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Sunday, January 3, 2021

Malaysians staying home less despite third wave; Beating Covid-19 in 2021 required managing time, risk and ambition

Report shows more people going out again after Dec 7


Since the start of the conditional movement control order in May, the amount of time Malaysians spent at home has mostly been on a downward trend even as Covid-19 cases soared in the past few months.

This is one of the insights from Oxford University’s Our World in Data portal (ourworldindata.org), which analysed a report from Google that tracks the movement of people in more than 130 countries since the pandemic began.

Google’s Covid- 19 Community Mobility Report records changes in the number of visitors each day to various types of locations such as workplaces, and retail and recreational areas.

The report, based on data Google collects from users who have their location history setting turned on, also measures the change in the amount of time people spend at home each day.

The daily changes are compared with a baseline figure taken from before the pandemic, which is the median value over the five-week period from Jan 3 to Feb 6, 2020.

Charts created by Our World in Data based on the Google report shows how the movement of people, including in Malaysia, changed throughout the pandemic.

When Covid-19 first emerged, many Malaysians were still spending their days mostly at their workplaces or other locations instead of being at home.

That changed after the MCO was introduced on March 18.

On March 27, time spent at home shot up with a 36.14% increase compared with the baseline period while the number of visitors to workplaces fell to negative 63.71% due to MCO restrictions.

Malaysians, however, started venturing out of their homes more following the introduction of the conditional MCO on May 4.

The conditional MCO relaxed some of the earlier restrictions, with most economic sectors and activities allowed to operate with physical distancing.

As a result, time spent at home started falling and on Aug 30 hit a low of just 4.57% more than the baseline.

The start of a third wave of Covid19 cases since Sept 20 saw a relatively brief increase in time spent at home.

However, the figure fell again especially after Dec 7 when restrictions on inter-district and interstate travel were lifted, with the exception of areas under the enhanced MCO

Beating Covid-19 in 2021: Managing time, risk and ambition


Think bigger: We must reimagine a a new social contract for health, one that protects citizens and non-citizens in fair, sustainable and politically acceptable ways. 

 VERY often in the pandemic of 2020, we found ourselves in situations with no good choices. That's normal. This is a once-in-a-lifetime pandemic with no useful policy textbooks or manuals. Public health experts and scientists raced to understand Covid-19, and we continue to learn more. Political leaders and policymakers struggled to deploy old solutions for a vast new problem.

It's now 11 months since Malaysia's first Covid-19 case. As we forge ahead into 2021, I humbly offer three strategies for Malaysia's national health: to use time wisely; to stabilise our tolerance levels of risk; and to match our solutions to the size of the problem. This will help us in our second year with Covid-19.

Firstly, Malaysia must use time wisely. In other words, we must prepare for future problems today, instead of waiting for the problems to arrive. For example, we had four months between June-Sept 2020 when we had very few cases. That quiet period came after a national MCO sacrifice of two months. We may not have utilised that four quiet months effectively.

Some of the problems in the third wave are similar to the problems in the first two waves. Examples include the living conditions of foreign workers, the speed and scale of testing and isolating, effective contact tracing using apps, data sharing from the Health Ministry, and coordination between federal-state responses.

This is why Malaysia must use time wisely in 2021. Quiet periods or not, the government must use time to rebuild, strengthen infrastructure and implement long-term durable solutions. Two specific examples include building the vaccine infrastructure before the first stocks arrive in Feb 2021, and to deliver a clear management plan when we find positive Covid-19 cases during the mass testing of foreign workers starting in Jan 2021.

In the second year of the pandemic, we cannot fight the same problems as in the first year. We must get these old problems under control, and then solve new ones. That means we must use our time wisely, and not waste it.

The second strategy for national health in 2021 is to stabilise our tolerance levels for risk. After one year, it seems like we are willing to tolerate much higher levels of risk, compared to the early stages of the pandemic. This can be dangerous. We must have a stable tolerance level of risk, not increasingly tolerate more and more risk.

Here's an example. In March, we had approximately 100-300 daily new cases. In December, we had approximately 850-2300 daily new cases. Despite this dramatic increase, everyone has started taking Covid-19 lightly. Government entities are no longer marching to the same disciplined tune as in the beginning of the pandemic and appear to be more relaxed. Citizens are no longer consistently wearing masks or physically distancing.

There may be reasons why we take it lightly. We all have pandemic fatigue and want our old lives back. Malaysia may have 2000 daily cases in December, but we feel better when comparing it to Indonesia's 5000-8000 cases or the United Kingdom's 13,000-53,000 cases in the same month. These are understandable, but dangerous.

We cannot take Covid-19 lightly. We cannot endlessly tolerate increasing amounts of pandemic risk. I do not think a second full lockdown will work to help avoid it. But I do not believe that we can endlessly tolerate more risk and assume that we will never need it.

What I do support is a stable level of risk tolerance. In other words, take Covid-19 consistently seriously until we are all safe. A pandemic continues to rage around us. To government agencies, take things seriously, communicate better, use time wisely and prepare for future problems. To citizens, wear your masks and stay home where possible. Don't let the increasing numbers numb us into thinking that we can endlessly tolerate more risk.

The third and final strategy for national health in 2021 is to match our solutions to the size of the pandemic. In other words, we need solutions that are proportional to the size of the problem. After one year of fighting Covid-19, we know that our pre-2020 solutions, tools and policies are inadequate. Covid-19 is simply too big for any old solutions.

