>, ktor\u00ed sa bez n\u00e1roku na odmenu postavili do prvej l\u00ednie, stovky zdravotn\u00edkov<\/a>, \u010do zomreli, ke\u010f robili svoju pr\u00e1cu ako najlep\u0161ie vedeli, aby zachr\u00e1nili \u017eivoty in\u00fdm, be\u017en\u00fdm \u013eudom. Ale aj na t\u00fdch, ktor\u00ed pomohli s n\u00e1kupom star\u0161\u00edm alebo chor\u00fdm susedom. V\u0161etk\u00fdch \u010do dodr\u017eiavali obmedzuj\u00face ale potrebn\u00e9 opatrenia na spomalenie \u0161\u00edrenia infekcie, ktor\u00fdch napriek tomu, \u017ee m\u00e9di\u00e1 radi zobrazuj\u00fa negat\u00edvne pr\u00edklady, bola v\u00e4\u010d\u0161ina.<\/p>\n\n\n\n

A \u010falej sa aj ja zameriam sk\u00f4r na niektor\u00e9 negat\u00edvne javy – nie preto, \u017ee\nby som t\u00fdm chcel vzbudzova\u0165 pozornos\u0165, ale upozornil na rizik\u00e1 pre verejn\u00e9\nzdravie. Preto\u017ee epid\u00e9mia sa z\u010faleka e\u0161te nekon\u010d\u00ed. <\/p>\n\n\n\n

Ako Albert Camus opisuje v knihe Mor, reakcia \u013eud\u00ed na prich\u00e1dzaj\u00facu epid\u00e9miu je apatick\u00e1. Nikto sa nechce znepokojova\u0165 nie\u010d\u00edm nevidite\u013en\u00fdm, chc\u00fa \u017ei\u0165, \u010di pre\u017e\u00edva\u0165 ako doteraz a z\u013eah\u010dovanie nebezpe\u010denstva je aj obhajobou ich \u017eivotn\u00e9ho \u0161t\u00fdlu. Ke\u010f zomrie prv\u00fd \u010dlovek a hlavn\u00e1 postava Dr. Rieux upozor\u0148uje \u00farady na hrozbu a potrebn\u00e9 opatrenia, je odmietnut\u00fd s t\u00fdm, \u017ee \u0161\u00edri paniku kv\u00f4li jedn\u00e9mu m\u0155tvemu. Po\u010det m\u0155tvych sa nasleduj\u00face dni zvy\u0161uje, \u010do prin\u00fati \u00farady podnikn\u00fa\u0165 z\u00e1kladn\u00e9 kroky, ale ich informa\u010dn\u00e9 plag\u00e1ty zd\u00f4raz\u0148uj\u00fa, \u017ee maj\u00fa situ\u00e1ciu pod kontrolou a v\u0161etko sa za p\u00e1r dn\u00ed vr\u00e1ti do norm\u00e1lu. Za p\u00e1r dn\u00ed s\u00fa v meste denne desiatky m\u0155tvych, \u013eud\u00ed sa zmoc\u0148uje strach a \u00farady prip\u00fa\u0161\u0165aj\u00fa, \u017ee v meste je epid\u00e9mia. Nasleduje karant\u00e9na, dlh\u00e9 z\u00fafal\u00e9 mesiace boja s morom a nakoniec sa t\u00ed, \u010do pre\u017eij\u00fa, te\u0161ia z v\u00ed\u0165azstva nad chorobou.<\/p>\n\n\n\n

