E hia te nui o te hekenga o te paitini o Omicron? E whakaatu ana ngā rangahau maha o te ao tūturu

"He tata te kaha o Omicron ki te kaha o te rewharewha ā-wā" ā, "He iti ake te mate o Omicron i a Delta". …… Nō nā tata nei, he maha ngā purongo mō te kaha o te momo hou o te mate korona, arā, ko Omicron, kua horapa haere i runga i te ipurangi.

Ina hoki, mai i te putanga mai o te momo ira Omicron i te Whiringa-ā-rangi 2021 me tōna horapa puta noa i te ao, kua haere tonu ngā rangahau me ngā kōrero mō te kaha me te tuku. He aha te āhua o te kaha o Omicron i tēnei wā? He aha ngā kōrero a te rangahau mōna?

Ngā rangahau taiwhanga maha: He iti ake te kaha o te Omicron
Ina hoki, i te tīmatanga o Hānuere 2022, i kitea i roto i tētahi rangahau mai i te Whare Wānanga o Hong Kong, Li Ka Shing Faculty of Medicine, he iti ake te mate o Omicron (B.1.1.529) ki te whakatauritea ki te momo taketake me ētahi atu momo ira kua whakarerekētia.
I kitea kāore i te whai hua te momo Omicron mutant ki te whakamahi i te transmembrane serine protease (TMPRSS2), engari ka taea e te TMPRSS2 te āwhina i te whakaekenga huaketo ki ngā pūtau manaaki mā te tapahi i te pūmua pīrahi o te coronavirus hou. I taua wā anō, i kitea e ngā kairangahau kua tino heke te whakaputanga Omicron i roto i ngā raina pūtau tangata Calu3 me Caco2.

Pūtake whakaahua ipurangi

I roto i te tauira kiore k18-hACE2, i whakaitihia te tukuruatanga Omicron i roto i ngā ara manawa o runga me raro o ngā kiore i whakaritea ki te momo taketake me te mutant Delta, ā, he iti ake te kino o tōna mate pūkahukahu, i te mea he iti ake te whakahekenga taumaha me te mate i puta mai i te mate Omicron i te momo taketake me ngā mutant Alpha, Beta me Delta.
Nō reira, i whakatau ngā kairangahau kua heke te whakaputa uri me te mate o Omicron i roto i ngā kiore.

Pūtake whakaahua ipurangi

I te 16 o Mei 2022, i whakaputa a Nature i tētahi tuhinga nā Yoshihiro Kawaoka, he tohunga huaketo matua nō Te Whare Wānanga o Tōkyō me Te Whare Wānanga o Wisconsin, e whakaū ana mō te wā tuatahi i roto i tētahi tauira kararehe he iti ake te kaha o Omicron BA.2 i te momo taketake o mua.

I tīpakohia e ngā kairangahau ngā huaketo BA.2 ora i wehea mai i Hapani hei pangia ngā kiore me ngā hamster k18-hACE2, ā, i kitea, i muri i te pangia ki te horopeta kotahi o te huaketo, he iti ake te nui o te huaketo i roto i ngā pukahukahu me te ihu o ngā kiore i pangia e te BA.2 me te BA.1 i tērā o te mate taketake o te momo New Crown (p<0.0001).

E whakaū ana tēnei hua paerewa koura he iti ake te kaha o Omicron i te momo taketake o te momo mohoao. He rerekē, kāore he rerekētanga nui o ngā taitara huaketo i roto i ngā pukahukahu me ngā ihu o ngā tauira kararehe whai muri i ngā mate BA.2 me BA.1.

Pūtake whakaahua ipurangi

I whakaatuhia e ngā whakamātautau PCR he iti ake ngā kawenga huaketo i roto i ngā pukahukahu me te ihu o ngā kiore i pangia e te BA.2 me te BA.1 i tērā o te momo New Crown taketake, inā koa i roto i ngā pukahukahu (p<0.0001).

He rite ki ngā hua i puta i ngā kiore, ko ngā tairongo huaketo i kitea i roto i te ihu me ngā pukahukahu o ngā hamster i pangia e te BA.2 me te BA.1 he iti iho i te momo taketake i muri i te 'werohanga' ki te horopeta kotahi o te huaketo, inā koa i roto i ngā pukahukahu, ā, he iti ake i roto i te ihu o ngā hamster i pangia e te BA.2 i te BA.1 – inaa, ko te haurua o ngā hamster i pangia e te BA.2 kāore i pangia e te mate pukahukahu.

I kitea anō kāore i roto i ngā momo taketake, arā, a BA.2 me BA.1, te whakawhiti-whakakorenga o ngā toto i muri i te pangia – he rite ki ngā mea kua kitea i roto i ngā tāngata o te ao tūturu i te wā i pangia ai rātou e ngā momo ira hou o te karauna.

Pūtake whakaahua ipurangi

Ngā raraunga o te ao tūturu: Kāore pea a Omicron e pāngia e te mate kino

He maha ngā rangahau i runga ake nei kua whakaahua i te whakahekenga o te kaha o Omicron i roto i ngā tauira kararehe taiwhanga, engari he rite tonu rānei i te ao tūturu?

