InfectiousDisease 101
In reality-No cases of ID are unlinked!
By it’s very virtue, ID means it’s linked from 1 case to another.
Sporadic or Unlinked is a temporary designation until investigation ie Contact Tracing (CT) uncovers the link-often part of a cluster or outbreak.
1st QR-based visitor logs tool for CT was @Selangkah_my Launched 5/5/2021
@my_sejahtera Check-In was launched 2/6/2021
What sets them apart?
1. The level of Analytic Sophistication
2. The ease of use for Health Care Workers (HCW)
CT automation means sifting through records of visitor logs & DO NOT require MANUAL corroboration.
By using patient’s phone number, @Selangkah_my algorithm sift thru millions of records, to create a list of “probable close contact”, ranked by its importance.
This ranking is important
So it won’t burden Health Inspectors (HI) to test persons who are unlikely to be infected.
@Selangkah_my built a proprietary dwell-time algorithm to create a “prioritization” (purple dots)
This automation saved trillions of man-hours & allows digital CT
Thorough & timely CT is  KEY to keeping case numbers LOW!
When @Selangkah_my was actively used in Selangor (May-Aug 2020) they managed to keep the positive cases (red line) low. 
Whenever cases emerge, S’gor quickly did Find, Test, Trace, Isolate & Support (FTTIS)
Success of @Selangkah_my CT was cut short by MOH & NSC: 
18/8/2020: MySJ was made mandatory. Biz were FINED if no MySJ displayed. @Selangkah_my was killed!
2/9/2020: Patient location data previously shared with the State Govt was STOPPED!
Stoppage of visitor logs & patient location data meant Selangor lost its CT ecosystem
From Sept 2020, the de facto CT ecosystem in Selangor was @my_sejahtera which only tracked 4% of COVID cases! codeblue.galencentre.org/2020/11/18/mys…
CASES ARE INCREASING IN SELANGOR NOW BECAUSE OF CT FAILURE.
@my_sejahtera Contact Tracing has failed miserably.
See graph showing spiking cases (red line) in Selangor  from mid-October 2020-3rd Wave!
MOH & MKN is now paying dearly for disabling the @Selangkah_my CT ecosystem.
The callous judgement call on that fateful day,  will forever remain a black dot in the history of COVID-19 data science in Malaysia!
MOH & NSC contributed to the malignant trajectory of the 3rd, 4th … waves of COVID cases, ICU cases, ventilated cases & deaths (Courtesy DrAS)
Pride & Arrogance has got the better of our health and political governance.
Only by taming our Ego, can we triumph COVID & exit the pandemic, together and safely as a nation.
Time to be transparent & share data & allow @mohdhelmi to activate the @Selangkah_my CT ecosystem.
Collaborative and Integrated Real Time Digital Solutions are a pivotal component of the GREAT RESET to:
1. Stay Ahead of the Pandemic Curve and
2. Grow the WellBeing of our nation
codeblue.galencentre.org/2021/02/19/sel…

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More from @drmusanordin

22 Jun
Agree our COVID-19 know how is evolving.
But needs to prioritise SCIENCE centric pandemic strategies.
Sanitised from Politics!
eg boosting coverage for Swak elections
Haven’t they learnt from Sabah PRN fiasco?

thestar.com.my/news/nation/20…
Good SCIENCE would prioritise vaccine coverage in HIGH INFECTION states!
Labuan-2109/100K
NS-707
KL-451
Sgor-394
S’wak-301
Sabah-Lowest Vaccine Coverage 12%
May sort out >70% of the nation’s COVID-19 nightmare!
And it makes good ECONOMIC sense too!
Sgor is the powerhouse of the nation.
Sgor contributed- 24.2% GDP
KL-16.4%
Sarawak-9.6%
Yet Sgor has the second lowest vaccine coverage
Is this political vendetta?
Just asking!

google.com.my/amp/s/themalay…
Read 4 tweets
22 Jun
11-point KPIs of Public Health to mitigate & en-route to exit the COVID-19 pandemic.
5 KPIs focuses on a speedy and effective FTTIS response.

