SITREP 36


SITREP 36



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Ministry of Health and Social Services
Republic of Namibia
) WOorrgladnizHaetailotnh
NAMIBIA
me
Date & Time of
report
Prepared by
COVID-19
23 April 2020 19:00
Surveillance Team
Country affected
Investigation start date
Namibia _
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
SITUATION UPDATE / HIGHLIGHTS
No new confirmed case was reported in the last 18 days (5 — 23 April 2020).
Cumulatively, 16 confirmed cases have been reported in the country, to date.
To date, of the 16 confirmed cases, seven (7) have recovered and discharged.
Supervised quarantine for all Namibians arriving from abroad for 14 days is
ongoing.
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
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 while 3 cases are local
transmissions.
There is no evidence of community transmission in the country at the moment.
Table 1: Confirmed cases by region as of 23 April 2020
Reporting
Total Cases | New cases | Active cases | Recovered
region
Khomas
11
0
5
6
//Karas
1
0
1
0
Erongo
4
0
3
1
Total
16
0
9
4
| Death
0
0
0
0

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3
24
1
0
Date of symptoms onset
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 23 April 2020
: il,
@ Male
@ Female
0
Oto4
5to 14 15to34 35t059 60to079
80+
Age group (years)
Figure 2 Age and sex distribution for COVID-19 confirmed cases in Namibia as of 23
April 2020

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0 100 200 300 400 500 km
a
COVID-19 Cases-Namibia
(2 Districts
® Positive Cases
Lab Tested Cases
[No Test
(11-10
Mi 11-49
@ 50-590
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 23 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 has been completed and
ready 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 on day 12 before release on day 15.
Contact tracing Summary
Table 2: National contacts tracing summary for Covid-19 as of 23.04.2020
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)
3
1
2
6
Number of contacts monitored/followed in the
last 24hrs
3
1
Z
6
Total number of Contacts completed 14-days
62
4A
follow up
95
201
po Number of contacts that developed signs 5
7
7
39
symptoms
Total Number of contacts tested positive
5
1
0
4
*Total Number of contacts tested without signs
and symptoms
18
1
© Total Number of contacts lost to follow up 0
2
8
27
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 facilities as of 23.04.2020
Region
Newly
quarantined
Cumulative
number of
Number of | Number of people
people
in quarantine
Oshana
24hrs
0
people
2
discharged | now
I
1
Ohangwena
1
Hardap
0
22
6
16
40
40
0
Otjozondjupa
0
100
61
39
Khomas
3
153
130
2d
Zambezi
5
108
80
28
//Karas
2
93
14
79
Erongo
0
28
0
28
Total
11
546
332
214
LABORATORY INVESTIGATIONS
e As of 23 April 2020, a total of 621 COVID-19 specimens were tested in the two
laboratories (NIP and Path Care) as per table 4. below:
Table 4: COVID-19 specimens recorded at NIP and Path care Laboratories as of
23.04.2020
As of 23/04/2020
Laboratory
Total
Total sample received by the Laboratory
Total sample tested
Total results received
Total sample re-tested
NIP | Path care | South Africa
539 | 204
-
743
424 | 197
-
621
424 | 197
-
621
Wil
-
72
Total results positive
9
6
an
16
Total results negative
Total sample discarded
415 | 191
-
606
Al |2
-
43
Total results pending
3
4
-
7
Total results inconclusive/indeterminate
0
0
-
0
@Total new suspected cases in last 24
ig fa
-
29
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 Integrated training on covid-19 concept note being revised to ensure the number
of participants and logistics arrangements are in alignment with the lock-down
directives and covid-19 social distancing.

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e Plans are underway to complete the Organogram, SOPs, TORs, Contingency
Response Plan and sentinel surveillance protocol in order to submit them for
clearance to senior management.
CASE MANAGEMENT
e Out of the 16 cumulative confirmed cases, 7 recovered, and have been discharged,
after testing negative for COVID-19 at 48 hours interval.
e The other 9 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 is nearing completion.
e A 12-bed Isolation Unit has been constructed at WCH, awaiting installation of
oxygen equipment
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 (ASH) 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 Forty (40) medical graduates were trained on IPC, surveillance and specimen
collection.
o They will be deployed on 24 April 2020 to Case Management and
Surveillance teams.
o Fifteen (15) of the medical graduates are still in the regions and need to be
trained.
e Health Facility readiness visit to the regions being planned.
e Bi-weekly ZOOM training sessions for Health Care Workers is ongoing.
INFECTION PREVENTION AND CONTROL (IPC)
e Conducted a training on overview of COVID-19 and IPC among 29 Nursing
volunteers from 3 Universities (UNAM, IUM, and Welwitchia University)
e Finalised IPC materials as part integrated training package
e Reviewed and finalised the SOP for management of remains of people who dies
from COVID-19
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LOGISTICS:
Facilitation of the allocation of quarantine facilities in the country and
transportation 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, | Environmental Health Practitioner, 2 Social Workers all for Zambezi , 1
Radiographer & 1 Medical Officer Onandjokwe, 26 student nurses Windhoek.
Cumulative number of recruitments as of 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
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 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
Regional social workers provide counselling to 70 persons in quarantine in 7
regions.
A total of 463 persons in need of shelter housed at two sites.
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
7
Dra-

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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.
MITC continue to provide lunch for the persons without shelter at the two sites in
Windhoek
Negotiations underway with a total of 160 persons in need of shelter who are
refusing to still to be placed.
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.
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 (HIN1) 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:
N
Incident Manager
Date: 23.04.2020
Secretariat