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Dr Musa Mohd Nordin Profile picture
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1 Oct, 15 tweets, 8 min read
10-20% COVID guys cause 80-90% spread
Lockdown hurts livelihood
Futile if generic+restrict wrong event/person
SO Lockdown super-spreader events/persons
eg 3C-events/elections/ministers/politicians
Cluster busting
Cheap/Rapid/Mass Testing
Think beyond MCO!
theatlantic.com/health/archive…
India-1.3B pop-6M COVID cases-2nd to US
Study of 85K cases & 600K contacts
5% caused 80% COVID infections-Pareto Logic
Selective Lockdown of high risk/super-spreader people/events NOT entire nation
Think beyond Ro.
Think “k” over-dispersed COVID bug
nytimes.com/2020/09/30/hea…
Politicians+Elections r SUPER-SPREADER persons+events
1 mass event+few politicians will sky-rocket #COVID19Malaysia
We r struggling to control/contain COVID
This is a totally irresponsible and reprehensible call
#No2SwakElections #KesianFrontLiners
malaymail.com/news/malaysia/…
Insanity is doing the same thing over & over again & expecting diff results-Einstein
We need to do COVID testing differently!
Shift from Analytic to Infection Sensitivity
High viral load=More infectious=Detected by RTK-Ag=Effective screening=Stop spread
nejm.org/doi/full/10.10… Image
RTK-Ag is cheap-simple-rapid-can repeat-testing at Point Of Care(POC)
Mass testing at POC+repeats+tracing+quarantine can prevent early asymptomatic spread/bust clusters/break chain of transmission/avoid MCO
Protect lives+livelihoods theatlantic.com/health/archive…
Like a pregnancy test FELUDA is a paper based test using gene-editing technology (CRISPR)
It fixes to the SARS-CoV-2 signature gene, highlights as:
2 blue lines: +VE COVID
1 blue line: -VE
TAT-1 hr
Cost-RM30
Sensitivity-96%
Specificity-98%
A game-changer! bbc.com/news/amp/world…
Putrajaya in same boat as @WhiteHouse
Science advise all exposed in Menteri Cluster/Travel ..
“Regardless of -VE test results, persons should SELF-Q for 14d after a known exposure OR after travel..”
M’sia can bust these SUPER-SPREADER clusters
We did b4
cdc.gov/mmwr/volumes/6… Image
Ro an average measure of COVID contagiousness doesn’t explain phenomenon of clustering & super-spreading.
It infects in big bursts-infected person may spread to many persons all at once.
eg Case 26 infected 114 pax
8937(Sivagangga) infected 45 in 3 states
malaymail.com/news/what-you-…
Dispersion factor “k” is the new COVID science
Majority DO NOT spread COVID
5-20% super-spreading persons/events caused 80-90% clusters!
A generic MCO is NOT the panacea to our 3rd wave.
Think beyond Ro & MCO ImageImageImageImage
Brief of COVID Clusters
Church: 117 cases 26/2
Tabligh: 3375 cases 11/3-8/7
Tahfiz: 635 cases 29/3-5/7  
Pudu(Construction Site): 80 cases 10/5-3/7
Migrant Workers: 649 cases 21/5-23/7 
Benteng(Detention Centre): 951 cases
Tembok(Prison): 1047 cases ImageImageImageImage
NO Quarantine/Retesting/Tagging/Tracking of Political Cluster unleashed 3rd Wave!
We busted Menteri Cluster by Cabinet Lockdown
SO:
1 Selective Lockdown of Super-Spreader persons/events
2 Aggressive Cluster-Busting
3 Rapid/Cheap/Mass Testing Don’t miss the FOREST for the TREES! ImageImage
Community spread is worrying!
Consider this Malaysia!
Antigen Rapid Test Kit (RTK-Ag) detects presence of virus at Point Of Care (POC)
Vital addition to testing arsenal to detect/trace + trigger isolate/quarantine + control/contain community transmission
who.int/news-room/deta…
RTK-Ag are:
-portable
-accurate
-specificity>95%
-analytical sensitivity 85-90%
-infection sensitivity >95%
-easy to do at POC
-faster 30-60min
-cheaper $5/test for LMIC (Malaysia included in list) -WHO sanctioned
-MUST prevent corrupt guys/companies from profiteering Image
#NowEveryoneCanTEST
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More from @drmusanordin

Dr Musa Mohd Nordin Profile picture
5 Sep
14 yrs siege limited entry of materials required to develop water and sanitation infrastructure.
Thus 97% of water is not-drinkable.
We built H2O treatment plants to provide safe & clean water world over inc Palestine, Org Asli villages, Cox Bazaar, Palu...
#SafeWater
HRH The Sultan of Perak inaugurated 10 H2O treatment plants and a dam built by IMARET for several Orang Asli villages
Safe water technology inspired & in partnership with Malaysian Armed Forces
#SafeWater
Soil in Cox Bazar, Bangladesh, housing 1 million refugees is cyanide rich.
Our H20 treatment plants had to eliminate this poison.
Several built to provide #SafeWater to the refugees
Solar activated.
Low maintenance
In partnership with @AlkhidmatOrg
Read 6 tweets
Dr Musa Mohd Nordin Profile picture
26 Jul
To begin with the lifting of mandatoryQ was premature!
Though unpopular but data centric skeptics challenged the move!
“..suggested that those returning from high-risk countries be subjected to mandatoryQ, particularly those returning from Indonesia ..

