SITREP 63


SITREP 63



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Ministry of Health and Social Services
Republic of Namibia
> World Health
<8 Organization
NAMIBIA
Outbreak Name
Date & Time of
report
Prepared by
COVID-19
20.05.2020 23:00
Surveillance Team
Country affected
Investigation start date
Namibia
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
1
SITUATION UPDATE / HIGHLIGHTS
¢ Two new confirmed cases were reported today (20 May 2020).
e Cumulatively, 18 confirmed cases have been reported in the country, to date.
e Ofthe 18 confirmed cases, fourteen (14) have recovered
¢ Supervised quarantine for all people arriving from abroad, for 14 days is ongoing.
e Stage | of the state of emergency ended on 4 May 2020, and stage 2 is ongoing
from 5 May until 2 June 2020;
o Wearing a mask in public is mandatory
o All borders will remain closed except for essential/critical services and
humanitarian support to the response.
© 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.
¢ The two cases who were confirmed on the 20'" of May 2020, both arrived in the
country from South Africa via Noordoewer border post in different private vehicles.
o They are both females aged 28 and 66 years old.
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o They were taken into mandatory quarantines in Karasberg District and their
samples were collected on 18 May 2020 as they were due for release on 21
May 2020.
¢ Total number of imported cases currently stands at 15 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 20 May 2020
Reporting
region
Total Cases | New cases | Active cases | Recovered | Death
Khomas
11
0
il
10
0
//Karas
3
2
2
1
0
Erongo
4
0
1
3
0
Total
18
2
4
14
0
3
88 2
3
25a
:0
|
|
SSS BoAEUSAESS TESeESeEREsS AEAEBRTS EeAeEsaBKssReS tSEASTBSIS ETESSETS aSTEHSSaSPs SnIgETnSESS HFHSTaSLnEaSSeRBaESgEslRsSESsaSEadSTaSaRaSaEaSnSgEsgsTe
Date of symptoms onset
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 20 May 2020
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4
3
= Male
2
mFemale
0
0-4
5tol4 15to34 35to59 60to79
80+
Age group
Figure 2: Age and sex distribution for COVID-19 confirmed cases in Namibia as of 20 May
2020
0 1—0_0— 200 300 400 500 km
COVID-19 Cases Namibia
(Districts
© Positive Cases
Lab Tested Cases
(1 No Test
1-49
50-100
@@ 101-150
Gi 151-1047
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 20 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.
e Surveillance activities
= Daily pillar and intra-pillar discussions are held to deliberate on 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
planned to be launched on 22 May 2020.
= Continous support for the COVID-19 intergrated online training in partnership
with WHO.
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= Active case search in all regions for searching for possible community
transmission is ongoing.
= Weekly ZOOM sessions with regional teams is on going, last meeting held 17
May 2020
= Contact tracing and monitoring is ongoing (see table 2).
= 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 20 May 2020
Variables
High | Medium | Low | Total
Total Number of contacts listed (potential)
70
52
137,
259
Total number of Contacts never reached
0
0
16
16
Total Number of contacts identified
70
52
121
243
Total Number of contacts that developed signs & symptoms
25
8
7
40
*Total Number contacts without signs & symptoms TESTED
20
5
27
52
© Total Number of contacts lost to follow up
0
2
5
7
Total Number of contacts tested positive (became cases)
3
I
0
4
Number of active contacts monitored/followed in the last 24hrs
2
0
0
2.
Total number of Contacts completed 14-days follow up
65
49
116 230
*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 20 May 2020
Region
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Karas
Newly
Cumulative number | Number — of | Number
of
quarantined 24hrs | of people
people
people
in
discharged
quarantine now
0
42
26
16
0
56
27
29
0
13
4
9
0
74
52
22
0
9
6
3
0
131
73
58
0
102
a
30
0
215
168
47
0
308
226
82
22
247
134
113
0
190
99
91
Erongo
5
52
39
13
Total
27
1439
926
513
LABORATORY INVESTIGATIONS
e As of 20 May 2020, a total of 2540 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 20 May
2020
Variaqi bles
NIP
Laboratory
Path care |
South
Afric7 a
Total
Total sample received by the Laboratory
2041
706
-
2747
Total sample tested
1864
676
-
2540
Total sample re-tested
119
22
-
141
Total results positive
11
6
*1
18
Total results negative
1853
670
-
2523
Total sample discarded
58
8
-
66
Total results pending
0
0
-
0
Total results inconclusive/indeterminate
0
0
-
0
Total new suspected cases in last 24 hours
81
13
-
94
*] Patient specimen collected and tested in South Africa, he travelled back before results came out
COORDINATION AND LEADERSHIP:
e Feedback meetings of pillar leads and Incident manager (IM) are ongoing (3
times a week), to share accomplishments and to address key challenges.
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¢ Integrated online trainings started on 6 May 2020 and are ongoing until 26 May
2020.
¢ Submitted final inputs on SOPs and indicators to pillars for finalisation and
submission to management for endorsement.
CASE MANAGEMENT :
¢ Out of the 18 cumulative confirmed cases, 14 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e The remaining 4 active cases are all asymptomatic.
INFECTION PREVENTION AND CONTROL:
e IPC activities are on going to address the specific activities in the terms of reference
¢ Completed IPC Facility Readiness Checklist from regions and continue engaging
the Case Management team.
e Distribution of PPE according to the plan for the regions is ongoing.
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 Screening and inspection of incoming travellers and trucks at points of entry and
check points is ongoing
e Points of Entry pillar is currently setting up the regions for receiving daily reports
on the activities at all Points of Entry.
e Conducted two online integrated training session on SOPs at POE in the country
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e The COVID-19 Communication Centre continues to give updates on COVID-19
and clarify miscommunications on a daily basis.

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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
through mass media.
The National Youth Council has mobilised resources to enable youth volunteers
host educational sessions at household level in all 121 constituencies.
The Community Engagement toolkit has been printed and being distributed to all
community health workers countrywide.
PSYCHOSOCIAL SUPPORT SERVICES:
Continous provision of health education,
food to people in need of shelter.
psychosocial
support
services,
as well
as
4, CHALLENGES:
Inadequate isolation units at health facilities in the regions.
Unavailability of probes and primers for NIP laboratory to start testing for Seasonal
Influenza (HIN1).
Insuficient PPE and swabs to conduct active case search in some districts.
5. RECOMMENDATIONS AND WAY FORWARD:
Establish fully equipped isolation units at health facilities in the regions.
NIP to fast track procurement process for laboratory testing kits ( probes and
primers) for Seasonal Influenza (H1N1) testing.
Logistics pillar to continue with the procurement and distribution of sufficient PPE
to the regions to ensure that response is not interrupted.
NIP to continue sourcing for swabs to provide adequate swabs needed for all
districts.
Incident
Date: 20 May 2020
Secretariat
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