Reported Kompas.com, Friday (11/13/2020), citing data from Worldometers at 05.15 WIB, the corona virus has infected 53,003,790 people worldwide.
Covid-19 has also resulted in the global death of 1,297,476 people, while as many as 36,922,736 people are reported to have recovered from corona virus infection.
Meanwhile, there are five countries that have recorded the highest cases of corona virus infection, namely:
- United States: 10,840,868
- India: 8,727,900 cases
- Brazil: 5,779,383
- France: 1,898,710
- Russia: 1,858,568 cases
The term appears I don’t know
Even though various strategies and policies have been implemented, a number of scientists and health experts consider it too limited to stop the rate of infection caused by the new corona virus, SARS-CoV-2.
“All of our interventions are focused on cutting off the transmission pathways of the virus to control the spread of pathogens,” said Richard Horton, editor-in-chief of the scientific journal The Lancet, was quoted as saying BBC, Thursday (12/11/2020).
Seeing the current condition of Covid-19, Horton considered it should not be regarded as a pandemic, but as a “syndemic”.
Sindemi is an acronym that comes from the words synergy and pandemic.
This means that a disease like Covid-19 does not stand alone.
So, what is a syndrome?
Epidemiologist from Griffith University, Australia, Dicky Budiman said, the term sindemic was first coined by Merrill Singer in the mid-1990s.
” Sindemi is collection or occurrence of two or more epidemics simultaneously or sequentially or it could be a group event of disease in a population with biological interactions, which worsen the prognosis and burden of existing disease, “said Dicky when contacted. Kompas.com, Friday (13/11/2020).
However, Dicky said that the syndemic was not part of a gradation or change of level that was known in the field public health.
He said, there are several levels in the field, sequentially, namely:
- Local Outbreak or Extraordinary Events (KLB)
- National Plague or National Disaster
“Apart from that, it doesn’t exist anymore. Currently there is no hierarchy that is considered higher than that,” said Dicky.
She said, sindemi is a methodological approach derived from the words synergy and epidemic.
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This means that there are several epidemics in a country, continent, or globally which synergize to become health problems, be it regional, national or global.
“Examples of this syndemic approach include obesity with diabetes and heart disease. It has become a syndrome. Because obesity is a person overweight, well people overweight it synergizes to be people who are prone to diabetes, “said Dicky.
“So that the diabetes epidemic also increases. Then people who are obese and diabetic, are very prone to heart disease or stroke. That is also an epidemic, because now it is global as well, in many countries it occurs,” he added.
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Dicky said, the Covid-19 syndrome has indeed occurred in several countries that have been severely affected by Covid-19, such as the United States.
“The synergy occurs between Covid-19 and obese people, people with diabetes, people with heart disease, hypertension. This makes the Covid-19 condition worse,” said Dicky.
“In addition, this syndemic is not only in that aspect but also health determinant, such as access to health services, and the economy. So that all these factors work together to worsen the pandemic control of one country, “he added.
Reporting from The Lancet, 22 October 2020, Emily Mendenhall, from the Science, Technology, and International Affairs Program, Edmund A Walsh School of Foreign Service, Georgetown University, said that the condition of the syndrome cannot be generalized globally.
He said there were different contexts in handling the pandemic in each country, so that not all countries could be said to have experienced the Covid-19 syndrome.
Mendenhall explained, the United States can be said to be experiencing a syndrome due to various factors, such as government policies and systemic rooted racism.
According to him, this has pushed the death rate and transmission of Covid-19 in the US to high.
On the other hand, Medenhall said, the condition of the syndrome cannot be said to have occurred in New Zealand. Because thanks to the right handling policies, New Zealand has responded well to the Covid-19 crisis.
How about Indonesia?
Dicky also agreed with the opinion put forward by Medenhall.
According to him, syndemics involve many factors in a country, so they cannot be compared to other countries.
“If a country like New Zealand or Australia, where other diseases tend to be under control, then the synergy is not fulfilled,” said Dicky.
However, Dicky revealed that the current condition of Covid-19 in Indonesia was right to be called a syndrome.
“If Indonesia is right. For example, the Covid-19 syndrome in children. Covid-19 infection in children in Indonesia is not really visible in numbers, because of the low coverage of tests in children,” said Dicky.
“But when compared to other countries we are one of the highest. Well, if we look at the syndemic aspect, the number of Covid-19 infections in children in Indonesia is high because immunization coverage may decline during this pandemic,” he added.
Immunization coverage will affect many other aspects, especially the immune system of children and the potential for other epidemic infections. In addition, Dicky also said that stunting in Indonesia is an epidemic.
“Stunting in Indonesia is one of the highest in the world, and this contributes to Covid-19. So if you look at the syndrome like that. In addition, there are other problems in children with syndemia, namely sanitation and hygiene,” said Dicky.
“Even in the city, but in a slum environment, that’s sanitation and hygieneugly. Now this contributes to children who live in that environment to tend to have low immune system, malnutrition, so that when their parents are infected with Covid-19, the chances of them getting infected will be easier. So that is the analysis of syndemics, “he continued.
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