Difference between:
*Asymptomatic*✅Covid❌symptoms for entire disease. (~40-45% of all Covid cases). Therefore, 🇲🇾 might have ~14K total cases (not ~8K) because no symptoms = no test.
*Pre-symptomatic*✅Covid, but❌symptoms yet. Median time to symptoms: 4-5 days from exposure.
One final important note is that "science is evolving" and facts will continue to emerge. As the datasets grow bigger and we analyse them better, conclusions may have to be revised.
We're still learning about SARS even though it "ended" in 2003.
Also important to note that 🇲🇾's contact tracing & targeted testing have been effective at finding all cases (both with & without symptoms).
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A: Possibly, and data is increasing to support this policy.
A "mix-and-match" vaccines policy has increasing science behind it. The scientific term is "heterologous prime boost" (thelancet.com/journals/lance……, from Oxford).
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Dua sebab penting:
🔺Saya tak mungkin tahu segala-gala ilmu & sains. Jadi, saya bergantung pada rakan sekerja yg lebih arif dlm bidang-bidang lain.
🔺Saya mungkin silap, jadi saya ingin kurangkan risiko itu.
Maka, Surat Rujukan akan menjaga kebajikan pesakit dgn lebih rapi.
2/
Mungkin saya pernah menulis beratus-ratus Surat Rujukan, spt kpd:
🔺Pakar jantung di Kuala Lumpur & Pulau Pinang
🔺Surat rujukan/sokongan utk Jabatan Kebajikan & badan zakat
🔺Rumah Seri Kenangan supaya mereka tahu keadaan fizikal seseorang warga emas yang baru sampai.
3/
A short story:
🔺A Funeral, Durians, SMEs & the Covid-19 Vaccines🔺
Had to organise a funeral (cause of death: lung cancer). Noticed dry ice being used.
Spoke with the undertaker, who told me that each dry ice brick is ~RM20, is -70 Celcius and lasts ~1-2 days.
1/5
Asked him about vaccine storage. He gave two ideas: 1. Ice-cream distributors have cold rooms reaching -20C. 2. Durian exporters to China use a freezing process reaching -80C.
Great ideas from a practical hands-on man!
2/5
This gentleman doesn’t have a degree, but he has decades of work experience & lots of common sense.
I told him that one Covid-19 vaccine requires -70C storage. He educated me that Siberia’s temperatures are “only” -60C, so human beings need to work hard to achieve -70C.
3/5
BEBENANG: Mengapa 🇲🇾 tak boleh umumkan harga vaksin?
Situasi ini amat kompleks. Kita mesti mempertimbangkan hujah & realiti utk kedua-dua belah situasi ini.
🔺Bab 1: di LUAR kawalan kerajaan (Tweet 3-9)
🔺Bab 2. di DALAM kawalan kerajaan (10-16)
🔺Bab 3: ringkasan (17-18)
1/18
Pertama sekali, sedikit pengumuman: 1. Saya seorang perunding bebas. 2. Saya tak memiliki stok apa-apa sykt di mana-mana. 3. Saya bekerja di Pharma 8 tahun (2Y sbg Medical Manager di 🇸🇬 + 6Y sbg Ethics & Compliance Director di Dubai, Shanghai & Paris, utk EEMEA & China).
2/18
BAB 1: DI LUAR KAWALAN KERAJAAN
Sykt farmaseutikal (atau pharma) mempunyai 3 pelanggan utama: 1. Kerajaan (kementerian, hospital atau insurans kerajaan) 2. Entiti swasta (hospital swasta, pengedar atau ejen) 3. Organisasi global (@UNICEF membeli 2 bilion dos vaksin/tahun).
BEBENANG: 6 SEBAB mengapa 🇲🇾 perlukan portfolio vaksin drpd pelbagai syarikat, bukan drpd satu sykt sahaja:
1. Tiada sykt yg mampu bekalkan segala keperluan vaksin 🇲🇾. Kalaupun wujud, mesti setiap negara akan bersaing, & kita masih tak mampu bersaing dgn negara kaya.
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2. Bahaya kalau kita bergantung pada satu sykt saja.
Mungkin ada kluster Covid-19 di kilang mereka. Mungkin ribut taufan melanda kilang mereka.
Mungkin mereka naikkan harga sbb ada kuasa monopoli. Atau mungkin vaksin mereka tak diluluskan NPRA.
2/12
3. Virus Covid mungkin ada mutasi. Ini disebut "antigenic drift".
Jika 🇲🇾 ada satu vaksin saja, & vaksin tu tak berkesan terhadap mutasi tersebut, maka seluruh bekalan vaksin itu dah tak boleh digunakan.
Portfolio vaksin mengurangkan pendedahan kita kpd risiko mutasi.