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SEREMBAN: Dengue cases in Negri Sembilan have spiked by more than 30% in the first seven months of the year compared to the same period in 2019, says state health, environment, cooperatives and consumerism committee chairman S. Veerapan.

He said 1,903 cases were reported during the period this year as against 1,449 last year.

Seremban had the bulk of the cases with 1,632 followed by Port Dickson (68), Rembau

(59), Jempol (52), Tampin (48), Jelebu (25) and Kuala Pilah (19).

“Although the number of cases spiked this year, the number of fatalities registered were seven, which was the same reported during the same period last year,” he said in a statement on Tuesday (Aug 4).

Veerapan said as of Aug 1,45 localities in the state had been delared epidemic areas.

“All these localities were in Seremban,” he said.

He said despite the recovery movement control order being in force, the authorities would continue with work to destroy potential Aedes breeding grounds and carry out fogging activities to check the increase in the number of cases.

By SARBAN SINGH.

Read more @ https://www.thestar.com.my/news/nation/2020/08/04/negri-sees-spike-in-dengue-cases-most-cases-in-seremban#cxrecs_s

DEMENTIA is a syndrome characterised by significant cognitive decline that is severe enough to affect independence in everyday activities.

The impairment must represent a significant decline from a previous level of functioning.

There are various forms of dementia – Alzheimer’s disease (the most common form of dementia), vascular dementia, Parkinson’s disease dementia and etc, while mixed forms often co-exist.

About 50 million people worldwide have dementia, with nearly 10 million new cases per year according to the World Health Organisation, and the number is expected to increase due to ageing of the population.

The global prevalence of dementia (of all causes) is 5-7% in adults aged 60 and above, and the risk doubles every five years after age 65. By the age of 85 or older, 25-50% of people will exhibit signs of dementia.

Future projections of the number of people with dementia (PWD) may be influenced by preventive interventions (lowering incidence), improvements in treatment and dementia care (prolonging survival), and disease-modifying interventions (preventing and slowing disease progression).

Being diagnosed with dementia is not a death sentence, although no treatment is currently available to cure the disease.

However, medications are available to slow down the progression, and lots can be offered to support and improve the lives of PWD and their families and carers.

Take the case of patient Andrew, 58, with vascular dementia (post-stroke dementia). He is well educated and used to work as a sales manager.

Pre-morbidly, he was a very polite person, a good talker with excellent job performance and socialises well with his colleagues, according to his wife.

His memory declined since 2016, and he became less talkative, forgetful and misplaced things – forgetting his ATM card PIN number, and frequently missing appointments with clients.

He stopped working a year later due to poor performance and his inability to manage his job routine.

His wife noticed he had difficulty with words and became quiet during family gatherings, as he had trouble expressing himself.

Andrew has three children but can’t remember their age. He can perform basic activities of daily living and personal care, helps with simple household chores, but he has stopped his banking activities and paying household bills since four years ago.

Two years ago he joined a qi gong exercise group and this has been his routine every morning. He is able to follow the moves and steps but sometimes encounters left-right disorientation.

Andrew is still able to drive but only when his wife is with him, as he occasionally needs her to assist in navigation.

The legal and ethical issues in this case is that Andrew is still actively driving around with cognitive impairment.

Research suggests that PWD tend to overestimate their driving abilities. As the disease progresses, their attention, concentration, visuospatial skills, judgment, decision-making and reflexes required for safe driving tend to decline. These put them at higher risk on the road, even for those with mild dementia.

Having early discussion on the plan for PWD to retire from driving and the alternatives (transportation and delivery) helps top address the matter.

Evaluation by an occupational therapy rehabilitation specialist is valuable, and even if PWD pass the driving test, they should be tested regularly every six months.

Carers need to be educated and aware of signs of unsafe driving such as difficulty navigating to familiar places, poor lane control, inappropriate driving speed, confusion over brake and gas pedals, failure to observe traffic signs, making slow or poor decisions, becoming easily angry or confused while driving, etc.

Consider ways to limit and distract PWD from driving as the disease progresses, and if they still insist on driving, implement last-resort preventive strategies such as removing access to the ignition key, or disabling or selling the vehicle.