Eur\u00f3pa nebola pripraven\u00e1 na pr\u00edchod epid\u00e9mie hlavne psychologicky a to napriek mno\u017estvu varovn\u00fdch sign\u00e1lov. Pre\u013eudnen\u00e9 ve\u013ekomest\u00e1, mno\u017estvo dopravn\u00fdch spojen\u00ed, ale aj po\u013enohospod\u00e1rske ve\u013ekochovy u\u013eah\u010duj\u00fa \u0161\u00edrenie infek\u010dn\u00fdch ochoren\u00ed. V posledn\u00fdch rokoch sa objavilo viacero epid\u00e9mi\u00ed – SARS, Zika, Ebola, MERS. Ale v\u0161etky Eur\u00f3pu obch\u00e1dzali a iba utvrdzovali v neod\u00f4vodnenom presved\u010den\u00ed, \u017ee je to nie\u010do, \u010do je \u010faleko a nem\u00f4\u017ee n\u00e1s ohrozi\u0165. Koronav\u00edrus bol e\u0161te vo febru\u00e1ri pre mnoh\u00fdch iba kuriozitou, alebo zdrojom vtipov. Niektor\u00ed n\u00e1s presvied\u010dali, \u017ee ne\u017eiad\u00face je naopak proti nemu nie\u010do podnikn\u00fa\u0165<\/a>. Eur\u00f3pa a USA stratili ne\u010dinnos\u0165ou dva a\u017e tri mesiace. Zauj\u00edmav\u00e9 je porovnanie Ju\u017enej K\u00f3rei a USA, preto\u017ee obe krajiny zaznamenali prv\u00fd pr\u00edpad v ten ist\u00fd de\u0148 \u2013 21.janu\u00e1ra a ich reakcia nemohla by\u0165 odli\u0161nej\u0161ia. Ju\u017en\u00e1 K\u00f3rea okam\u017eite mobilizovala \u0161t\u00e1tny apar\u00e1t na boj s epid\u00e9miou, zaviedla \u0161tandard extenz\u00edvneho testovania, ktor\u00fd nesk\u00f4r prebralo mnoho kraj\u00edn. USA testovanie ignorovali e\u0161te \u010fal\u0161ie dva mesiace, americk\u00fd prezident Trump hrozbu verejne z\u013eah\u010doval a brzdil americk\u00e9 zdravotn\u00e9 \u00farady pred podniknut\u00edm z\u00e1sadnej\u0161\u00edch prevent\u00edvnych krokov. Rozdiel v po\u010dte m\u0155tvych ku koncu m\u00e1ja je 270 v K\u00f3rei a viac ako 106-tis. v USA. Bezradnos\u0165 a neschopnos\u0165 kona\u0165 proti epid\u00e9mi\u00ed predo dvermi silne podporovala naivn\u00e1 predstava o \u201eochrane ekonomiky\u201c. 27. febru\u00e1ra pricestoval Nicola Zingaretti, jeden z najvy\u0161\u0161\u00edch talianskych politikov do Mil\u00e1na, k fotk\u00e1m na soci\u00e1lnej sieti s miestnymi \u0161tudentmi pridal aj koment\u00e1r \u201enem\u00f4\u017eeme zmeni\u0165 na\u0161e zvyky \u2026 na\u0161a ekonomika je silnej\u0161ia ako strach, po\u010fme von na aperit\u00edv, k\u00e1vu, pizzu\u201c<\/em>. Za 10 dn\u00ed pridal \u010fal\u0161iu spr\u00e1vu, \u017ee je nakazen\u00fd koronav\u00edrusom\u2026 Ako sa nesk\u00f4r presved\u010dili aj krajiny, ktor\u00e9 nezaviedli lockdown<\/a>, ekonomika nem\u00f4\u017ee norm\u00e1lne fungova\u0165 v podmienkach epid\u00e9mie. Ve\u013ek\u00e1 \u010das\u0165 obyvate\u013eov je vtedy pr\u00e1ceneschopn\u00e1. Kv\u00f4li masov\u00e9mu \u0161\u00edreniu n\u00e1kazy sa \u013eudia boja \u00eds\u0165 nie len nakupova\u0165, ale aj do pr\u00e1ce alebo do \u0161koly, nehovoriac o m\u0155tvych a \u013eu\u010foch s trval\u00fdmi n\u00e1sledkami po prekonan\u00ed ochorenia. Ni\u010d ekonomiku neochr\u00e1ni viac, ako zabr\u00e1nenie \u0161\u00edrenia n\u00e1kazy, aj ke\u010f niektor\u00e9 opatrenia s\u00fa n\u00e1kladn\u00e9 a je potrebn\u00e9 ich prija\u0165 r\u00fdchlo. Naopak, mentalita pod\u013ea ktorej je ekonomika prvorad\u00e1, viedla k ekonomick\u00e9mu kolapsu. \u201eVerejn\u00e1 mienka\u201c, ani ekonomick\u00fd analfabetizmus nie s\u00fa pod\u013ea m\u00f4jho n\u00e1zoru ospravedlnen\u00edm za neschopnos\u0165, ktor\u00e1 umo\u017enila masov\u00e9 \u0161\u00edrenie epid\u00e9mie v mnoh\u00fdch krajin\u00e1ch. Politici, ktor\u00ed to umo\u017enili, by mali nies\u0165 zodpovednos\u0165 a spolo\u010dnos\u0165 by sa mala pou\u010di\u0165 a po\u010d\u00fava\u0165 expertov.<\/p>\n\n\n\n

