Wednesday, August 19, 2009

No Health Curfew For Now

"The virus is not going to go away, it is going to stay for a long time” - Dr Ismail Merican (Health director-general)

I'm beginning to wonder. Are we asking too much from our government? Or, are we really lacking in knowledge about the whole H1N1 issue that we have become so alarmist, demanding that the government do more?

Have we been reading too much about the issue and have been misled by all the literature?

In reality, everything is "under control" and we all, really have nothing to worry about.

We have to trust the authorities, for they know better. Is this the case?

Both Dr Ismail and National Security Council director-general Mohamed Thajudeen Abdul Wahab agreed that the situation in the country is under control and that there is no need to impose a health curfew.

(A health curfew may involve the closure of all schools and the cancellation of all public and social functions. Public gathering venues may also be temporarily closed.)

They said the situation in the country is manageable, with the influenza A (H1N1) mortality rate at only 0.007 per cent.

Dr Ismail, appearing on a NSTLive session at Balai Berita yesterday, said the ministry would not advise the government to impose the curfew just yet.

He said a health curfew would not stop the virus from spreading.

Dr Ismail said Malaysians could demand for a national health emergency or health curfew but warned that if they were not disciplined enough, then all the measures put in place would not help in containing the H1N1.

Both the National Security Council and the Health Ministry said the situation in the country was manageable, with the influenza A (H1N1) mortality rate at only 0.007 per cent.

Thajudeen told the NST that declaring a curfew would be the last resort, where the situation had reached the worst case scenario.
“We are far from that level,” he said.

He said that the government needed cooperation from the public to curb the spread of the virus and asked those who were sick to quarantine themselves.

Dr Ismail urged Malaysians to play their part in delaying the spread of the disease while the ministry concentrated on giving treatment.

He felt strongly that there was a lot more that the ministry could do, through the cooperation of the public, corporate bodies, business enterprises and others, to delay the spread of the disease.

Dr Ismail said Malaysians should go on with their normal life but strictly adhere to personal hygiene, such as washing their hands with soap and water and using hand sanitiser, to avoid being infected.

"Please wear your face mask if you are sick. By doing so, you will protect others from being infected," he said, adding that Malaysians could demand for a national health emergency or health curfew.

But he warned that if they were not disciplined enough, then all the measures put in place would not help in containing the H1N1.

Yesterday, the Health Ministry recorded three more deaths, raising the death toll to 67 with 4,501 confirmed cases.

Dr Ismail said 276 H1N1 patients were being treated in hospitals nationwide and that 36 were in intensive care units. Of those in the ICUs, 21 are in the high-risk category and suffering from various complications due to their illnesses.

* Malaysian Medical Association president Dr David K.L. Quek concurred with the decision, saying that the World Health Organisation and the Centers for Disease Control and Prevention in the United States had never mentioned a curfew. He said Mexico, which announced a one-week curfew in May to contain the virus, only did so because they did not know what they were facing as the virus was then new.

(Source: NST)

19 comments:

the witch's broo said...

nuraina,

I'm not sure if i am an alarmist. i do know that I am damn worried.i feel so helpless.

Atat said...

Dear Nuraina,

We are really being led by the blind.

Sorry but I am not convinced the Government knows exactly what is happening out there and if they firmly believe they could arrest these issues by pushing the responsibilites to the people - they are wrong.

Without proper measures in separating the areas for treatment at hospitals and addressing exposure at schools and public areas it would be difficult.

I recall you entry regarding the waitress and I would do exactly what you did, if I was in your place. If I was in the waitress place, I may still come to work because I need the money to live and pay my bills. Unfortunately, if one works as a cleaner, waitress there is no off day and absence means no money for that day. When the salary is very little, deduction of 1 day salary is a lot. Government must look into this ...It is a very complex issue.

Sorry, but I still believe the Government has failed to prevent the flu and also failed in mitigating the spreading of the flu.

I would like to convey my greatest gratitude to you as you take the trouble to blog on this matter.

Thanks

Atat said...

Dear Nuraina,

Sorry meant (in my earlier posting)

..if I were in your place. If I were in the waitress place, I may still come to work because I need the money to live and pay my bills...

I am really mad because of late I spend a lot of time at hospitals - having to help ailing family members get treatment.

In my view - The Government is too laid back.

Anonymous said...

In 3 days we start fasting. Throats will be parched, bodies will be dehydrated during the day. A vulnerable time for many. Every mak cik, akak, adik of unknown health status with a kitchen will be selling something at the bazaar. Food as always will be put on display for anyone and everyone to pick, breathe on and touch. Then, in a little over a month or so, a mass movement of people will take place.

Has the Health Ministry considered that? No, they are just playing down to the fact that we still have until October before a second wave of the virus hits. I don't think we have that much time. We need action. Now.

Rosa

Samuel Goh Kim Eng said...

