ABSTRACT
COVID-19 salgınının yönetiminde ülkelerin hazırlıklı olmaması ve küresel sağlık sisteminin yetersizlikleri, salgını dünya genelinde küresel boyutlu sağlık krizine dönüştürmüştür. Bu çalışmada, COVID-19 sağlık krizinin ülkelerin sağlık sistemleri üzerine etkisi, küresel sağlık sistemleri boyutuyla literatür doğrultusunda değerlendirildi. Koronavirüs, diğer salgınlardan farklı olarak gelir düzey ayrımı gözetmeden tüm ülkelerde, hızla yayılmıştır. Birleşmiş Milletler ve Dünya Sağlık Örgütü (WHO) ülkeler arasındaki sosyal, ekonomik ve sağlık eşitsizliklerine bağlı, COVID-19 sürecinin daha kötüye gitmemesi için küresel dayanışma politikalarının desteklenmesinde ortak yaklaşımın gerekli olduğunu bildirmiştir. Fakat küresel siyasette etkili bazı güçlü ülkeler arasındaki anlaşmazlıkların küresel sağlık sistemini ve salgın yönetimini olumsuz etkilediği görülmüştür. COVID-19 salgının başlamasıyla bazı ülkeler "önce benim milletim" yaklaşımını ön plana çıkararak küresel sağlık politikalarının adil uygulanması yaklaşımını baltalamıştır. Dünya Ticaret Örgütüne üye ülkeler yapılmış ticaret anlaşmalarını da ihlal ederek salgınla mücadelede gerekli olan ürünlere ihracat kısıtlaması getirmiştir. Yine yüksek gelirli ülkelerin salgın sürecinde halk sağlığı ve insan hakları yaklaşımlarını göz ardı ederek satın alma gücüyle COVID-19 aşılarını elde ettiği bildirilmiştir. Dünya genelinde, pandemi sürecinde küresel sağlık sistemine daha fazla ihtiyaç duyulduğu halde salgınının küresel düzeyde etkili yönetilemediği görülmüştür. Küresel sağlık sisteminin etkili yönetişimi için yeniden tasarımın gerekli olduğu vurgulanmıştır.Alternate : The countries' unpreparedness in managing the COVID-19 epidemic and the inadequacies of the global health system have turned the outbreak into a worldwide health crisis. In this study, the impact of the COVID-19 health crisis on the health systems of countries was evaluated based on the literature in terms of global health systems. Unlike other epidemics, the coronavirus has spread rapidly in all countries, regardless of income. The United Nations and the World Health Organization (WHO) stated that a joint approach is necessary for supporting global solidarity policies so that the COVID-19 process due to social, economic, and health inequalities between countries does not get worse. However, it has been seen that the disagreements between some powerful countries that are influential in global politics negatively affect the global health system and epidemic management. With the onset of the COVID-19 epidemic, some countries brought the "my nation first" approach to the fore, undermining the fair implementation of global health policies. The member countries of the World Trade Organization have also violated the trade agreements made and imposed export restrictions on the products necessary for the fight against the epidemic. It has also been reported that high-income countries disregarded public health and human rights approaches during the epidemic and reached COVID-19 vaccines proportional to their purchasing power. It has been observed that the epidemic cannot be managed effectively at the global level, although the global health system is more needed throughout the world during the pandemic process. It was emphasized that redesign is necessary for effective governance of the global health system.
ABSTRACT
Coronavirus disease 2019 or COVID-19 caused by novel coronavirus/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV) is an ongoing pandemic that has emerging global effects and requires rapid and reliable diagnostic testing. Quantitative reverse transcription-polymerase chain reaction (q-RT-PCR) is the gold standard method for SARS-CoV-2 detections. On the other hand, new approaches remedy the diagnosis difficulties gradually. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) as one of these novel approaches may also contribute to faster and cheaper field-based testing. The present study was designed to evaluate this rapid screening diagnostic test that can give results in 30-45 min and to compare the effectiveness of LAMP to the q-RT-PCR. The 30 randomly chosen patient samples were generated by nasopharyngeal swabs with a portion of the SARS-CoV-2 nucleic sequence. The sample of quantification cycle (Cq) values was tested using RT-LAMP as well as by conventional q-RT-PCR. The patient samples were tested with four different kits (SENSObiz COVID-19 [SARS-CoV-2] LAMP Assay, the QIAseq DIRECT SARS-CoV-2 kit, Biospeedy SARS-CoV-2 Variant Plus kit, and CoVirion-CV19-2 SARS-CoV-2 OneStep RT-PCR kit) and two different PCR devices (GDS Rotor-Gene Q Thermocycler and Inovia Technologies GenX series). Based on 30 patient samples, the positive/negative ratio (P/N) was 30/0 as Biospeedy and Covirion (positivity 100%), 28/2 as Qiagen kit (positivity 93.3%) for the samples studied on the Inovia device while the same samples on the Rotor-Gene device were 30/0 as Biospeedy and Covirion (positivity 100%), 29/1 as Qiagen kit at the first day (96.7%). On the fifth day, the samples were studied in the Inovia device and the respective results were obtained: 27/3 as Biospeedy (positivity 90%), 16/14 as Qiagen (positivity 53.3%), 28/2 as Covirion kit (positivity 93.3%). When these samples were studied in the Rotor-Gene device, it was 29/1 in Biospeedy and Covirion (positivity 96.7%), 19/11 in the Qiagen kit (positivity 63.3%). When these samples were compared with the LAMP method it was found to be 19/11 (positivity 63.3%) on the first day and 18/12 (positivity 60%) on the fifth day. SARS-CoV-2 test studies will contribute to a proactive approach to the development of rapid diagnosis systems. The LAMP approach presents promising results to monitor exposed individuals and also improves screening efforts in potential ports of entry.