SITREP 35


SITREP 35



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Ministry of Health and Social Services
Republic of Namibia
(@\\) World Health
7 Organization
NAMIBIA
Outbreak Name
Date & Time of
report
Prepared by
COVID-19
22 April 2020 19:00
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 17 days (5 — 22 April 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, to date.
e To date, of the 16 confirmed cases, seven (7) have recovered and discharged.
o One (1) new recovery was recorded today.
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 22 April 2020
Reporting
Total Cases | New cases | Active cases
region
Khomas
11
0
3
//Karas
1
Erongo
4
0
1
0
3
Total
16
0
9
| Recovered
6
0
1
7
| Death
0
0
0
0

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Ee
24
14
0-
Date of symptoms onset
Figure I Epi-curve for COVID-19 confirmed cases in Namib ia as o,of 22 April 2020
m Male
@ Female
0to4
5to14 15to34 35to59 60to79
80+
Age group (years)
Figure 2 °° Age and sex for COVID-19 confirmed cases in Namib ia as oOy,f 22 April 2020
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0 100 200 300 400 500 km
a
COVID-19 Cases-Namibia
C3 Districts
e Positive Cases
Lab Tested Cases
(3 No Test
[1-10
@ 11-49
Ge 50-590
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 22 April
2020
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 time data dashboard is completed to be
launched soon.
= Active case finding in all regions aimed at looking for possible community
transmission is ongoing.
= 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 22.04.2020
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
>
>
8
last 24hrs
Total number of Contacts completed 14-days 61
4B
95
199
follow up
Total Number of contacts that developed signs 25
7
4
39
& symptoms
Total Number of contacts tested positive
3
1
0
4
*Total Number of contacts tested without signs
and symptoms
17
1
8
26
© Total Number of contacts lost to follow up
0
2
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 of origin.
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Table 3: Number of people in mandatory quarantine facility as of 22.04.2020
Region
Newly
Cumulative
Number of _ | Number of people
quarantined
number of
people
in quarantine
24hrs
people
discharged | now
Oshana
2
2
0
2
Ohangwena
0
21
4
17
Hardap
0
40
40
0
Otjozondjupa
0
100
61
39
Khomas
0
150
130
20
Zambezi
3
106
79
27
//Karas
0
91
14
77
Erongo
0
28
0
28
Total
5
538
328
210
LABORATORY INVESTIGATIONS
e As of 22 April 2020, a total of 590 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
22.04.2020
As of 22/04/2020
Laboratory
Total
NIP | Path care | South Africa
Total sample received by the Laboratory
509 | 200
-
709
Total sample tested
404 | 186
-
590
Total results received
404 | 186
-
590
Total sample re-tested
Total results positive
71 =|0
-
71
9
6
*]
16
Total results negative
395 | 180
-
7a
Total sample discarded
32 | 2
-
34
Total results pending
2
12
-
14
Total results inconclusive/indeterminate
0
0
-
0
@Total new suspected cases in last 24
2 18
-
30
hours
*1 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
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
Out of the 16 cumulative confirmed cases, 7 recovered, and have been discharged,
after testing negative for COVID-19 at 48 hours interval.
The other 9 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 not yet completed.
A 12-bed Isolation Unit has been constructed at WCH, awaiting installation of
oxygen equipment
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.
Katutura State Hospital (KSH) TB ward being re-purposed into a COVID-19
ward.
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
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.
Bi-weekly ZOOM training sessions for Health Care Workers is ongoing.
INFECTION PREVENTION AND CONTROL (IPC)
Conducted a training on overview of COVID-19 and IPC among 29 Nursing
volunteer from 3 Universities (UNAM,IUM & Welwitchia)
Finalised IPC materials as part integrated training package
Reviewed and finalised the SOP for management of remains of people who dies
of COVID-19
LOGISTICS:
Facilitation of the allocation of quarantine facilities in the country and transport
for discharged people from quarantine facilities is ongoing.
Provision of commodities’ specifications and verification for procurement is being
done regularly
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 all for Zambezi , 1
Radiographer & 1 Medical Officer Onandjokwe, 26 student nurses Windhoek.

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Cumulative number of recruitment as on 21 April 2020 = 925
POINTS OF ENTRY:
Inspection was done at 2 big open markets of Windhoek to assess it for readiness
to re-opening
Cross Barmen Resort one of the quarantine facilities was disinfected.
Continuing to work on the training content of the planned integrated training for
COVID-19 response.
Provisional tippy taps are being installed at all the roadblocks around Khomas.
A concept note on establishing truck ports in major towns and along the borders
have been finalized.
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
The communication hub continues to give updates on COVID-19 and also clarify
miscommunications on a daily basis.
o 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 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 461 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 25 April 2020. A total of 161 needs assessment forms were
completed by 22 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.
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4. CHALLENGES
Inadequate and at some places lack of isolation units at health facilities and at
points of entry in the regions.
The COVID-19 rapid 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
Regions need training addressing all pillars of the response team.
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.
Finalize need assessment of persons in need of shelter and compile report with
recommendations for relevant authorities for planning and implementation.
Approved:
A421.
Incident Manager
Date: 22.04.2020
ACR AS
Secretariat
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