Wednesday, August 12, 2009

H1N1 Public Apathy

This is my third posting on H1N1. Earlier I wrote that if H1N1 cannot be controlled because of local transmission, then we can foresee that the number of cases would climb up rapidly. Hence, we are told that we now have more than 2000 confirmed cases. What is surprising is that death toll have reached 38. As of yesterday, the WHO has recorded about 208,155 confirmed cases in 174 countries with 1,688 deaths, which brings the average mortality rate in H1N1 to about 0.5 - 0.8 percent. With 2000 cases, we are talking about 10 to 16 deaths. Here in Malaysia, we are talking about mortality rate that is nearly 4 times more than the accepted norm of 0.5percent. This is a cause of concern to the authorities and the rakyat.

In any infectious disease outbreak, controlling the source of infection is of paramount importance. Hence, the individual plays an important role in order to contain the disease. Public apathy in Malaysia is frightening. The level of cleanliness in public places leaves much to be desired. In a lot of shopping centres and offices, don’t hope to find soap in the public toilet. It is indeed sad that Hong Kong had done a better job in maintaining cleanliness of public amenities from public lift to toilet. Even public toilets in hotels in Malaysia, KLIA and LCCT have no soap. I have also read in the papers today that in Subang Airport, there was no soap found in the public toilet. The MOH has been advising the public to wash their hands regularly with soap to prevent viruses, but without soaps in public toilets, how are we going to contain the disease? Not only that, the public lifts are also not cleaned regularly, let alone sanitized. An infected person would have infected a lot of places in the course of his travelling and daily contact. Hence, one of the first rules in containment of infectious disease is cleanliness of premises which are frequently used by the public.

There is also a lack of public education or the education itself is not reaching the target group. The awareness should start from the schools. The MOH should not just close down schools whenever someone is infected with the H1N1 and send the children home. The children will just regard the closing down of the schools as school holidays for them. It is better for MOH to teach school children on self-cleanliness and to avoid close contact with other children by wearing masks.

The high mortality rate in Malaysia has also raised panic among the public who are now rushing to get the anti virals to protect themselves. However, the anti-virals must be taken with caution. It has its harmful side effects, especially on some children where it will cause nausea and vomiting, leading to dehydration and other sickness. Therefore, parents must be extra careful when it comes to the anti-virals because it will promote resistance, of which will weaken the body’s immune system and cause it vulnerable to fight any flu virus. Besides that, many are concerned about the late diagnosis of the doctor for H1N1. Many believed that the deaths from H1N1 were caused by late diagnosis from the doctors. This perception has to change. Doctors have to equip themselves with updated information from the WHO in order to make the right diagnosis. There is no excuse since there is enough publicity to alert doctors on the H1N1.

We must all keep in mind that it takes two to tango. Without the cooperation from the public, the government itself is unable to contain the disease. Hopefully both the government and the public will continue to stay alert to prevent further spread of the disease.

公众对H1N1已麻木不仁?

这是我第三篇关于H1N1流感的文章。我之前说过,如果我们无法控制本土感染趋势,确诊病例必将飙升。世界卫生组织昨天证实全球174个疫区国家的累计病例已激增至20万8千155宗,1千688人死亡,死亡率约0.5-0.8%巴仙。回到大马,我国的H1N1病例已超过2千宗,死亡人数高达38人,死亡率是世卫数据的四倍,值得当局和公众高度关注。

要控制任何传染疾病,控制感染源头最为关键,而每个人都有发挥的角色。不过,一些人民却表现得漠不关心,这种态度让人担忧。公共场所的清洁和卫生水平仍不理想,许多购物商场、办公楼,甚至是机场及一些酒店的厕所也没有准备肥皂。卫生部不断提醒人民勤洗手以防病毒,在卫生设施欠奉的情况下,如何遏防疫情?不仅如此,公共升降机也没有定时清理,更不用说进行消毒。受感染者公开活动,通过与人接触能迅速传染他人。因此,维持公共场所的清洁和卫生是防疫的首要条件。

此外,缺乏公众教育和抗疫宣导,或讯息无法递及目标群体,也是我国抗疫过程面对的另项一问题。教育和醒觉应从学校做起,当校内证实有学生受感染,卫生部不该只把病童送回家或关闭学校。学生会把学校关闭现象当成放假。相反的,卫生部应该教导学生保持个人清洁卫生,以及戴上口罩以避免密切接触。

H1N1流感死亡率偏高使大马人民一度陷入恐慌,纷纷抢购抗流感药物。然而,所以人们必须谨慎服用。抗流感药物具有副作用,尤其会导致孩童感到恶心、呕吐甚至脱水等其他不适。家长们必须额外小心,一旦服用过量将削弱人体的免疫能力,无法对抗任何流感的病毒。

另一方面,大家也极度关注医生对H1N1流感的诊断。许多人认为医生延诊导致一些人死于H1N1流感。人们必须摒弃这种观念,而医生们也需密切跟进世卫公布的疫情讯息,以迅速进行确诊。

我们须知,抗疫工程需要双向的配合。没有人民的充分合作,政府无法遏制疫情。希望政府和人民继续保持警觉,协力灭抗流感。

10 comments:

Anonymous Says said...

