SITREP 68


SITREP 68



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Ministry of Health and Social Services
Republic of Namibia
& ) World Health
3 Organization
NAMIBIA
Outbreak Name
Date & Time of
this report
Prepared by
COVID-19 outbreak
25.05.2020
22:50 hrs
Surveillance Team
Country affected
Investigation start date
Namibia
13 March 2020
1.
SITUATION UPDATE / HIGHLIGHTS
e No new confirmed case was reported today (25 May 2020).
e Cumulatively, 21 confirmed cases have been reported in the country, of which
fourteen (14) have recovered.
e 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.
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.
¢ On 23 May 2020 a 47 years old Namibian male, truck driver, who returned from
South Africa tested positive.
e Total number of imported cases currently stands at 18 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 25 May 2020
Reporting
Total Cases | New cases | Active cases | Recovered | Death
region
Khomas
li
0
2
9
0
//Karas
3
0
2
1
0
Erongo
5
1
1
4
0
Hardap
2
0
2
0
0
Total
21
i
7
14
0
10 11
12
2)
14
15
16
a7
18
19
20
2
Epidemiological week, 2020
Figure 1: Epi-curve for confirmed COVID-19 cases in Namibia as of 25 May 2020
5
4
2
1
0
i
0-4
5--14
15-34
35-59
60-79
Age group
=Male
=Female
80<
Figure 2: Age and sex distribution for COVID-19 confirmed cases in Namibia as of 25 May
2020
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0— 100 — 200 — 300 400 500km
COVID-19 Cases-Namibia
© Positive Cases
Lab Tested Cases by Districts
(No Test
1-49
@ 50-100
@@ 101-200
@@ 201-1600
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 25 May 2020
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
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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
" Two teams of National Rapid Response were deployed to give technical support
during the investigation of the new confirmed cases in //Karas and Hardap
Regions.
"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; 476 calls answered at
the hotline today (25.05.2020) and 10 alerts investigated (mostly truck drivers’
and quarantine related issues).
= Data entry is ongoing, realtime data dashboard will be launched on 1 June 2020.
= Active case search in all regions is ongoing.
= Weekly ZOOM sessions with regional teams is on going, last meeting held 17
May 2020; issues of truck driver screening and quarantine facilities discussed
= Contact tracing and monitoring is ongoing (see table 2);
"People under mandatory quarantine are being monitored daily (see table 3) and
are being tested on day 12 before release on day 15 if they test negative.
= Plans are underway to conduct online Data management training early June; 48
participants (34 HIS officers and 14 Regional MIS officers) identified and
training materials under development
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Contact tracing Summary
Table 2: National contacts tracing summary for COVID-19 as of 25 May 2020
Variables
High | Medium | Low | Total
Total Number of contacts listed for follow up (potential)
80
58
143 281
Total Number of contacts identified (cumulative)
80
58
127
265
Total number of Contacts never reached
0
0
16
16
© Total Number of contacts lost to follow up
0
2
5
GL
Total Number of contacts that developed signs & symptoms| 26
8
1
41
(cumulative)
Total Number of contacts that tested positive (became cases)
3
1
0
4
*Total Number contacts without signs & symptoms TESTED
20
5
27
52
Number of active contacts monitored/followed in the last 24hrs
9
3
4
16
Total number of Contacts completed 14-days follow up| 68
(cumulative)
52
118 238
*Number of contacts without signs & symptoms that were tested. One tested positive.
© Seven contacts are lost to follow up, all are non-Namibians and have travelled back to their countries of origin.
Table 3: Number of people in mandatory quarantine facilities as of 25 May 2020
Region
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Karas
Erongo
Total
Newly
quarantined
24hrs
1
0
0
0
2
0
0
0
0
0
0
6
9
Cumulative
Number of | Number of people in
number of people | people
quarantine now
discharged
52
26
26
56
32
24
13
4
g
78
60
18
14
6
8
136
100
36
102
22
30
244
214
30
412
258
154
247
134
113
190
99
91
67
46
21
1611
1051
560
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Table 4. Distribution of truck drivers who came into Namibia from neighboring countries
and their destination regions on 25 May 2020.
Destination
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
South Africa
56
Country of departure
Zambia
0
Botswana
0
Total
Angola
176
LABORATORY INVESTIGATIONS
e As of 25 May 2020, a total of 3118 (3023 are first time tests and 165 are re-tested
samples) 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 25 May
2020
Variables
NIP
[LPaatbhorcaatroery [South Afriea | -°™
|Total sample received by the Laboratory
2479
7716
| Total sample tested
| Total sample re-tested
2278
745
142
23
Total results positive
14
6
Total results negative
2264
739
Total sample discarded
58
8
Total results pending
1
0
Total results inconclusive/indeterminate
0
0
Total new suspected cases in last 24 hours
70
0
:
3255
-
3023
-
165
=I
21
-
3003
-
66
-
1
-
0
:
70
*] Patient specimen collected and tested in South Africa, he travelled back before results came out
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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 training started on 6 May 2020 and are ongoing until 26 May
2020.
CASE MANAGEMENT:
e Conducted a simulation/drill at Windhoek Central Hospital COVID-19 ICU to
assess the readiness of the health care workers on 23 May 2020.
¢ Out of the 21 cumulative confirmed cases, 14 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e All the 7 active cases are clinically stable
INFECTION PREVENTION AND CONTROL:
e IPC activities are on going as part of IPC preparedness plan;
o Distribution of PPE according to Regional plans
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.
e Distribution of PPEs to the regions
POINTS OF ENTRY:
e Screening and inspection of incoming travellers and trucks at points of entry and
check points is ongoing
e Plans are underway to prepare the regions to collect and submit daily reports at the
points of entry.
e SOP for management and monitoting of cross border road transport at designated
Points of Entry and COVID-19 checkpoints finalised
e Checklist for assessment of quarantine facility at ground crossing drafted.

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RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e The COVID-19 Communication Center continues to update the public on the status
of COVID-19, the impact on different sectors and address rumours around COVID
19.
e A total of 110 000 copies of flyers on COVID -19 facts have been printed and the
distribution has commenced especially to the schools that are due to open
o These copies are translated into 8 local languages.
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.
¢ Insuficient PPE and swabs for sample collection from suspected cases identified
through active case search in some districts.
e Inadequate nasopharyngeal swabs and appropriate transport media.
5. RECOMMENDATIONS AND WAY FORWARD:
e Establish fully equipped isolation units at health facilities in the regions.
¢ 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 and appropriate transport media for all districts.
Approved:
Incident i
Date: 25 May 2020
Cohinebh
Secretariat
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