thestar.com.my/news/nation/20…
which formed 75% of returnees which tested positive for Covid-19.
The other 10% who have tested positive for Covid-19 were from Singapore and 9% from Britain, so we need to be particularly vigilant of returnees from these countries”
Skeptics warned “..the government to emulate the strict self-Q rules enforced in South Korea where local returnees & foreign visitors were closely monitored using a mobile application that could track their whereabouts and store info about their symptoms..”
Read 5 tweets
Dr Musa Mohd Nordin Profile picture
16 Jun
Ex-CDC chief writes: there’s far too much amateur epidemiology out there. Deaths, hospitalizations, and diagnosed cases are just part of the iceberg @KKMPutrajaya @codebluenews @FIMAweb @MPAEDS @boosulyn
threadreaderapp.com/thread/1271142…
Infection Fatality Rate: 0.8%
For every single death we expect: 125 COVID19 infections
DSH data:
Asymptomatic: 47%
Symptomatic: 53%
Total COVID19 deaths in Malaysia as at 15/6/2020: 121
Total infections expected: 121X 125 = 15,125
Total confirmed cases reported 15/6/20: 8,494
We have only detected 1 in every 2 who are infected
Asymptomatic #COVID19 undetected: 3,116
Symptomatic #COVID19 undetected: 3,514
We need to remain vigilant with tracing-testing-rapid response @KKMPutrajaya @codebluenews @FIMAweb @MPAEDS @boosulyn
Read 4 tweets
Dr Musa Mohd Nordin Profile picture
5 Jun
I will hazard a plausible reason for the excess:
1,412 deaths in people aged >60y in Oct-Dec 2019 and
461 deaths in Jan-Mar 2020.
If you see the graph you will be able too.
@KKMPutrajaya M’sia was experiencing an unusual influenza season! @boosulyn @MPAEDS @codebluenews
The rate of positive specimens reported to Flu-Net was:
2019-21.2%
Jan-Mar 2020-26.4%
Compare this to the positive rates in:
2016-8.6% (diag)
2017-13.3%
2018-10.7%
Even during the H1N1 pandemic the incidence was only 18.1% @immunise4life
The influenza-associated mortality rates/100,000 person years in S’pore (no M’sian data) is:
167.8 for those >65y versus 14.8 for all ages
ie 11X more
This explains the excess mortalities in the older people! @immunise4life
Read 5 tweets
Dr Musa Mohd Nordin Profile picture
4 Jun
It seems that the demands of upcoming exams is the critical factor in sch re-opening rather than the science. Seems neither a safe nor smart strategy. Most countries r beginning with the youngest, namely opening creches, kindys, pri classes @KemPendidikan codeblue.galencentre.org/2020/05/23/the…
Global data indicate that risk of covid in children is low ranging from 1% in young children to 6% in older children. Thus eg Holland opened pri sch since 11 May. Sec sch only on 2 June @KemPendidikan reverse strategy? rivm.nl/en/novel-coron…
Children <12y r most impacted by sch closures. The double whammy of learning regression & nutritional deficits. The B40 kids who rely on sch meals, have zero access to pc & internet remain hungry & marginalised! Social Safety Nets for them? @RinaMohdHarun jamanetwork.com/journals/jama/…
Read 4 tweets
Dr Musa Mohd Nordin Profile picture
3 Jun
Selaku umat serumpun, kami mengambil berat situasi #COVIDー19 dinegara jiran. Ini untuk maslahah saudara2 kita diIndonesia dan juga risiko penularan keMalaysia. Rajah ini menunjukkan kes harian covid di-Indonesia. Ia masih belum menunjukkan trend mendatar maupun menurun @jokowi
Selagi curve covid tidak flatten, is akan mengancam kemampuan perkhidmatan kesihatan. Membuka ekonomi semula semasa curve masih belum mendatar akan meningkatkan risiko pertambahan kes dan kematian yg bakal mengancam kapasiti sistem kesihatan untuk memberi khidmat yg baik @jokowi
Terdapat beberapa index utk mengetahui kita telah bersedia utk kurangkan lockdown. Negara2 spt Korea, Australia dan Malaysia menunjukkan kes covid positif yg < 3%. Ini hanya tercapai jika negara2 melakukan ujian yg mencukupi. Pakistan & Bangladesh terlalu tinggi dgn kes +ve 20%
Read 11 tweets

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