Dear Dr Chua,
When this pandemic first started in Mexico, the media sensationalized about the H1N1 disease like anything. Then a few weeks ago, it stopped sensationalizing it. When it stopped, the real thing happened in Malaysia. Now there is no news about it in Mexico. What happened ? The estimation is that for roughly 20 people, there is one confirmed case. The case is confirmed via throat swab and not blood test. This confirmed case need not exhibit any signs and symptoms of H1N1. But those who are not confirmed to have that disease will have fever, sore throat and look sick. The confirmed case is NOT allowed to be admitted after seen by the doctor. The patient can sue him or her on the grounds of negligence. But the one having all the symptoms are asked to be admitted. While on admission, there is no blood taken to confirm the case. There is no Tamiflu jabs. Not that it is encouraged. See the contradictory actions there ? The patient is not given any other supplements like vitamin C tablets, besides the drip. What is happening in the Ministry of Health ? Nobody can be contacted for information there. Other then the high command, is there nobody else who can do anything ? What is the point of wearing all the gowns, masks, gloves and walking around spreading the disease ? Just who is protecting whom ? Or the staff protecting themselves only. That is very selfish. That is also unbecoming of people first, performance now. The pandemic is still on together with the air pollution.

lleekh said...

YOur attitude is the same like those in authority! When something goes wrong, blame the people. When there is success, claim the credit! When children fall sick..oh the parents are negligent. WHen Students fail, parents are negligent. When snatch thefts increases, the women did not take precaution. When rape happens the women were looking for it!

Pearls said...

The fact is that everyone is not serious about this. I mean EVERYONE.

Parents continue to send their children to school/day care/nanny even though the kid is having a runny nose or bad cough or sometimes even fever. It is common to see schoolchildren bringing their fever medicine to school. Parents' excuse is that they cannot take off from work, they got no one to help out and there is no where to send their kids to.

For the love of God!! these parents shouldnt be parents in the first place. That is your own child, WTF la.. take leave and stay home with your kid la! If you have to stand up to your bosses, do it! Save all the leave to go holiday or to go for mega sale, cannot take leave for your sick child ah? Ridiculous!!! For the life of me, I cannot understand such selfishness!

Adults like you and me, I see people coughing and blowing their nose off everywhere everyday. You see them in shopping malls happily shopping away and throwing their used tissue all over the place, in cinemas, in restaurants. There is no care to the fact that they are sick and they should at home! Their logic is "aiyah... so boring sit at home! I gotta eat mah.. I gotta buy things mah. I cannot sit at home type la..if not I go mad"

In my office, there is even one who just came back from overseas coughing and sniffling away!! What can you say? You tell them to go home, they just smile and look the other way. Bosses are happy that they have such hardworking and dedicated staff and tell you to mind your own business. For the life of me, I cannot understand such indifferent and "evilness"!

So! the story goes for any contagious disease may it be H1N1 or whatever that is coming next, it all pinpoint down to one thing and that is each and everyone of us must play our part!

As an individual, if you are sick, damn hell well go see a doctor and take MC! If the doctor is being pesky and refuse to give, demand for it! STAY HOME AND GET WELL! Eat whatever you have at home and stop being so fussy.

As a parent, please! if your child shows signs of being sick, go to the doctor. Dont be a miser and think you can save a few bucks by not going to the doctor and "let your child build immunity". Take leave, give up whatever pleasureable routine you might have and nurse your child back to health! Dont be a selfish moronic idiot!

As bosses/supervisors, please la! stop thinking of that S and 2 vertical lines!! Be compassionate and responsible to your other healthy staff.. keep those sick ones away at all cost!

And.. lastly, government, I think for this H1N1 case, they have done quite well. Of course plenty people will have plenty to say about why didnt this or that, should have this and that.. but these morons fail to see the fact that there is just so much a government can do! The majority of action has to be done by each and everyone of us! To start with, each and everyone of us must learn not to be so self centered and moronic!

Tuanku said...

Dear Dr Chua,

The Pandemic A(H1N1) is the least concern factor for BN leaders after the global huge outbreak in last few months. Unfortunately, BN are more concern on playing politics to find strategies in toppling PR state govts. Similar the local media like Utusan Malaysia and Berita Harian focus on publishing racist and religion issues, Malay coward and Anwar traitor stories daily. Many other non Malay media newspapers also too involved in political news. The H1N1 Pandemic outbreak news in Malaysia was totally cover up by the sensational political news everyday.

The failure of Ministry of Health and its Minister to warn the Rakyat on the proper procedures and guidelines to prevent the H1N1 spreading like wild fire in Malaysia. Many school headmasters are also negligences in carrying out their duties to ensure their teachers and students should be protected with face masks and precautionary measure to prevent H1N1 from spreading in schools.

Last but not least, your Health Minister is still sleeping in his laurel because his Ministry failed to prevent fatalities and more H1N1 victims todate. The latest update is 44 fatalities and more than 3,000 rakyat are infected.

