SITREP 31


SITREP 31



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Ministry of Health and Social Services
Republic of Namibia
Z28\\) y WOorrgladnizHaetailotnh
NAMIBIA
Outbreak Name
Date & Time of
report
Prepared by
COVID-19
18 April 2020 20:00
Surveillance Team
Country affected
Investigation start date
Namibia —™*”
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
1. SITUATION UPDATE / HIGHLIGHTS
e Hon. Minister of Health and Social Services conducted a support visit to the PHEOC
today
e No new confirmed case was reported in the last 13 days (5 — 18 April 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, to date.
e Six (6) confirmed cases have recovered and discharged, to date
e Supervised quarantine for all Namibians arriving from abroad 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 of the Republic of Namibia
o All borders will remain closed except for essential/critical services and
humanitarian support to the response.
o All other prevention measures are applicable to the entire country
2. BACKGROUND
Description of the 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 18 April 2020
Reporting
Total Cases | New cases | Active cases
region
Khomas
11
0
5
| Recovered
6
//Karas
1
0
]
0
Erongo
0
4
0
Total
16
0
10
6
| Death
0
0
0
0
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2-
14
0-
Date of symptoms onset
Figure I Epi-curve for COVID-19 confirmed cases in Nami b ia as oO,yf 18 April 2020
: rl
m@ Male
@ Female
O0to4
5to14
15t034 35to59 60to79
80+
Age group (years)
Figure 2. Age and sex for COVID-19 confirmed cases in Namib ia asOoyf 18 April 2020
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* Positive Cases
° Lab Tested Cases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 18 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 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.
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 real data dashboard is completed to be launched
early next week.
= 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 2) and all contacts will be tested
= People under mandatory quarantine are being monitored daily (see table 3)
and will be tested before release after 14 days
* Testing will expand to include people seen at outpatient as well as admitted
inpatient with symptoms (any one of cough, sore throat, fever, chills,
myalgia/body pains or shortness of breath)
Contact tracing Summary
Table 2: National contacts tracing summary as of 18.04.2020
Variables
Contact risk level
High
Medium | Low | Total
Total Number of contacts listed (potential)
67
48
118
233
Total Number of contacts identified
67
48
102
217
Total Number of active contacts (being
followed)
8
5
5
18
Number of contacts monitored/followed in the
last 24hrs
8
5
5
18
Total number of Contacts completed 14-days
56
40
92
188
follow up
Total 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 10
1
4
15
and symptoms
© Total Number of contacts lost to follow up 0
2
5
¢
Total number of Contacts never reached
0
0
16
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.

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Table 3: Number of people in mandatory quarantine facility as of 18.04.2020
Region
Newly
quarantined
Cumulative
number of
Number of people | Number of
in quarantine now | people
24hrs
people
discharged
Ohangwena
2
16
14
2
Hardap
0
40
0
40
Otjozondjupa
0
100
39
61
Khomas
1
150
21
129
Zambezi
3
95
af
68
/Karas
0
26
26
0
Total
6
427
127
300
LABORATORY INVESTIGATIONS
e Asof 18 April 2020, a total of 5 COVID-19 specimens were recorded for testing (64
re-tests to see if the cases have recovered) in the two laboratories (NIP and Path Care)
as per table below:
Table 4: COVID-19 specimens recorded at NIP and Path care Laboratories as of
18.04.2020
As of 18/04/2020
Laboratory
NIP | Path care | South Africa
Total sample received by the Laboratory
439 | 185
~
Total sample tested
344 | 180
-
Total results received
344 | 180
-
Total sample re-tested
65 | 0
-
Total results positive
9
6
*]
Total results negative
335 | 177
-
Total sample discarded
Bo | 2
-
Total results pending
0
0
-
Total results inconclusive/indeterminate
0
0
-
@Total new suspected cases in last 24
5 10
-
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
624
524
524
65
16
512
32
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 Plans to initiate National Sentinel Surveillance have been discussed and agreed with
the Technical Operations Cluster (Case Management, IPC, Surveillance and National
laboratory and it was agreed that testing for Seasonal Influenza will start once the
laboratory receives the probes and primers.

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e Consolidating IMS/EOC organogram and harmonizing SOPs and TORs from all
thematic pillars for submission to IM and senior management.
e National Health Emergency Management Committee meeting on COVID-19 held on
17 April 2020
CASE MANAGEMENT
e Out of the 16 cumulative confirmed cases, 6 recovered, and have been discharged,
after testing negative for COVID-19 at 48 hours interval.
e The other 10 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 to be completed on 22 April 2020.
e A 12-bed Isolation Unit has been constructed at WCH, furnishing and equipping of
the facility to be finalized on 20 April 2020.
e Rhino Garments’ building renovation to be repurposed as an isolation facility.
o The memorandum of understanding between MoHSS and private hospitals are
being prepared on the renovation and operation of the 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, Rhino Park, and
Roman Catholic private hospital) have been designated as the private hospitals for the
response of COVID-19 with a combined total of 8 ICU beds and 32 beds 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 is conducted daily at WCH, KSH, and Robert Mugabe
Clinic.
e Bi-weekly ZOOM training sessions for Health Care Workers is ongoing.
LOGISTICS:
e Facilitation of the allocation of quarantine facilities in the country and transport for
discharged people from quarantine facilities is ongoing.
e Distributed a total 1256 PPE to regions,
e Provision of commodities’ specifications and verification for procurement is being
done regularly
e Three hundred and thirty one (331) personnel appointed since 13 March 2020.
e Appointment letters signed for additional personnel to come on board to assist in the
response are as follow; 258 community health workers, 6 emergency care
practitioners, 38 enrolled nurses, and 5 medical officers.

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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
produced materials on lockdown.
Media cards with messages on why an extension of a lockdown is developed and
shared on social media.
The RCCE is discussing the impact of COVID-19 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.
The RCCE continues to share messages on Covid-19 prevention measures
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 of regional social workers on their role in the COVID-19 response
continues in order to guide them in activities to be conducted.
A total of 398 persons in need of shelter housed at two sites
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.
MTC continue to provide lunch for the persons without shelter at the two sites in
Windhoek
Total of 160 persons in need of shelter still to be placed, due to the fact that they
refused to be moved. Consultation with City of Windhoek is ongoing.
Assessment of persons in need of shelter commenced on 16 April and will continue
until 20 April 2020.
Conducted and ongoing consultative meetings with the Regional Governor and CEO
of the City of Windhoek on the planning for services to persons in need for shelter
after the COVID-19 outbreak.
Installed Tippy Taps for persons living under bridges.
POINTS OF ENTRY:
The roadblock of Okahandja-Otjiwarongo has been to be moved out of town as it was
too closed to Okahandja town.
Provisional tippy taps are being installed at all the roadblocks around Khomas.
Continuing to work on the training content of the planned integrated training for
COVID-19 response.

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e A concept note on establishing truck ports in major towns and along the borders have
been finalized.
4. CHALLENGES
o Inadequate and at some places lack of isolation units at health facilities and at points
of entry in the regions.
The COVID-19 response team inadequately staffed
o Unavailability of probes and primers for NIP laboratory to start testing for Seasonal
Influenza (H1N1) from beginning May 2020.
5. RECOMMENDATIONS
« Establish fully equipped isolation units at health facilities and at points of entry in the
regions.
« Fast track procurement process laboratory testing kits (probes and primers) for
Seasonal Influenza (H1N1) testing
= Continue to build capacity of response workers.
Approved:
Incident Manager
Date: 18.04.2020
Seéretariat
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