SITREP 28


SITREP 28



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Outbreak Na
Ministry of Health and Social Services
Republic of Namibia
SSeS
EEE,
(S\\e\\y WOorrgladnizHaetailotnh
NAMIBIA
COVID-19
Country affected
Date & Time of
report
Prepared by
15 April 2020 19:40
Surveillance Team
Investigation start date
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
SITUATION UPDATE / HIGHLIGHTS
No new confirmed case was reported in the last 10 days (5 — 15 April 2020).
Cumulatively, 16 confirmed cases have been reported in the country, to date.
Three confirmed cases have recovered and discharged, to date
Supervised quarantine for all Namibians arriving from abroad for 14 days is ongoing.
The honourable Vice president visited the Public Health Emergency Operation Centre
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
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 15 April 2020
Reporting
Total
New
Active cases | Recovered | Death
region
Cases
cases
Khomas
cf
0
8
3
0
//Karas
1
0
1
0
0
Erongo
4
0
4
0
0
Total
16
0
13
3
0
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2
14
0-
Date of symptoms onset
Figure I Epi-curve for COVID-19 confirmed cases in Namibia as of 15 April 2020
: il
@ Male
@ Female
0
O0to4
5 to 14
15to34 35to059 60to79
80 +
Age group (years)
Figure 2 Age and sex for COVID-19 confirmed cases in Namib ia aso of 15 April 2020
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0 100 200 300 400 500km. ~~
COVID-19 Cases- Namibia
“ Districts
a
** PLaobsitTievseteCdaseCsases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 15 April
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 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, 15.04.2020
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 15.04.2020
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
20
4
4
28
followed)
Number of contacts monitored/followed in the 20
4
4
28
last 24hrs
Total number of Contacts completed 14-days 43
39
9]
173
follow up
Total Number of contacts that developed signs 3
Z
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
7
# Total number of Contacts never reached
1
0
16
17
*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 15.04.2020
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
2
Hardap
|0
40
0
0
40
Otjozondjupa | 39
100
0
0
39
Khomas
1
143
5
J -ve
125
Zambezi
3
89
3
I -ve
60
2 discarded
//Karas
0
1
0
0
0
Total
0
385
8
6
266
LABORATORY INVESTIGATIONS
e As of 15 April 2020, a total of 532 COVID-19 specimens were recorded for testing
(38 re-tests to see if the cases have recovered) 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
15.04.2020
As of 15/04/2020
Laboratory
Total sample received by the Laboratory
NIP | Path care | South Africa
357 | 175
-
Total sample tested
290 | 173
fe
Total results received
Total sample re-tested
290 | 173
-
38
Total results positive
Total results negative
Total sample discarded
Total results pending
9
6
*]
281 | 167
-
29 |2
-
0
0
-
Total results inconclusive/indeterminate
0
0
-
@Total new suspected cases in last 24
hours
5
0
-
*] 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
532
463
463
38
16
448
31
0
0
>
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 IMS/EOC organogram and harmonizing SOPs and TORs from all
thematic pillars for submission to IM and senior management.

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Issues regarding HR and risk allowance for clinicians are being deliberated on
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 and all are asymptomatic.
Conversion of casualty department at Windhoek Central Hospital (WCH) into a
highly infectious referral ICU underway.
A 12-bed Isolation Unit has been constructed at WCH, awaiting inauguration.
Ramatex renovation underway to be repurposed as an isolation facility
Katutura State Hospital (KSH) TB ward being re-purposed into a COVID-19 ward.
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
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.
Plan to visit Regions to assess readiness is underway.
PPE available in stock: 616
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 this is done concurrently with the social media
updates.
Distribution of printed IEC materials to the regions is ongoing.
A mass media campaign on lockdown has commenced with updates of previously
material produced on lockdown.
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
© 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: 15.04.2020
AE
he
ecretariat