SITREP 11


SITREP 11



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Ministry of Health and Social Services
Republic of Namibia
rgraind izHaetailotnh
NAMIBIA
! Ouitres Name ~ F
Date & Time of
report
Prepared by
29 March 2020 23:42
Surveillance team
Region
Country affected
Investigation start date
Date of outbreak declaration in Namibia: 14 March 2020.
Namibia
13 March 2020
e No new confirmed cases have been reported on 29 March 2020
e Cumulatively, 10 Imported cases reported — with travel history from affected countries;
while | is being investigated if its imported or local.
e Thematic group meetings continue to be held daily, since the 14 March 2020
e Supervised quarantine for all Namibians for 14 days from affected countries is ongoing
Partial lockdown took effect on 28 March 2020 till 16 April 2020. Borders has been
closed except for essential/critical services and humanitarian support to the response.
e Key Challenges include:
o Inadequate isolation and quarantine facilities, human resources and material supplies
including PPE, ICU units and ventilators.
= Description of the latest cases
= Index cases: Two confirmed cases of COVID-19 were reported in Windhoek
district on 13 March 2020. The married couple; a 35-year-old male and a 25-year-
old female, arrived from Madrid, Spain on 11 February 2020.
= Case number 9, is a 35 years old Namibian female, who traveled from South Africa,
on 20 March 2020 with her husband and 9 months old baby. She was tested at a
private facility on 24 March 2020 in Windhoek, with complains of sore throat, dry
cough, fever, body pains and headache.
The family then travelled to Swakopmund on 26 March 2020 to be able to self-
quarantine at their own house. Contact tracing is ongoing.
= Case number 10, a 41-year-old female Namibian citizen, who traveled from Dubai,
Ethiopia via South Africa, on 17 March 2020. She was tested on 26 March 2020 at
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Robert Mugabe Clinic with the following symptoms; fever, cough, sore throat,
shortness of breath, vomiting, and myalgia.
= Case number 11, is a 69 years-old Namibian male, traveled from South Africa on
12 March 2020, tested at Omaruru medical practice on 25 March 2020 complaining
of chills, cough and body pains (no fever). The sample was sent to NIP in
Windhoek on 27 March 2020. He tested positive on 28 March 2020.
Table 1: Cases by reporting region as of 29 March 2020
Reporting
Total
New
Active cases | Recovered
region
Cases
cases
Khomas
8
1
5
2
Karas
1
0
1
0
Erongo
2
2
2
0
Total
11
3
9
2
Death
0
0
0
0
u
7
0 100 200 300 400 500km
Kestmintees |
a
|
|
j po j
(<<) COVID-19 Cases Namibia Districts
2% Positive Cases
~ Lab Results Pending
* Negative cases
= Lab Tested cases
*Omaruru case in not illustrated in the map
Figure 1: Suspected and confirmed COVID-19
2020
cases in Namibia
per District, as of 29 March
=" Number of Laboratory confirmed cases: 11
a Alive and dead: 0 death and 11 cases alive.

