1/ Successes of Public Health (PH) is largely invisible
They go unreported-out of sight out of mind!
PH funding < Sec/Tertiary/Curative/Tehab
eg Success of Vaccines-Took us 15 years to get PCV in our Nat Imm Program in 2020
But 1 case of polio/diphtheria-Msia goes hysterical!
2/ To detect #COVID19 before it spreads, PH needs FREQUENT/ACCESSIBLE/RAPID TESTING
We cannot detect pre/asymptomatic cases before they spread if we do not test FREQUENTLY
RTK-Ag picks out the infectious cases.
A powerful test for #COVID19 contagiousness youtube.com/embed/4vvgefwK…
3/ RTK-Ag perform best in areas of active transmission
And when collected from a case with highest viral loads (most infectious)
2 days before (pre/asymptomatic) and up to 5-7 days after symptom onset
Rapid testing=Rapid isolation=Faster control of spread=Containment
4/ Needs reform of TESTING MINDSET
Old-School to New-Science
Targeted to Mass
One-Off to Frequent
Lab-Based to Point Of Care
Complex to Simple
Slow PCR to Rapid RTK
Expensive to Cheap
Sympto to Asympto detection
MCO to Open Economy #NowEveryoneCanTest threadreaderapp.com/thread/1311438…
5/ Frequent/accessible/rapid TESTING+DISTANCING+MASKING+WASHING+COVAX is the ONLY way to restart business without new outbreaks.
Opening sch, keeping healthy, restoring customer confidence req frequent TEST-TRACK-TREAT-ISOLATE response
MCO-hurts lives & livelihoods!
So NOMCO
6/ #COVID19Malaysia PH policies must b BEST PRACTICES
NOT blunt & damaging tools like MCO
BUT tools friendly to lives & livelihoods eg Rapid Testings
In this critical 3rd wave, Malaysia must use all the tools available at our disposal, not just lockdowns. malaymail.com/news/what-you-…
7/ Simple/Rapid/Cheap RTK-Ag is HERE
It will radically change our pandemic response
Allows PH to quickly DETECT-ISOLATE the sick-TRACK- CONTAIN community transmission FASTER
BUT...Will Public Health go in this direction to END #COVID19Malaysia pandemic? threadreaderapp.com/thread/1294600…
6 #IMARETCOVIDBusters en-route to Semporna
Old hands in medical relief
2 operate IMARET Charity Clinics in KL+Johor
1 paeds prof
1 anaes
2 MO+Asst MO
With RTK-Ag+ PPE
Turn Around Time< 1 hr
Rapid Testing=Rapid Detection=Rapid Isolation=Rapid Tracking=END outbreaks @imamalaysia
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On-point @ProfAdeeba
Didn’t they preach 3Cs?
Distance>2m+Talk<15 min+Mask are NOT high COVID risk!
CMCO is an OVERKILL
-Kills livelihoods
-Kills economy
-Harms mental health
-Spawns national HYSTERIA
Why punish MakCikKiah who wants to put food on table? astroawani.com/berita-malaysi…
COVID-19 + MCOs disproportionately burdens low rank/paid workers aka #MakcikKiah selling goreng pisang at PPR flats
Causes big holes in their pockets and brains-anxiety/depression/suicides
M’sia MUST use all tools available NOT JUST MCOs! WHO dah kata-kan? malaymail.com/news/what-you-…
Unlike @DrAmarMOH others blurt nos without analysis of trends
Downtrending of unlinked cases=decreasing community spread
Data speaks against CMCO
RTK-Ag as part of pop-level strategy to “sweep” & isolate infected individuals is the way fwd to contain/eliminate #COVID19Malaysia
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
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 ..
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..”
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
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