SITREP 69


SITREP 69



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(a<3) WOorrgladnizHaetailothn
Ministry of Health and Social Services
Republic of Namibia
Outbreak Name
Date & Time of
this report
Prepared by
COVID-19 outbreak
26.05.2020
22:50 hrs
Surveillance Team
Country affected
Investigation start date
Namibia
13 March 2020
SITUATION UPDATE / HIGHLIGHTS
One new confirmed case was reported today (26 May 2020); Erongo Region,
Walvis Bay District.
Cumulatively, 22 confirmed cases have been reported in the country, of which
fourteen (14) have recovered.
Supervised quarantine for all people arriving from abroad for 14 days is ongoing.
The National Rapid Response Team deployed support Karas Region trained a total
of 46 participants from the Regional Health Office and Keetmanshoop District on
Surveillance, IPC and Case Management.
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.
On 23 May 2020 a 47 years old Namibian male, truck driver, who returned from
South Africa tested positive.
Total number of imported cases currently stands at 19 while 3 cases are local
transmissions.
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 26 May 2020
Reporting
Total Cases | New cases | Active cases
region
Khomas
//Karas
11
0
2
3
0
2
Erongo
6
1
1
Hardap
2
0
2
Total
22
1
8
| Recovered
9
1
4
0
14
| Death
0
0
0
0
0
6
5
2
1
|0
tt
10
11
12
3
14
15
16
ag
18
19
20
21
22
Epidemiological week, 2020
Figure 1: Epi-curve for confirmed COVID-19 cases in Namibia as of 26 May 2020
a5
s3 4
2z5 3?
, a 0
0to4
5to14
15 to 34
35 to 59
60 to 79
Age group
= Male
mFemale
80+
Figure 2: Age and sex distribution for COVID-1 9 confirmed cases in Namibia as of 26 May
2020
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© 100 200 300ee 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, 26 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
sign/symptom
with severe acute respiratory illness (fever and
of respiratory disease, e.g., cough, shortness of
at least one
breath; AND
3[Pa

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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
= Call centre continue operations for 24 hours every day; 954 calls answered at
the hotline today (26.05.2020) and 18 alerts investigated (Mostly on truck
drivers violating quarantine regulations)
= Data entry is ongoing, realtime data dashboard will be launched on 1 June 2020.
* Active case search in all regions is ongoing.
= 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 26 May 2020
Variables
High | Medium | Low | Total
Total Number of contacts listed for follow up (potential)
95
63
190
348
Total Number of contacts identified (cumulative)
Total number of Contacts never reached
95
63
174 | 332
0
0
16
16
© Total Number of contacts lost to follow up
0
x
5
7
Total Number of contacts that developed signs & symptoms| 26
8
7
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
24
6
50
80
Total number of Contacts completed 14-days follow up| 65
(cumulative)
57
119 241
*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 26 May 2020
Region
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
*Hardap
Otjozondjupa
Khomas
Zambezi
//Karas
Erongo
Total
Newly
quarantined
24hrs
0
0
0
3
4
2
0
52
14
0
0
0
75
Cumulative
Number of | Number of people in
number of people | people
quarantine now
discharged
52
42
10
56
41
15
13
4
9
81
67
14
18
6
12
138
114
24
133
104
29
296
215
81
426
307
119
247
134
113
190
99
91
67
46
21
1717
1179
538
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Table 4. Distribution of truck drivers who came into Namibia from neighboring countries
and their destination regions on 26 May 2020.
Destination
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
South Africa
85
111
3
4
8
1
I
1
0
1
2
0
21
238
Country of departure
Zambia
Botswana
DRC
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
63
0
4
63
9
4
Total
Angola
7
92
4
115
0
3
0
4
0
8
0
1
0
1
0
1
5
5
0
i
0
2:
0
0
0
88
16
321
LABORATORY INVESTIGATIONS
e As of 26 May 2020, a total of 3201 (3033 are first time tests and 168 are re-tests)
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 26 May
2020
Variables
Total sample received by the Laboratory
Total sample tested
Total sample re-tested
Total results positive
Total results negative
Total sample discarded
Total results pending
Total results inconclusive/indeterminate
Total new suspected cases in last 24 hours
NIP
2491
2288
145
15
2273
58
0
0
12
Laboratory
Path care | South Africa
786
-
745
-
23
-
6
al
739
-
8
-
10
=
0
-
10
-
Tovtael
3277
3033
168
22,
3012
66
10
0
22
+] 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.
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.
e Out of the 22 cumulative confirmed cases, 14 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
© Of the 8 active cases, | is critically ill in ICU. The 7 are all clinically stable.
INFECTION PREVENTION AND CONTROL:
e IPC activities are on going as part of IPC preparedness plan;
© Distribution of PPE according to Regional plans
o Observed IPC readiness in the Windhoek Central Hospital COVID-19 ICU
during the simulation exercise conducted on 23 May 2020.
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:
© 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 designsted
Points of Entry and COVID-19 checkpoints finalised
© 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:
e Inadequate isolation units at health facilities in the regions.
e Insufficient 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.
e 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.
Date: 26 May 2020
CUA she
Secretariat
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