SITREP 26


SITREP 26



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Ministry of Health and Social Services
Republic of Namibia
(MK2e)y WOorrgladnizHaetailotnh
NAMIBIA
Outbreak Name
COVID-19
Country affected
Namibia
Date & Time of
report
Prepared by
13 April 2020 17:40
Surveillance Team
Investigation start date
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
1. SITUATION UPDATE / HIGHLIGHTS
e No newconfirmed case was reported in the last 9 days (5 — 13 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 13 April 2020
Reporting
Total
New
Active cases | Recovered | Death
region
Cases
cases
Khomas
1]
0
8
3
0
//Karas
1
Erongo
4
0
ii
0
4
0
0
0
0
Total
16
0
13
3
0
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2-
14
0-
Date of symptoms onset
Figure 1 Ep t-Curve for COVID-19 confirmed cases in Namibia as of 13 April 2020
: iL
@ Male
@ Female
)
O0to4
5 to 14 15t034 35to59 60to79
80+
Age group (years)
Figure 2 Age and sex for COVID-19 confirmed cases in Nami b ia as 0,of 13 April 2020
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¢ comes
\\\\ :
*G. ere
Kearastarg
0 100 2p 00 o 300m4p 00 500 km._-
Re
a
CJODViIsDtr-i1c9ts Cases- Namibia
*% Positive Cases
¢ Lab Tested Cases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 13 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
Confirmed case: A person with laboratory confirmation of COVID-19 infection,
irrespective of clinical signs and symptoms.
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Active surveillance suspected case definition
A patient who present with Acute Infection/Severe Acute Respiratory Infection
with any of the following signs and symptoms: cough, sore throat, fever, chills,
myalgia/body pains or shortness of breath
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.
= Active case finding is currently underway in Khomas, Erongo and Kharas
regions, aimed to look for possible community transmission.
= 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, 13.04.2020
Laboratory results
Region
Number of suspected cases
Khomas | 22
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 13.04.2020
Variables
Contact risk level
High
Medium
Low | Total
Total Number of contacts listed (potential)
67
46
Total Number of contacts identified
66
46
fTooltlaolweNdu)mber of active contacts (being
ad
?
Number of contacts monitored/followed in the
last 24hrs
aa
?
Tfoatlallow number of Contacts completed 14-days
41
36
116 229
100
212
,
:
a6
88
165
Total Number of contacts that developed signs
& symptoms
23
6
8
37
Total Number of contacts tested positive
3
1
0
4
*Total Number of contacts tested without signs 10
I
4
15
and symptoms
© Total Number of contacts lost to followup | 0
2
5
7
# Total number of Contacts never reached
1
0
16
L7
*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 13.04.2020
Region
Newly
Cumulative | Number of
Test results | Number of
quarantined | numberof | people who
people
24hrs
people
developed signs
discharged
& symptoms
and tested
Ohangwena
0
12
0
0
1
Hardap
0
40
0
0
40
Otjozondjupa | 0
61
0
0
20
Khomas
0
142
J
5 -ve
125
Zambezi
0
86
3
I -ve
55
2 discarded
//Kharas
0
1
0
0
0
Total
0
343
8
6
260
LABORATORY INVESTIGATIONS
e As of 13 April 2020, a total of 508 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
13.04.2020
As of 13/04/2020
Laboratory
Total sample received by the Laboratory
Total sample tested
Total results received
NIP | Path care
333 | 175
276 | 173
276 | 173
| South Africa
-
-
-
Total results re-test
27 |0
-
Total results positive
Total results negative
9
6
*]
267 | 167
-
Total sample discarded
29 {2
-
Total results pending
0
0
-
Total results inconclusive/indeterminate
0
0
~
a new suspected cases in last 24
10 12
-
ours
*] Patient specimen collected and tested in South Africa, he travelled back before results came out
@ Total new suspected cases laboratory results received within 24 hours
Total
508
449
449
2d
16
434
31
0
0
2
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.

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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.
e PPE available in stock: 616
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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The IEC materials printed has been distributed to the regions namely Khomas,
Omusati, Oshana, Ohangwena, Karas, Zambezi and Kunene.
The COVID-19 backdrop and two pull-up banners has been erected at the
communication hub.
The Risk Communication and Community Engagement committee continues to give
support to the institutions involved in COVID-19 message development.
A pamphlet designed for the san communities is being translated.
Radio schedules for live studio interviews, and the airing of jingles and live read has
been concluded and implementation is expected to start soon.
IEC materials have been submitted to UNDP for reprint.
PSYCHOSOCIAL SUPPORT SERVICES:
Health education, psychosocial support and post counselling services 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
Health education and psychosocial support services at places where persons in need of
shelter are placed is ongoing
“Tippy taps” erected at sites where persons in need of shelter are placed
Conducted radio talks on COVID-19 and psychosocial support services available
Equipped persons at the sites for persons in need of shelter in doing their own laundry
and cooking
CHALLENGES
Inadequate and at some places lack of isolation units at health facilities and at points
of entry in the regions.
Inadequate PPE
Insufficient COVID-19 laboratory testing kits
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:
fr—]
Incident] Manager
Date: 13.04.2020
Sedretariat
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