SITREP 14


SITREP 14



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a
Xe
Ministry of Health and Social Services
Republic of Namibia
World Health
Organization
NAMIBIA
Outbre: akName | COVID-19
Country affected
Namibia
Date & Time of
report
Prepared by
01 April 2020 20:00
Surveillance Team
Investigation start date
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
1.
SITUATION UPDATE / HIGHLIGHTS
e Two new confirmed cases reported on 01 April 2020 at Swakopmund, Erongo Region.
e Cumulatively, 13 confirmed cases reported;
e Supervised quarantine for all Namibians arriving from affected countries for 14 days is
ongoing
e Partial lockdown of Erongo and Khomas regions took effect on 28 March 2020 till 16
April 2020. Borders have been closed except for essential/critical services and
humanitarian support to the response.
e Key Challenges include:
© Inadequate isolation and quarantine facilities,
o Inadequate human resources
o Inadequate material supplies including PPE, ICU units and ventilators.
o Inadequate infrastructure, equipment and supplies at Points of Entry
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2. BACKGRAUND
= 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 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
Robert Mugabe Clinic with the following symptoms; fever, cough, sore throat,
shortness of breath, vomiting, and myalgia.
Case number 11, a 69 years-old Namibian male, who traveled from Dubai,
Ethiopia via South Africa, on 17 March 2020, and confirmed positive on 28
March 2020.
The two cases, who were reported on 1 April 2020, are family member of case
number 10 and they arrived together from South Africa on 17 March 2020.
o A husband of case number 10, is a 36-year-old male Namibian, whose
sample was collected in Swakopmund on the 28 March 2020 and sent to
NIP Windhoek for testing. He presented fever, chills, sore throat, body
pain, and headache.
o A daughter of case 10 and 12, is a 9-month-old female Namibian, whose
sample was also taken in Swakopmnund on the 28 March 2020 and
sent to Windhoek NIP for testing. She presented with fever, chills, and
poor appetite.
o They are both being isolated together with case number 10 in their house
in Swakopmund.
Table 1: Confirmed cases by region as of 1 April 2020
Reporting
Total
New
Active cases | Recovered
region
Cases
cases
Khomas
8
0
7
1
Karas
1
0
1
0
Erongo
4
2
4
0
Total
13
2
12
i
Death
0
0
0
0

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pene ete
ote
+}.
cobabis
ating Matto
0 100 200 300 400 500 km
TT
————
COVID-19 Cases-Namibia
~) Districts
Positive Cases
* Lab Tested Cases
Figure 1: Suspected and confirmed COVID-19 cases in Namibia per District, as of 1 April 2020
3. EPIDEMIOLOGY & SURVEILLANCE
Contact Tracing Summary
Table 2: Contacts tracing summary as of 01.04.2020
Variables
High
Contact risk level
Medium | Low | Total
Contacts identified
23
24
95
142
Number of contact traced today
19
14
34
67
Number of contact monitored today
17
9
21
47
Contact completed 14 days follow up today
5
ll
43
a9
Number of contact that developed signs &
symptoms tested
5
1
4
10
*Number of contact without signs and
symptoms tested
_
3
0
1
4
© Number of contact lost to follow up
0
2
5
7
# Contacts never reached
0
0
2
2
*Number of (highly exposed) contact without signs & symptoms tested. One tested positive.
© Seven contacts are lost to follow up, all are non-Namibians and have travelled back to
their countries.
# Two contacts could not be reached as they did not provide contact numbers

