OPINION

WHAT TO MAKE OF OUR PANDEMIC CURVE?

What can be discerned from the shape of the latest wave of local community Covid-19 cases in the pandemic curve?

(1) From the 1 total case on July 11th, it spiked sharply in 9 days to a peak of 182 cases by July 20th, followed by an equally sharp descent to 130 cases 3 days later, only to hover at a near plateau around that number till today’s 131 cases.

(2) The reason why there is a plateau instead of a further decline of total cases is because the great efforts by MOH to control the large and established clusters are met with a corresponding increase in unlinked cases. From the peak on July 20th, over the last 11 days, the halving of linked cases is matched by a doubling of unlinked cases.

(3) This indicates that Covid-19 infections are diffusing and dispersing out from the main clusters and predictable scenarios to sporadic, unforeseen and widely separated localities.

(4) If this trend continues, the great efforts by MOH to test, trace, quarantine and isolate potential cases in order to ring-fence outbreaks will become less and less effective in suppressing case numbers as they are unlikely to keep up with the ever widening diffusion of cases.

(5) With the sharp increase in the number of the very ill Covid-19 patients, those requiring oxygen supplementation (26 people) or those in intensive care units (ICU) (7 people) over the last two weeks, rising from 8 to 33 people, our efforts and strategy appear not to be achieving our objectives in fighting the pandemic. We should remember that our main objectives are firstly, to prevent death and severe illness, secondly, to prevent our health system from being overwhelmed, thirdly, to prevent the high morbidity of widespread infections, and lastly, to allow our economy to recover its vibrancy and our nation to recover her confidence.

(6) It is time to switch gears soon as our vaccination rates especially among the >60s are about to be high enough. Less resources should be spent trying to trace every case of infection especially when they are mild or asymptomatic. More efforts and new initiatives to identify, safeguard and possibly mandatorily vaccinate the elderly, those with co-morbidities and other vulnerable people should be instituted as soon as possible.

97% of ...

Isn’t it a curious thing that the term “97%” seems to jump up at you almost everywhere, all the time?

First, the good news:

97% of the mortality from Covid-19 infection can be prevented by the CoronaVac Covid-19 vaccine.

No wonder:

97% of King County (US) Covid-19 cases were unvaccinated people.

But the bad news is:

97% of Indians are being left poorer by the  Covid-19 pandemic.

While:

97% of people say that they want to return to the workplace for some or most of the time when possible.

97% of sports fans will be happy to attend live sport events again in the future

But, this is contradicted by: 

97% of office workers want to continue working from home post-pandemic.

Is it because:

97% of office workers feel frustrated at work?

Frustrated by?:

97% of all organisations reporting malware attacks in 2020.

Especially if:

97% of Fortune 500 companies are relying on social media.

And the wide use of apps, like:

97% of TikTok’s user counts are reached through Indian apps.

97% of internet users in Kenya use WhatsApp.

Or is it because:

97% of women aged 18-24 faced sexual harassment?

Of course, we wouldn’t forget the old, familiar one, the original “97%”:

97% of climate scientists “really” do agree that climate change is real and humans are the cause of it.

And some happy consequences when green policies are implemented:

97% of Scotland’s electricity demand in 2020 was met by renewables.

97% reduction of water consumption in electricity generation by the use of wind power and solar energy.

97% of plastic bottles in Norway are recycled.

But yet:

97% of Earth’s land area may no longer be ecologically intact.

Is that why?:

97% of pigs in the US are raised in a factory, not in a traditional farm.

No? 

Well, if this long account is too much for your ears, be assured that:

97% of ruptured eardrums heal naturally.

But, there is no comfort in this saddest of news: 

97% of traffic for SIA has been dropped in January 2021!

But finally, I think 97% of these 97% claims are wild generalisations that should not be fully believed.

Opinion

SUPERVISED AND ENFORCED UNIVERSAL N95 MASKING AS THE SOLUTION TO THE COVID-19 PANDEMIC

Back on 5 February 2020, (https://touch.facebook.com/story.php?story_fbid=2662707927099382&id=100000806023869) I was one of the first people to recognise that Covid-19 can be transmitted asymptomatically and advocated universal masking as a measure to prevent such transmission. After some initial illogical objection from many quarters, universal masking is now widely practised and has become mandatory in many countries.