Caring for PWD poses many challenges for the family and carers. Progressive deterioration of memory makes PWD more difficult to make decisions, remember things, communicate with others and even deal with their own personal care.

Furthermore, their mood swings and change of personality and behaviour (for some PWD) makes the job of caring more difficult and complicated.

Caring for PWD is not just about giving one’s time and energy, but also the potential loss of income when carers have to change work schedules, take leave of absence, and even give up their job to be there for the patient.

It is not an easy task to care for a loved one with dementia, especially when most of the carers are the patient’s children in their 50s, 60s or older who increasingly find themselves disabled and in need of medical assistance and help from others. Carers like them frequently need to provide support to both younger and older family members, while at the same time deal with their own issues.

Appropriate acknowledgement, support, respite and rewards should be given to reduce a carer’s stress and exhaustion.

Sometimes, all the carer needs is a good listener and to find a balance among all the demands for the carer to sustain his or her role.

Indisputably, there is personal satisfaction and positive aspects in caregiving – knowing that the carer is needed, appreciation from family members, having a sense of accomplishment and the opportunity to show love for the disabled loved one, and many more.

Dr Lam Ngee Wei is a consultant physician (internal medicine) and geriatrician at Subang Jaya Medical Centre.

By Dr Lam Ngee Wei.

Read more @ https://www.thestar.com.my/opinion/columnists/my-doctor-knows/2020/07/26/when-the-mind-declines#cxrecs_s

PUTRAJAYA: Authorities are looking at adding public health to the school syllabus to educate children on what needs to be done to prevent Covid-19 infection.

Health director-general Datuk Dr Noor Hisham Abdullah (pic) said the Education Ministry had already raised the matter.

“There is already a suggestion for this.

“We are looking into including what is being practised now into the school syllabus for children to learn and practise,” he said at a media engagement on Wednesday (July 29).

On the reopening of schools, Dr Noor Hisham said there had been no incident of Covid-19 cases in schools since they were reopened.

“With the standard operating procedures in place, schools are a safe place.

“If there are risks, we will manage it by closing the affected school.

“What we want to look into now is after school session ends,” he said.

He said authorities were looking at how to prevent overcrowding when students left classes for their transport.

“During this time, students will crowd together, and we should avoid this. We are looking at whether students can be released in stages to avoid overcrowding,” he said.

By MAZWIN NIK ANIS.

Read more @ https://www.thestar.com.my/news/nation/2020/07/29/public-health-may-become-part-of-school-syllabus#cxrecs_s

KUALA LUMPUR: NON-MEDICAL cloth face masks or face coverings, which are gaining in popularity during the Covid-19 pandemic, may not be all what they are made out to be.

Although some may be fashionable, decorative and aesthetically pleasing, health experts said that the public should ensure the masks meet the Health Ministry’s criteria to give maximum protection and were developed based on the latest World Health Organisation (WHO) guidelines to ensure effectiveness.

This came following the government’s mandating of masks on public transport and crowded public spaces effective from Aug 1, where social distancing is impossible, to reduce the spread of Covid-19.

According to the ministry’s guidelines, fabric masks require a minimum of three layers, where the innermost layer is in contact with the wearer’s face and outermost layer exposed to the environment.

The ideal combination of material, it said, should include:

AN INNERMOST layer of hydrophilic material, such as cotton or cotton blends;

AN OUTERMOST layer made of hydrophobic material, like polypropylene, polyester, or their blends, which can limit external contamination from penetrating to the wearer’s nose and mouth; and,

A MIDDLE hydrophobic layer of synthetic non-woven material, such as polypropylene or a cotton layer, that may enhance filtration or retain droplets.

Infectious disease consultant Datuk Dr Christopher Lee said reusable masks should not just be for decorative purposes or used as an accessory, but they should also be made according to the stipulated criteria.

Lee, who is the head of the National Covid-19 Mortality Review Committee and former deputy Health director-general (research and technical support), said although wearing any face covering was better than none, a three-layered mask was preferred.

