SITREP 34


SITREP 34



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Ministry of Health and Social Services
Republic of Namibia
VYes<ya) WoOrrlgadnizoHaeetailotnh
—
NAMIBIA
Outbreak Name
Date & Time of
report
Prepared by
COVID-19
21 April 2020 18:00
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 No new confirmed case was reported in the last 16 days (5 — 21 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 21 April 2020
Reporting
Total Cases | New cases | Active cases | Recovered | Death
region
Khomas
11
0
5
6
0
//Karas
1
Erongo
4
0
1
0
4
0
0
0
0
Total
16
0
10
6
0

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Zz
L
0
Date of symptoms onset
Figure 1 ee Ep t-curve for COVID-19 confirmed cases in Nam iibia as of 21 April 2020
m@ Male
@ Female
Oto4
5to14
15to34 35to59 60to79
80+
Age group (years)
Figure 2 Age and sex for COVID-19 confirmed cases in Nami bia as of 21 Apri 1 2020
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0 SS100 200 300 400 500 km ~
COVID-19 Cases-Namibia
(= Districts
Lab Tested Cases
C7 No Test
[3 1-10
G@ 11-49
Mi 50-600
@ Positive Cases
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 21 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

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Confirmed case: A person with laboratory confirmation of COVID-19 infection,
irrespective of clinical signs and symptoms.
Active surveillance working case definition as of 20 April 2020
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 in the past 7 days.
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
soon.
" Active case finding is currently underway in Khomas, Erongo and Kharas
regions, aimed to look for possible community transmission and, is planned to
be rolled out to all the other regions for expanded testing.
« 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
Contact tracing Summary
Table 2: National contacts tracing summary as of 21.04.2020
Variables
Contact risk level
High
Medium | Low | Total
Total Number of contacts listed (potential)
68
48
118
234
Total Number of contacts identified
68
48
102
218
Total Number of active contacts (being
followed)
4
2
2
8
Number of contacts monitored/followed in the 4
7
2
g
last 24hrs
Total number of Contacts completed 14-days 61
43
follow up
95
199
Total Number of contacts that developed signs 25
7
7
39
& symptoms
Total Number of contacts tested positive
3
1
0
4
*Total Number of contacts tested without signs
and symptoms
17
]
© Total Number of contacts lost to followup | 0
2
8
26
5
7
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 21.04.2020
Region
Newly
Cumulative
Number of people | Number of
quarantined
number of
in quarantine now | people
24hrs
people
discharged
Ohangwena
0
21
17
4
Hardap
0
40
0
40
Otjozondjupa
0
100
39
61
Khomas
0
150
20
130
Zambezi
0
103
26
77
//Karas
65
91
77
14
Erongo
28
28
28
0
Total
93
533
207
326
LABORATORY INVESTIGATIONS
e As of 21 April 2020, a total of 566 COVID-19 specimens were tested 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
21.04.2020
As of 21/04/2020
Laboratory
NIP | Path care | South Africa
Total sample received by the Laboratory
483 | 185
-
Total sample tested
383 | 183
-
Total results received
383 | 183
-
Total sample re-tested
68 | 0
-
Total results positive
9
6
*
Total results negative
374 | 177
-
Total sample discarded
oe |e
-
Total results pending
1
0
-
Total results inconclusive/indeterminate
0
0
-
@Total new suspected cases in last 24
19 lo
-
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
668
566
566
68
16
551
34
1
0
19
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 complete the Organogram, SOPs, TORs, Contingency Response Plan and
sentinel surveillance protocol by Wednesday, 22 April 2020 and submit these for
clearance to senior management.

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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 22 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 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 Provision of commodities’ specifications and verification for procurement is being
done regularly
e A total of 94 appointments approved and emailed to regions & Hospitals, (44 HEW
Omusati, 2 HEW Otjozondjupa, 7 Registered Nurses Hardap, 2 Social Workers, 6
Registered Nurses,1 Pharmacist Assistant 1 Pharmacist,2 Enrolled Nurses, 1
Environmental Health Practitioner, 2 Social Workers for Zambezi , 1 Radiographer &
1 Medical Officer Onandjokwe, 26 student nurses Windhoek.
e Cumulative number of recruitment as on 21 April 2020 = 925

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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.
The RCCE team worked with the City of Windhoek to develop messages for traders
and customers at the open markets .
The traders have to be trained before they start to operate.
The Media continue to communicate messages on COVID-19 and the extension of the
lockdown.
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 460 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.
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.
Assessment of persons in need of shelter commenced on 16 April and will continue
until 25 April 2020. A total of 154 needs assessment forms were completed by 21
April 2020.
Two (2) telephonic and 22 face to face counselling sessions were conducted.
Finalize need assessment of persons in need of shelter and compile report with
recommendations for relevant authorities for planning and implementation.
CHALLENGES
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
Unavailability of probes and primers for NIP laboratory to start testing for Seasonal
Influenza (H1N1) from beginning May 2020.
Inadequate swabs for Covid-19

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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 in the two selected sentinel sites (Katutura
Hospital and Robert Mugabe clinic). The sites can be extended later.
= Finalise integrated training capacity package (addressing all pillars) and conduct
training in all the regions
" Conduct a need assessment to identify the readiness of all regions in terms of
equipped isolation facilities, IPC, PPEs and adequate response task force.
Approved:
Incident Manager
Date: 21.04.2020
Tp
©
Secretariat
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