Dr Musa Mohd Nordin Profile picture
Consultant Pediatrician, Instagram @drmusanordin
Dr Zulkifli Ismail Profile picture Adele Tan Profile picture Joanna Lee Hue Ling Profile picture 6 added to My Authors
Mar 28 5 tweets 2 min read
Stunting (low height/age)
🇲🇾kids under-5
▶️21.8% (2019)

Wasting (low wt/ht) ⬆️9.7% (2019) from 8% (2015)

Underweight (low wt/age)
⬆️14.1%(2019) from 12.4%(2015)

theedgemarkets.com/article/state-… Complications of Malnutrition:
⬇️ IQ
▶️Weak Immunity➡️Recurrent infections⬇️ Growth
▶️Smaller stature adults
⬇️Productivity
⬆️Risk obesity➡️NCDs
⬆️Premature ☠️
Oct 31, 2021 5 tweets 3 min read
95.5% adults Vaxxed

UnVaxxed Pop [P] = 4.5%
4076 deaths of 4.5% P
Rate of UnVaxxed Deaths
=4076/[0.045 x P]
▶️90578/P
 
2159 deaths of 95.5% Vaxxed P
Rate of Vaxxed Deaths
=2159/[0.955 x P]
▶️2261
 
Rate of UnVaxxed Deaths
=90578/2261 more than Vaxxed Deaths
▶️40x💥💥💥 Rate of UnVaxxed Deaths
▶️90578/P
Rate of Pfizer Deaths
=550/[0.52 x 0.955 x P]
▶️1108/P
Rate of Sinovac Deaths
=1573/[0.39 x 0.955 x P]
▶️4223/P

Rate of UnVaxxed Deaths 90578/1108 times > Pfizer Deaths
▶️82x💥
90578/4223 > Sinovac Deaths
▶️21x💥
Sinovac Deaths ▶️3.8x > Pfizer💥
Sep 22, 2021 7 tweets 3 min read
Keberkesanan Vaksin Pfizer & Moderna Melawan Delta
Dikalangan 5.6 Juta  Warga Emas 🇺🇸 >65 tahun
✅2.7 Juta Pfizer
✅2.9 Juta Modera
➡️148K Infeksi Breakthrough (2.6%)
➡️30K Masuk Hospital (20%)
➡️9.4K Masuk ICU (34%)

humetrix.com/powerpoint-vac… Image ✅Kadar Infeksi Breakthrough (IB) ➡️2.6%
✅Kadar masuk hospital IB ➡️20% (32% Mar-Dis 2020)
✅Kadar masuk ICU ➡️34% (32% Mar-Dis 2020)
✅Kadar mati➡️2.2% (12% Mar-Dis 2020) Image
Aug 16, 2021 6 tweets 3 min read
Tahap neutralizing antibodi lepas vaksinasi menentukan perlindungan-correlate of protection
➡️Neutralisasi boleh menjangka perlidungan drp sesuatu jenis vaksin.
➡️Model yg bakal diguna pakai utk mengawal trajektori pandemik dgn strategi vaksinasi
nature.com/articles/s4159… Amat besar jurang perbezaan titer antibodi (ab) antara vaksin mRNA & Sinovac.
Lepas 28 hari dos ke2
➡️Tahap ab PRNT50 mRNA 10X ganda
➡️Tahap ab PRNT90 mRNA 13X ganda
➡️Perbezaan 10-13X ganda tahap ab merupakan perbezaan yg besar didlm keberkesanan vaksin – Vaccine Efficacy (VE)
Aug 13, 2021 10 tweets 4 min read
facebook.com/tvalhijrah/vid… Wanita yg hamil & dijangkiti covid:
⬆️Covid teruk
⬆️Masuk ICU
⬆️Bantuan pernafasan
⬆️3X Mati dibandingkan dgn wanita covid yg tidak hamil
⬆️Sebab komobiditi hamil spt kencing manis, darah tinggi.
⬆️Keguguran
⬆️Kelahiran mati
⬆️Kelahiran pramatang

rcog.org.uk/globalassets/d…
Aug 9, 2021 4 tweets 2 min read
An oversimplification of the science
1. In first few days of illness viral loads (VL) r similar bet vaxxed & unvaxxed
2. NHS study only captured the early few days of symptomatic persons.
3. 90-97% mRNA and 70% AZ vaxxed are asymptomatic! 3. Though similar VL are they viable in vaxxed vs unvaxxed?
4. VL in vaxxed maybe rendered non-viable and/or less infectious. by neutralising antibodies
5. VL in unvaxxed are replication competent virus
6.    PCR cannot differentiate between them threadreaderapp.com/thread/1424780…
Aug 7, 2021 4 tweets 2 min read
Transcript of the conversation in question.