Datuk Dr Christopher Lee

“It doesn’t matter if it’s decorative or not, as long as the cloth mask is made of the right material. The selection of material is an essential first step as filtration and breathability vary depending on the fabric.

“The mask should cover the nose, mouth and chin, and fit snuggly on the sides of the face. It has to be washed daily when used, hence it is best to have at least two masks.

“A quick check of non-surgical fabric masks may be performed by attempting to breathe, through the mouth, and the multiple layers into your hand. You should not feel much wind.”

Dr Lee said fabric masks might not be as efficient as surgical mask, but the focus was not on finding the perfect solution, but to minimise the risk of transmission.

Professor Dr G. Jayakumar of the Community and Occupational Medicine at the Faculty of Medicine in Melaka Manipal Medical College said three-layered fabric masks, if appropriately worn, would provide some protection against Covid-19.

He said improper use, like pulling them below the chin, frequently touching the masks, handling them with unsanitised hands or improper disposal creates a false sense of security to the user and might pose more harm to the user and the public.

“Do-it-yourself (DIY) masks should be of cotton material with multiple layers of fabric that allow users to breathe easily and have to be easily laundered and machine-dried.

“Each layer of the masks has specific relevance in the prevention of transmission of droplets from the user. The respiratory system in a healthy individual can filter minute particles of up to 10 microns.

The government still allows decorated fabric masks as they have become the preferred choice. -NSTP/File pic

“Viruses are minute particles of less than one micron in size. Filtering layers within the masks are the most important aspects for filtering the minute particles.”

He, however, said the use of a mask was insufficient to provide an adequate level of protection (to the healthy wearer against infection) or source control (preventing the infected wearer from transmitting the virus to others).

He said other precautionary measures should also be adopted, like social distancing and maintaining good hygiene and proper cough etiquette.

“Children under two years, individuals who have respiratory or heart ailments with a history of breathing difficulty must refrain from wearing masks.

“People who are incapacitated, mentally or physically challenged, who cannot remove masks on their own are also advised not to wear masks.”

Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar said masks could be a trendy tool that reflected people’s positive behaviour in understanding the infection, as well as proper cough and sneezing etiquette.

“It is a good sign when it is becoming trendy, but they should follow proper specifications.”

Datuk Dr Zainal Ariffin Omar

Deputy Health Minister Datuk Dr Noor Azmi Ghazali said the government allowed decorated fabric masks as they had become the preferred choice.

He said the ministry would announce details of the specifications and types of face masks that could be worn, and guidelines on how to use and dispose of them.

“It is more important to emphasise the proper use of masks and how to dispose of them.”

Fabric masks are recommended for those with no breathing difficulties, workers and people in public areas.

Three-ply surgical masks are recommended for healthcare workers, people with any symptoms suggestive of Covid-19, and vulnerable people, including people aged 60 and above and those with underlying comorbidities.

By Tharanya Arumugam, Muhammad Zulsyamini Sufian Suri.

Read more @ https://www.nst.com.my/news/nation/2020/07/611723/non-medical-cloth-masks-must-meet-health-criteria

PRIOR to the government’s reimposition of the use of face masks in crowded public places from Aug 1, we have been witnessing more and more people taking lightly anti-Covid-19 measures by not wearing face masks or observing social distancing.

I don’t have to go far to see the complacency among people. I just have to drive to restaurants and sundry shops in my neighbourhood.

Only a few customers wore face masks and practised social distancing.

A survey by TV3 found there were just too many people — patrons and owners of premises — flouting the standard operating procedures.

Everyone acknowledges that we cannot afford to have another Movement Control Order if there is a spike in the disease.

Although the virus’ double-digit infection rate may be statistics to some, these victims can be our loved ones.

Hence, we must continue to adhere to the health and safety guidelines.

Indeed, the rising number of infections over the past week is worrisome.

Now, countries in the northern hemisphere are bracing for a second wave of Covid-19.

The Telegraph editor Sherelle Jacobs wrote in her column that countries risked an immediate resurgence of the virus if they lifted their lockdowns.

