SITREP 23


SITREP 23



1 Page 1

▲back to top


Outbreak Name
Date & Time of
report
Prepared by
Ministry of Health and Social Services
Republic of Namibia
(GQS\\) World Health
Ss Organization
NAMIBIA
COVID-19
10 April 2020 21:00
Surveillance Team
Country affected
Namibia
Investigation start date
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
1. SITUATION UPDATE / HIGHLIGHTS
e No new confirmed cases were reported today (10 April 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, 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
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 March 2020.
* Total number of imported cases currently stands at 13 and 3 cases local
transmission
" There is no evidence of community transmission in the country at the moment.
1|Page

2 Page 2

▲back to top


Table 1 ee Confirmed cases by region as of 10 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 10 April 2020
2|Page

3 Page 3

▲back to top


6
5
4
% Male
@ Female
. io
E
Oto4 5toil4 15to34 35to59 60t0 79 80+
Age group (years)
Figure 2. Age and sex for COVID-19 confirmed cases in Namibia as of 10 April 2020
*% e
Ludentz
Vow
Keetmanshoon
2
i aa ee
0 100 200 300 400 500km\\. °ee a
COVID-19 Cases- Namibia
(“J Districts
* Positive Cases
° Lab Tested Cases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, as of 10 April 2020
3|Page

4 Page 4

▲back to top


3. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS
EPIDEMIOLOGY & SURVEILLANCE
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.
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.
« 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.
o All 29 specimens have tested to-date are negative (see table 2).
« Training of 10 administration officers from the MoHSS occurred on 9 April
2020, and they have been placed on the call-centre already.
= Contact tracing is ongoing (see table 3)
= People under mandatory quarantine are being monitored daily (see table 4)
Table 2. Number of suspected cases from project active case search, 10.04.2020
Region
Khomas
Erongo
//Karas
Total
Number of suspected cases
22
5
2
29
Laboratory results
Positive
0
0
0
0
Negative
22
5
2
29
4|Page

5 Page 5

▲back to top


Contact tracing Summary
Table 3: National contacts tracing summary as of 10.04.2020
Variables
Contact risk level
High
Medium | Low | Total
Total Number of contacts listed
a
49
119 237
Total Number of contacts identified
70
49
101 220
Total Number of active contacts (being
33
ul
10
54
followed)
Number of contacts monitored/followed in the 33
l
9
53
last 24hrs
Total number of Contacts completed 14-days
34
34
88
156
follow up
Total Number of contacts that developed signs 23
6
7
36
& 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
a
# Total number of Contacts never reached
1
0
16
i?
*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 4: Number of people in mandatory quarantine facility as of 10.04.2020
District
Name of the
Cumulative | Number of people
Test
Number of
Facility
number of | who developed signs | results
people
people
& symptoms and
discharged
tested
Mariental | Hardap Resort
40
0
0
40
Rock Lodge
ao
0
0
39
Okahandja | (Debmarine)
Gross Barman
22
0
Windhoek | *Other places in
142
5
0
0
5 Negative | 103
Windhoek
Katima
Zambezi
86
3
3 Negative | 18
mulilo
Waterfront park
Karasburg | Orange river lodge | 1
0
0
0
Total
330
8
8
200
*Pandeinge guesthouse, Rio guest house, Moringa gues thouse, Carrolus guest house,
okapuka, Sun Karros,
5. | P

6 Page 6

▲back to top


LABORATORY INVESTIGATIONS
Stock level of testing kits at NIP is currently 1300
As of 10 April 2020, a total of 488 COVID-19 specimens were recorded for
testing in the two laboratories (NIP and Path Care) as per table below:
Table 5: COVID-19 specimens recorded in at NIP and Path care as of 10.04.2020
As of 10/04/2020
Laboratory
Total
NIP | Path care
South Africa
Total sample received by the Laboratory
315 | 173
-
488
Total sample tested
209 | 17)
-
430
Total results received
259 | 17)
-
430
Total results positive
9
6
*]
16
Total results negative
250 | 165
-
415
Total sample discarded
oe oi2
-
31
Total results pending
0
0
-
0
Total results inconclusive/indeterminate
0
0
-
0
@Total new suspected cases in last 24 hours | 19 | 0
-
19
*I Patient specimen collected and tested in South Africa
@ Total new suspected cases laboratory results were received within 24 hours
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.

7 Page 7

▲back to top


= 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.
= Ramatex renovation underway to be repurposed as an isolation facility
* Katutura State Hospital (KSH) 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 (from different wards and from private
facilities) on case management and IPC occurs every day at WCH, KSH, and
Robert Mugabe Clinic.
« Bi-weekly ZOOM training sessions for Health Care Workers is ongoing.
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 and also
clarify miscommunications on a daily basis.
» 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.
« Regions continue to distribute messages at community level. Special attention is
given to vulnerable members of the society such as people living with disability
and those with minimal access to media.
PSYCHOSOCIAL SUPPORT SERVICES:
"Health education, psychosocial support and post counselling services offered to
people under quarantine, COVID-19 confirmed cases and their families are ongoing
« Daily orientation to regional social workers on their role in the COVID-19 response
continue
7|Page

8 Page 8

▲back to top


« Health screenings conducted at all sites where persons in need of shelter were placed
" Conducted assessment of vulnerable persons at the dumpsite in Windhoek and
provided food.
= Health education and psychosocial support services at places where persons in need of
shelter are placed is ongoing
= “Tippee taps” installed at sites where persons in need of shelter are placed
" Facilitated release of 75 persons who were under mandatory quarantine at Heja
Lodge, Swiss Chalets and Kahmo Guesthouse. No one showed any signs and
symptoms.
4. 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
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:
Incident Manager
Date: 10.04.2020
Secretariat