SITREP 27


SITREP 27



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Ministry of Health and Social Services
Republic of Namibia
Ny World Health
w Organization
NAMIBIA
Outbreak Name.
COVID-19
‘Country affected
Namibia
Date & Time of
report
Prepared by
14 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 new confirmed case was reported in the last 10 days (5 — 14 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 The lockdown has been extended until 4 May for entire country, as announced on 14
April 2020 by His Excellency, the President.
o All borders will remain 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.
Table 1: Confirmed cases by region as of 14 April 2020
Reporting
Total
New
Active cases | Recovered | Death
region
Cases
cases
Khomas
11
0
8
3
0
//Karas
1
0
1
0
0
Erongo
4
0
=
0
0
Total
16
0
13
3
0

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2-
14
0+
Date of symptoms onset
FigureI Ep t-Curve for COVID-19 confirmed cases in Namibi 1a as O,yf 14 April 2020
@ Female
Oto4
5to14 15to34 35to59 60to79
80+
Age group (years)
Figure2 Age and sex for COVID-19 confirmed cases ©in Na mi b ia aso of 14 April 2020
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‘Opa
%
‘
*
see
ee
*
fF
>
*
°
:
are
we
0 100 200 300 400 500km
eee
mesencnans
semnanenen|
COVID-19 Cases- Namibia
Districts
. Positive Cases
* Lab Tested Cases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 14 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 diagnosed with Upper/Lower Respiratory Infection (Mild or Severe)
presenting 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)
and will be tested before discharge, starting after 15 April
« Testing will expand to include outpatients with symptoms (any one of cough,
sore throat, fever, chills, myalgia/body pains or shortness of breath)
Table2: Number of suspected cases of COVID-19 from active case search, 14.04.2020
Laboratory results
Region
Number of suspected cases
Positive
Negative
Khomas | 22
0
22
Erongo
5
0
5
//Karas
2
0
2
Total
29
0
29
Contact tracing Summary
Table 3: National contacts tracing summary as of 14.04.2020
Variables
Contact risk level
High
Medium | Low |
Total Number of contacts listed (potential)
67
46
116
Total Number of contacts identified
66
46
100
Total Number of active contacts (being
20
5
7
followed)
Number of contacts monitored/followed in the 20
5
7
last 24hrs
Total number of Contacts completed 14-days 43
38
8g
follow up
en Number of contacts that developed signs 3
6
4
symptoms
Total Number of contacts tested positive
]
1
0
*Total Number of contacts tested without signs
and symptoms
10
1
4
© Total Number of contacts lost to follow up 0
2
5
# Total number of Contacts never reached
1
0
16
*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.
Total
229
212
32
32
169
36
4
15
7
17
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Table 4: Number of people in mandatory quarantine facility as of 14.04.2020
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
39
Khomas
0
142
J
J -ve
125
Zambezi
3
89
3
1 -ve
60
2 discarded
//Karas
0
1
0
0
0
Total
0
346
8
6
265
LABORATORY INVESTIGATIONS
e As of 14 April 2020, a total of 513 COVID-19 specimens (including 28 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
14.04.2020
As of 14/04/2020
Laboratory
Total sample received by the Laboratory
NIP | Path care | South Africa
338 | 175
-
Total sample tested
281 | 173
-
Total results received
Total results re-test
Total results positive
281 | 173
-
28 |0
-
9
6
*]
Total results negative
272 | 167
-
Total sample discarded
29 |2
-
Total results pending
0
0
-
Total results inconclusive/indeterminate
0
0
-
@Total new suspected cases in last 24
5
0
-
hours
*] 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
513
454
454
28
16
439
31
0
0
5
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 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.
e Issues regarding HR and risk allowance for clinicians are being deliberated on

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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 this is done concurrently with the social media
updates.
e Distribution of printed IEC materials to the regions is ongoing.
e A mass media campaign on lockdown has commenced with updates of previously
material produced on lockdown.
e Media cards with messages on why an extension of a lockdown is developed and
shared on social media.

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e The RCCE is discussing the impact of COVID on different thematic social welfare
areas such as stigma & discrimination, GBV, child rights etc. The idea is to identify
the appropriate messages to targeted groups.
e The RCCE is also continuing sharing advocating messages on ‘social distancing’
PSYCHOSOCIAL SUPPORT SERVICES:
e Conduct daily planning and feedback meeting team members.
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 Health education, psychosocial support services provided, as well as food and other
material distributed at places where persons in need of shelter are placed is ongoing.
e Health education and psychosocial support services at places where persons in need of
shelter are placed is ongoing
e Equipped persons at the sites for persons in need of shelter in doing their own laundry
and cooking
e Received 120 two-men tents, 240 blankets and 240 matrasses from MTC Namibia for
persons in need of shelter.
e MTC will continue to provide lunch for the persons without shelter at the two sites
(278 + 73 persons).
e Total of 160 persons in need of shelter still to be placed.
e Received 50 wood pallets to be used at sites for persons in need of shelter.
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 materials
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 workers.
Approved:
Incident Manager
Date: 14.04.2020
oR,
Secretariat
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