What a BIG shame to BN ?

Well, the Rakyat still consider Dr Chua is a goodman and a caring Health Minister in Malaysia. Welcome Dr Chua to take over this vital portfolio from the sleeping Liow immediately. We, Rakyat Boleh will support Dr Chua on your Empire Strike Back to General Hospitals. Please tell Najib today.

kenny said...

Dear Datuk Seri

You successor as Minister of Health is more interested in politicking than in dong actual work. All he does is to mouth prepared statement.

The DG is out of his depth. The Minister is next to useless. So what can we expect expect more death.

Anonymous Says said...

It is the patient's right to seek for treatment and it is the patient's right to ask to be admitted to the ward or not. What does it mean when the patient has to seek the permission of the doctors to be admitted for the H1N1disease ? It is the patient who is sick and who needs help. The doctor is healthy and has the calling to treat all. Is the hospital so flooded with patients that these new patients are denied of their right for treatment ? Why is there no center to manage only only the H1N1 disease ? The other day, the news reported about jabs available in all hospitals and clinics. This is a doubtful piece of news trying to reduce public stress to the disease. From here it is seen that Malaysians on the whole do not value health. May be as compared to other things and issues, health is not that important. What is a slight fever as compared to making money even though the fever is there ? Take some Panadol and go on working. Then regarding the mask. This H1N1 disease is an occupation hazard. But the people supplying the masks talk about its' costs rather than the importance of wearing the masks. The costs of the handscrub. The costs of the gowns. The cost of everything needed to protect one from the disease. Even the Ministry of Health is not helping at all. So nobody is surprised if the disease is still spreading. People cannot understand what is quarantine. People cannot understand what is air pollution. Investigation has to be carried out as to why there is an existence of this disease in the first place. Is this a form of covert biological warfare in its' testing stage ? Is this a way of reducing the swelling global population so that there is enough food and resources for all ? Can't help being paranoid because the disease which started from somewhere so far away somehow makes its' way here and makes its' home here too.

GTLim said...

Dear Dr Chua,

Problems like this gets worse when the Ministry is run by inexperienced and tidak apa type of people.

Dato Seri Liow hands are already full with this H1N1 problems and yet he can find time to rub shoulder with the President. What is he trying to achieve? Or is he trying to find a scapegoat later on? That he has been too busy with OTK's affair that he has overlook this and overlook that..right?

We need action and control! Ask OTK for the $10m and use it well to control this pandemic crisis.

GTLim said...

Dear Dr. Chua,

The Health Ministry or Datuk Seri Liow has just received the Rakyat's wake-up call and is taking action finally. I hope the spread of this H1N1 can be controlled quickly.

The problem with this H1N1 is that its symptom is so identical to the ordinary flu that it's hard to make out whether it's bad or not and it will be beyond a poor family's budget to send the members to the doctor each time someone has a fever or running nose or sore throats or etc etc etc. It's cheaper to treat them with traditional medicine.

Tell me if I am doing wrong!. When I am down with a flu, I would take 2 Panadol and every 4 hourly until it's ok or any fever that will subside or go away. After 48 hrs, if it's still bad, then only I would see my doctor. Touch wood, I didnt reach that level thus far.

In the light of my experience, how about the Health Ministry giving away free Panadol to the Rakyat with some lessons on the right way to use Panadol. There is a good chance to save people from the deadly virus streptococcus or H1N1.

Michelle Saw said...

Dear Dr Chua,
According to the U.S. National Library of Medicine and the National Institutes of Health.
Colostrum, both in healthy subjects and high-risk cardiovascular patients, is at least 3 times more effective than vaccination to prevent flu and is very cost-effective.
http://www.ncbi.nlm.nih.gov/pubmed/17456621

Excerpts from The STAR on Tuesday 11 August 2009
High-risk groups include children who are below five years, senior citizens 65 years and above, children and youth under 19 who have been taking asprin for long-term, pregnant women, those who suffer from athsma, cronic lung disease, organ failure, cardiovascular, liver and blood system diseases, diabetic, obese people and those with low immunity.

Immunizen from USA - Colostrum
Immunizen was shown to increase the number of Killer T-cells, those which fight infections such as colds and flus, within the first day of supplementation. By supplementing with Immunizen at the onset of a cold or flu, you should see a relief from symptoms and a shortened duration time for the illness.
http://www.unicitynetwork.com.my/systems/science/science_18401.html

The only way to fight these viruses is to strengthens the body's defense system.

Do you think this is one of the solutions to overcome this H1Nl influenza epidemic?


Regards
Michelle Saw
Mobile: 012 - 617 8223
email: msaw_18@yahoo.com
Subang Jaya

GTLim said...

Article from MALAYSIAKINI:
Quote:
Aug 29, 09 5:13pm
A report by the World Health Organisation (WHO) revealed that Malaysians have low understanding and poor knowledge on the spread of influenza A (H1N1).
Unquote:
Bukan Malaysian. It's our "DR LIOW" Minister of Health

What a disgrace!!!!!!

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