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COVID-19 Pandemisi İki Aylık Değerlendirme Raporu

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COVID-19 Pandemisi İki Aylık Değerlendirme Raporu COVID-19 PANDEMİSİ İKİ AYLIK DEĞERLENDİRME RAPORU TÜRK TABİPLERİ BİRLİĞİ TÜRK TABİPLERİ BİRLİĞİ COVID-19 Danışma ve İzleme Kurulu COVID-19 PANDEMİSİ İKİ AYLIK DEĞERLENDİRME RAPORU 14 Mayıs 2020 TÜRK TABİPLERİ BİRLİĞİ COVID-19 PANDEMİSİ İKİ AYLIK DEĞERLENDİRME RAPORU İçindekiler SUNUŞ ................................................................................................................................................. 4 TTB COVID-19 Danışma ve İzleme Kurulu Üyeleri ............................................................................... 6 1. BÖLÜM: GİRİŞ ............................................................................................................... 7 Raporun Amacı .................................................................................................................................... 7 Raporun Hazırlanma Yöntemi ............................................................................................................. 7 Raporun Sınırlılıkları ............................................................................................................................ 7 2. BÖLÜM: KÜRESEL DURUM ............................................................................................ 8 COVID-19 Pandemisinde Küresel Durum ............................................................................................ 8 COVID-19 Pandemisi: Ülke Örnekleri ................................................................................................ 12 COVID-19 Pandemisinde Zaman Çizelgesi (Kronolojik Olarak Önemli Gelişmeler) .......................... 16 COVID-19 Pandemisinin Evreleri Dünya Sağlık Örgütü (DSÖ) influenza örneği üzerinden bir pandeminin evrelerini şöyle tanımlamaktadır (WHO, 2009): ........................................................... 21 3. BÖLÜM: TÜRKİYE HAZIRLIK SÜRECİ.............................................................................. 23 Pandemik İnfluenza Ulusal Hazırlık Planı........................................................................................... 23 Türkiye Hazırlık Süreci (10 Ocak – 10 Mart) ...................................................................................... 30 Türkiye’nin Pandemiye Yanıt Verme Kapasitesi ................................................................................ 34 Türkiye’de Sağlık Sisteminin Pandemiye Hazırlık ve Yanıt Verme Kapasitesi Bağlamında Değerlendirilmesi .............................................................................................................................. 43 4. BÖLÜM: TÜRKİYE’DE COVID-19 PANDEMİSİ YÖNETİMİ ............................................... 44 Türkiye’de Durum .............................................................................................................................. 44 Pandemi Mücadelesinin Örgüt Yapısı ................................................................................................ 46 Pandemide Risk İletişimi ve Medya ................................................................................................... 48 Pandemi Mücadelesi Sırasında İletişim ............................................................................................. 54 Pandemi Sürecinde Sağlık Bakanlığı, SGK ve Cumhurbaşkanlığı Mevzuatındaki Değişiklikler .......... 62 Pandemi Sürecinde Kişisel Verilerin Kullanımı ve Etkileri ................................................................. 68 Pandemi Risk Gruplarına Karşı Yaklaşım ........................................................................................... 69 Karantina, Ayrı Tutma, Ayırma Uygulamaları; Toplumsal Hareketliliği Sınırlandıran Diğer Uygulamalar ...................................................................................................................................... 71 Sağlık Çalışanlarının Sağlığı ve Güvenliği ........................................................................................... 78 Türkiye’de Enfekte Olan ve Yaşamını Yitiren Sağlık Çalışanları ve Uluslararası Karşılaştırma .......... 83 5. BÖLÜM: TÜRKİYE’DE PANDEMİYE KARŞI SAVAŞIM ...................................................... 87 Pandemi Savaşımında Sahada Yürütülen Hizmetler ......................................................................... 87 Olası Hasta ve Kesin Hasta Tanımının Değerlendirilmesi ve Karşılaştırılması (Sağlık Bakanlığı Rehberleri, WHO ve ECDC) ................................................................................................................ 90 2 TÜRK TABİPLERİ BİRLİĞİ COVID-19 PANDEMİSİ İKİ AYLIK DEĞERLENDİRME RAPORU Tanı Testinin Özellikleri ve Kullanılması ............................................................................................ 