“For months, we’re cudgelled with questionable comparisons to the Spanish flu, which hit in June 1918, and returned to an even more deadly effect in the autumn of the same year.”

If the people in the northern hemisphere countries worry about the virus springing back, we should be worried as well.

As countries are reopening their economies with the lifting of restrictions on trade and travel, the virus can make a comeback and infect Malaysians if we continue with our lackadaisical attitude towards upholding safety and precautionary measures, while milling around in crowded places.

Nevertheless, whenever I scroll through Twitter, Instagram and Facebook, I’m always amused to find words like “covidiot” or “moronavirus” that people use to insult each other when they disregard health and safety guidelines during the pandemic.

Sadly, these terms are coined to demonstrate a form of “quarantine shaming” on those who flout health guidelines.

I have seen far too many videos on social media of covidiots, who have been caught on video and in photos not adhering to social distancing or not wearing face masks in crowded places.

I feel that it is an intrusion (on one’s privacy), putting the person on a “public trial” and demonstrating his carelessness.

The callousness of these keyboard warriors must stop as they should have just reported the matter to the authorities.

On a lighter note, they have coined so many other slang words when commenting on more relatable and humorous challenges during the pandemic.

One such word is “doomsurfing”, which means compulsively surfing the Internet for upsetting news.

Don’t we all do this, too?

Also, while some people argued that we are being paranoid over the slight increase in the number of infections, we should be worried about the threat of a second wave if people don’t listen to the Health Ministry’s warnings.

The threat of a second wave is clear and present.

The war against the pandemic is not over. Complacency can destroy our health and the economy.

Benjamin Elijah Mays, an American civil rights leader, once said: “The tragedy of life is not often in our failure, but in our complacency; not in our doing too much but rather in our doing too little; not in our living above our ability, but rather in our living below our capacities.”

By Rohiman Haroon.

Read more @ https://www.nst.com.my/opinion/columnists/2020/07/611619/complacency-can-destroy-our-health-economy

The Health Ministry said in a statement that at least 168 people were examined at the Poipet health centre and preliminary tests showed it was Chikungunya. -File pic

PHNOM PENH: The Cambodian government has identified the “mystery disease” that affected more than 160 people in Poipet town.

The Health Ministry said in a statement that at least 168 people were examined at the Poipet health centre and preliminary tests showed it was Chikungunya.

It said residents of Poipet commune’s Kbal Koh, Poipet and O’Chrov villages, and those from Phsar Kandal commune’s Prey Kub, O’Neang and O’Russey villages experienced fever with temperatures of 38º Celsius, red skin rashes and joint pain.

Of the 168 people admitted to hospitals, the ministry said the conditions of 32 people were serious but their health have since improved.

The Khmer Times reports Health Minister Mam Bun Heng as saying that preventive measures against Chikungunya were similar to those for dengue fever.

Chikungunya is a viral illness transmitted by mosquitoes with symptoms that include abnormal fever, sore throat, skin rashes and serious joint pains and, in some cases, convulsions.

Chikungunya is not life-threatening in itself as patients can recover within a week. However, if a patient catches the virus while having other diseases, it can be life-threatening.

The ministry said it was also testing some of the patients for Covid-19 infection.

Bun Heng urged the relevant authorities to continue disseminating information about the disease to the community, especially in schools, so that residents and children were aware of the danger and the preventive measures.

Meanwhile, The Phnom Penh Post reports that health officials in other provinces launched a campaign to spray mosquito repellent on residents’ homes and put mosquito larvicide in large water basins, which are commonly found outside houses.

The ministry said the re-emergence of the virus in the province could signal another public health risk.

Provincial Department of Health director Le Chan Sangvat told the Post that after the outbreak of Chikungunya in the villages, emergency response teams of the provincial hospital sprayed disinfectant in target villages in Poipet town.

Sangvat called on residents to be vigilant against an outbreak of Chikungunya and practise preventive measures like removing mosquito habitats, sanitising homes and sleeping under mosquito nets.

Preah Vihear provincial Department of Health director Kuong Lo said disinfectants were sprayed around residents’ houses in three villages bordering the Laos border in Chheb district after many patients were believed to have developed Chikungunya.