facebook.com/ResetMalaysia.…

Minutes 57:00-57:50
Dr. Abu Hafiz:
Moderna telah pun diluluskan di USA dan banyak negara yang lain, tetapi seperti mana yang Dato' sebutkan, NPRA masih belum lagi meluluskan. (1) Apa sebenarnya masalah kepada kita dalam menerima vaksin-vaksin yang telah diluluskan di dalam negara-negara maju? (2)
Aug 6, 2021 7 tweets 3 min read
DG MOH 1991-2001:
“many questions had been raised by the suspension of Parliament, adding that the rationale behind it was not clear to him”
“must ensure that all his decisions were made with professionalism rather than political considerations.
freemalaysiatoday.com/category/natio… God gave him a golden opportunity to save 32 million people.
To save a whole nation in crisis and engulfed in a deadly pandemic.
Instead he chose to save one person.
An unprecedented dereliction of trust & responsibility.
Dishonouring a doctor’s oath Primum Non Nocere
Jul 29, 2021 8 tweets 4 min read
This is more fun than cows in condominium.
The parliament is convulsing in pandemonium.
The speaker is behaving like foetid meconium.
His spine needs fixing with rods of titanium. Sidang Parlimen sudah dicuri
PM dan Speaker dah cabut lari
DiJepun kalau Raja diingkari
Kabinet semua wajib harakiri
Jul 23, 2021 9 tweets 5 min read
Our 3rd visit to CAC Stadium Melawati 23/6/202 @DrDzul
We were expecting to see a smaller crowd since KKM on 14/6 declared Cat 1&2 DO NOT need to go to CAC
They will be digitally monitored from home
We were disappointed!
By 6am the crowd was piling up!
The CAC expect about 5K! Lorong diluar khemah hadir diCAC untuk potong gelang pink.
Mereka kini beratur sampai hujung jalan 550m!
Yang dibawah khemah -6 saluran kes baru covid.
Saya agak 90% covid kategori 1-2
Mereka tak sepatut ada disini.
Boleh dipantau dari rumah
Tengok baby tu-KKM tak kesian ke?
Jul 21, 2021 11 tweets 5 min read
PM, NSC, KKM, MOSTI putting all their eggs in the Vaccine Basket!
No one is doubting importance of ramping up V-rollout.
BUT it must NOT be done at the expense of FTTIS.
Protection for individual is at least 5 weeks after 1st dose.
Protection for nation earliest 4th quarter (1) ImageImage Meanwhile we must ramp-up Testing!
We must detect the infected, isolate them and stop them from becoming outbreaks or clusters
Ramp-up Testing to drop Positive Rate <5%
Conservative estimate of daily test is 1% of the unvaccinated population Image
Jul 18, 2021 8 tweets 3 min read
In influenza, hemagglutination inhibition (HAI) titer of 1:40 is thought to provide 50% protection from infection
This assay is used to predict Vaccine Efficacy (VE) and to assist in the annual reformulation of seasonal influenza vaccines.
 ema.europa.eu/en/documents/s… Neutralizing antibody levels is highly predictive of protection in COVID
This apart from T cell responses or B cell memory responses as additional potential correlates of protection.

nature.com/articles/s4159…
Jul 5, 2021 5 tweets 2 min read
The site KKM quoted is a conspiracy theorist
Pseudo-science they are propagandist
OMG! KKM dah termasuk dalam list
Senarai quack doctor yang specialist PSI quoted WHO interim guidance out of context
KKM please read the full WHO text
Be wary of the PSI false pretext
Or become a victim of fake news next
who.int/publications/i…
Jul 4, 2021 4 tweets 2 min read
WHO kan dah suruh RTK-Ag testing
MOH marah & asyik melenting
We all buat digital contact tracing
MOH masih lapuk dgn telephoning
 
Ada one video on test, trace and vaccinate
It’s citizens it helps to educate
Based on science that’s so very accurate
MOH masih lagi procrastinate? Jan 2020 dah suruh MOH decanting
Non-COVID patients they shouldn’t be keeping
So care of COVID they will be specializing
Better survival rates we will be showing nst.com.my/news/nation/20…
Jul 1, 2021 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…
Jun 28, 2021 4 tweets 2 min read
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…
Jun 26, 2021 12 tweets 7 min read
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)
Jun 22, 2021 4 tweets 2 min read
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!
Jun 22, 2021 4 tweets 2 min read
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
Jun 16, 2021 5 tweets 2 min read
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
Jun 15, 2021 11 tweets 4 min read
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…