SITREP 25


SITREP 25



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Ministry of Health and Social Services
Republic of Namibia
x) OWorrgladnizHaetailotnh
NARIBIA
Outbreak Name
COVID-19
Country affected
Namibia
Date & Time of
report
Prepared by
12 April 2020 20:40
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 8 days (5 — 12 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
Reporting
region
Total
Cases
Khomas
11
by region
New
cases
0
as of 12 April 2020
Active cases | Recovered
8
3
| Death
0
Karas
1
0
1
0
0
Erongo
4
0
4
0
0
Total
16
0
13
3
0
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4
i
QO +.
Date of symptoms onset
FigureI e° Epi-curve for COVID-19 confirmed cases in Nami ia as oOyf 12 April 2020
@ Male
@ Female
0to4
5to14 15to034 35to059 60to79
80+
Age group (years)
Figure 2 °e Age and sex for COVID-19 confirmed cases in Namib ia asoOyf 12 April 2020
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en “ Xatima Mtuel,a.,
?
Nee
0 100 200 300 400 500 km.” ‘
|
a
re
COVID-19 Cases- Namibia
( Districts
® Positive Cases
° Lab Tested Cases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, as of 12 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).
= 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, 12.04.2020
Region
Number of suspected cases
Khomas | 22
Laboratory results
Positive
0
Negative
22
Erongo
5
0
5
//Karas
2
0
2
Total
29
0
29
Contact tracing Summary
Table 3: National contacts tracing summary as of 12.04.2020
Variables
Contact risk level
High
Medium | Low | Total
@Total Number of contacts listed (potential)
67
46
116
229
Total Number of contacts identified
66
46
100
212
Total Number of active contacts (being
om)
7
8
37
followed)
Number of contacts monitored/followed in the Om)
=
g
37
last 24hrs
Total number of Contacts completed 14-days
4]
36
87
164
follow up
rahe Number of contacts that developed signs 3
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
2
5
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 facili
Region
Newly
Cumulative | Number of
quarantined | number of | people who
24hrs
people
developed signs
& symptoms
and tested
Ohangwena_ | 3
12
0
Hardap
40
0
Otjozondjupa
61
0
Khomas
142
Jj
Zambezi
86
3
//Kharas
Total
1
0
343
8
as of 12.04.2020
Test
Number of
results | people
discharged
0
I
0
40
0
39
5
125
Negative
3
46
Negative
0
0
8
251
LABORATORY INVESTIGATIONS
e As of 12 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:
e No new lab results NIP was not open today.
Table 5: COVID-19 specimens recorded at NIP and Path care Laboratories as of
12.04.2020
As of 12/04/2020
Laboratory
Total
NIP | Path care
South Africa
Total sample received by the Laboratory
S22 | 173
-
495
Total sample tested
266 | 171
-
437
Total results received
266 | 171
-
437
Total results re-test
27 610
-
21
Total results positive
9
6
*]
16
Total results negative
257 | 165
-
422
Total sample discarded
29 {42
-
31
Total results pending
0
0
-
0
Total results inconclusive/indeterminate
0
0
-
0
@Total new suspected cases in last 24 hours | 7
0
-
7
*] Patient specimen collected and tested in South Africa, he travelled back before results came out
@ Total new suspected cases laboratory results were rec eived within 24 hours
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.
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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.
e Issues regarding HR and risk allowance for clinicians are being deliberated on
CASE MANAGEMENT
e Out of the 16 cumulative confirmed cases, 3 recovered, and have been discharged,
after testing negative for COVID-19.
e The other 13 confirmed cases are in stable condition and all are asymptomatic.
e Conversion of casualty department at Windhoek Central Hospital (WCH) into a
highly infectious referral ICU underway.
e A 12-bed Isolation Unit has been constructed at WCH, awaiting inauguration.
e Ramatex renovation underway to be repurposed as an isolation facility
e Katutura State Hospital (KSH) TB ward being re-purposed into a COVID-19 ward.
e Four Private hospitals in Windhoek (Mediclinic, Lady Pohamba Private Hospital,
Rhino Park Private Hospital, and Roman Catholic Hospital) have been designated as
the private hospitals for the response of COVID-19 with a combined total of 8 ICU
beds and 32 for moderate to severe cases.
o COVID-19 patients with health insurance cover are eligible to access care in
any of the 4 designated facilities
e 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.
e Bi-weekly ZOOM training sessions for Health Care Workers is ongoing.
e Revised SoP (version 2) was released for circulation.
e Plan to visit Regions to assess readiness is underway.
LOGISTICS:
e Facilitation of the allocation of quarantine facilities in the country and transport for
discharged people from quarantine facilities is ongoing.
e Procurement of PPE, Medical suppliers and pharmaceuticals is ongoing
e Provision of commodities’ specifications and verification for procurement is being
done constantly
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e The communication hub continues to give updates on COVID 19 and also clarify
miscommunications on a daily basis.
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e 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.
e The Development Workshop Namibia has delivered printed information, education and
communication materials in 4 languages: English, Oshiwambo, Otjiherero and Silozi.
e 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:
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
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 and swabs
5. 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.
= Continue to build capacity of response teams.
Approved:
MArAna
Incident] Manager
Date: 12:04.2020