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Table 3: Number of people in mandatory quarantine facility of 01.04.2020
Name of the Facility
Number of people
Hardap Resort
40
Rock Lodge ( by Debmarine)
37
Other places in Windhoek
131
Zambezi Waterfront park
62
Total
270
4. LABORATORY INVESTIGATIONS
= Two positive, and 3 inconclusive results were reported at NIP on | April 2020.
= Stock level of testing kits at NIP is low, only 525 laboratory extraction phase
(Qiagen Mini Spin columns) available.
= As of 1 April 2020, a total of 326 COVID-19 specimens were recorded in the two
laboratories (NIP and Path-care) as per table below:
Table 4: COVID-19 specimens recorded in at NIP and Path care as of 01.04.2020
As of 01/04/2020
Laboratory
Total
Total sample sent to the Laboratory
NIP | Path care | South Africa
170 | 156
-
326
Total sample tested
119 | 154
-
273
Total results received
119 | 154
-
273
Total results positive
6
6
*1
13
Total results negative
107 | 148
-
255
Total results pending
18 | 0
-
18
Total results inconclusive
4
0
-
4
Total sample discarded
25 12
-
27
Total new suspected cases in last 24 hours | 13 | 0
-
13
*] Patient specimen collected and tested in South Africa
5. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS
A. COORDINATION AND LEADERSHIP:
= National Health Emergency Management Committee on COVID-19 response was
activated on 14 March 2020.
* Coordination meetings are held daily.
" His Excellency the President of the Republic of Namibia, declared a lockdown for
21 days for Khomas Region and Erongo Region effective as of 28 March 2020.
* Members of the coordination committee conducted monitoring for support
supervision at road blocks and isolation facilities in Windhoek on the 1*t April 2020.
= Organograms for EOC, Standard Operating procedures and other
organizational/management aspects have been put together and are ready for
submission and endorsement by Senior management.
"Various partners are actively participating in different pillar groups for COVID-19
response.
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B. SURVEILLANCE:
Daily pillar and intra-pillar discussions are held to deliberate daily progress, gaps
and way forward;
Contact tracing is ongoing
Call centre continue operations for 24 hours per day.
People under mandatory quarantine are being monitored daily
Training is planned for Erongo region for surveillance and contact tracing on 2-4
April 2020. Two regions (Omusati, and Oshana) have not attended surveillance
training. The virtual training platform for surveillance training are underway for
Omusati,and Oshana
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.
. CASE MANAGEMENT
= Out of thirteen confirmed cases, one has been discharged after he recovered and
tested negative.
= The other twelve confirmed cases are in stable conditions.
= Training on COVID-19 is ongoing, daily sessions at Robert Mugabe, WCH and
KSH. Zoom meeting held weekly
* Conversion of casualty department at WCH into a highly infectious referral [CU
underway (anticipated to be completed by 03 April 2020).
= A 12-bed Isolation Unit is under construction at final stage of completion at
WCH.
= Honourable Prime Minister visited both WCH casualty and isolation facility
under construction on 31 March 2020
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= Project Active Case Finding (ACF) is currently underway in Khomas, Erongo
and Kharas regions, aimed to look for possible community transmission
= Standard Operating Procedures are currently being revised
D. LOGISTICS:
= Facilitation of the allocation of quarantine facilities in the country.
= Procurement of PPE, Medical suppliers and pharmaceuticals
= Provision of commodities specifications and verification for procurement
E. RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
= Educational sessions continue to be conducted in various media
= Psychosocial support is being offered on daily basis to people under quarantine
= The setup of a communication hub where press conferences and live streams are
to be broadcasted has been completed.
= The video clips with the special messages on COVID-19 from the Honourable
Deputy Minister of MICT started airing on NBC TV. Plans are underway to
have these video air on One Africa TV.
= The MoHSS continue to conduct press briefing as the situation progresses.
= Additional community health community health workers have been refreshed on
COVID-19 message before their development to their catchment areas
6. CHALLENGES
Inadequate and at some places lack of isolation units at health facilities and at points of
entry in the regions.
o Inadequate PPE and printed IEC materials on COVID-19
o Insufficient COVID-19 laboratory testing kits
7. RECOMMENDATIONS
= Establish fully equipped isolation units at health facilities and at points of entry in the
regions.
= Fast track procurement process for Personal Protective Equipment and COVID-19
laboratory testing kits
= Expedite printing of EIC materials in different vernacular languages
Approved:
Incident
Date: 01.04.2020
Secretariat