SITREP 17


SITREP 17



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Ministry of Health and Social Services
Republic of Namibia
8”8, OWorrgladnizHaetailotnh
NAMIBIA
Date & Time of
report
Prepared by
04 April 2020 23:00
Surveillance Team
Investigation start date 13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
1.
SITUATION UPDATE / HIGHLIGHTS
Two new confirmed cases were reported today (04 April 2020)
Cumulatively, 16 confirmed cases have been reported in the country, to date.
Two confirmed cases (5&6) have recovered and discharged on 04 April 2020
Supervised quarantine for all Namibians arriving from other countries for 14 days is
ongoing.
A total of 35 people completed 14-day supervised quarantine on 4 April 2020 and
were discharged.
Partial lockdown of Erongo and Khomas regions took effect on 28 March 2020 till 16
April 2020.
o Borders have been closed except for essential/critical services and
humanitarian support to the response.
o All others prevention measures are applicable to the entire country
Key Challenges include:
Inadequate isolation and quarantine facilities,
Inadequate human resources at all levels
Chronic shortage of PPEs, amidst logistic supply chain problems
Inadequate material supplies including ICU units and ventilators.
Inadequate infrastructure, equipment and supplies at Points of Entry
BACKGROUND
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.
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Case (#14) is a 35 years old Namibian female health worker, who tested in
Windhoek on the 28 March 2020 after presenting with fever, cough, sore throat,
and headache.
Two new confirmed cases were recorded on 4" April 2020
" Case (#15) is a 31-year-old male Namibian, who was a driver for a family that
arrived from South Africa on 26 March 2020. He reported at Robert Mugabe
Clinic on 30 March 2020, with the complaints of cough, body pain, sore
throat, and shortness of breath.
= Case (#16) is a 46-year-old male Namibian permanent citizen healthcare
worker, with the history of travel to South Africa and return to Namibia on 02
March 2020. He was tested at Robert Mugabe Clinic, with fever, chills, body
pain, and sore throat on 30 March 2020.
= Both the two tests came out inconclusive before it was sent to NICD in South
Africa for confirmation. Positive results were received on 4 April 2020.
Table 1: Confirmed cases by region as of 4 April 2020
Reporting
Total
New
Active cases | Recovered | Death
region
Cases
cases
Khomas
11
2
8
3
0
Karas
1
0
1
0
0
Erongo
4
0
4
0
0
Total
16
2
13
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Date of onset
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 04 April 2020
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Figure 2: Suspected and confirmed COVID-19 cases in Namibia per District, as of 04 April 2020
3. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS
EPIDEMIOLOGY & SURVEILLANCE
e 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.

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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.
e Surveillance activities
# Daily pillar and intra-pillar discussions are held to deliberate daily progress,
gaps and way forward;
= Call centre continue operations for 24 hours per day.
= People under mandatory quarantine are being monitored daily (see table 3)
» Data entry is ongoing and data dashboards are under development using
existing platforms.
= Contact tracing is ongoing (see table 2)
Contact tracing Summary
Table 2: Contacts tracing summary as of 04 .04.2020
Variables
Contact risk level
High
Medium | Low | Total
Number of potential contacts
35
28
99
162
Number of contacts identified
35
21
87
152
Number of active contacts
20
11
ZA
52
Number of contacts monitored
16
6
4
26
Contacts of contacts discharged
11
14
61
86
Number of contacts that developed signs &
g
1
5
14
symptoms
*Number of contacts tested without signs and
3
0
#
7
symptoms
Number of contacts tested positive
3
1
0
4
© Number of contacts lost to follow up
0
2
5
Zi
# Contacts never reached
0
0
10
10
*Number of (highly exposed) contacts 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.
# Three contacts could not be reached as they did not provide contact numbers

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Table 3: Number of people in mandatory
Name of the Facility | Cumulative
number of
people
Hardap Resort
40
Rock Lodge
39
(Debmarine)
*Other places in
139
Windhoek
Zambezi Waterfront
68
park
Gross Barman
22,
Total
308
quarantine facility of 04.04.2020
Number of people who | Number of people
developed signs &
discharged
symptoms
0
0
0
0
4
35
3
0
0
0
7
35
LABORATORY INVESTIGATIONS
Stock level of testing kits (laboratory extraction phase) at NIP is 700.
As of 4 April 2020, a total of 362 COVID-19 specimens were recorded for testing
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 04.04.2020
As of 04/04/2020
Laboratory
NIP | Path care
South Africa
Total sample sent to the Laboratory
206 | 156
-
Total sample tested
158 | 154
-
Total results received
157 | 154
-
Total results positive
9
6
*]
Total results negative
Total results pending
147 | 148
-
1
0
-
Total results inconclusive/indeterminate
1
0
-
Total sample discarded
28 =| 2
-
Total new suspected cases in last 24 hours
6
0
-
*] Patient specimen collected and tested in South Africa
COORDINATION AND LEADERSHIP:
Total
362
312
311
16
295
i
1
30
6
COVID-19 responders from all 8 thematic (Pillar) groups have been activated and
are operating from the National Public Health Emergency Operation Centre
(PHEOC) since 14 March 2020.
Coordination and other pillar team meetings on COVID-19 response are held
daily.
A Media Centre for providing up-to date and accurate information has been
established at the Khomas Regional Council offices and provides daily updates
twice a day — 10am and 4pm by the MoHSS and key stakeholders.
Monitoring and Evaluation is being conducted regularly to ensure smooth
coordination of COVID-19 interventions.
Various partners are actively participating in different pillar groups for COVID-19
response.

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CASE MANAGEMENT
= Out of the 16 cumulative confirmed cases, 3 recovered, and have been
discharged, after tested negative for COVID-19.
= The other 13 confirmed cases are in stable conditions.
= Conversion of casualty department at WCH into a highly infectious referral
ICU underway.
# A 12-bed Isolation Unit is under construction at final stage of completion at
WCH.
= Ramatex renovation underway to be repurposed as an isolation facility
« Repurposed hotels/lodges/resorts identified for accommodation of front-liners
and asymptomatic/mild suspect/probable/confirmed cases of COVID-19.
= Consultations with UNAM to avail a clinic for COVID-19 patients is ongoing.
=" More screening sites have been identified in the regions.
= Project Active Case Finding (ACF) is currently underway in Khomas, Erongo
and Kharas regions, aimed to look for possible community transmission
LOGISTICS:
= Facilitated the allocation of quarantine facilities in the country.
= Procurement of PPE, Medical suppliers and pharmaceuticals is ongoing
= Provision of commodities* specifications and verification for procurement is
being done constantly
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 MoHSS in-conjunction with other sectors continues to give daily updates
and prevention measures on COVID-19 at the communication hub.
= The MoHSS continue to conduct press briefing as the situation progresses.
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CHALLENGES
o 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 JEC materials on COVID-19
o Insufficient COVID-19 laboratory testing kits
Need for health information and education materials in multiple languages
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 IEC materials in different vernacular languages
Approved:
fr
Maem
Incident Manager
Date: 04.04.2020
Secretariat