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Dr Musa Mohd Nordin Profile picture
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1 Jul, 5 tweets, 2 min read
Wait & See Lagi!
AZ followed by Pfizer vaccines generated a robust immune response
BETTER antibody response than AZ-AZ
Obviates rare risk of blood clots
Highest T-cell response  > P-P or AZ-AZ or P-AZ
Offers flexibility
Address late/low supply issues
 
thelancet.com/journals/lance…
Fortified by Spanish study
AZ-P antibody response 3.5X that of AZ-AZ
Only 1.7% participants reported headache, muscle pain, malaise
 
reuters.com/business/healt…
Whilst JKJAV wait & see or worst still procrastinate …
Canada, South Korea, Bahrain, Spain, Italy, Germany, UAE are going ahead with the mix & match schedule

reuters.com/world/middle-e…
Is JKJAV considering ONE dose Pfizer or AZ vaccine only in post-COVID patients?
At least 7 studies showed a robust immune response
This Hybrid Immunity ramps antibodies 50X
This dose sparing strategy will save us 750,000 doses for COVID naïve Malaysians.
drmusanordin.com/2021/05/27/one…
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More from @drmusanordin

Dr Musa Mohd Nordin Profile picture
28 Jun
Selepas kajian Sepanyol, kajian UK juga sahkan bahawa:
1. Kombinasi AstraZeneca(AZ)-Pfizer(P) natijahkan respon antibody & sel memori melebihi AZ-AZ
2 Respon antibody tertinggi dgn P-P
3 Respon sel memori tertinggi dgn AZ-P

bbc.co.uk/news/health-57…
Kombinasi AZ-P:
1. atasi risiko darah beku AZ yang jarang berlaku namun lebih tinggi jika umur<50thn
2. tingkatkan perlindungan dari covid termasuk mutasinya
3. kombinasi lebih anjal
4. atasi isu kurang bekalan vaksin
MOH & JKJAV mesti pertimbang ASAP

reuters.com/business/healt…
Yg telah kena COVID, hanya perlu 1 dos Pfizer BUKAN 2!
COVID+Pfizer tingkatkan antibody 50X ganda!
Mcm ambil 2 dos Pfizer!
MOH & JKJAV jgn membazir vaksin Pfizer dgn memberi 2 dos kpd bekas pesakit COVID!
Alihkan 730K dos kpd yg tidak pernah kena covid.

nature.com/articles/s4159…
Read 4 tweets
Dr Musa Mohd Nordin Profile picture
26 Jun
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.
Read 12 tweets
Dr Musa Mohd Nordin Profile picture
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
Dr Musa Mohd Nordin Profile picture
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
Dr Musa Mohd Nordin Profile picture
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
Dr Musa Mohd Nordin Profile picture
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

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