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Ano nga ba ang Herd Immunity?

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Ang virus ay mabilis na kumakalat sa mga komunidad. Ang paghinto nito ay mangangailangan ng immunity sa sakit ng isang makabuluhang porsyento ng mga tao. Ngunit paano tayo makakarating rito?

Ano nga ba ang herd immunity?

Nagbibigay ito ng hindi direktang proteksyon – o bakod na kaligtasan sa sakit (tinatawag din na pangangalaga ng kawan) – para sa mga hindi immune sa sakit kapag ang karamihan sa isang populasyon ay immune sa isang nakakahawang sakit.

Halimbawa, kung 80 porsyento ng isang populasyon ay immune sa isang virus, apat sa bawat limang tao na nakatagpo ng isang taong may sakit ay hindi magkakasakit (at hindi na ikakalat ang sakit). Sa ganitong paraan, pinapanatili nito sa ilalim ng kontrol ang pagkalat ng mga nakakahawang sakit. Nakasalalay sa kung paano nakakahawa ang impeksyon, 70 porsyento hanggang 90 porsyento ng isang populasyon ay karaniwang nangangailangan ng kaligtasan sa sakit upang makuha ang sobrang kalakal.

Paano tayo nakakuha ng sobrang dami ng kaligtasan sa sakit sa iba pang mga nakakahawang sakit?
Ang mga sukat, mumps, polio, at bulutong ay mga halimbawa ng mga nakakahawang sakit na dati nang pangkaraniwan ngunit bihira ngayon sa ilang mga bansa dahil ang mga bakuna ay nakatulong upang maitaguyod ang sobrang kawan ng resistensya. Sa mga komunidad, na may mas mababang saklaw ng bakuna, kung minsan nakikita natin ang mga paglaganap ng mga sakit na maiiwasan sa bakuna dahil wala silang proteksyon ng bakahan.

Para sa mga impeksyong walang bakuna, kahit na maraming mga may sapat na gulang ang nakabuo ng kaligtasan sa sakit dahil sa nakaraang impeksyon, ang sakit ay maaari pa ring ikalat sa mga bata, at maaari pa ring mahawa ang mga may mahina na immune system. Nakita ito bago nabuo ang mga bakuna para sa marami sa mga nabanggit na sakit.

Ang iba pang mga virus (tulad ng trangkaso) ay mutate sa paglipas ng panahon, kaya ang mga antibodies mula sa mas maagang impeksiyon ay nagpoprotekta sa isang maikling panahon lamang. Ito ay mas mababa sa isang taon, para sa trangkaso. Kung ang SARS-CoV-2, ang virus na nagdudulot ng COVID-19, ay tulad ng iba pang mga coronavirus na kasalukuyang nakakahawa sa mga tao, kung gayon maaari nating asahan ang mga taong nahawahan na maging immune sa loob ng maraming buwan hanggang taon, ngunit marahil hindi lahat ng kanilang buhay.

Ano ang kakailanganin para sa SARS-CoV-2 upang makamit ang kaligtasan sa sakit?

Mayroong dalawang mga paraan upang makamit ang herd immunity tulad ng anumang iba pang impeksyon: Ang isang malaking proporsyon ng populasyon ay maaaring mahawahan o makakuha ng isang bakunang proteksiyon. Batay sa mga naunang pagtantya ng pagkakahawang ng virus na ito, marahil kakailanganin natin ng hindi bababa sa 70 porsyento ng populasyon upang maging immune sa proteksyon ng mga kawan.

Sa pinakamasamang kaso (halimbawa, kung hindi tayo gagawa ng pisikal na distansya o gumawa ng iba pang mga hakbang upang mapabagal ang pagkalat ng SARS-CoV-2), sa isang bagay ng ilang buwan, ang virus ay maaaring makahawa sa maraming tao. Masisira nito ang ating mga ospital at magdulot ng mataas na rate ng pagkamatay.

