SITREP 18


SITREP 18



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Ministry of Health and Social Services
Republic of Namibia
(2\\) World Health
ay ONrAgaMniIzBatIiAon
eak Name
Date & Time of
report
Prepared by
05 April 2020 23:00
Surveillance Team
Investigation start date 13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
SITUATION UPDATE / HIGHLIGHTS
No new confirmed cases were reported today (05 April 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, to date.
e Three confirmed cases have recovered and discharged to date.
e Supervised quarantine for all Namibians arriving from other countries for 14 days is
ongoing.
e 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:
o Inadequate isolation and quarantine facilities,
O° Inadequate human resources at all levels
Oo Chronic shortage of PPEs, amidst logistic supply chain problems
oO Inadequate material supplies including ICU units and ventilators.
Oo Inadequate infrastructure, equipment and supplies at Points of Entry.
2. 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.
Case (#15) is a 31-year-old male Namibian, who drove a friend and her family
that arrived from| South Africa on 26 March 2020. He reported at Robert Mugabe
Clinic on 30 March 2020, complaining of cough, body pain, sore throat, and
shortness of breath. The specimen was collected same day and sent to NIP.
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The result came out inconclusive on the 01 April 2020 and sent to NICD SA for
confirmatory test. The final result came out positive on the 04 April 2020.
Case (# 16) is a 46-year-old male Namibian permanent resident and health
professional, with the history of travel to SA to attend a conference. He came back
on the 2" March 2020. He developed flu like symptoms on the 19 March 2020,
which solved after self-medications. He then presented at Robert Mugabe Clinic,
with fever, chills, body pain, and sore throat on 30 March 2020. The specimen was
collected same day and sent to NIP. The result came out inconclusive on the 01
April 2020 and sent to NICD SA for confirmatory test. The final result came out
positive on the 04 April 2020.
Total number of imported cases currently stands at 13 and local transmission is 3
There is no evident community transmission in the country at the moment.
Table 1: Confirmed cases by region as of 05 April 2020
Reporting
Total
New
Active cases | Recovered | Death
region
Cases
cases
Khomas
11
0
8
3
0
Karas
1
0
1
0
0
Erongo
4
0
4
0
0
Total
16
0
13
3
0
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Date of symptoms onset
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 05 April 2020
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COVID-19 Cases- Namibia
(_J Districts
%* LPaobsittievsetedCasCeasses
Figure 2: Suspected and confirmed COVID-19 cases in Namibia per District, as of 05 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.
= Project Active Case Finding (ACF) is currently underway in Khomas, Erongo
and Kharas regions, aimed to look for possible community transmission.
= Contact tracing is ongoing (see table 2)
Contact tracing Summary
Table 2: Contacts tracing summary as of 05 .04.2020
Variables
Contact risk level
High
Medium | Low | Total
Total Number of contacts listed
44
28
102
174
Total Number of contacts identified
40
28
89
157
Total Number of active contacts (being
om)
Ul
4
54
followed)
Number of contacts monitored/followed in the 7
5
4
%6
last 24hrs
Total number of Contacts completed 14-days
15
14
63
92
follow up
T&otaslymNputmobmser of contacts that developed signs
8
1
5
14
Total Number of contacts tested positive
3
1
*Total Number of contacts tested without signs
and symptoms
a
0
0
4
4
7
© Total Number of contacts lost to follow up
0
2
5
7
# Total number of 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 quarantine facility of 05.04.2020
Name of the
Cumulative | Number of people
Test results | Number of
Facility
number of | who developed signs
people
people
& symptoms and
discharged
tested
Hardap Resort
40
0
0
0
Rock Lodge
39
0
0
0
(Debmarine)
*Other placesin | 141
4
4 Negative | 35
Windhoek
Zambezi
76
3
3 Negative | 0
Waterfront park
Gross Barman
ae
0
0
0
Total
318
a
7
35
LABORATORY INVESTIGATIONS
= Stock level of testing kits (laboratory extraction phase) at NIP is 700 and
confirmation tests are about 400
= As of5 April 2020, a total of 366 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 05.04.2020
As of 05/04/2020
Laboratory
NIP | Path care
South Africa
Total sample received bythe Laboratory
206 | 160
-
Total sample tested
158 | 158
-
Total results received
157 | 158
-
Total results positive
9
6
=]
Total results negative
147 | 152
-
Total sample discarded
26 42
-
Total results pending
1
0
-
Total results inconclusive/indeterminate
1
0
-
Total new suspected cases in last 24 hours
0
4
-
*I Patient specimen collected and tested in South Africa
Total
366
316
315
16
299
30
1
1
4
COORDINATION AND LEADERSHIP:
* 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.
" Many efforts to increase isolation and quarantine facilities ongoing.
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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. None with severe
symptoms.
= 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.
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
® 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.
PSYCHOSOCIAL SUPPORT SERVICES:
= Mapping of 3 shelters for placement of persons without shelter in Windhoek
completed
* Rapid assessment on persons without shelter conducted
* Provision of food, water, as well as psychosocial support and public health education
were provided to a group of 900 persons in need of shelter in Windhoek
# Psychosocial support and post counselling services offered to people under
quarantine, COVID-19 confirmed cases and their families are ongoing
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CHALLENGES
oO Inadequate and at some places lack of isolation units at health facilities and at points
of entry in the regions.
Inadequate PPE and printed IEC materials on COVID-19
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.
Continue to build capacity of response workers.
gol Approved:
Incident Manager
Date: 05.04.2020
Af
Secretariat
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