I te 7 o Hune 2022, i whakaputa te WHO i tētahi pūrongo e aromatawai ana i te rerekētanga o te kaha o te hunga i pangia i te wā o te mate urutā Omicron (B.1.1.529) ki te whakataurite ki te mate urutā Delta.

I roto i te pūrongo, 16,749 ngā tūroro hou mō te mate manawa i roto i te hōhipera mai i ngā kawanatanga katoa o Āwherika ki te Tonga, tae atu ki te 16,749 mai i te mate urutā Delta (2021/8/2 ki te 2021/10/3) me te 17,693 mai i te mate urutā Omicron (2021/11/15 ki te 2022/2/16). I whakarōpūtia hoki ngā tūroro ki te mate kino, te mate kino me te kore kino.

he mea nui: kua whiwhi koe i te hauhautanga urutomo, i te hāora me te hāora whakawhiti ihu rere nui rānei, i te hāora kiriuhi waho o te tinana (ECMO) rānei, i te whakaurunga rānei ki te ICU i te wā e noho ana koe ki te hōhipera.
-tino kino (tino kino): i whiwhi hāora i te wā e noho ana i te hōhipera
-kāore i te kino: ki te kore tetahi o ngā whakaritenga o runga ake nei e tutuki, ka kiia te tūroro kāore i te kino.

I whakaatuhia e ngā raraunga i roto i te rōpū Delta, 49.2% i pangia e te mate kino, 7.7% i tino kino, ā, 28% o ngā tūroro katoa i pangia e te mate Delta i mate, i roto i te rōpū Omicron, 28.1% i tino kino, 3.7% i tino kino, ā, 15% o ngā tūroro katoa i pangia e te mate Omicron i mate. Waihoki, ko te roanga toharite o te noho ki te hōhipera he 7 rā i roto i te rōpū Delta, ki te whakaritea ki te 6 rā i roto i te rōpū Omicron.

Hei tāpiritanga, i tātarihia e te pūrongo ngā āhuatanga awe o te tau, te ira tangata, te tūnga werohanga me ngā mate tāpiri, ā, i whakatau ko te hononga o Omicron (B.1.1.529) he iti ake te tūponotanga o te mate kino me te mate kino (95% CI: 0.41 ki te 0.46; p<0.001) me te iti ake o te tūponotanga o te mate i roto i te hōhipera (95% CI: 0.59 ki te 0.65; p<0.001).

Pūtake whakaahua ipurangi

Mō ngā momo rerekē o Omicron, kua tātaritatia hoki e ētahi atu rangahau tō rātou kaha.

I tātarihia e tētahi rangahau rōpū mai i New England ngā kēhi 20770 o Delta, 52605 kēhi o Omicron B.1.1.529 me 29840 kēhi o Omicron BA.2, ā, i kitea ko te ōwehenga o ngā mate he 0.7% mō Delta, 0.4% mō B.1.1.529 me 0.3% mō BA.2. Whai muri i te whakatikatika mō ngā āhuatanga whakapoauau, i whakatau te rangahau he iti ake te mōrearea o te mate mō BA.2 ki te whakataurite ki a Delta me B.1.1.529.

Pūtake whakaahua ipurangi

I arotakehia e tētahi atu rangahau mai i Āwherika ki te Tonga te mōrearea o te whakaurunga ki te hōhipera me te mōrearea o te putanga kino mō Delta, BA.1, BA.2 me BA.4/BA.5. I whakaatuhia e ngā hua o te tātaritanga, mai i te 98,710 o ngā tūroro hou i pangia e te mate, 3825 (3.9%) i whakaurua ki te hōhipera, ā, 1276 (33.4%) o rātou i pāngia e te mate kino.

I roto i te hunga i pangia e ngā whakarerekētanga ira rerekē, 57.7% o ngā tūroro i pangia e Delta i pāngia e te mate kino (97/168), ki te whakaritea ki te 33.7% o ngā tūroro i pangia e BA.1 (990/2940), 26.2% o BA.2 (167/637) me te 27.5% o BA.4/BA.5 (22/80). I whakaatuhia e te tātaritanga maha-taurangi ko te tūponotanga o te whakawhanake i tētahi mate kino i roto i te hunga i pangia e Delta > BA.1 > BA.2, engari ko te tūponotanga o te whakawhanake i tētahi mate kino i roto i te hunga i pangia e BA.4/BA.5 kāore i tino rerekē ki te BA.2.
Kua iti ake te kaha o te mate, engari me mataara tonu

Kua whakaatuhia e ngā rangahau taiwhanga me ngā raraunga tūturu mai i ētahi whenua he iti ake te kaha o te Omicron me ōna momo ira, ā, he iti ake te tūponotanga ka pā mai he mate kino atu i te momo taketake me ētahi atu momo ira kua whakarerekētia.