Sa pinakamahusay na kaso, pinapanatili namin ang kasalukuyang mga antas ng impeksyon – o kahit na bawasan ang mga antas – hanggang sa makukuha ang isang bakuna. Mangangailangan ito ng isang pinagsamang pagsisikap sa bahagi ng buong populasyon, na may ilang antas ng patuloy na pisikal na distansya sa isang pinalawig na panahon, malamang sa isang taon o higit pa, bago mabuo ang isang mabisang bakuna, masuri, at makagawa ng masa.

Ang pinaka-malamang na sanhi ay sa isang lugar sa gitna, kung saan ang mga rate ng impeksyon ay tumataas at mahulog sa paglipas ng panahon; kapag ang mga bilang ng mga impeksyon ay nahuhulog, maaari naming mamahinga ang mga hakbang sa paglipad sa lipunan, at pagkatapos ay kailangang muling ipatupad ang mga hakbang na ito habang tumataas muli ang mga bilang. Kakailanganin ang isang matagal na pagsisikap hanggang sa mabuo ang isang bakuna upang maiwasan ang mga pangunahing pag-aalsa. Kahit na pagkatapos, matapos ang kanilang kaligtasan sa sakit, ang SARS-CoV-2 ay maaari pa ring makahawa sa mga bata bago sila mabakunahan, o mga may sapat na gulang. Ngunit hindi malamang na magkaroon ng pagsabog na kumakalat na nakikita natin ngayon sa mahabang panahon dahil maraming populasyon ang magiging immune sa hinaharap.

Bakit hindi magandang ideya na ma-impeksyon sa SARS-CoV-2 upang “makumpleto ito”?

Sa ilang iba pang mga karamdaman, tulad ng bulutong bago nabuo ang bakuna na varicella, ang mga tao ay sadyang sinasadya na mailantad ang kanilang sarili bilang isang paraan upang makuha ang kaligtasan sa sakit. Ang pamamaraang ito ay maaaring makatwiran para sa mas malubhang sakit. Ngunit para sa SARS-CoV-2 ang sitwasyon ay ibang-iba: Ang COVID-19 ay nagdadala ng mas mataas na peligro ng malubhang sakit at kahit na kamatayan.

Ang rate ng kamatayan ng COVID-19 ay hindi alam, ngunit iminumungkahi ng kasalukuyang data na 10 beses na mas mataas kaysa sa trangkaso. Mas mataas pa ito sa mga mahina na grupo tulad ng mga matatanda, at mga taong may mahinang immune system. Kahit na ang parehong bilang ng mga tao ay sa huli ay nahawahan ng SARS-CoV-2, mas mahusay na i-space ang mga impeksyon na iyon sa paglipas ng panahon upang ang mga doktor at ospital ay hindi mapuspos. Ang mas mabilis ay hindi palaging mas mahusay, tulad ng nakita namin na may mataas na rate ng namamatay sa mga nakaraang epidemya.

Ano ang dapat nating asahan sa mga susunod na buwan?

Nagmamadali na ang mga siyentipiko sa pagbuo ng isang mabisang bakuna. Samantala, dahil ang karamihan sa populasyon ay nananatiling hindi dinidisimpekta sa SARS-CoV-2, mangangailangan ito ng ilang mga hakbang upang maiwasan ang pagsabog.

Ang mga pisikal na hakbang sa paglalakbay na kinakailangan ay maaaring magkakaiba-iba sa paglipas ng panahon at hindi dapat palaging maging mahigpit tulad ng aming kasalukuyang batas sa kanlungan. Ngunit maliban kung nais nating mahawahan ng SARS-CoV-2 ng daan-daang at libu-libong mga Pilipino (kung ano ang kakailanganin upang maitaguyod ang kawalang-kalakal sa bansang ito), ang buhay ay hindi malamang na maging “normal” muli hanggang sa mabuo ang isang bakuna at malawak na ipinamamahagi.

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