SITREP 64


SITREP 64



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Ministry of Health and Social Services
Republic of Namibia
es World Health
<7 Organization
NAMIBIA
Outbreak Name
Date & Time of
report
Prepared by
COVID-19
21.05.2020 23:34
Surveillance Team
Country affected
Investigation start date
Namibia
13 March 2020
Date of outbreak declaration in Namibia: 14 March 2020.
as
SITUATION UPDATE / HIGHLIGHTS
e One new confirmed case was reported (today) 21 May 2020.
© One case who had two consective negative tests by the 19" of May 2020 was
reswabed when he complained of sore throat and the results came out positive.
e Cumulatively, 19 confirmed cases have been reported in the country, to date.
e Ofthe 19 confirmed cases, fourteen (14) have recovered
e Supervised quarantine for all people arriving from abroad, for 14 days is ongoing.
e Stage 1 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.
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.
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e The new confirmed case is a 30 years old Namibian male who returned from South
Africa on 9 May 2020. He was quarantined in Hardap Region and was tested on the
19" of May 2020 as he was due to be released on the 22™ of May 2020. He has
since been taken into isolation in Hardap Region and he is in stable condition.
© 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.
° They are both females aged 28 and 66 years old.
° They were taken into mandatory quarantines in Karasburg 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 16 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 21 May 2020
Reporting
Total Cases | New cases | Active cases | Recovered | Death
region
Khomas
I
0
2
9
0
//Karas
2
2
1
0
Erongo
4
0
0
4
0
Hardap
1
1
1
0
Total
19
3
5
14
0
3
um |
Date of laboratory confirmation
Figure 1: Epi-curve for COVID-19 confirmed cases in Namibia as of 21 May 2020
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Figure 2: Age and sex distribution for COVID-19 confirmed cases in Namibia as of 21 May
2020
4
3
|2
,a
0-4
8a BE
5to14
15 to 34
35 to 59
60 to 79
80+
Age group
m Male
Female
© 100 200 300 400 500km
—
COVID-19 Cases Namibia
C1 Districts
© Positive Cases
Lab Tested Cases
(No Test
1-49
50-100
101-150
@@ 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 is to be launched.
= Support for the COVID-19 intergrated online training in partnership with WHO.
® Active case search in all regions for searching of possible community
transmission is ongoing.
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= 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 21 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)
Number of active contacts monitored/followed in the last 24hrs
Total number of Contacts completed 14-days follow up
3
dL
0
4
2
0
0
2
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 21 May 2020
Region
Newly
quarantined
24hrs
Kunene
7
Omaheke
0
Kavango
0
Omusati
4
Oshana
0
Ohangwena
0
Hardap
0
Otjozondjupa
0
Khomas
11
Zambezi
0
//Karas
0
Erongo
0
Total
22
Cumulative
Number of | Number
of
number of people | people
people
in
discharged
quarantine
now
49
26
23
56
27
29
13
4
9:
78
52
26
9
6
3
131
BB
58
102
7
30
215
168
47
319
226
93
247
134
113
190
99
91
52
39
13
1461
926
535
Table4. Distribution of truck drivers who came into Namibia from neighboring countries
and their destined regions as of 21 May 2020.
Country of departure
Destination
South Africa
Total
Zambia
Botswana
Angola
Karas
36
0
0
1
37
Khomas
115
0
0
4
119
Oshana
2
0
0
4
6
Otjozondjupa
7
0
0
2:
9
Kavango
1
0
0
0
1
Ohangwena
4
0
0
3
7
Hardap
10
0
0
0
10
Kunene
0
0
0
0
0
Omaheke
0
0
0
0
0
Omusati
Oshikoto
Zambezi
Erongo
Total
0
0
fi
0
1
5
0
1
1
7
1
0
0
0
1
13
24
Li
0
38
194
24
3
15
236
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LABORATORY INVESTIGATIONS
e As of 21 May 2020, a total of 2624 COVID-19 specimens were tested in the two
laboratories (NIP and Path Care) as per table 5 below:
Table 5: COVID-19 specimens recorded at NIP and Path care Laboratories as of 21 May
2020
Laboratory
Total
Variables
NIP
Path care | South Africa
Total sample received by the Laboratory
2133
706
-
2839
Total sample tested
Total sample re-tested
1948
676
123
22
-
2624
-
145
Total results positive
Total results negative
12
6
1936
670
i
19
-
2606
Total sample discarded
58
8
-
66
Total results pending
4
0
-
4
Total results inconclusive/indeterminate
0
0
-
0
Total new suspected cases in last 24 hours
92
0
-
92
*/ 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.
e Integrated online trainings started on 6 May 2020 and are ongoing until 26 May
2020.
CASE MANAGEMENT :
e Out of the 19 cumulative confirmed cases, 14 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e One of the remaining 5 active cases has sore throat while the other three are
asymptomatic.
INFECTION PREVENTION AND CONTROL:
e IPC activities are on going to address the specific activities in the terms of reference
¢ Distribution of PPE according to the plan for the regions is ongoing.
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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.
POINTS OF ENTRY:
Screening and inspection of incoming travellers and trucks at points of entry and
check points is ongoing
Points of Entry pillar is currently setting up the regions for receiving daily reports
on the activities at all Points of Entry.
Conducted two online integrated training session on SOPs at POE in the country
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
The COVID-19 Communication Centre continues to give updates on COVID-19
and clarify miscommunications on a daily basis.
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, psychosocial support services, as well as
food to people in need of shelter.
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 (H1N1).
Insuficient PPE and swabs to conduct active case search in some districts.

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5. RECOMMENDATIONS AND WAY FORWARD:
e Establish fully equipped isolation units at health facilities in the regions.
e NIP to fast track procurement process for laboratory testing kits ( probes and
primers) for Seasonal Influenza (HIN1) testing.
© Logistics pillar to continue with the procurement and distribution of sufficient PPE
to the regions to ensure that response is not interrupted.
e NIP to continue sourcing for swabs to provide adequate swabs needed for all
districts.
h
Approved:
l
Ahi \\Ous aa 2
Incident Manager
Date: 21 May 2020
¢
b
Secretariat
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