Fast forward 15 months, it is a sad failure of public policy that this pandemic is still rolling on with a vengeance. Up till today, there are now 158 million cases and 3.3 million deaths despite 310 million people already vaccinated. 

There are 4 reasons why many countries are experiencing large spikes in infections in their 3rd or 4th waves:

(1) Vaccinations are not proceeding fast enough.

(2) Consequently, the virus has been allowed time to mutate into dangerous variants that spread faster and become more deadly.

(3) There is a failure to institute adequate masking and social distancing measures as people still congregate for social, religious and political activities.

(4) Masks when worn do not prevent transmission because the masks are poor quality cloth masks or they are not worn properly.

To me, the solution to this pandemic is to mandate the compulsory wearing of N95 masks universally. If worn properly, such a practice will reduce everyone’s exposure to the virus by 99%! This will surely spell the beginning of the end of the pandemic. Last year’s objection based on the excuse of having insufficient supply of N95 masks no longer holds water. The world had 15 months to activate a wartime effort to mass-produce N95 masks for the whole world. If there was enough time, effort and money to introduce the vaccine, why wasn’t there enough time, effort and money for the manufacture of something far simpler and cheaper - the N95 mask?

(NB: I’m not alone in this opinion. Please see  https://www.google.com.sg/amp/s/www.washingtonpost.com/opinions/2021/01/26/n95-masks-safest-next-best-options/%3foutputType=amp)

 It’s Truly Labour Day

Are we labouring under a curse?

Or is this just a blip in the universe?

What are we to make of all this?

Can a Higher Being do something, please?

Sojourned on a planet we called our own,

While bitten by a virus we’ve never known,

We’ll have to show that we are really worthy

By taking full charge of our own destiny.

CLIMATE CHANGE / GLOBAL WARMING - WHAT'S THAT?

Opinion

Let's try to take Joe Biden's assertion that "climate change" is "the existential threat of our time" seriously. According to climate change believers, they wish to convince the world of 3 things:

(1) The current warming trend of mean global temperatures is unprecedented and soon will become irreversible; and this will lead to dangerous weather extremes and the end of the world.

(2) This trend is solely caused by man's burning of fossil fuels emitting too much CO2 which raises global temperature through its greenhouse effect. No other factor is involved.

(3) The solution to this crisis is for the world to strive to limit the rise in global temperature to less than 1.5*C above pre-industrial levels by halving carbon emissions by 2030 and then to "net zero" by 2050.

Let me humbly submit that all 3 assertions are false or do not make any logical or scientific sense.

(1) Our current temperature or temperature trend is unremarkable. The mean global temperature in 1880 was 13.8*C and is estimated to be 15*C in 2020 which is a rise of 1.2*C already, but in absolute temperature terms, these temperatures are much cooler than any air-conditioned room today. So, unsurprisingly, there had been absolutely no evidence of increase in trends of weather extremes or disasters; and most people are going about their business without a thought about doomsday which is purportedly just around the corner.

Also. perhaps, it would be more objective if we look at longer-term records. Since mankind is only 200,000 years-old, to be objective, we should look at the mean global temperature record over the last 400,000 years. This showed temperature differences of up to 12*C between peaks and troughs every 100,000 years in accordance with the Milankovich cycles. So, a 1.2*C rise is actually nothing!

If we go back even further, we will see that mean global temperature 500 million years ago was 35*C, more than double that in 2020, but 35*C is nothing to shout about because that can frequently be the afternoon temperature in sunny Singapore here and to us it is "normal" since time immemorial. Also, if we got here in 2021 because the planet was not destroyed 500 million years ago, why should we worry about that now if the temperature has more than halved in the intervening period?