93 Tedavi Süreci (Kullanılan İlaçlar, Doz vb. Sağlık Bakanlığı Rehberlerinin Literatür Eşliğinde Değerlendirilmesi) ............................................................................................................................. 95 Pandemide Aile Sağlığı Merkezleri .................................................................................................. 105 Kamu Hastanelerinde Sunulması Gereken Hizmetler ..................................................................... 107 Üniversite Hastanelerinde Yürütülen Hizmetler ............................................................................. 111 Özel Hastaneler ve Özel Sağlık Kuruluşları Yürütülen Hizmetler ..................................................... 113 Pandeminin İkincil Etkisi .................................................................................................................. 114 Olgu ve Ölüm Bildirimleri ve Kayıtlar .............................................................................................. 123 Yeniden Açılma ................................................................................................................................ 125 6. BÖLÜM: TTB FAALİYETLERİ ......................................................................................... 128 TTB Kronolojisi (Ocak – 11 Mayıs) .................................................................................................. 128 TTB Açıklamaları ve Temel Belgeler ................................................................................................ 133 TTB-UDEK Koronavirüs Pandemisi Çalışma Grubu Faaliyetleri ....................................................... 138 TTB’nin Sağlık Bakanlığı’ndan Yanıtını Beklediği Sorular ................................................................. 139 7. BÖLÜM: NE YAPILMALI? / TTB VE TABİP ODALARININ ÖNERİLERİ ............................... 141 Kısa Erimli Öneriler (önümüzdeki 2 ay) ........................................................................................... 141 Orta Erimli Öneriler (2020 sonuna kadar) ....................................................................................... 143 3 TÜRK TABİPLERİ BİRLİĞİ COVID-19 PANDEMİSİ İKİ AYLIK DEĞERLENDİRME RAPORU SUNUŞ Dünya ve ülkemiz milyarlarca insanın geçimini, sosyal hayatını ve hepsinden önemlisi sağlığını bedenen ve ruhen sarsan, COVID-19 diye adlandırılmış bir pandemi döneminden geçiyor. COVID-19 salgını kapitalist sistemin tüketim ve piyasa odaklı sağlık sistemlerinin iflasını gösterir- ken, geçmiş başarılı ve başarısız deneyimlerden dersler çıkarılarak kamusal temelli, insan odaklı, koruyucu sağlık hizmetlerini önceleyen bir bakışın egemen olması gerektiğini açık olarak ortaya koymuş durumda. Bu nedenle COVID-19 sürecine dair bugün yapılacak her değerlendirme ve atılacak her adım, salgının sadece bu anını değil dünyamızın ve ülkemizin yakın gelecekte yaşayacağı sorunları için de belirleyici olacaktır. Türk Tabipleri Birliği (TTB) olarak, COVID-19 salgını dönemini sadece bir tartışma ve değerlen- dirme dönemi olarak görmedik. İlk günden bugüne halkın, hekimlerin ve sağlık çalışanlarının sağlığının korunmasının yanı sıra sağlığın sosyal belirleyicileri olan ve salgın ortamında milyonlar- ca yurttaş için “yeterli ve dengeli beslenebilmeyi” sağlayacak düzenli bir gelire sahip olma; ücret- siz ya da çok düşük harcamayla “barınma-ısınma-su-elektrik ve iletişim” olanağına sahip olma taleplerinin hem dillendiricisi hem de takipçisi olduk. COVID-19 Pandemisi dünya üzerinde bulunan bütün ülke ve insanları etkilemiş durumda. Solu- num ve temas yolu bulaşıcılığı ile komorbid hastalarda daha fazla olmakla birlikte bütün insanlar- da ölümcül risk taşıması nedeniyle COVID-19 ile mücadelenin bütün dünyada ve ülkemizde bi- limsel yöntemler ve epidemiyolojik veriler kullanılarak ciddi bir işbirliği ve koordinasyonla yürü- tülmesini zorunlu kılmıştır. TTB olarak COVID-19 pandemi sürecinde Dünya Tabipleri Birliği, diğer ülke Tabip Birlikleri ve en önemlisi Dünya Sağlık Örgütü’nün ilgili birimleri ile olabildiğince iletişim içinde olmaya, onları bilgilendirmeye ve oralardan bilgilenmeye çalıştık. Salgının ilk döneminden itibaren Sağlık Ba- kanlığı’na gerek kurumsal gerekse de başkan düzeyinde kişisel iletişim kanallarının açık olması için çabaladık. “Bilimsel Danışma Kurulları” da dâhil olmak üzere her kurula kurumumuz bünye- sinden uzman arkadaşlarımızın katkı koyabileceğini illettik. Başlangıç döneminde Sağlık Bakanlığı iletişim kanalını kısmen açık tutmuş olsa da son dönemde iletişimin tekrar monoloğa dönmesi, TTB olarak soru, öneri ve taleplerimizi açık mektuplar aracılığıyla iletmek zorunda bıraktı. Sağlık Bakanlığı’nın kendi “bilimsel danışma kurulunun” mu, “Bakanlık bürokrasisinin” mi ya da bir başka “yetkili kurulun” mu verdiğinin tam olarak bilemediğimiz ülkemizdeki
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