BETTER TREATMENTS NOT PUNISHMENTS

Please don't merely think of bigger punishments
Pray concentrate more on intensive public health education
The general public deserves the best forms of treatment
When faced with this unexpected drastic health situation

(C) Samuel Goh Kim Eng - 190809
http://MotivationInMotion.blogspot.com
Wed. 19th Aug. 2009.

NURAINA A SAMAD said...

witch: why we are concerned is that someone has fallen ill.
in my office, for instance, one of our reporters has been diagnosed with H1N1 and has been told ot quarantine himself at home.
we all interacted with him. So...


Atat: there are times i feel we're overly worried, that we should just do what we can to prevent ourselves from being infected, that the virus is already here, so let's deal with it, and not force the authorities to do more.
but when i see friends and people i know lose their loved ones, i feel that we haven't done enough.
there are divergent views about whether we should shut down everything, just for a week. but, Dr Ismail (he knows better?) thinks that will not help.
some people are convinced it will.
i'm asthmatic. so should i worry? of course...i try to stay healthy because even a mild flu can trigger my asthma attacks.

about that waitress. of course, i feel so sorry that she had to work altho she was clearly unwell. if i were her employer, i'd still take care of her needs.

thanks for visiting...

Anonymous said...

"Both the National Security Council and the Health Ministry said the situation in the country was manageable .."
- Manageable? Manageable! How are they defining manageable please. 70 fatalities is manageable? Sick people not able to get tested manageable?

"Thajudeen told the NST that declaring a curfew would be the last resort, where the situation had reached the worst case scenario.“We are far from that level,” he said.
- Who determines and by what definition would you consider a worst case scenario? 3,000 victims? Or is it 1,000 not counting the 'high risk' groups?

Anonymous said...

There's obviously NO PLAN B from the government,putting up a brave face smiling in front of the media will not save the people.Putting in place preventive measures immediately will. As how fast the virus spread n kill, we should take 1st place worldwide in 2 months time.Then what?Ask the whole cabinet out for a brave face photocall?

armouris said...

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tok kemuning said...

This is all that i know...two weeks ago it was 13. Then in 2 weeks as of today (20/08/09) it is maybe become 70 already. From 13 to 70 in 2 weeks to me it is really alarming.

Two weeks ago the death rate was below 0.04% BUT currently it is 0.07%. The rate almost double in two week.

We need specific instruction from our government no more merely talk. We need real action and real instruction now.

Anonymous said...

pihak media kena banyak main peranan menyalur maklumat2 supaya orang awam memahami dan tidak "create panic" among our self. Salurkan maklumat2 tentang kebersihan dan elak ke tempat orang ramai kecuali jika perlu. Kalau tidak bingung kita semua dibuatnya.

Anonymous said...

Dear Nuraina,

I am confused as to how the 0.007% is arrived at. If the number of confirmed infection is 4501, then the mortality rate of 67 death should be 1.489%. Is my maths wrong? If I used the population of Malaysia (assume to be 28 million), the rate is 0.0002%

Anonymous said...

Puan Nuraina,

Human's behavior and physical reaction is partly under direct influence of the emotional state. Let say if someone is facing a calamity, cataclysm, catastrophe, and disaster, he/she tend to be emotional and subsequently develops some amount of anxiety, depression, hapless and helplessness.

But then we realised different person might react differently even though they are subjected to a same condition. For example, when a mishap occur, the emotional reaction would varies depending on who became the victims. Certain individuals remain cool and calm whereas others might get into a state of panic so easily!.

In political perspective, obviously that factors such as critical thinking, fair judgments and rationality are deemed so central and becomes the integral part that lead to a successful discourse. especially on issue that is considered highly critical not only , yet the opposition (slime balls) still so much none the wiser.

They (opposition scumbags) by nature inclined to oppose every single issue not for the purpose of getting to the bottom of it but for the sake of opposing; and to show their tru color for being a dissenter.

In the context of H1N1, even though it scares the hell out of us and when the adrenaline rushed into the blood streams, how could anyone be that cool? Yes how to expect people not to push the panic button!

So one of the way to prevent peoples from panic and jump the gun over this complex issue, they ought to be informed in the most transparent manner. And most importantly, as long as for any drastic measure that might need to be taken is subjected to the risk-benefit work out, meaning it is not to be used on a trial and error basis, that by itself would have won peoples confidence.

To be fair, and given the complexity of a pandemic managements why don't we just leave the critical decision part to the relevant authority to do what they think best. For us, it is more useful on our part to invest the time and energy in sectors which might give a good return -- give more cooperation; and more moral support to those who have been sweating over day and night fighting tooth and nail to bring down the morbidity rate caused by H1N1.

sahabat.

Anonymous said...

To anon 1.55

The 0.007% was correctly stated. With 68 (latest) deaths but you have the number of confirmed cases wrong. Work it backwards and you will arrive at the correct number of confirmed cases.
That is how they arrive at that figure.
God help us all.

mr.embunpagi said...

hai......the Curfew for sure is not now....but....it come that way......

selampit said...

