Aralık 2019'dan beri dünyayı tehdit eden koronavirüs, geçirdiği mutasyonlarla bambaşka bir noktaya geldi. Mutasyonun önce İngiltere, ardından Güney Afrika, en son da Brezilya'da görülmesi tüm dünyada endişe yaratıyor.
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Aralık 2019'dan beri dünyayı tehdit eden koronavirüs, geçirdiği mutasyonlarla bambaşka bir noktaya geldi. Mutasyonun önce İngiltere, ardından Güney Afrika, en son da Brezilya'da görülmesi tüm dünyada endişe yaratıyor.
Söz konusu üç varyanta ülkemizde de rastlandı. Sağlık Bakanı Fahrettin Koca en son yaptığı açıklamada mutasyonlu virüsün 17 kentte görüldüğünü duyurdu. Hürriyet'te yer alan habere göre, Bilim Kurulu Üyesi ve Ankara Şehir Hastanesi Yoğun Bakım Uzmanı Prof. Dr. Sema Turan ise mutasyonlu virüs görülen kent sayısının 23'e yükseldiğini açıkladı.
23 şehrin hangileri olduğuna dair henüz resmi olarak bir bilgi paylaşılmadı. Şehir olarak tek somut bilgi Karadeniz Teknik Üniversitesi Tıp Fakültesi Tıbbi Mikrobiyoloji Anabilim Dalı Başkanı Prof. Dr. Faruk Aydın'dan geldi. Prof. Dr. Aydın yaptığı açıklamada mutasyonlu virüsün Trabzon'da görüldüğünü söyledi.
Bu varyantlar ülkemiz ve dünyada hızla yayılırken akıllarda tek bir soru var: "Salgında üçüncü dalga mı geliyor?" Sağlık Bakanlığı Bilim Kurulu Üyesi Prof. Dr. Tevfik Özlü tüm detayları anlattı.
1) Mutasyonun da etkisiyle salgında üçüncü bir dalgayı bekliyor muyuz?
Maalesef dünyada ciddi bir üçüncü dalga tehdidi var. Özellikle virüsteki mutasyonları yakından takip edenler bu tehdidin giderek daha da yakınlaştığını görebiliyorlar. Dünyada dolaşan virüsler arasında tanımlanan varyasyonların giderek çokça yer kapladığını görüyoruz. Normalde var olan 'SARS-CoV-2'nin yerini bu varyantlar almaya başladı.
Virüsün varyasyonları, baştan beri dolaşımda olan virüse kıyasla en az yüzde 30 hatta yüzde 70 kadar daha hızlı bulaşıyor. Bu geometrik artış kısa zamanda ciddi sayıda kişinin hastalanmasına yol açabilir. Çünkü her gün katlanarak giden bir artış söz konusu. Bir önceki gün sayı üç ise diğer gün birdenbire dokuz vakayla karşılaşılabiliyor. Dolayısıyla bu süreçte zaten var olan salgının yeniden daha büyük bir dalga olan 'üçüncü dalga' ile karşımıza çıkması mümkün.
2) DSÖ Avrupa'yı çok sert bir şekilde eleştirerek, "Bu şekilde devam edildiği sürece üçüncü dalganın olması çok olası" açıklamasını yapmıştı. Batı'da şu an bir esneklik söz konusu, bu süreci nasıl etkiler?
Avrupa ülkelerinde bununla ilgili simülasyonlar yapılıyor ve bu dalgada günlük vaka sayılarının 100 binleri geçeceği öngörülüyor. Umarım bu olmaz ama böyle bir olasılığın varlığını da görmezden gelmemiz hata olur. Çok dikkatli olmak, tedbirleri gevşetmemek lazım.
Şu anda Avrupa'daki vaka sayılarında bir iyileşme söz konusu ama bunlar, tedbirlerin sıkı bir şekilde uygulanmasıyla edinilmiş sonuçlardı. Bizde de aynı şekilde. Ancak tedbirlerde gevşemeye gidilirse tekrar bir artış olması beklenen bir durum. Bunun yanında, yeni varyantlar için durum giderek karmaşıklaşırsa ki öyle olması bekleniyor, gelecek dalganın çok daha büyük olacağı ve ülkelerin sağlık sistemi üzerinde yönetilmesi zor bir yük oluşturacağı endişesi hâkim.
3) Kısıtlamaların gevşetilmesi için sizce ne kadar daha bir zaman var?
Son zamanlarda varyant virüsün bulaşma hızındaki artışın yanı sıra, daha ağır hastalığa neden olduğu ve daha çok ölüme yol açtığı bilgileri gelmeye başladı. Bunlar sorunu daha da büyütecektir. Onun için şu aşamada kararsız bir noktadayız. Henüz normalleşmeye geçmek için uygun bir zaman olduğunu düşünmüyorum. Konuyla ilgilenen bütün sağlıkçıların da düşünceleri bu yönde…
4) Üçüncü bir dalga gerçekleşirse, alınan önlemlerde herhangi bir değişiklik olur mu?