By New Straits Times.

Rad more @ https://www.nst.com.my/world/region/2020/07/611480/chikungunya-outbreak-cambodia-sickens-160

KUALA LUMPUR: Wearing face masks will be made compulsory for those on public transports and in crowded public areas from Aug 1 as the authorities work to break the chain of Covid-19 transmission.

Senior Defense Minister Datuk Seri Ismail Sabri Yaakob said those who fail to comply with the new rules will face a fine of up to RM1,000.

He said the Covid-19 infection trend in the country seems to be on the rise, although at a minimal increase.

The Health Ministry, he said, had reported a decline in the level of compliance by individuals and business premises with the standard operating procedures (SOP), including on public transports such as the LRT and KTM trains.

“People are not observing social distancing or using face masks on public transports. The SOP that should be practiced in public areas, especially in enclosed spaces, are also not being complied to by certain quarters.

“Therefore, the government has decided to make using face masks compulsory effective Aug 1 on public transports and crowded public areas.

“Members of the public are allowed to use cloth face coverings, but they must be stitched in accordance with the World Health Organisation’s (WHO) specifications for homemade masks,” he said during a press conference here today.

Ismail Sabri said the decision to make wearing masks mandatory was made following reports of new clusters and as per the Health Ministry’s advice.

The Health Ministry, he said, would release the specifications for the cloth masks.

Wearing of face masks and social distancing, he said, were two essential practices that would help break the chain of Covid-19 transmission.

By Tharanya Arumugam

Read more @ https://www.nst.com.my/news/nation/2020/07/610978/covid-19-mask-wearing-mandatory-aug-1

ON Monday, Prime Minister Tan Sri Muhyiddin Yassin said the government was contemplating making it compulsory for people to wear face masks when in public. This follows a spike in the number of Covid-19 infections and active cases.

What is more worrying is that it is not just imported cases that have contributed to the rise, but local transmissions as well.

From single-digit daily cases, we have now gone back to double-digit increases. New clusters have sprouted out of nowhere, most notably at an old folks’ home in Kluang and in several places in Sarawak.

The government has rightly taken the decision to revert to having people returning from overseas quarantined in centres instead of at home since there are some who insist on flouting regulations by not taking tests or even staying at home. But this solves only the problem of imported cases.

What about local transmissions? If before, Malaysians were relatively good in following regulations under the Movement Control Order, the distinct drop in the number of cases seems to have lulled us into complacency.

This newspaper has reported that many Malaysians are not wearing face masks any more, but one doesn’t need to read about it to know this is so. All one needs do is take a trip outside the house.

In public places and where there are crowds of people — this is where it must be made mandatory for face masks to be worn — be they in public transportation, at eateries, grocery stores or malls. It is the next logical step in our fight against Covid-19.

The government must make it so and it must be lauded for such a move.

There are studies that show that using face masks has reduced the number of infections. A study by Texas A&M University examined the chances of Covid-19 infection and how the virus is easily passed from person to person.

It said that using a face mask reduced the number of infections by more than 78,000 in Italy from April 6 to May 9 and by more than 66,000 in New York City from April 17 to May 9.

Some European countries have made it compulsory — the Czech Republic, for example. A recent report in The Washington Post says as Covid-19 spreads its claws across the globe, there have been more countries that have made wearing face masks mandatory.

Covid-19 is still a clear and present danger. Even United States President Donald Trump, who has for so long played down the threat, has now taken a different and more serious tone.

And yes, he has made a complete U-turn when it comes to face masks, urging Americans to wear protective face coverings.

There are still some, of course, who will thumb their noses at such warnings. Despite the presence of studies, they say there is no proof that face masks can stop the virus.

The naysayers in countries like the US and United Kingdom postulate that making face masks mandatory would impinge on their human rights and freedom.

To them, we say: it’s better to have some sort of covering than none at all. It’s for your own good and the good of those around you.

Read more @ https://www.nst.com.my/opinion/leaders/2020/07/610795/nst-leader-make-face-masks-mandatory