(2) If the contribution of man-made CO2 (through the burning of fossil fuels) to total global CO2 emissions is only 4.4% and CO2 residence time in the atmosphere is only 4 years, how can man-made CO2 be the control knob of global temperature, especially when CO2 from any source is responsible for only 4.2% of the total greenhouse effect of all greenhouse gases?

(3) 15.3*C mean global temperature is no magic number and it is difficult to fathom how or why we will cease to exist if that number is breached. In any case, we are already at 15*C. So, are we going to spend perhaps more than $100 trillion over the next 79 years just to prevent the rise of another meaningless 0.3*C, especially when nothing bad is going to happen??

The Club of Stink Kong and Notzilla

Joining the Club you ought to be,

Even if your fault you can’t see.

Sign the contract that ain’t pretty,

Even though you can’t afford its fee.

Give up your gold to feed Stink Kong

Even as Notzilla’s gas and fire is all wrong.

While the little big people play along,

We can only sing this sad quiet song.

Though many will lose their gain,

Isn’t it time now to stop the feign?

While the second is being ordained,

Let’s redefine the first arrangement again.

BECAUSE IT’S THE CHINESE NEW YEAR

Still fighting Covid-Nineteen.

What a cruel year it has been!

Filled with sadness, anxiety and fear,

The virus is all we see and hear.

Yet, with the world in a rare unity,

Regardless of race, ideology or nationality,

Let’s never shed another tear.

Because it’s the Chinese New Year!

BACK

Pull back the curtain,

Unknown things become certain.

Flick back your hair,

You’ll see someone standing there.

Pull back your punch;

Learn to forfeit your free lunch.

Roll back the years,

Cos’ there’s no time for tears.

Hold back your belief

That every man is a thief.

But to earn back the trust,

The golden rules are a must.

 TWENTY

Twenty twenty,

Trouble aplenty.

Twenty twenty-one, 

Battle yet to be won. 

Twenty twenty-two, 

You’ll be vaccinated too. 

Slowly, slowly, we’ll see.

We’ll get there, maybe.

Protocol for Emergency Treatment of Anaphylaxis (after Covid-19 vaccination)

1. Patient to be observed for 30 mins in the clinic after Covid-19 vaccine (and patient to observe himself for 24 hrs at home).

2. Diagnose anaphylaxis.

-Urticaria, angioedema

-Dyspnea, wheeze

-Dizziness, syncope, hypotension

-Nausea, vomiting, diarrhea, cramping abdominal pain

-Flush

-Upper airway edema

-Headache

-Rhinitis

-Substernal pain

-Pruritus without rash

-Seizure

3. Call 995 immediately.

4. Place patient in recumbent position and elevate lower extremities, but treat patient sitting up if he is breathless.

5. Monitor vital signs frequently (every two to five minutes) and stay with the patient.

6. Administer adrenaline 1:1,000 (weight-based) adults: 0.01 mL per kg, up to a maximum of 0.2 to 0.5 mL every 10 to 15 minutes as needed; children: 0.01 mL per kg, up to a maximum dose of 0.2 to 0.5 mL by SC or IM route and, if necessary, repeat every 15 minutes, up to two doses.

7. Maintain airway with an oropharyngeal airway device. Administer oxygen (if you have), usually 8 to 10 L per minute; lower concentrations may be appropriate for patients with chronic obstructive pulmonary disease.

8. IM Piriton 1 ml stat.

9. IM Adrenaline 0.15 to 0.3 mL, into injection site (left deltoid) to inhibit further absorption of the injected substance (vaccine).

10. Set up IV line to treat hypotension with IV fluids.

11. Treat bronchospasm with Ventolin nebuliser 2 mls:1 ml saline stat.

12. Give IM hydrocortisone 100 mg stat or tab prednisone 20 mg stat orally in mild cases. This does not work immediately but reduces the risk of recurring or protracted anaphylaxis. These doses can be repeated every six hours, as required.

13. All fatal and life-threatening events are to be reported to HSA within 24 hrs and all other Severe Adverse Events and Adverse Events of Special Interest within 48 hrs online at https://www.hsa.gov.sg/adverse-events. Fatal events also are to be reported to the Coroner.