SITREP 21


SITREP 21



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Ministry of Health and Social Services
Republic of Namibia
2s\\S)y WOorrgladnizHaetailotnh
NAMIBIA
Outbrea
Date & Time of
report
Prepared by
08 April 2020 22:00
Surveillance Team
Investigation start date
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
L.
SITUATION UPDATE / HIGHLIGHTS
No new confirmed cases were reported today (08 April 2020).
Cumulatively, 16 confirmed cases have been reported in the country, to date.
Supervised quarantine for all Namibians arriving from other countries for 14 days is
ongoing.
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
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.
= Total number of imported cases currently stands at 13 and local transmission are
A
« There is no evidence of community transmission in the country at the moment.
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Table 1 Confirmed cases by region as of 08 April 2020
Reporting
region
Khomas
Karas
Erongo
Total
Total
Cases
11
16
New
cases
Active cases Recovered | Death
13
0#
Date of symptoms onset
Figure 1 Epi-curve for COVID-19 confirmed cases in Namibia as of 08 April 2020
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6
5
4
3
|
@ Male
@ Female
Oto4 5to14 15to34 35to59 60to 79
O+
Age group (years)
Figure 2. Age and sex for COVID-19 confirmed cases in Namibia as of 08 April 2020
\\ Pw
—
RN 0 10a 0 200 300 400 EN 500 mit
(C“JOVDIisDt-ri1c9ts Cases- Namibia
ie Voxiuntiess:
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, as of 08 April 2020
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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.
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)

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Contact tracing Summary
Table 2: National contacts tracing summary as of 08 .04.2020
Variables
Contact risk level
High
Medium | Low | Total
Total Number of contacts listed
64
47
116
221
Total Number of contacts identified
63
47
100 210
Total Number of active contacts (being
36
14
7
67
followed)
Number of contacts monitored/followed in the 36
14
7
67
last 24hrs
Total number of Contacts completed 14-days
24
30
78
32
follow up
Total Number of contacts that developed signs 19
4
7
30
& symptoms
Total Number of contacts tested positive
3
1
0
4
*Total Number of contacts tested without signs
and symptoms
10
1
4
15
© Total Number of contacts lost to follow up
0
2
5
7
# Total number of Contacts never reached
1
0
16
17
*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.
# Seventeen contacts could not be reached as they did not provide contact numbers.
Table 3: Number of people in mandatory quarantine facility of 08.04.2020
Name of the
Cumulative | Number of people
Facility
number of | who developed signs
people
& symptoms and
tested
Hardap Resort
40
0
Rock Lodge
39
0
(Debmarine)
*Other placesin | 142
a
Windhoek
Zambezi
78
3
Waterfront park
Gross Barman
22
0
Total
321
8
Test results | Number of
people
discharged
0
40
0
0
4 Negative | 39
1 pending
3 Negative | 0
0
0
8
79
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LABORATORY INVESTIGATIONS
Stock level of testing kits at NIP is currently 1300
As of 8 April 2020, a total of 444 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 08.04.2020
As of 08/04/2020
Laboratory
NIP | Path care
Total sample received by the Laboratory
274 | 170
Total sample tested
218 | 167
Total results received
218 | 167
Total results positive
9
6
Total results negative
209 | 161
Total sample discarded
29 |2
Total results pending
0
1
Total results inconclusive/indeterminate
0
0
Total new suspected cases in last 24 hours
23 |0
*I Patient specimen collected and tested in South Africa
South Africa
-
-
-
=I
-
-
~
-
-
Total
444
385
385
16
370
31
1
0
23
COORDINATION AND LEADERSHIP:
Daily feedback meetings between pillar leads, coordination team and Incident
manager ongoing, to share daily accomplishments and to address key challenges
Monitoring at road blocks, quarantine and isolation facilities being conducted
regularly to ensure smooth coordination of COVID-19 interventions.
Members from coordination team have been allocated to support/coordinate pillar
activities, by participating in their respective pillar meetings, when possible.
Many efforts to increase isolation and quarantine facilities are ongoing.
Finalizing needs assessment and integrated capacity training plans for the
responders at National and regional levels.
Consolidating and harmonizing SOPs and TORs from all thematic pillars for
submission to IM and senior management.
CASE MANAGEMENT
= Out of the 16 cumulative confirmed cases, 3 recovered, and have been
discharged, after testing negative for COVID-19.
= The other 13 confirmed cases are in stable condition. Case #10 requires
significant psychological counselling and support.
= Conversion of casualty department at Windhoek Central Hospital (WCH) into
a highly infectious referral ICU underway.
= A 12-bed Isolation Unit is under construction in the final stage of completion at
WCH.
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« Ramatex renovation underway to be repurposed as an isolation facility
= Katutura State Hospital (ASH) TB general ward being re-purposed into a
COVID-19 ward.
= More screening sites have been identified in the regions and NGOs have been
contacted to assist in setting up sites for screening and testing.
= Training of Health care workers occurs every day at WCH, KSH, and Robert
Mugabe Clinic.
» ZOOM training sessions for Health Care Workers is ongoing.
« Standard Operating Procedure was revised and has been distributed.
LOGISTICS:
« Facilitation of the allocation of quarantine facilities in the country and transport
for discharged people from quarantine facilities is ongoing.
= 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:
=» The communication hub continues to give updates on COVID 19 ona daily basis.
Beside the updates, the hub is used to clarify miscommunications of that have
been picked up in the community through media.
« A total of 75500 posters and leaflets have been printed. These materials on
COVID 19 patient management and they are to meant for health workers.
Distribution is being sorted out for all health facilities (both public and private)
in all regions.
=" The Development Workshop Namibia has delivered printed information,
education and communication materials in 4 languages: English, Oshiwambo,
Otjiherero and Silozi.
= Conducted information session on COVID 19 with the NAMPOL officials at
Patrick Training College. The session covered prevention messages and the use
of safety gears, the safety measure while work place and in community and lock
down measures. A total of 20 have attended.
= Regions continue to distribute messages at community level. The target has
been also on the vulnerable members of the society such as people living with
disability and those with minimal access to media just to ensure that they have
access to information.
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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
= Health education, psychosocial support and post counselling services offered to
people under quarantine, COVID-19 confirmed cases and their families are ongoing
= Two social workers assigned to surveillance team
= Old Mutual Namibia donated food to the amount of N$200,000.00 for persons in need
of shelter in Windhoek
= Daily orientation to regional social workers on their role in the COVID-19 response
continue
« Tip taps set up at the places where persons in need of care were placed
« Health education and psychosocial support services at places where persons in need of
shelter are placed
4. CHALLENGES
© Inadequate and at some places lack of isolation units at health facilities and at points
of entry in the regions.
o Inadequate PPE
o Insufficient COVID-19 laboratory testing kits
o Need for health information and education materials in multiple languages.
5. RECOMMENDATIONS
= Identify and costed urgent needs e.g. PPE to submit to the management to ensure
health care workers are protected from infections when handling suspected and
confirmed cases
® 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.
= Continue to build capacity of response workers.
Approved:
(
Date: 08.04.2020
Secretariat