Anonymous at 1:55 PM wrote

"I am confused as to how the 0.007% is arrived at. If the number of confirmed infection is 4501, then the mortality rate of 67 death should be 1.489%. Is my maths wrong? If I used the population of Malaysia (assume to be 28 million), the rate is 0.0002%"

Well so am I.

I guess the MOH simply multiply the 'announced figure' of 4501 confirmed cases by 200, probably by analyzing various figures and data provided by government hospitals and clinics throughout the country.

So 4501 X 200 = 900200 'estimated' confirmed cases.

And (67/900200) * 100 = 0.00744%

Anyway, this is what I think based on what I know, and I could be wrong.

Atat said...

Hello,

I found an interesting article titled : A(H1N1): We don’t want to be reduced to mere statistics!

http://mt.m2day.org/2008/content/view/25902/84/


Selamat Berpuasa

Anonymous said...

I have read http://mt.m2day.org/2008/content/view/25902/84/ and in principle, I agree with the recommendations. Nevertheless, we can tell or demand the govt what to do but under the current circumstances, we have to act by ourselves.

I this regard, we have to act on the basis of solid information, not emotion or paranoia.

Talking about paranoia, I have also read one Malaysiakini letter titled: H1N1: Gov't should snap out its ostrich mentality (http://www.malaysiakini.com/letters/111032).

I have noticed one very obvious paranoia with this, the suggestion that everybody wear masks.

This absolutely bollocks! After all there is a shortage of mask. What the govt has done is to put price controls but so far I have not read any concrete steps to increase the supply of masks in the market. Such actions will not solve the problem of mask shortage; in fact the suggestion that everybody should wear mask would aggravate the shortage!

And Kak Nuraina, you have unfortunately been paranoid too! I get the feeling that you are in the favor of a health emergency with curfews. This will only work if Malaysian borders are totally sealed. This is not the case at all. In fact as I wrote in the previous comment, tourists are seemed to be exempted from the 7 day quarantine advice! So shutting down the country one or two weeks will not make much difference.

So what are we facing? (in this regard I think many Malaysians are simply not informed - or ill informed...)

A simple mathematical model with these assumptions will help us to understand what are we facing:

30% of population might catch swine flu = 8.1m people

15% of these infected might suffer complications = 1.215 m people

2% of the infected might need hospital treatment = 0.615 m people

0.1-0.35% fatality rate (from the infected) = 8,100 to 28,350 deaths

Note: bear in mind that the seemingly high Malaysian death rate might be due to the under-reporting of actual swine flu cases. In this instance the denominator (number of confirmed swine flu cases in Malaysia) may not represent what is actually happening. Due to the logistical problems, hospitals will not just test anybody who come and show all the symptoms. Also there might be instances where people do not go to hospitals at all, especially those who show only mild symptoms.

Note that the Health Minister chooses a lower figure i.e. only 20% of the population will be infected. Whether this is the case: only time will tell. The 30% that I choose is based on the UK projection.

So what can we do?

Can the the suggestions (or even legislation or forceful requirements) of good personal hygiene, quarantine, social distancing, wearing facial mask or in the extreme shutting down all economic activities for one/two weeks help to reduce these numbers?



Happy Ramadan!!!


Yours Truly,
Mamat

selampit said...

First of all, I'd like to stress that there is NOTHING the government could have done do to STOP the spread of the H1N1 influenza.

A virus is genetically designed to do one thing - replicate, and does so by using our cells' genetic materials as the resource. Have you ever wondered why the influenza virus attacks our respiratory system, forcing us to cough and sneeze?

Billions of years of natural evolution. The virus that found ways jump from host to host survives, those that failed to do so perished.

"Maslow's hierarchy of needs" dictates that every human is a social creature that needs friendship, sense of belonging and inter-social contact, and we will use everything at our disposal (energy, imagination etc.) to fulfill those needs. We naturally and psychologically DESPISE the word 'quarantine' or 'isolation'.

Therefore the H1N1 virus has finally found THE MOST EFFICIENT VECTOR that ever existed - genus Homo Sapiens Sapiens.

Stop the infection? The best that anyone CAN do is to minimize the rate of infection.

In my opinion, the most efficient way to achieve minimum rate of infection is through direct government intervention. The government must play a major role here, and should not leave the burden of a mass 'prevention campaign' to the the scared, uninformed and confused public out there.

To emphasize my point, what will happen if our country's traffic systems come to a halt say, for one day. No traffic cops, no traffic lights, no annoying JPJ roadblocks. In short, NO GOVERNMENT INTERVENTION.

TOTAL CHAOS...

Despite the fact that our licensed motorists are armed with various road safety knowledge, and are familiar with road traffic laws.

Why? You all know why...