6 KPIs offers tangible metrics which are science based, realistic and doable.
If we carefully monitor these datasets it will enable, empower the authorities to:
a. gradually roll out our economic activities i.e. safety@work
b. re-open our schools i.e. safety@school
c. allow more social and sports programs i.e. safety@community
After >1 yr in operation, the crisis preparedness response centre (CPRC) should be reviewed & evaluated:
1. To strengthen its TOR
2. To better function as the nation’s COVID Nerve Centre
3. To reinforce public trust in the government’s pandemic response
Read 4 tweets
16 Jun
Public Health (PH) Metrics to determine 3 Phases of National Recovery Plan is:
1 Not good Science
2 Random in nature
3 No tangible retrospective or prospective  data stipulated.
Will NOT Mitigate Pandemic.
Only buys time to later unleash another COVID wave when the MCO is eased. Image
Attached is a combination of Key Performance Indicators (PH) to Mitigate the Pandemic En-Route to Exiting it.
The first 5 KPI emphasizes the Critical Importance of a Warp Speed FTTIS Response.
This is the back to basics of effective & efficient COVID-19 Pandemic Management. Image
The next 6 KPI offers Tangible Data which are:
1 Science-based
2 Realistic and
3 Doable
Meticulous & consistent monitoring of these datasets will direct the:
1 Economic rollout Safe@Work
2 Re-opening of schools Safe@School
3 Viability of social & sports programs Safe@Community Image
Read 5 tweets
15 Jun
Scotland Study on Vaccine Effectiveness (VE) of 2 doses AZ & Pfizer doses against all COVID and Symptomatic Infections.
Pfizer vaccine provides excellent protection against Delta variant
Less protection with AZ thelancet.com/journals/lance… [1]
Is it time to consider boosting AZ with Pfizer as second dose?
Heterologous boosting is safe [2]

thelancet.com/journals/lance…
Interim safety analysis in UK mix-and-match study, showed increase systemic AEFI in AZ-Pfizer heterologous vaccine schedule compared to the AZ-AZ , Pfizer-Pfizer homologous group.
And associated with increased paracetamol use.
Reassuring that the systemic AEFI were short-lived[3]
Read 11 tweets
8 Jun
KKM mesti amanah & cekap dlm komunikasi
Semua pasti gembira dgn tren kes COVID yg menurun
Tetapi ini mesti diimbangi dgn ujian COVID yg mencukupi
Ini penting utk mempastikan kita mengesan bilangan kes COVID setepat mungkin
Yaitu kita tidak under-diagnos bilangan kes dinegara kita
Utk mengetahui kita telah mengawal pandemik dgn baik, kadar ujian positif COVID mesti <5%
Kadar positif ini ditentukan oleh WHO
Rajah menunjukkan bahawa kita gagal utk mencapai kadar positif ini
Maknanya masih banyak kes didalam negara kita yg tidak dikesan dgn ujian massa COVID
Kita boleh anggarkan kes harian COVID dgn kaedah berikut
Kadar kematian diMsia =0.56% [ (3536 kematian/627652 kes) X 100% ]
Maka jika pada 8 Jun 2021 kita rekod 76 kematian, maknanya bilangan kes COVID sepatutnya  76/0.56 X 100 iaitu 13,571.
Tetapi kita hanya merekod 5,566 kes
Read 8 tweets
6 Jun
Case & death curve is virtually vertical!
FTTIS & Vaccine Rollout under-par
MOH & JKJAV recalcitrant in failed modus operandi
S’gor-4th highest Infection Rate
But has lowest CFR-NS (0.51%), S’gor (0.45%), P’ng (0.31%)-Hmm!
< National CFR Average (0.54%)
9 states >National Average ImageImageImageImage
Lessons from COVID-19 Infection Rates VERSUS Vaccination Rates Breakdown by STATES:
1. National Coverage at 7.1% is abysmal.
2. S’pore is 39%
3. All states should be like Putrajaya – 47% uptake
4. OR focus on HIGH Infection States to plunge the spiralling cases & deaths Image
5. S’gor with 4th HIGHEST Infection Rate has 2nd LOWEST coverage!
6. MOH & JKJAV is this political vendetta? Just asking!
7. Why is Sabah’s coverage lowest at 5.6% when S’wak with similar demography is nearly double at 10.1%
8. Don’t wait like HIDE 14 months later to analyse! Image
Read 4 tweets

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