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Penanganan Gagal Ginjal Kronis pada Transisi Menuju ke Endemi

PEMERINTAH semakin percaya diri dalam merespons tren menurunnya kasus harian covid-19. Sejak 4 Februari lalu pemerintah memutuskan membuka Bali bagi kedatangan turis asing dengan prosedur karantina. Mulai 7 Maret turis asing boleh masuk ke Bali tanpa karantina. Itulah kebijakan untuk membuka keran ekonomi pariwisata Bali dengan keyakinan bahwa situasinya semakin membaik. Memang kurvanya semakin melandai meskipun belum mencapai level yang aman secara nasional. Pada 14 Maret 2020, kasus harian hanya bertambah 14.900, sudah jauh menurun daripada saat puncak gelombang ketiga pada 16 Februari lalu yang mencapai 64.718 orang.  Penurunan ini dicapai karena gabungan berbagai hal, seperti protokol kesehatan, pembatasan mobilitas sosial, dan tentu saja pencapaian vaksinasi massal. Untuk vaksinasi dosis pertama sudah mencapai 193.014.314 orang (92,68% dari total target).

Moving from Pandemic to Endemic

Experts project that this pandemic will gradually become endemic. Therefore, early on, we prepare a roadmap so that we can deal with the endemic more smoothly without turmoil. The next step after the second wave of Covid-19 subsides is to continue to put health into priority (healthy oriented). Lessons from the imposition of restrictions on community activities deserve to become a stepping stone on the road map to endemic. It turns out that strict and measurable restrictions on activities can ease the rampage of the corona, so that it can open up opportunities for economic revival. This must have related with the government's attitude that is more open to receiving suggestions and criticism. The current restriction is clearly a more healthy-oriented policy, which is different from the misguided economic-oriented policy that was implemented at the beginning of the pandemic. At that time the government did not close the door to arrivals from abroad, desperately invited foreign tourists, financed buzzers, there was indifferent and slow response of the health authorities, the lack of tracing and testing, and the lack of concern for the heavy burden of health workers and health filities.

Overcoming Omicron and Future Variants

We all have the same hope: that Covid-19, which has infected 400 million people and claimed 5.8 million lives on planet Earth, will become an ordinary, mild disease, or even disappear from the face of the Earth. Don't take Omicron lightly. The impact of this variant is indeed not as severe as the Delta variant because the majority have mild symptoms. The transmission of Omicron has been very "hot" and our country is starting to be disrupted by a surge in Covid-19 cases. The World Health Organization (WHO) declared Omicron (B.1.1.529) as a variant of concern (VoC) on 26 Nov. 2021. Invading the world over like a blitzkrieg, the number of Omicron cases is rising rapidly. In fact, the daily global increase is now 4-5 times (around 3 million cases) the peak of the Delta variant (around 750,000). Death rates followed. If the peak of Delta reached a fatality rate of 11,000 deaths per day, today Omicron kills 12,000 per day.

Mengatasi Omicron dan Varian Masa Depan

Jangan menganggap enteng Omicron. Dampak varian ini memang tak sedrastis varian Delta karena mayoritas bergejala ringan. Penularan Omicron sangat ”ngegas” dan negara kita mulai terganggu lejitan kasus Covid-19. Organisasi Kesehatan Dunia (WHO) sendiri memasukkan Omicron (B.1.1.529) sebagai varian yang harus diwaspadai (variant of concern/VoC) sejak 26 November 2021. Menginvasi ke seluruh dunia seperti ”perang kilat” (blitzkrieg), angka kasus Omicron sangat cepat menanjak. Bahkan, kini penambahan hariannya 4-5 kali lipat (sekitar 3 juta kasus) dari saat puncak varian Delta (sekitar 750.000). Tingkat kematian pun mengikuti. Kalau puncak Delta tingkat kematiannya 11.000-an per hari, kini Omicron sudah menewaskan sekitar 12.000-an per hari. Data epidemiologi terbaru menunjukkan peningkatan infeksi pesat di Eropa, mayoritas akibat Omicron. Pada September 2021, lebih dari sejuta kasus penularan baru per minggu, tetapi pada minggu pertama Januari 2022 menjadi lebih dari tujuh juta kasus per minggu, meningkat tujuh kali lipat. Kini seluruh Eropa menderita penularan yang cepat, bahkan Perancis, Inggris, dan Rusia melampaui 100.000 kasus per hari.

Learning from New Variant Breaking into the Country's Gates

If the government is serious about tightening the mobility of citizens, the entry gate for foreign nationals should also be strictly guarded. Because, through the country's gate, a new variant of the virus from abroad enters. The "half-hearted lockdown" policy must face the harsh reality. When the implementation of the emergency community activity restrictions (PPKM) was almost over, the Covid-19 rampage was even more intense. The optimism of the Coordinating Minister for Maritime Affairs and Investment Luhut Pandjaitan, who was appointed by President Jokowi as the commander to lead this special mission to deal with the second wave of Covid-19, was wrong. Instead of gently sloping towards the target of below 10,000 cases of transmission per day, it skyrocketed beyond 50,000. On July 15, 2021, the daily number of positive cases was 56,757 and 982 cases died. In fact, when the emergency PPKM began to be implemented on July 3, 2021, there were "new" 27,913 cases and 493 deaths. More than double!