Heoi, i roto i tētahi tuhinga arotake i te putanga o Hānuere 2022 o The Lancet, ko 'Milder but not mild' te taitara, i kīia ahakoa ko te mate Omicron te take o te 21% o ngā whakaurunga hōhipera i roto i te taupori taitamariki o Āwherika ki te Tonga, ko te ōwehenga o ngā pakarutanga e hua ai te mate kino ka piki ake pea i roto i ngā taupori he rerekē ngā taumata o te mate me ngā taumata rerekē o te werohanga. (Ahakoa rā, i roto i tēnei taupori taitamariki o Āwherika ki te Tonga, 21% o ngā tūroro i te hōhipera i pangia e te momo SARS-CoV-2 omicron he kino te putanga haumanu, he ōwehenga ka piki ake pea, ka puta he pānga nui i roto i ngā pakarutanga i roto i ngā taupori he rerekē ngā taupori me ngā taumata iti o te ārai mate i ahu mai i te mate, i ahu mai rānei i te werohanga.)

I te mutunga o te pūrongo a te WHO i whakahuatia ake nei, i kite te tīma ahakoa te iti o te kaha o te momo o mua, tata ki te hautoru o ngā tūroro Omicron (B.1.1.529) i te hōhipera i pāngia e te mate kino, ā, ko ngā momo whakarerekētanga karauna hou i haere tonu te whakaputa i te nui o te mate me te mate i roto i ngā kaumātua, ngā taupori ngoikore te pūnaha ārai mate, ngā taupori kāore anō kia werohia. (E hiahia ana hoki mātou ki te whakatūpato kia kaua tā mātou tātaritanga e tirohia hei tautoko i te kōrero rerekētanga 'ngawari'. Tata ki te hautoru o ngā tūroro Omicron i te hōhipera i pāngia e te mate kino, ā, 15% i mate; he maha ngā tau kāore i te iti……I roto i ngā taupori ngoikore, arā, ngā tūroro i ngā tau tino pakeke, i roto i ngā taupori he nui te taumaha o ngā mate tāpiri, i roto i ngā tūroro ngoikore me roto i te hunga kāore anō kia werohia, ko te COVID-19 (ngā VOC katoa) kei te whai wāhi tonu ki te nui o te mate me te mate.)

Ko ngā raraunga o mua mai i Omicron i te wā i tīmata ai te tuarima o ngā ngaru o te mate urutā i Hong Kong e whakaatu ana, tae noa ki te 4 o Mei 2022, e 9115 ngā mate i roto i te 1192765 ngā kēhi hou i karaunatia i te tuarima o ngā ngaru (he reiti mate mata o te 0.76%) me te reiti mate mata o te 2.70% mō te hunga neke atu i te 60 tau te pakeke (tata ki te 19.30% o tēnei rōpū tau kāore i werohia).

He rerekē, e 2% noa iho o ngā tāngata o Aotearoa neke atu i te 60 tau te pakeke kāore anō kia werohangahia, he hononga tata tēnei ki te iti o te reiti mate mata o te 0.07% mō te mate urutā hou.

I tētahi atu taha, ahakoa e kīia ana ka noho a Newcastle hei mate urutā ā-wā a muri ake nei, he rerekē te tirohanga a ngā tohunga mātauranga.

E whakapono ana ētahi kaipūtaiao tokotoru nō Te Whare Wānanga o Ōtautahi me te Pokapū Rangahau Tahi o te Kotahitanga o Ūropi, he mea tūpono noa iho te iti o te kaha o te Omicron, ā, ko te tere tonu o te whanaketanga o ngā mate pāwera (te whanaketanga o ngā mate pāwera) ka puta pea he momo hou.

He rerekē tēnei i te mawhiti o te ārai mate me te horapa, e pāngia ana e te pēhanga whanaketanga kaha, ko te kaha o te mate he 'hua taha' noa iho o te whanaketanga. Ka whanake ngā huaketo kia nui ake ai tō rātou kaha ki te horapa, ā, ka piki ake pea te kaha o te mate. Hei tauira, mā te whakanui ake i te kawenga huaketo hei whakahaere i te horapa, ka taea tonu e ia te whakaputa mate kino ake.

Ehara i te mea koinā anake, engari he iti noa iho ngā kino ka pā mai i te kaha o te huaketo i te wā e horapa ana te huaketo mēnā ka puta ngā tohu i puta mai i te huaketo i muri mai i te mate - pērā i ngā huaketo rewharewha, te HIV me te hepatitis C, hei tauira noa iho, he nui te wā ka horapa i mua i te pānga kino.

Pūtake whakaahua ipurangi

I roto i ēnei āhuatanga, tera pea he uaua ki te matapae i te ia o te momo ira hou o te karauna ira mai i te kaha iti o Omicron, engari ko te rongo pai ko te whakaatu a te kano kano karauna hou i te iti o te mōrearea o te mate kino me te mate ki ngā momo ira katoa, ā, ko te whakanui ake i ngā reiti werohanga taupori he huarahi nui tonu hei whawhai i te mate urutā i tēnei wā.
Ngā mihi: I arotakehia tēnei tuhinga e Panpan Zhou, PhD, Te Kura Rongoā o Te Whare Wānanga o Tsinghua me te Hoa Tohu Paerua, Te Whare Rangahau o Scripps, USA
Te matū whakamātautau-ā-unoa a Omicron i te kāinga