SITREP 41


SITREP 41



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Ministry of Health and Social Services
Republic of Namibia
@ ) World Health
S3# Organization
NAMIBIA
Outbreak Name
Date & Time of
report
Prepared by
COVID-19
28 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
© No new confirmed case was reported in the last 24 days (5 — 28 April 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, to date.
Of the 16 confirmed cases, eight (8) have recovered.
e Supervised quarantine for all people 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
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.
¢ Total number of imported cases currently stands at 13 while 3 cases are local
transmissions.
e There is no evidence of community transmission in the country at the moment.
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Table 1: Confirmed cases by region as of 28 April 2020
24
a4
0
Date of symptoms onset
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 28 April 2020
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5
4
i
m™ Male
Female
_ io
i
Oto4
5to14 15to34 35toS9 60to79
80+
Age group (years)
Figure 2: Age and sex distribution for COVID-19 confirmed cases in Namibia as of 28
April 2020
© 1—00——200—3—00 400 500 km
©COVDIiDst-r1i9cts Cases-Namibia
* Positive Cases
Lab Tested Cases
No Test
@ 1-10
™5m™ 0-115-9490
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 28 April
2020
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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.
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
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= 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 28.04.2020
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 A
i
jl
.
followed)
Number of contacts monitored/followed in the 5
;
i
5
last 24hrs
Total number of Contacts completed 14-days
follow up
62
44
96
202
Total Number of contacts that developed signs
& symptoms
25
8
uf
40
Total Number of contacts tested positive
3
1
0
4
*Total Number of contacts tested without signs
and symptoms
20
1
© Total Number of contacts lost to followup | 0
8
29
5
7
Total number of Contacts never reached
0
0
16
16
*Number ofcontacts 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 28.04.2020
Region
Kunene
Newly
quarantined
24hrs
4
Cumulative
number
people
4
Number of | Number of people
of | people
in
quarantine
discharged _| now
0
4
Omaheke
18
18
0
18
Kavango
0
2
0
2
Omusati
ZA
Ag
0
17
Oshana
0
3
2
1
Ohangwena
1
36
16
20
Hardap
0
40
40
0
Otjozondjupa
0
| Khomas
32
100
61
39
190
17
B
Zambezi
1
112
86
26
//Kharas
1
100
19
81
Erongo
0
28
3
25
Total
64
650
374
276
LABORATORY INVESTIGATIONS
e As of 28 April 2020, a total of 800 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
28.04.2020
As of 28/04/2020
Laboratory
Total
NIP | Path care | South Africa
Total sample received by the Laboratory
720 | 207
-
927
Total sample tested
600 | 202
-
802
Total results received
600 | 200
-
800
Total sample re-tested
195 |
-
80
Total results positive
9
6
*1
16
Total results negative
591 | 196
-
787
Total sample discarded
41 |2
-
43
Total results pending
0
2
-
2
Total results inconclusive/indeterminate
0
0
-
0
@Total new suspected cases in last 24 hours
19 \\1
-
80
“! 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
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COORDINATION AND LEADERSHIP:
Daily feedback meetings between pillar leads, coordination team and Incident
manager ongoing, to share daily accomplishments and to address key challenges
Final inputs to the organogram, SOPs, TORs, M&E, Contingency Response Plan
and sentinel surveillance protocol are being incorporated, in order to submit them
for clearance to senior management by Monday, 27 April 2020.
CASE MANAGEMENT
Out of the 16 cumulative confirmed cases, 8 recovered, and have been discharged,
after testing negative for COVID-19 at 48 hours’ interval.
The other 8 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 is nearing completion.
WCH COVID-19 ICU construction complete, and now being furnished.
Katutura State Hospital (KSH) TB ward being re-purposed into a COVID-19
ward. Completion date set for 08 May 2020.
Plans for Katutura Nurses Home renovations underway to accommodate the staff
of COVID-19 response.
Pre-fabricated isolation units being constructed in Opuwo, Oshakati, and Rundu.
Health Facility readiness visit to the regions being planned. Awaiting management
approval.
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 for HCWs in
Correctional facilities and from Ministry of Defence
Finalised IPC materials as part integrated training package
SOP for management and handling of remains of people who die from COVID-19
is in progress
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LOGISTICS:
e Facilitation of the allocation of quarantine facilities in the country and
transportation for discharged people from quarantine facilities is ongoing.
e Provision of commodities’ specifications and verification for procurement is being
done regularly
POINTS OF ENTRY:
e Inspection was done at 5 big open markets of Windhoek to assess it for readiness
to re-opening
e Continuing to work on the training content of the planned integrated training for
COVID-19 response.
e Tippy taps are being installed at all the roadblocks around Khomas.
e A concept note on establishing truck ports in major towns and along the borders
has been finalized.
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e 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.
e The Media continue to communicate messages on COVID-19 and the extension of
the lockdown.
e The RCCE continues to share messages on COVID-19 prevention measures
PSYCHOSOCIAL SUPPORT SERVICES:
e Health education, psychosocial support and post counselling services to people
under quarantine, COVID-19 confirmed cases and their families are ongoing
e A total of 465 persons in need of shelter housed at two sites.
e Provision of health education, psychosocial support services, as well as food at
places where persons in need of shelter are placed is ongoing.
e Persons in need of shelter received medical screening and ten persons were
referred to heath facilities for treatment.
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© Draft leaflet was developed on messages for gender-based violence, alcohol and
drug abuse, suicide prevention and prevention of elder abuse during COVID-19.
e Draft SOP for bereavement amidst COVID-19 finalized.
4. CHALLENGES
e Inadequate and at some places lack of isolation units at health facilities and at
points of entry in the regions.
e Unavailability of probes and primers for NIP laboratory to start testing for
Seasonal Influenza (H1N1) from beginning May 2020.
e Regions need training addressing all pillars of the response team, but travelling
seems unfeasible due to the lockdown.
e Inadequate viral swabs and PPE at different regions such as Otjozondjupa and
Hardap regions, to implement active case search testing.
5. RECOMMENDATIONS
e Establish fully equipped isolation units at health facilities and at some points of entry
in the regions.
e NIP to fast track procurement process laboratory testing kits (probes and primers) for
Seasonal Influenza (H1N1) testing in the two selected sentinel sites (Katutura
Hospital, and Rehoboth Hospital).
e Finalise ONLINE integrated training package (addressing all pillars) by 30 April and
complete assessment for readiness for regions and districts to start virtual training on
covid-19 by 5th May 2020.
e Provide technical guidance regarding the post-lockdown period measures (i.e. post
May 2020)
—
;
Incident Manager
Date: 28.04.2020
.
a ih A
Secretariat
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