Category: Advisory

Suspected case of Covid-19

Suspected case of Covid-19

The guideline below is meant for doctors and HCW. Doctors need to have a high index of suspicion and be actively on the look out for possible Covid-19 patients, especially if you are in a red zone.

You should be highly suspicious if your patient meets BOTH the clinical AND epidemiological criteria, AND in the absence of a more likely diagnosis.

The original message that started the panic

The original message that started the panic

The problem with this type of unverified and inaccurate messages is that it unnecessarily adds to the fear already existing and heightened in the community.

The other problem is the repercussion of such a message.

Imagine if another doctor who is facing the same situation sees this, and realises the damage it will do to his clinic. He may end up keeping everything under wrap, and not take the extra precaution that we did, thereby increasing the risk for both staff and patients, and the community as a whole.

We must take it upon ourselves to take responsibility for all our actions. Therefore, we should reflect before we act. This is especially important in our Internet age where news travel almost instantaneously.

However, what is even more damaging is that a hugely important message is loss under all this noise. This virus IS in our community. It is spreading quietly. It is infective even before you are symptomatic, and therefore you may not know that you have it when you spread it to others.

Thus, it falls upon all of us to take this CMCO seriously, and to follow all recommended SOP strictly.

  1. Wear your face mask, and make sure you wear it properly. 3-ply surgical mask and N95 are the best. They are proven and tested. I do not recommend cloth mask. They may look good and feel comfortable but they are not proven to be equal to the surgical masks.
  2. Practice physical distancing. Also, minimise your exposure time with anyone you come into contact with.
  3. Wash your hands regularly and thoroughly with soap and water, and avoid touching your face with your hands. Be mindful where your hands go to. If they touch your mask, wash them.
  4. Stay home as much as possible. Do not go out unnecessarily.

Truth and the Covid-19 Pandemic

Truth and the Covid-19 Pandemic

Truth and the Covid-19 Pandemic

If there is any blessings arising from this Covid-19 pandemic, it is that it is showing us the importance of truth.This is because we cannot fight this pandemic with denials, lies and distortion of truth. Doing so only makes the situation worse for everyone.

There have been many reports of patients who have history of close contact with known Covid-19 patients denying this very important aspect of their medical history when they go and see their doctors. This resulted in triage error, thus sending them to doctors who are not properly attired and protected. Later, when they are tested positive, they finally admitted but by then it is already too late. Scores of healthcare personnel would have to be quarantined for at least 2 weeks. Sometimes, an entire clinic or department had to be closed down. At a time when we are already short of all kinds of healthcare resources, including skilled personnel, this is nothing short of a disaster.

Another important tool to fight this pandemic is accurate and truthful information. Unfortunately, there have been wide and indiscriminate dissemination of fake news and suspicious information disguised as coming from authentic authorities or experts. This means we will waste valuable time trying to sieve through what can be trusted and what are lies. Accurate information can help us understand the disease better, and make it easier for us to protect ourselves. Fake news are harmful, often giving false sense of security or trigger outright fear or panic.

Lastly, truth is not a privileged but a necessity in healthcare. One may distort reality and still succeed in politics or even business, but it is disastrous and even deathly when applied in healthcare. Little wonder that we now see our politicians, who are used to distorting realities, having a difficult time trying to cope with this pandemic. Their method is useless in this fight.Let the scientists and doctors take the driver’s seat in this fight, and the politicians humbly taking the backseat.

How do I know if I have Covid-19 infection?

How do I know if I have Covid-19 infection?

With the coronavirus (Covid-19) pandemic, it is understandable if you are concern and wonder if you have the infection and not know about it, since some people may be asymptomatic. On the other hand, your healthcare facilities can easily get overwhelmed with unnecessary screening and testings.

So, what should you do if you are not sure whether you may have the Covid-19 infection or not? Well, here is a simple and quick method to assess your risk by yourself. It is not foolproof but it can be used as a first step to assessing your own risk of getting the infection.

Are you at risk of having the Covid-19 infection?

If, after doing the self assessment above, you think you may have the Covid-19 infection, here is what you need to do next.

Covid-19 “Lockdown” in Malaysia

Covid-19 “Lockdown” in Malaysia

The Covid-19 pandemic has forced many countries to take drastic actions to slow down its spread. The Malaysian government has announced a Movement Control Order, beginning from 18 March 2020 to 31 March 2020.

Below is a summary of the order:

The main purpose of this order is to restrict human movements and interactions. The rationale is that by reducing human movements and interactions, we can slow down the spread of the Covid-19 viruses. This will buy time for the local healthcare agencies to track down, quarantine and treat those with the viruses. Without this step, our local healthcare workers and resources are just overwhelmed by the rapidly increasing numbers.

This is undeniably a drastic step, and will definitely affect our economy negatively, but it is a necessity to avert an even more serious situation if not done. Therefore, it is in the interest of all Malaysians to come together as one to fight this Covid-19 contagion.

Here are some simple personal protection measures to consider:

  1. Avoid crowd – This is by far the best way to slow down the spread of the virus., thus the rationale for the implementation of the Movement Control Order. So, avoid panic buying. It is in such crowded places that the viruses can easily spread.
  2. Practice Social Distancing. Give a space of at least 1 meter between yourself and another. Actually, the further the better.
  3. Wash your hands frequently. Since the virus is spread through water droplets in the air, it can land on just about any surfaces. Most important to notice are door knobs, table tops, hand shakes, close contact with another. Frequent hand washing will eliminate the virus from your hands.
  4. Avoid touching your mouth, eyes and nose, as these moist areas are most vulnerable to the entry of the virus into the body.
  5. Wear mask appropriately. Surgical masks are made to prevent the wearer from spreading viruses and bacterias to others. So, if you are feeling unwell or if you are afraid that you might be carrying the virus without showing any symptoms, then wear a mask to prevent spreading to others. Also, the type of masks used is important. Only 3-ply surgical masks, N95 and N99 masks are known to be effective in filtering the virus. The rest are questionable. (Click here for a demo on face masks)

Finally, the Covid-19 infection is most serious to the elderly with underlying illnesses. Therefore, be considerate of the elderly at home and elsewhere. Keep them safe.

Movement Control Order 2020 Covid-19

Frequently Asked Questions on Movement Control Order (Malay version)

Frequently Asked Questions on Movement Control Order (English version)

Do not mix grapefruit with your pills

Do not mix grapefruit with your pills

Doctors have warned of a “lack of knowledge” about the dangers of mixing some medications with grapefruit.

The fruit can cause overdoses of some drugs by stopping the medicines being broken down in the intestines and the liver.

The researchers who first identified the link said the number of drugs that became dangerous with grapefruit was increasing rapidly.

They were writing in theĀ Canadian Medical Association Journal.

The team at the Lawson Health Research Institute in Canada said the number of drugs which had serious side effects with grapefruit had gone from 17 in 2008 to 43 in 2012.

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US warns drugs may have sexual side effects

US warns drugs may have sexual side effects

WASHINGTON (April 14, 2012): Two Merck drugs for treating male baldness and enlarged prostate will now carry extended labels to add more possible sexual side effects, US regulators said.

The changes involve Propecia and Proscar, both of which contain the active ingredient finasteride, after patients reported additional adverse effects that were not apparent at the time of the drugs’ approval, the US Food and Drug Administration said Friday.

The new Propecia label will include “libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug,” the FDA said. Propecia is a drug to treat male baldness.

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