कोरोना लक्षण देखिए घरैमा बस्ने कि क्वारेन्टाइन सेन्टर जाने?
दिव्य रोशनी(धरान)/अन्य मुलुकबाट सीमापार भएर आउनसक्ने सम्भाव्यता मध्यनजर गरेर भाइरस प्रवेश रोक्न सरकारले अति आवश्यक एवम् असाधारण उपाय अवलम्बन गरेको छ। शैक्षिक संस्था बन्द छन्, उत्सव तथा कार्यक्रम रोकिएका छन्। सबै उडान बन्द छन्। पूर्वसूचना दिएर यो चरणमा देश नै लक-डाउनमा छ।यी कदम ठूलो आर्थिक क्षतिका बावजुद साहसिक कदम मान्नुपर्छ। योभन्दा उत्तम अर्को विकल्प नभएकाले पनि यसलाई परिस्थितिको मागका रूपमा लिइनुपर्छ। यो एकान्तवास पूर्ण प्रजातान्त्रिक एवम् करकापरहित वातावरणमा गरिएको सत्प्रयास हो।यो आलेख तयार पार्दासम्म कोरोना परीक्षण गर्ने सुविधा सरकारको राष्ट्रिय जनस्वास्थ्य प्रयोगशाला काठमाडौं र बिपी कोइराला स्वास्थ्य विज्ञान प्रतिष्ठान, धरान गरी दुई स्थानमा मात्र छन्। सीमित स्रोतसाधन भएको यस परिस्थितिमा कोरोना भाइरस रोक्न महत्वपूर्ण हुनसक्ने केही बुँदा यहाँ चर्चा गरिएको छ।
- जोखिम कम गर्न हामीले अंगिकार गरिराखेको सामाजिक दुरी अति आवश्यक छ। चीनको अनुभव हेर्दा, मार्च १ सम्ममा सांघाईमा दस लाख मानिस संक्रमित हुनसक्ने आकलन गरिएकोमा सामाजिक दुरीले त्यो संक्रमण हुन दिएन। सर्वसाधारणले पनि यो बुझेर लक-डाउन जस्तो व्यवस्था सम्पूर्ण रूपले सफल बनाउनु उनीहरूको दायित्व रहेछ भन्ने थाहा पाए। अन्यथा हामीले धनजनको क्षतिको ठूलो मूल्य चुकाउनुपर्ने हुनसक्छ। यसको ज्वलन्त उदाहरण हाल इटालीको अवस्था हो।
- रोकथामको अर्को पाटो भनेको परीक्षण दायरा बढाएर हरेक शंकास्पद व्यक्तिको परीक्षण गर्नु हो। तर हाम्रो जस्तो सीमित स्रोतसाधन भएको देशमा अति विशिष्ट यो परीक्षण सबै ठाउँमा गर्न तुरुन्तै सम्भव छैन। वुहानमा सबै संक्रमितलाई कोरोनाकै लागि मात्र तोकिएका निश्चित अस्पताल भर्ना गराउनु रोग नियन्त्रणको अर्को ठूलो उपलब्धि थियो।
- स्वास्थ्यकर्मी अग्रपंक्तिमा हुन्छन्। उनीहरू संक्रमित भएको खण्डमा अरूलाई पनि सर्ने डर हुन्छ। स्वास्थ्यकर्मीले जोखिमको तहअनुसार व्यक्तिगत सुरक्षा उपकरण (पिपिई) प्रयोग गर्नुपर्छ। विश्वमै पिपिई अभाव भएको ध्यानमा राखी नेपालमा स्वास्थ्यसंस्था एवम् स्वास्थ्यकर्मी आफैंले तथा राष्ट्रिय आविष्कार केन्द्रका र अन्य संघसंस्थाले पनि यो बनाउनु आवश्यक भएको छ।
- नेपाल सरकार, बिपी कोइराला स्वास्थ्य विज्ञान प्रतिष्ठानको द्रूत प्रतिक्रिया टोली आदिले तयार पारेजस्तो हरेक उपचारको मानक कार्यविधि तयार गरी त्यसैअनुसार उपचार हुनु पनि जरूरी छ। स्थानीय तहमै पिपिई तयार गराउने र परीक्षण क्षमता बढाउने योजना तत्काल सुरू गर्नु आवश्यक छ।
- अहिलेसम्म विदेशबाट आएका नेपालीमध्ये ५ जनालाई संक्रमण पुष्टि भइसकेको छ। यो अवस्थामा कसरी हामी सीमित स्रोतसाधनको उच्चतम सदुपयोग गरेर हाम्रै प्रयोगशालामा कोरोना परीक्षण गर्नसक्ने हुन्छौं र सीमित आइसियू तथा भेन्टिलेटरबाट सहज सेवा दिन सक्छौं भनेर मनन गर्नु अत्यावश्यक रहन्छ।
- हामी सबैले सजग हुनुपर्ने अर्को महत्वपूर्ण कुरा, यो विश्वसंकटका बेला मुख्यपंक्तिमा रहेका स्वास्थ्यकर्मीलाई जोखिमपूर्ण रोगको उपचारनिम्ति प्रोत्साहित कसरी गर्ने भन्ने हो। सरकारका तर्फबाट यी अग्रपंक्तिका रक्षकलाई ढाढस दिँदै उनीहरूमा थप हौसला र उत्साह थप्नु जरूरी छ।