In the early stages, all governments are forgiven if they don't know what to do. After one year of Covid-19, all governments lose that excuse. Given the scale of Covid-19, we need ambitious, imaginative and Very Big solutions to a Very Big problem. In other words, unprecedented problems need unprecedented solutions, not old, timid and ineffective solutions.

This means that our government must aim much higher in 2021. We need new ways to deliver history's most important vaccination program, as safely, effectively and quickly as possible. We must reimagine a new social contract for health, that protects citizens and non-citizens in fair, sustainable and politically acceptable ways. We can integrate our non-health and health infrastructure to enable better contact tracing, such as South Korea's use of credit card transactions and China's use of QR codes. We need a true whole-of-society response.

In the first year, governments can be forgiven for relying on what they are familiar with. In the second year, governments must respond to Covid-19 in much bigger ways. This once-in-a-lifetime problem requires once-in-a-lifetime solutions. Only then can we beat this pandemic.

The Covid-19 pandemic will define not just 2020, but the 2020s. The strategic choices we make in 2021 will define how effectively Malaysia manages Covid-19 and recovers from it. This new year let us make three resolutions as a country: to use our time wisely, to stabilise our tolerance of risk, and to bring ambitious giant solutions to a giant problem. — Sin Chew Daily/Asia News Network

Dr Khor Swee Kheng is an independent consultant for the World Health Organisation. The views expressed here are solely his own and do not necessarily reflect those of The Star. 

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Friday, January 1, 2021

Happy New Year 2021: Stay Home to stay Safe


https://youtu.be/Qt0dAbyjU-c


https://youtu.be/nDJKtzUcXyU



Health experts say the current Covid-19 situation in the country is not favourable for social gatherings even for welcoming the New Year.

“Current active cases have exceeded 21,000 and daily numbers are close to 2,000. We should not expose ourselves to any risk of infection,” said Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman.

“We should also not strain our healthcare system further.”

The conditional movement control order (MCO) was eased for the sake of the country’s economy, and not for engaging in big social crowds or family gatherings, said Dr Malina.

She advised the public to continue to comply with SOP, as the vaccine was yet to be made available locally.

“Hopefully the vaccine will reach our country soon. Singapore has started the vaccination for their frontliners today (yesterday) and their cases are much lower compared to us, we have to be more consistent and vigilant against Covid-19.

“Or we can expect early next year to be markedly different from our neighbouring country,” she said.

Universiti Malaya professor of epidemiology and public health Prof Dr Sanjay Rampal said for the next few weeks, it was important to do two things.

“First, avoid being in congested and confined areas for prolonged durations. It may be hard at times to maintain the minimum 1m physical distancing but we have to.

“Second, there may be a need to maintain a social circle for longterm emotional and psychosocial support, but avoid a large bubble, and restrict mixing across networks,” he said.

For New Year celebrations, Dr Sanjay suggested that the public usher in the New Year by staying at home.

Large gatherings, if any, should be held in big, open spaces while practising physical distancing, he said, adding that the location should have sufficient amenities to promote good sanitation and hygiene.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah concurred that celebrations should be held in open areas with good ventilation to reduce the probability of getting infected.

Dr Raj said air conditioned and closed spaces without good ventilation posed a risk to people.

“Malaysians can celebrate in open areas by observing the SOP laid out by the Health Ministry. Use your face mask, observe social distancing, and wash and sanitise your hands regularly,” he said.

Going into the new year, Dr Raj believed there would not be “total freedom”.

“There will still be restrictions for the whole of next year. Hopefully, the vaccine can ease that for us. However, let’s remain positive and hope for the best,” he said.

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Tuesday, December 29, 2020

Core Exercises for Stroke Patients to Improve Balance and Walking (Gait)


https://youtu.be/dGBqTLtdVuA 



Seated Core Exercises


https://youtu.be/twZ1hnetOP8


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The best way to improve balance after stroke is with core exercises. You can also download 13 pages of free rehab exercises here: https://flnt.rehab/2JGii7r

These core exercises for stroke patients are guided by Cassi, DPT (Doctor of Physical Therapy).

Cassi's core exercises are relatively easy and will help you improve your balance and gait (manner of walking).

To get more information on stroke recovery, download our FREE ebook here:https://flnt.rehab/2zg3yt0

Best Hand Exercises for Stroke Patients at Home

https://youtu.be/i0JYsLyJEnE 

These hand exercises for stroke patients are guided by Barbara, OTA. You can also download 13 pages of free rehab exercises here: https://flnt.rehab/2JGii7r



Best Stroke Recovery Hand Exercises - Stage 1


https://youtu.be/ZKR1nOtCNKU 

Dr. Scott Thompson shares the best stroke recovery hand exercises. Use these hand exercises and hand therapy tools to advance your stroke recovery. 

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We are so happy to have you here. We are Flint Rehab, and we're pretty passionate about stroke rehabilitation.

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Because we believe that...

  • ...You can defy the odds and achieve a higher recovery - if you believe in yourself.
  • ...Stroke education is of the utmost importance because it can help you achieve that higher recovery. 
  • ...Emotional healing is just as important as physical healing, so we always talk about both.
  • ...Regaining movement after stroke does not have to be boring.

That's why we pour so much energy into both maintaining an extensive stroke education blog and creating fun, effective rehabilitation devices.

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If you aren't interested, we understand. You can opt out here or at the bottom of any email at any time. No hard feelings!

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