SITREP 49


SITREP 49



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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
06 May 2020 20:34
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 32 days (5 April — 6 May 2020).
e Cumulatively, 16 confirmed cases have been reported in the country, to date.
e Ofthe 16 confirmed cases, nine (9) have recovered.
o One (1) confirmed case recovered today (06/05/2020)
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 2 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 a mask in public is mandatory
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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 06 May 2020
Reporting
Total Cases | New cases | Active cases | Recovered | Death
region
Khomas
11
0
3
8
0
//Karas
1
0
1
0
0
Erongo
4
0
1
0
Total
16
0
7
9
0
34
24
i
:
|
|
2Ss
o|J S Se SS SReREs SHRRs SR e RRs R SSe P AsSReSs REiS Rs S RSI RSs Se SResS SRSs H k ASHOHsERSERRse S[S KBSs A E SRHE se BRSAs aSKOSss M a RR : HSe e AAESRe sNs S REMe s T RSB Ese KHEs SeRSes H Ks RtOSRs eRSRsKSaoe eS aKEEz5aK2DRSseBS2S
Date of symptoms onset
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 06 May 2020
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5
4
3
L
m= Male
Female
0&
:
Oto4
5to14
15to34 35to59 60to79
80+
Age group (years)
Figure 2: Age and sex distribution for COVID-19 confirmed cases in Namibia as of 06
May 2020
©— 100 — 200 — 300 400 500km
iCOVDIisDtr-i19 Cases-Namibia
* Positive Cases
Lab Tested Cases
() No Test
@1-10
mu 5101--46900
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 06 May 2020
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3. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS
EPIDEMIOLOGY & SURVEILLANCE
e 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
= 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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= Daily pillar and intra-pillar discussions are held to deliberate daily progress,
gaps and way forward;
= Call centre continue operations for 24 hours every 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 if they test negative.
Contact tracing Summary
Table 2: National contacts tracing summary for COVID-19 as of 06.05.2020
Variables
Contact risk level
High | Medium | Low | Total
Total Number of contacts listed (potential)
68
52
137 | 257
Total Number of contacts identified
68
52
121 | 241
Total Number of active contacts (being followed)
1
0
0
1
Number of contacts monitored/followed in the last 24hrs | 1
0
0
i
Total number of Contacts completed 14-days follow up | 64
49
116 | 229
Total Number of contacts that developed signs &
25
8
symptoms
7
40
Total Number of contacts tested positive
3
1
0
4
*Total Number
symptoms
of contacts
tested
without
signs
and 20
5
27
52
© 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.
The number of contacts for the truck driver who was confirmed in Zambia are 23, all from
Zambezi Region and the 14 days incubation since their last exposure has lapsed.
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Table 3: Number of people in mandatory quarantine facilities as of 06.05.2020
Region
Kunene
| Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Karas
Erongo
Total
Newly
quarantined
24hrs
if
0
0
if
1
9
0
0
0
8
1
0
33
Cumulative
number
people
22
20
4
56
6
58
40
168
220
125
109
35
863
Number of | Number of people
of | people
in
quarantine
discharged | now
0
22
0
20
2
2
4
52
2
4
24
34
40
0
100
68
150
70
103
22
93
16
28
7
546
317
LABORATORY INVESTIGATIONS
e As of 06 May 2020, 1192 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
06.05.2020
|
Laboratory
Total
NIP | Pathcare | South Africa
Total sample received by the Laboratory
1080 | 247
-
1327
Total sample tested
950 | 242
-
1192
Total results received
950 | 242
-
1192
Total sample re-tested
89 1
-
90
Total results positive
9
6
*1
16
Total results negative
941 | 236
-
1177
Total sample discarded
41
4
-
45
Total results pending
0
0
-
0
Total results inconclusive/indeterminate
0
0
-
0
| @Total new suspected cases in last 24 hours
TH \\2i
-
98
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COORDINATION AND LEADERSHIP:
Daily feedback meetings between pillar leads, coordination team and Incident
manager (IM) ongoing, to share daily accomplishments and to address key
challenges.
Final inputs to the organogram, incorporated and final version submitted to IM for
clearance.
All pillars submitted their SOP’s with the exception of the Surveillance which is
being finalized.
Dry runs/testing in preparation for integrated Zoom trainings started 6 May 2020.
CASE MANAGEMENT
Out of the 16 cumulative confirmed cases, 9 recovered, and have been discharged
after testing negative twice for COVID-19 at 48 hours’ interval.
The remaining 7 active 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 with a total of8 beds.
Construction of WCH isolation facility complete, installation of oxygen and
slophopper completed, while interlocks still being installed.
Katutura State Hospital (KSH) TB ward being re-purposed into a COVID-19
ward. Completion date set for 08 May 2020.
Pre-fabricated isolation units being constructed in Opuwo, Oshakati, and Rundu.
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
SOP for management and handling of remains of people who die from infectious
diseases completed and signed.
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 1392 people were appointed to the outbreak response team to date.
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POINTS OF ENTRY:
A meeting was held with other stakeholders, after which the SOP for the
management and monitoring of trucks and other cross border vehicle drivers was
finalized.
The implementation of the SOP will be enhanced once the Transport Sector
directives to combat the spread of COVID-19 has been gazetted.
Continuing to work on the training content of the planned integrated training for
COVID-19 response.
Screening and inspection of incoming travellers and trucks at points of entry and
check points are ongoing
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
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.
The Media continue to communicate messages on COVID-19 and the lifting of
the lockdown to stage 2.
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.
A total of 523 persons in need of shelter housed at two sites in Windhoek, while a
total of 102 still on the street.
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.
Drafted SOPs: (i) Bereavement amidst COVID-19 finalized; Pre- and Post-testing
Counselling; and Psychosocial Support Services to Persons in Quarantine.
BP

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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 Inadequate viral swabs and PPE at different regions such 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.
e Complete assessment for readiness and dry runs in preparation for virtual/ZOOM
training on COVID-19 by 6 May 2020.
Approved:
Incident Manager
Date: 06.05.2020
Secretariat