SITREP 46


SITREP 46



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Ministry of Health and Social Services
Republic of Namibia
Outbreak Name
Date & Time of
report
Prepared by
COVID-19
03 May 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 29 days (5 April — 3 May 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, to date.
e Of the 16 confirmed cases, eight (8) have recovered.
e Supervised quarantine for all people arriving from abroad, for 14 days is ongoing.
e On 30 April 2020, His Excellency, the President of the Republic of Namibia
announced that stage 1 of the lockdown will be lifted on 5 May 2020 and stage 2
will be implemented until 3 June.
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
o Wearing of mask in public will be mandatory
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.
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e 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.
Table 1: Confirmed cases by region as of 03 May 2020
Reporting
Total Cases | New cases | Active cases | Recovered | Death
region
Khomas
i
0
4
7
0
//Karas
1
0
1
0
0
Erongo
4
0
3
1
0
Total
16
0
8
8
0
34
|
e
|
23 | 3.
—3 14
SSsFSSSSTFSSSSSISSIRSIs o4 SSSHSS[ SB|ESSRSi RRE= RRBSRERAARB
SSs Sgs RSxs Rsss S SgsS Rss RsxS Rss<s R—sS Asss RSSs RsSs ASss RKsCs RKs AsCg RRsCs RsRs Asss KSs RRsgs AsSs RKsg Rgss RsCs Ksss Rgsgs Kgsg Rgs Asqgs Ssss RgAK
Date of symptoms onset
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 03 May 2020
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6
5
4
Ee
2
0 fl
:
Oto4
5to14
15to34 35to59 60to79
80+
Age group (years)
= Male
@ Female
Figure 2: Age and sex distribution for COVID-19 confirmed cases in Namibia as of 03
May 2020
0—1— 00 2— 00 — 300 — 400 500 km
COVID-19 Cases-Namibia
@ Districts
* Positive Cases
Lab Tested Cases
(1@@N-o1110-4T9est
50-600
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 03 May 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.
Surveillance activities
= Investigation of the Namibian truck driver who tested positive of COVID-19
in Zambia on 22 April 2020.
= Daily pillar and intra-pillar discussions are held to deliberate daily progress,
gaps and way forward;
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= 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 search in all regions aimed at looking for possible community
transmission is ongoing.
= Weekly ZOOM sessions with regional teams set to be held every Thursday,
last meeting held on 30.04.2020
= 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 03.05.2020
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)
1
0
0
1
Number of contacts monitored/followed in the last 24hrs | 1
0
0
1
Total number of Contacts completed 14-days follow up | 64
45
37
206
Total Number of contacts that developed
symptoms
signs &
25
8
7
40
Total Number of contacts tested positive
3
1
0
4
*Total Number of contacts tested without signs and 20
1
symptoms
8
29
© Total Number of contacts lost to follow up
0
2
5
7
Total number of Contacts never reached
0
0
16
16
#Contacts for a case confirmed in Zambia
0
2
16
18
*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.
# Number of contact linked to a Namibian who tested positive in Zambia.
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Table 3: Number of people in mandatory quarantine facilities as of 03.05.2020
Region
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Karas
Erongo
Total
Newly
quarantined
24hrs
0
0
2
2
0
6
0
17
2
0
S
0
34
Cumulative
number
people
15
20
4
42
5
49
40
168
216
117
107
35
818
Number _ of | Number of people
of | people
in
quarantine
discharged | now
0
1
0
20
2
2
1
41
2
3
21
28
40
0
100
68
150
66
101
16
93
l4
28
7.
538
280
LABORATORY INVESTIGATIONS
e As of 03 May 2020, a total of 1011 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
03.05.2020
As of 03/05/2020
Laboratory
:
Total
NIP | Path care | South Africa
Total sample received by the Laboratory
911 | 226
-
1137
Total sample tested
789 | 222
-
1011
Total results received
789 | 222
-
1011
Total sample re-tested
81 {1
-
82
Total results positive
9
6
*1
16
Total results negative
780 | 216
-
996
Total sample discarded
41 |3
-
44
Total results pending
00
-
0
Total results inconclusive/indeterminate
0
0
-
0
@Total new suspected cases in last 24 hours
14 /|0
-
14
*1
@
PTaottiaelntneswpescuismpeenctceodllceacsteesd
and tested in South Africa, he travelled back
laboratory results received within 24 hours
before
results
came
out
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COORDINATION AND LEADERSHIP:
e Daily feedback meetings between pillar leads, coordination team and Incident
manager (IM) ongoing, to share daily accomplishments and to address key
challenges.
e Final inputs to the organogram, incorporated and final version submitted to IM for
clearance.
e Inputs to the SOPs, TORs, M&E, Contingency Response Plan and sentinel
surveillance protocol being incorporated in the final draft
CASE MANAGEMENT
e Out of the 16 cumulative confirmed cases, 8 recovered, and have been discharged
after testing negative for COVID-19 at 48 hours’ interval.
e The other 8 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 with a total of 8 beds.
e Construction of WCH isolation facility complete, installation of oxygen and
slophopper completed, while interlocks still being installed.
e Katutura State Hospital (KSH) TB ward being re-purposed into a COVID-19
ward. Completion date set for 08 May 2020.
e Pre-fabricated isolation units being constructed in Opuwo, Oshakati, and Rundu.
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 for HCWs in
Correctional facilities and from Ministry of Defence
e Finalised IPC materials as part integrated training package
e 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.
¢ Provision of commodities’ specifications and verification for procurement is being
done regularly.
e A total of 1282 people were appointed to the outbreak response team to date.
POINTS OF ENTRY:
e Continuing to work on the training content of the planned integrated training for
COVID-19 response.
e Developed a strategy on managing and monitoring trucks and other vehicles using
POEs in the Country
e A concept note on establishing truck ports in major towns and along the borders
has been finalized.
e Screening and inspection of incoming travellers and trucks at points of entry and
check points are ongoing
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e The communication hub continues to give updates on COVID-19 and 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 513 persons in need of shelter housed at two sites in Windhoek.
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Provision of health education, psychosocial support services, as well as food at
places where persons in need of shelter are placed are ongoing.
Draft leaflet was developed on messages for gender-based violence, alcohol and
drug abuse, suicide prevention and prevention of elder abuse during COVID-19.
Draft SOP for bereavement amidst COVID-19 finalized.
4, CHALLENGES
Inadequate and at some places lack of isolation units at health facilities and at
points of entry in the regions.
Unavailability of probes and primers for NIP laboratory to start testing for
Seasonal Influenza (H1N1) from beginning May 2020.
Regions need training addressing all pillars of the response team, but travelling
seems unfeasible due to the lockdown.
Inadequate viral swabs and PPE at different regions such to implement active case
search testing.
5. RECOMMENDATIONS
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.
© Complete assessment for readiness for regions and districts to start virtual training on
COVID-19 by 5 May 2020.
¢ Continue to provide technical guidance regarding the post-lockdown period measures.
Approved:
anager
Date: 03.05.2020
==
Bn
Secretariat