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🇲🇾. Internal Med. Tweet on #COVID, #HeartFailure & #Books. Our bookish IG: FamiliMembaca.
8 May

When we say "Lessons from India" -it's not enough just by sharing countless devastating stories & pictures of dying/dead people because of #COVID



- Too soon of reopenings
- Relaxation of SOP when other countries are still not clear
- A classic example of too little, too late
- Don't rely on PCR for mass testing
- Lockdown is only a temporary measure: MUST strengthen other measures.
- Channel majority 💸 to hospitals, staffing & equipment. Skim on other areas that can be salvaged later when this pandemic is controlled.
- If health resources crash,
NO MONEY can save us.
- Divert other sectors' staffing to HEALTH sector
Read 5 tweets
8 May
5 takeaway points from @DrAmarMOH :

🚨Use RTK to ramp up mass testing
🚨Boost staffs & increase efficacy at vaccination sites
🚨Share data on side effects of vaccines openly: transparency
🚨Non-essential services: Work from Home
🚨Lead by example
"We need to stop depending on the slow reverse transcriptase polymerase chain reaction (RT-PCR) tests but use rapid antigen testing (RTK-Ag) of people with or without Covid-19 symptoms. RTK-Ag may have a lower accuracy but make up in speed and impact."
" It does not make sense to keep vaccination centres open all the time and fatigue our health staff. It would be advisable to use up all available vaccines as quickly as possible by boosting staffing and efficiency at all vaccination sites; and then wait for fresh supply."
Read 5 tweets
6 May
"Prioritise the elderly & high risks"

Easy to be said,
NOT easy to be done.

Many elderly people are still vaccine-hesitant:their main source of info is "fear-mongering" Whatsapp chain messages.

This is a 🧵on #COVID vaccine's risk & why we should not wait for an IDEAL vaccine.
2/ Many of the high risk patients who we counselled for vaccine still are hesitant & adopted approach of "Tunggu Dulu la"
Despite our best efforts explaining the risks

Remember when Pfizer first came out? Many people went bonkers over the anaphylaxis issue despite reassurances.
3/ When Pfizer came out, people say "oh I wanna wait for AZ/Sinovac/J&J"

Now AZ are in, people are super scared over the risk of VITT (blood clots):they are saying "Let's wait for Pfizer" 🤷🏻‍♀️

J&J also has reports of VITT now.

Sinovac has minimal data on adverse effects for now.
Read 12 tweets
5 May
One of the best balanced summary on the Astra Zeneca vaccine & what is at stake.…
"vaccinating 100,000 people ages 80 and older in an area with high infection rates—886 infections per 100,000 people per month, the level seen in Europe in January—would prevent 1239 hospitalizations and 733 deaths over a period of just 4 months (see tables, below). "
"By contrast, vaccinating 100,000 people age 20 to 29 would lead, on average, to 1.9 cases of the blood clotting disorder. But it would not prevent any deaths from COVID-19, although it would prevent 64 hospitalizations in an area with high infection rates."
Read 6 tweets
9 Jan
Nampak ada yg berminat dgn tweet saya (2019) berkenaan anak saya yg gemar membaca.

Saya kongsikan tips utk galakkan anak membaca; (semoga bermanfaat utk yg lain)

1) Ibu bapa harus membaca & pastikan anak nampak anda membaca.
Anak nampak, anak akan ikut insyaAllah.
2) JANGAN paksa.

Minat membaca tidak boleh dipaksa. Jadikan membaca suatu aktiviti yg digemari.

Saya jadikan waktu membaca sebagai satu waktu "us-time"/aktiviti bersama - anak menghargai bahawa membaca adalah suatu aktiviti kekeluargaan yg menggembirakan.
3) Kenali minat membaca anak anda.

Buku jenaka/adventure/klasik?

Ada kanak2 yg belum cenderung terhadap mana2 topik/genre buku - tidak mengapa.
Dedahkan anak kepada pelbagai genre & beberapa jenis buku.

Layan minat mereka walaupun jenis 📚 itu mungkin bukanlah citarasa anda.
Read 10 tweets
8 Apr 20
Shortage of #PPE is a serious issue.

Let’s take a doctor who does screening - 1 set of PPE (mask, face shield, head cover, isolation gown, plastic apron, shoe cover) can last him for 4 hours - afterwards he needs to rest & change (all drenched in sweat).

8h shift = 2 sets PPE
That is 1 doctor.

If a team - mass screening
Average of 10 person/team
20 sets PPE per 8hours at 1 site

We have ~>100 screening sites.

And 34 hospitals managing SARI & #COVID19 -
they have multiple departments/wards required to wear PPE during rounds/procedures

Can u imagine?
The maths on the number of PPE worn per day for whole 🇲🇾 is mind-blowing.

But that’s what is required for the protection of HCW so that our health system won’t crash.

If multiple HCW gets infected due to not having adequate PPE;
manpower will be down.
Healthcare will collapse.
Read 10 tweets
6 Apr 20
1/ A small effort from IMARET for the HCW.

We aim to produce more of such on other related topics eg HCQ usage, US thorax in #Covid_19 , prophylaxis for HCW etc.

Starting humbly with basics.
Project started cos many HCW said they didn’t have time to digest journals.#MedTwitter
2/ The #IMARETRapidReviewSeries should not be treated as a guideline or a publication equivalent.

It’s meant to present findings from publications in bite-size points so that it can be digested by the HCW in a fast manner.

In pandemic - Time is an Essence.
3/ In war, soldiers need weapons.

Weapons in a pandemic:

As #Covid_19 is a fluid & dynamic issue -
we need all the information that we can gather in order to boost up our artillery.

If anyone interested to contribute; pls DM me.
Read 6 tweets
22 Mar 20
1/ Buat doktor di 🇲🇾 Malaysia,

Saya menyeru (tidak kira apa jua bidang anda: perubatan/FMS/GP/pembedahan/O&G/ortopedik/public health etc):

Start reading on management of #covid19.
We are up against a marathon. U will maybe needed at frontline sooner/later.

Thread: links

Clinical Updates 01/2020 by Dr Suresh ID Physician managing #COVID19malaysia in Hosp Sg Buloh
Read 10 tweets