- हामीले माथि उल्लेखित समाधानका उपायमध्ये लक-डाउन त गर्यौं, तर परीक्षण दायरा अझै बढाएर संक्रमितलाई उपचार गर्ने र उक्त संक्रमण अन्यमा तथा अनवरत सेवा प्रवाह गरिरहेका स्वास्थ्यकर्मीलाई हुन नदिन पिपिई व्यवस्था सकेसम्म चाँडो गर्न अपरिहार्य छ।
नोवेल कोरोना भाइरस
भाइरसका धेरै प्रजातिमध्ये नोवेल कोरोना भाइरस, कोरोना भाइरस परिवारको बिटाकोरोना परिवारमा पर्छ। यो भाइरसले गराउने रोगको नाम कोभिड-१९ हो। यो रोग विश्वमा सबभन्दा पहिला चीनको हुबेइ प्रान्तको वुहान सहरमा देखापरेको थियो। पछि विश्वभर महामारी रूपमा फैलिरहेको छ। सामाजिक एवम् शारीरिक दुरी बढाउनु र घरमै बस्नु यसको रोकथामका महत्वपूर्ण उपाय हुन्।
माध्यम:• यो रोग मुख्यतः संक्रमितले खोक्दा वा हाछ्युँ गर्दा निस्कने कण र छिटा अरू व्यक्तिको मुख, नाक वा आँखामा परेर श्वास-प्रश्वासका माध्यमबाट सर्छ।
• संक्रमितबाट निस्किएका कण ऊ वरिपरिका सर-सामानमा पनि धेरैबेरसम्म रहन्छन् र ती वस्तु छोएका हातले नाक, मुख, आँखा, वा अनुहार छोएमा समेत सर्ने सम्भावना रहन्छ।
कोरोना संक्रमण भएपछि सामान्यतया २ देखि १४ दिनभित्र लक्षण देखा पर्न सक्छन्। त्यही भएर १४ दिन क्वारेन्टाइनमा बस्नुपर्छ। यसनिम्ति सेल्फ-क्वारेन्टाइन वा पूर्वतयारीका साथ बनाइएका विशेष स्थान प्रयोग गर्न सकिन्छ।
मुख्य लक्षणः
ज्वरो आउने (१००.४ डिग्री फरेनहाइटभन्दा बढी) — ८८%
सुख्खा खोकी — ६७%
थकाइ लाग्ने, जिउ गल्ने — ३८%
सास फेर्न गाह्रो हुने — १८%
कसलाई प्रयोगशालामा जाँच गर्ने?
कोरोना भाइरस महामारी संसारभर फैलिएको अवगत नै छ। रोग नियन्त्रणका तीन ‘टि’ अर्थात् ट्रेस (पत्ता लगाउने), टेस्ट (परीक्षण) र ट्रिट (उपचार) को सिद्धान्तमा परीक्षण अत्यन्त महत्वपूर्ण पाटो हो।यो परिप्रेक्ष्यमा अमेरिका, बेलायत, इटाली जस्ता विकसित मुलुकमा समेत परीक्षण र उपचारका साधन-श्रोत अभाव छ। हाम्रो जस्तो विकासोन्मुख देशमा यस्ता साधन कम हुनु स्वभाविक मानिन्छ।
त्यसैले, सामुदायिक प्रसारण सुरू नभएको अहिलेको अवस्थामा सामान्य ज्वरो, घाँटी दुख्ने, सिँगान बग्ने, हाछ्युँ आउने जस्ता लक्षण ‘सामान्य रुघाखोकी’ मात्रै पनि हुनसक्छ। र, यस्ता सबै बिरामीको जाँच गरिराख्नु आवश्यक हुँदैन।हालसम्म कोरोनाको कुनै उपचार नभएकाले जटिलता नभएका सामान्य बिरामीको उपचारका रूपमा आइसोलेसन र सहयोगी हेरचाह मात्र भए पुग्छ। त्यसैले सामान्य रुघाखोकी लाग्दैमा आत्तिनु पर्दैन। घरैमा आफूलाई सेल्फ-आइसोलेसनमा राखी अरूलाई संक्रमित हुनबाट बचाउन सकिन्छ।
तर सामान्य समस्या भएका बिरामीको अवस्था बिग्रिँदै गए, उच्च ज्वरो आए वा सास फेर्न गाह्रो भए तुरुन्तै नजिकैको स्वास्थ्य संस्था वा अस्पतालमा सम्पर्क गर्नुपर्छ। सामान्य व्यक्तिमा उच्च ज्वरोसँगै सुख्खा खोकी र सास फेर्न गाह्रो भए जाँच गराउनुपर्छ। यदि कोही कोरोना प्रभावित क्षेत्रको यात्रा गरेर हालसालै मात्र फर्किएको भए सामान्य लक्षणमा पनि परीक्षण जरुरी हुन्छ। साथै संक्रमितको उपचारमा संलग्न स्वास्थ्यकर्मीलाई यस्ता लक्षण देखिए जाँच गराउनुपर्छ।
प्रयोगशाला जाँच कहाँ हुन्छ?