 O Slovensku sa d\u00e1 poveda\u0165, \u017ee ho epid\u00e9mia takmer obi\u0161la. Epidemiologick\u00e1 situ\u00e1cia je v s\u00fa\u010dasnosti u n\u00e1s lep\u0161ia ako aj v priemerne postihnut\u00fdch eur\u00f3pskych krajin\u00e1ch. Nepochybne je to aj d\u00f4sledok spr\u00e1vnych opatren\u00ed, ako aj \u010fal\u0161\u00edch faktorov (relat\u00edvna izolovanos\u0165, ni\u017e\u0161ia hustota os\u00eddlenia). Krajiny, ktor\u00e9 si ved\u00fa dobre (Nemecko, Rak\u00fasko, \u010cR, SR) sa stret\u00e1vaj\u00fa s javom, ktor\u00fd ved\u00faci nemeck\u00fd virol\u00f3g prof. Christian Drosten ozna\u010dil ako paradox prevencie<\/a>. Nemeck\u00e9 nemocnice s\u00fa polopr\u00e1zdne, niektor\u00ed \u013eudia nerozumej\u00fa, pre\u010do pretrv\u00e1vaj\u00fa protiepidemick\u00e9 opatrenia a tvrdia, \u017ee vl\u00e1da reagovala prehnane. Inak povedan\u00e9, aj niektor\u00ed z t\u00fdch, \u010do by inak zomreli, sa c\u00edtia by\u0165 nepr\u00e1vom obmedzen\u00ed, preto\u017ee si napr\u00edklad nemohli \u00eds\u0165 s priate\u013emi do kr\u010dmy. Ako potvrdzuj\u00fa v\u00fdskumy psychol\u00f3gov, \u013eudia robia pri pos\u00faden\u00ed rizika systematicky chybn\u00e9 odhady.<\/p>\n\n\n\n

Asi naj\u00fabohej\u0161ou \u010drtou \u013eudsk\u00e9ho spr\u00e1vania pri epid\u00e9mi\u00ed je roz\u0161irovanie medic\u00ednskych bludov a hoaxov. Kto d\u00fafal, \u017ee kr\u00edza dovedie \u013eud\u00ed k rozumu, mus\u00ed by\u0165 sklaman\u00fd, aj ke\u010f \u0161\u00edrenie kon\u0161pir\u00e1cii je \u017eia\u013e s\u00fa\u010das\u0165ou epid\u00e9mi\u00ed. Napr\u00edklad v r. 2014 po\u010das epid\u00e9mie eboly, v z\u00e1padnej Afrike niektor\u00ed miestni domorodci tvrdili, \u017ee ebola neexistuje, \u017ee vl\u00e1da si ju vymyslela, aby si zabezpe\u010dila zahrani\u010dn\u00fa pomoc. Alebo, \u017ee ebolu v skuto\u010dnosti \u0161\u00edria zdravotn\u00edci s cie\u013eom vyhubi\u0165 domorod\u00e9 obyvate\u013estvo. Podobn\u00e9 \u201emy\u0161lienky\u201c sa r\u00fdchlo objavili na soci\u00e1lnych sie\u0165ach aj pri koronav\u00edrusovej pand\u00e9mii. Okrem in\u00e9ho tvrdenia, \u017ee koronav\u00edrus vraj \u0161\u00edria 5G siete, \u0161\u00edrenie v\u00edrusu vraj podporuje Bill Gates, m\u00e1 sl\u00fa\u017ei\u0165 na \u201e\u010dipovanie prostredn\u00edctvom o\u010dkovania\u201c, je to \u201eprojekt\u201c farmaceutick\u00fdch firiem, bol vytvoren\u00fd v laborat\u00f3riu ako biologick\u00e1 zbra\u0148, v skuto\u010dnosti neexistuje a je to iba divadlo na zastra\u0161enie a manipulovanie obyvate\u013eov a mnoho \u010fal\u0161\u00edch. V s\u00fa\u010dasnosti sa jedn\u00e1 o ob\u013e\u00faben\u00fd obsah kon\u0161pira\u010dn\u00fdch m\u00e9di\u00ed v snahe z\u00edska\u0165 \u010d\u00edtanos\u0165 bizarn\u00fdmi spr\u00e1vami, neo-fa\u0161istick\u00fdch politikov \u0161\u00edriacich strach ako aj be\u017en\u00fdch nevzdelan\u00fdch hlup\u00e1kov, \u010do im naletia.<\/p>\n\n\n\n