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Contact Tracing Summary
Table 2: Contacts tracing summary as of 29 .03.2020
Variables
High
Contact risk level
Medium
Low
Total
Contacts identified
19
17
64
101
Number of contact traced to-date | 18
15
20
53
Number of contact monitored
V7
13
18
48
today
Contact completed 14 days
follow up to-date
2
;
au
at
Number of contact that
developed signs & symptoms
5
1
4
10
tested
s*i:Ngunsmbaenrd
of contact
symptoms
without
tested
3
0
1
4
* Number of contact lost to
0
>
10
2
follow up
*Number of (highly exposed) contact without signs & symptoms tested. One tested
positive.
*Most of the contacts lost to follow up are non-Namibian who left to their countries
4. LABORATORY INVESTIGATIONS
# The samples of 6 confirmed cases were taken by Path-Care and tested in South
Africa, while 4 confirmed cases were taken and tested by NIP. An additional
confirmed case had the sample collected in South Africa and the positive result was
received whilst the case was in Namibia.
= As of 29 March 2020, a total of 246 COVID-19 specimens were recorded in the two
laboratories (NIP and Path-care) as per table below:
Table 3: COVID-19 specimens recorded in at NIP and Path care as of 29.03.2020
As of 29/03/2020
Laboratory
NIP
Total sample sent to the 95
Laboratory
Total sample tested
80
Total results received
77
Total results positive
4
Path care | South Africa
154
-
152
-
131
-
6
*1
Total
246
232
208
11
Total results negative
Total results pending
Total sample discarded
77
125
0
21
11
2
-
213
-
5
-
13
New suspected cases
3
0
-
3
*] Patient specimen collected and tested in South Africa
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COORDINATION AND LEADERSHIP:
National Health Emergency Management Committee on COVID-19 response was
activated on 14 March 2020.
The outbreak was declared by Hon. Minister of Health on 14 March 2020.
The Ministry continue to conduct press briefing as the situation progresses. Last
press briefing conducted on 29 March 2020.
Coordination meetings are held daily.
His Excellency Dr Hage Geingob declared and issued guidelines for a lockdown for
21 days for Khomas Region and Erongo Region effective as of midnight 27 March
2020.
A High level meeting (chaired by secretary to cabinet) held on 29 March 2020
discussed the implementation of lockdown guidelines and way forward
SURVEILLANCE:
Daily pillar and interpillar meetings are held to discuss daily progress, gaps and way
forward;
Contact trancing is ongoing and alert/call centre is receiving alerts from the general
public.
All quarantine facilities are being monitored daily
Case definitions as of 20 March 2020:
Suspect case:
A. A patient with acute respiratory illness (fever and at least one sign/symptom of
respiratory disease, e.g., cough, shortness of breath), AND a history of travel to or
residence in a location reporting community transmission of COVID-19 disease
during the 14 days prior to symptom onset;
OR
B. A patient with any acute respiratory illness AND having been in contact with a
confirmed or probable COVID-19 case (see definition of contact) in the last 14
days prior to symptom onset;
OR
C. A patient with severe acute respiratory illness (fever and at least one
sign/symptom of respiratory disease, e.g., cough, shortness of breath; AND
requiring hospitalization) AND in the absence of an alternative diagnosis that fully
explains the clinical presentation.
Probable case: A suspect case for whom testing for COVID-19 is inconclusive.
Inconclusive being the result of the test reported by the laboratory
Confirmed case: A person with laboratory confirmation of COVID-19 infection,
irrespective of clinical signs and symptoms.
.
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o CASE MANAGEMENT
a There are 11 confirmed cases under case management to date. Eight of cases
are within the Khomas Region, while two in Erongo and one in Kharas Region.
= As of 29 March 2020, all patients are stable.
=» Case #8, #9 and #11 are in self-isolation at home and are stable. Otherwise all
other cases are admitted in isolation facilities (case #3 in Windhoek Central
Hospital 6E, case # 7 at Keetmashoop Hospital, case #10 at Robert Mugabe
Hospital & the rest are at HKIA isolation unit).
# Training on COVID-19 is ongoing, daily sessions at Robert Mugabe, WCH and
KSH. Zoom meeting held weekly
= More screening sites are being assessed
= Renovations are nearing completion of COVID-19 referral ICU at WCH (to be
complete by 03 April 2020).
= A 12-bed Isolation Unit has been constructed on WCH complex.
= Roman Catholic Hospital, Mediclinic, Lady Pohamba and Rhino Park Private
hospitals have screening, testing and isolation wards.
=" Feedback from 11 Regions on preparedness to respond to COVID19 was
recieved. Erongo, Karas, Khomas, Oshana, Hardap, Omaheke, Otjozondjupa,
Zambezi and Omusati, have established screening, swabbing and isolation
facilities.
o LOGISTICS:
= Set up a mobile clinic at quarantine facility in Windhoek.
* Installation of Ventilators and ICU monitors at Robert Mugabe Clinic.
« Facilitation of the allocation of quarantine facilities in the country.
# Issuing of identification cards to participants in COVID-19 operations
o RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
= Educational sessions continue to be conducted in various media
= Media houses are engaged. The Government leadership appeared on a National
Broadcaster to share the status of COVID 19
* Psychosocial support is being done on daily basis to people under quarantine
o Lack of fully equipped isolation facilities in the regions at health facilities and points
of entry in the regions.
Insufficient Personal Protective Equipment/clothing.
Insufficient isolation facilities and COVID-19 testing kits
Insufficient reagents/components for local testing for COVID-19
Lack of quarantine facilities for health workers who are managing the cases.

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=" Need for improving country coordination and communicating information between
management and technical working groups.,
# Finalization of all relevant SOPs per pillar and TOR
=" Need for complete Rapid Response Team
= Fully equip National Public Health Emergency Operations Centre
« All positive cases must be in isolation centres or in private homes/farms with minimal
risk of exposing others.
= Make use of NIP services and ensure specimens collected are of good quality and
persons tested meet case definition
Cleared i
Ki \\ On =
—
cident Managér
Date: 29.03.2020
Secretariat
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