SITREP 24


SITREP 24



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Ministry of Health and Social Services
Republic of Namibia
NAMIBIA
‘Outbreak Name
COVID-1 9
. Country affected
Namibia
Date & Time of
report
Prepared by
11 April 2020 21:00
Surveillance Team
Investigation start date
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
1. SITUATION UPDATE / HIGHLIGHTS
e No new confirmed case was reported in the last 7 days (5 — 11 April 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, to date.
e Three confirmed cases have recovered and discharged
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
e 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.
e Total number of imported cases currently stands at 13 and 3 cases local transmission.
e There is no evidence of community transmission in the country at the moment.
Table 1: Confirmed cases by region as of 11 April 2020
Reporting
Total
New
Active cases | Recovered | Death
region
Cases
cases
Khomas
11
0
8
3
0
Karas
1
Erongo
4
0
1
0
4
0
0
0
0
Total
16
0
13
3
0

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2+
14
02
Date of symptoms onset
Figure 1 Epi-curve for COVID-19 confirmed cases iin Namibia as oyf 11 April 2020
m Male
m@ Female
Oto4
5to14
15to34 35to59 60to79
80+
Age group (years)
Figure2 Age and sex for COVID-19 confirmed cases in Namib ia as oyf 11 April 2020
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[CJOVDIisDt-ri1c9ts Cases- Namibia
* Positive Cases
* Lab Tested Cases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, as of 11 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.
Probable case: A suspect case for whom testing for COVID-19 is inconclusive.
Inconclusive being the result of the test reported by the laboratory
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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.
Data entry is ongoing and data dashboards are under development using
existing platforms.
Active case finding is currently underway in Khomas, Erongo and Kharas
regions, aimed to look for possible community transmission.
o All 29 specimens 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)
Table2: Number of suspected cases of COVID-19 from active case search, 11.04.2020
Laboratory results
Region
Number of suspected cases
Positive
Negative
Khomas
22,
0
22
Erongo
5
0
3
//Karas
2
0
2
Total
29
0
29
Contact tracing Summary
Table 3: National contacts tracing summary as of 11 .04.2020
Variables
Contact risk level
High
Medium | Low | Total
@Total Number of contacts listed (potential)
67
46
Total Number of contacts identified
66
46
Total Number of active contacts (being
followed)
ae
5
Number of contacts monitored/followed in the
last 24hrs
=
TAoltlaolw nuapmber of Contacts completed 14-days
4l
35
116
229
100 212
-
3
nt
86
162
Total Number of contacts that developed signs
& symptoms
_
:
¢
ae
Total Number of contacts tested positive
3
1
0
4
*Total Number of contacts tested without signs 10
1
4
15
and symptoms
© Total Number of contacts lost to follow up
0
2
>
7
# Total number of Contacts never reached
1
0
16
17
@ Number amended due to data cleaning; eight contacts for both case 3 and case 8 were listed twice
*Number of 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.

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Table 4: Number of people in mandatory quarantine facility as of 11.04.2020
Region
Cumulative
Number of people who
Test results | Number of
number of
developed signs &
people
people
symptoms and tested
discharged
Ohangwena
9
0
0
0
Hardap
40
0
0
40
Otjozondjupa
61
0
0
39
Khomas
142
5
5 Negative
109
Zambezi
86
3
3 Negative
46
//Kharas
1
0
0
0
Total
339
8
8
234
LABORATORY INVESTIGATIONS
e Stock level of testing kits at NIP is currently 1300
e As of 11 April 2020, a total of 495 COVID-19 specimens (including 27 retest) were
recorded for testing in the two laboratories (NIP and Path Care) as per table below:
Table 5: COVID-19 specimens recorded at NIP and Path care Laboratories as of
11.04.2020
As of 11/04/2020
Laboratory
Total sample received by the Laboratory
NIP | Path care
322 | 173
South Africa
-
Total sample tested
266 | 171
-
Total results received
Total results re-test
266 | 171
-
27 =|0
-
Total results positive
Total results negative
Total sample discarded
9
6
*]
257 | 165
-
29 =|2
-
Total results pending
0
0
-
Total results inconclusive/indeterminate
0
0
-
@Total new suspected cases in last 24 hours | 7
0
-
*1 Patient specimen collected and tested in South Africa, he travelled back before results came out
@ Total new suspected cases laboratory results were received within 24 hours
Total
495
437
437
27
16
422
31
0
0
7
COORDINATION AND LEADERSHIP:
e Daily feedback meetings between pillar leads, coordination team and Incident
manager ongoing, to share daily accomplishments and to address key challenges
e Monitoring at road blocks, quarantine and isolation facilities being conducted
regularly to ensure smooth coordination of COVID-19 interventions.
e Efforts to increase isolation and quarantine facilities are ongoing.
e Finalizing needs assessment and integrated capacity training plans for the responders
at National and regional levels.
e Consolidating and harmonizing SOPs and TORs from all thematic pillars for
submission to IM and senior management.
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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.
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 75 500 COVID-19 posters and leaflets have been printed. These materials
are on patient management and they are 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.

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PSYCHOSOCIAL SUPPORT SERVICES:
e Health education, psychosocial support and post counselling services to people under
quarantine, COVID-19 confirmed cases and their families are ongoing
e Daily orientation to regional social workers on their role in the COVID-19 response
continue
e Conducted assessment of vulnerable persons at the dumpsite in Windhoek and
provided food.
e Health education and psychosocial support services at places where persons in need of
shelter are placed is ongoing
e “Tippy taps” erected at sites where persons in need of shelter are placed
e Facilitated release of 75 persons who were under mandatory quarantine at different
places in Windhoek. No one showed any signs and symptoms.
e Conducted radio talks on COVID-19 and psychosocial support services available
e Equipped persons at the sites for persons in need of shelter in doing their own laundry
and cooking
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:
Incident Manager
Date: 11.04.2020
Secretariat
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