Önlemler ve yapılacaklar aşağı yukarı aynı. Maske, mesafe ve hijyen üçlüsü aynı şekilde önem taşıyor. Kapalı ortamlarda mümkün olduğunca bulunmamak ve sosyal izolasyona önem vermek çok önemli. Bunlar yeni virüslere karşı da etkili önlemler olmaya devam ediyor. Hatta maskeyi usulüne uygun kullanmak gibi konular daha da önem kazanmaya başladı. Önemli noktalara dikkat edersek, mutasyonlu virüsün de yayılmasını alınan tedbirlerle önleyebiliriz.
5) Aşılanma süreci yeni virüslere karşı da etkili mi?
Aşı bu süreçte olumlu bir katkı sağlayacaktır. Ama yine de mutasyona uğrayan virüsün aşıyla sağlanacak olan bağışıklıktan kendini kurtarabileceği yönünde de gözlemler var. Henüz daha bu konuda kesin kanıtlar olmasa da bakıldığında yapılan çalışmalarda aşının oluşturduğu antikorlardan etkilenme oranı Güney Afrika varyantında 10'da 1'e kadar azalmış durumda. Yani antikorlardan yüksek oranda bir kaçış sağlanabiliyor. Antikorların etkinliği zayıflamış görünüyor. Yine de hâlâ etkisinin olduğu gerçeğini de göz ardı etmemek gerekir.
YAZ AYLARINDA MUTANT VİRÜS BİR SÜRPRİZ YAPABİLİR
6) Mutasyonlardaki bulaş hızında mevsim de etkili mi? Örneğin bahar ve yaz aylarında risk düşer mi?
Mevsimler, virüsün bulaşma riskinde elbette önemli bir rol oynuyor. Yaz aylarının gelmesiyle beraber salgında bir miktar azalma olacaktır. Bu durum geçen yıl da aynı şekildeydi. Ancak mutant virüsler bu beklentiyi bozabilir de… Yani beklenildiği gibi bir düşüş yaşanmayabilir. Tam yaza girişte beklenmedik bir artışla karşı karşıya kalabiliriz. Böyle bir sürprize de yine hazır olmak gerekiyor.
7) Ülkemizde mutasyon analizleri baştan beri her vakada yapılıyor mu?
Her vakada yapılmıyor. Sadece örnek olarak seçilen bazı vakalarda yapılmakta. Şimdilerde yeni yeni, pozitif çıkan örneklerin mutasyon varyant analizleri yapılmaya başlandı. Dolayısıyla önümüzdeki haftalarda biz Türkiye'de dolaşan virüslerin ne kadarının varyant virüs olduğunu görebileceğiz. Herhangi bir artış olup olmadığını şeffaf bir şekilde izleyebileceğiz. Bu da gelecekle ilgili önerilerde bulunma konusunda bizi daha da güçlü kılacaktır diye düşünüyorum.
Ama göründüğü kadarıyla bugün bütün dünyada konuyla ilgilenen, yakından takip eden kurum ve kuruluşlar varyantlarla ilgili üçüncü bir dalgayı ciddi bir tehdit olarak görüyorlar. Buna karşı devletlerin tedbir almasını öneriyorlar. Umarım bu kötü senaryo gerçekleşmez ama hazırlıklı olmakta fayda var.
8) Güney Afrika'da AstraZenaca aşısı durduruldu. Özellikle mutasyonda etkisi olmadığı açıklandı. Aşı konusunda gözlerin Rusya ve Çin'e çevrilmesi hakkında neler düşünüyorsunuz?
Ne yazık ki Oxford'un ürettiği AstraZenaca aşısı Güney Afrika'da yeterli olmadı. Ama bu aşı konusunda çok önemli bir sonuç. İnaktif aşılar, bu açıdan sanki az etkilenecek gibi görülüyor. Yalnız bu da aslında kesin değil. Çalışmaya ya da bir kanıta bağlı olmadan tahmin olarak söylüyorum ama sonuç itibariyle Oxford aşısıyla Rus aşısı teknik olarak birbirine benziyor.
9) Rus aşısını farklı kılan nedir?
Rusların kullandığı iki farklı vektör daha büyük bir avantaj sağlıyor. Çünkü ilk dozda ve ikinci dozda kullanılan vektör aynı olduğunda ilk vektöre karşı gelişen tepki ikinci doz için zayıflatıcı bir etki oluşturabiliyor. O açıdan Ruslar bunu öngörerek ikinci doz için kullanılan vektörü farklılaştırmışlar. Bu da o aşı için gerçekten pozitif avantaj olarak ortaya çıktı. Yayınlanan çalışmada sonuçlar oldukça iyi gözüküyor. Hatta Oxford, Rus aşısıyla birlikte çalışma kararı aldı. Bundan sonra süreci birlikte takip edecekler.
Dünyada bu aşıların farklı ülkelerde de üretilmesi konusunda Rusya'nın anlaşmaları var. Türkiye'de de bir ilaç şirketimizle bu anlaşma imzalandı. Olaylara kendi açımızdan bakarsak Türkiye'nin aşı seçiminin aslında uygun olduğu görülüyor. Bu inaktif aşı hem daha güvenli bir aşı, hem de bu tür mutasyonlardan etkilenme olasılığı biraz daha düşük gibi... Umarım Rusya'nın ürettiği aşının da Türkiye'de üretilmesi mümkün olur, bu da bizim aşıya daha kolay ulaşmamızı sağlar.