राष्ट्रिय जनस्वास्थ्य प्रयोगशाला टेकु, काठमाडौं र बिपी कोइराला स्वास्थ्य विज्ञान प्रतिष्ठान, धरानमा मात्रै हाल यो जाँच हुन्छ। दक्ष व्यक्तिले पूर्ण सुरक्षित पिपिई लगाएर मात्रै बिरामीको नमूना संकलन गर्नुपर्छ। उक्त पिपिई एकपल्टको प्रयोगपछि सुरक्षित बिसर्जन गर्नुपर्छ। पिपिई अभाव भएकाले उपचारमा संग्लन चिकित्सकले सावधानीपूर्वक आवश्यक व्यक्तिको मात्रै जाँच गराउने निर्णय लिनुपर्ने अहिलेको अवस्था छ।
परीक्षण पोजेटिभ आए के गर्ने?
कोरोना पोजेटिभ आएमा उक्त बिरामीलाई आइसोलेसनमा राखिनुपर्छ र डाक्टरको निगरानीमा उपचार अगाडि बढाउनुपर्छ।
घरमा सेल्फ क्वारेन्टाइनमा कसरी बस्ने?
संक्रमितको सम्पर्कमा आएका, संक्रमण जोखिममा रहेका वा संक्रमण फैलिरहेको स्थानबाट आएका व्यक्तिले निश्चित अवधिसम्म आफू बस्दै आएको स्थान वा कुनै निर्दिष्ट गरिएको स्थानलाई क्वारेन्टाइन भनिन्छ। घरमा सेल्फ क्वारेन्टाइन बस्दा निम्न कुरामा ध्यान पुर्याउनुपर्छ।
- पर्याप्त भेन्टिलेसन भएको कोठामा एक्लै बस्ने। यो सम्भव नभए छुट्टै ओछ्यानमा सुतिरहेको अर्को व्यक्तिसँग कम्तिमा एक मिटर दुरी राख्ने। आफू बस्ने कोठा आफैं सफा गर्ने।
- छुट्टै बाथरूम, शौचालय प्रयोग गर्ने। सम्भव नभएमा प्रयोग गरेपछि बाथरूम, शौचालय आफैं सफा गर्ने।
- घरभित्र साझा रूपमा प्रयोग हुने ठाउँ जस्तै भान्सा, शौचालयमा आवतजावत कम गर्ने।
- काममा, विद्यालयमा वा सार्वजनिक क्षेत्रमा नजाने। सार्वजनिक यातायात प्रयोग नगर्ने र स्वास्थ्य संस्था जानबाहेक अरू काममा बाहिर ननिस्किने।
- नियमित आफ्नो हात साबुनपानीले मिचीमिची २० सेकेन्डसम्म धुने वा हात सफा राख्न अल्कोहलयुक्त स्यानिटाइजर प्रयोग गर्ने। हात नधोई मुख, नाक, आँखा छुनबाट जोगिने।
- आफूले प्रयोग गर्ने सामान घरका अन्य व्यक्तिसँग साझा रूपमा प्रयोग नगर्ने। प्रयोग गरेका सामान साबुन र पानीले सफासँग धुने।
- अन्य व्यक्तिसँग प्रत्यक्ष सम्पर्क कम गर्ने। सम्पर्कमा आउनु परे कम्तिमा एक मिटर दुरी राख्ने। एउटै कोठामा पनि मास्क लगाएर मात्र सम्पर्क गर्ने।
- खोक्दा वा हाछ्युँ गर्दा मुख र नाक टिस्यु पेपर, रुमाल या कुहिनाले छोप्ने। प्रयोग गरेका टिस्यु, रुमाल, मास्क र अन्य सामान छुट्टै फोहोर फाल्ने ठाउँमा फाल्ने र साबुनपानीले हात धुने। धोएका लुगा घाममा राम्ररी सुकाएपछि मात्र प्रयोग गर्ने।
- क्वारेन्टाइनमा रहँदा आफ्नो शरीरको तापक्रम दैनिक जाँच्ने र दिइएको फारममा रेकर्ड गर्ने। दैनिकरूपमा १४ दिनको स्वास्थ्य स्थिति तोकिएको स्वास्थ्य निकायमा जानकारी दिने। क्वारेन्टाइनमा रहँदा अन्य केही समस्या भए तोकिएको स्वास्थ्य निकायबाट प्राप्त निर्देशन पालना गर्ने।
(प्राध्यापक सञ्जीव कुमार शर्मा बिपी कोइराला स्वास्थ्य विज्ञान प्रतिष्ठान, धरानको इन्टरनल मेडिसिन विभाग प्रमुख हुन्)
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