Dlhodob\u00e9 \u0161\u00edrenie medic\u00ednskych bludov m\u00e1 nepriazniv\u00e9 d\u00f4sledky na verejn\u00e9 zdravie. Dobr\u00fdm pr\u00edkladom je o\u010dkovanie, pri ktorom je jednozna\u010dn\u00fd vedeck\u00fd koncenzus o jeho prospe\u0161nosti, ale dezinform\u00e1cie \u010das\u0165 popul\u00e1cie zneis\u0165uj\u00fa. Napr\u00edklad zao\u010dkovanos\u0165 proti chr\u00edpke je na Slovensku iba 4,4%, \u010do je jedno z najni\u017e\u0161\u00edch v EU. Pod\u013ea \u0161t\u00fadie<\/a> z r. 2017 u det\u00ed s CF je \u010dasto potrebn\u00e9 odklada\u0165 o\u010dkovania kv\u00f4li ak\u00fatnym infekci\u00e1m a ich zao\u010dkovanos\u0165 je n\u00e1sledkom toho ni\u017e\u0161ia, resp. oneskoren\u00e1 oproti ostatnej popul\u00e1cii. Podobne niektor\u00ed pacienti s oslabenou imunitou nem\u00f4\u017eu dosta\u0165 v\u0161etky o\u010dkovania a musia sa spolieha\u0165 na skupinov\u00fa imunitu \u2013 ke\u010f je zao\u010dkovan\u00e1 dostato\u010dn\u00e1 \u010das\u0165 popul\u00e1cie, aby sa patog\u00e9n v nej ne\u0161\u00edril. Antivaxersk\u00e9 bludy vyslovene podporuj\u00fa \u0161\u00edrenie infek\u010dn\u00fdch ochoren\u00ed a dopl\u00e1caj\u00fa na to najviac zranite\u013en\u00e9 skupiny, \u010do si zasl\u00fa\u017ei nielen spolo\u010densk\u00e9 opovrhnutie, ale aj zodpovedaj\u00face pr\u00e1vne postihy.<\/p>\n\n\n\n

V s\u00fa\u010dasnosti u\u017e po\u010d\u00favame \u013e\u00fabiv\u00e9, ale nemiestne re\u010di politikov o \u201eobdob\u00ed obnovy po korone\u201c, podporen\u00e9 rozd\u00e1van\u00edm \u0161t\u00e1tnej pomoci najm\u00e4 ve\u013ek\u00fdm firm\u00e1m. Prezieravej\u0161ie krajiny, ale pripravuj\u00fa u\u017e teraz aj vybavenie nemocn\u00edc, zdravotn\u00edckej infra\u0161trukt\u00fary pre pr\u00edpad druhej vlny, podobne ako v\u00fdrobn\u00e9 kapacity pre vakc\u00edny. Eur\u00f3pska komisia schv\u00e1lila bal\u00edk pomoci<\/a> v celkovej v\u00fd\u0161ke 750 mili\u00e1rd eur. Ur\u010dite bude ve\u013ea n\u00e1vrhov, kde prostriedky investova\u0165. Jednou z ciest je miesto z\u00e1chrany odvetv\u00ed, ktor\u00e9 u\u017e nemaj\u00fa perspekt\u00edvu v ekonomike 21. storo\u010dia, pripravi\u0165 sa na bud\u00face epid\u00e9mie, ktor\u00e9 pr\u00eddu, ale nevieme kedy. Investova\u0165, samozrejme okrem in\u00fdch oblast\u00ed, aj do medic\u00ednskeho v\u00fdskumu a zdravotn\u00edctva. V pr\u00edrode sa vyskytuje okolo 5000 druhov koronav\u00edrusov, ktor\u00e9 s\u00fa schopn\u00e9 prech\u00e1dza\u0165 medzi r\u00f4znymi druhmi hostite\u013eov. A to je iba jedna skupina patog\u00e9nov, popri mno\u017estve \u010fal\u0161\u00edch. Podobne \u010del\u00edme narastaj\u00facemu probl\u00e9mu s antibiotickou rezistenciou.<\/p>\n\n\n\n

\u010cas myslie\u0165 na bud\u00facu epid\u00e9miu je teraz.<\/p>\n","protected":false},"excerpt":{"rendered":"

V polovici marca sme priniesli prvé informácie o tom, ako epidémia nového koronavírusu môže ovplyvniť pacientov s cystickou fibrózou. Odvtedy vďaka intenzívnemu medicínskemu výskumu pribúdajú nové poznatky o tomto ochorení prakticky každý deň. Časť týchto poznatkov je zhrnutá v tomto článku, ktorý … Continued<\/a><\/p>\n","protected":false},"author":7,"featured_media":2102,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"kt_blocks_editor_width":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-2095","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-informacie"],"yoast_head":"\nKoronav\u00edrus COVID-19 a cystick\u00e1 fibr\u00f3za - Slan\u00e9 deti<\/title>\n<meta name=\"description\" content=\"Nov\u00e9 poznatky o koronav\u00edruse COVID=19 v\u0161eobecne a pri ochoren\u00ed cystick\u00e1 fibr\u00f3za.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/slanedeti.sk\/cms\/koronavirus-covid-19-a-cysticka-fibroza\/2095\" \/>\n<meta property=\"og:locale\" content=\"sk_SK\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Koronav\u00edrus COVID-19 a cystick\u00e1 fibr\u00f3za - 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