SITREP 71


SITREP 71



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Ministry of Health and Social Services
Republic of Namibia
Be World Health
<# Organization
NAMIBIA
Outbreak Name
Date & Time of
this report
Prepared by
COVID-19 outbreak
28.05.2020
21:00 hrs
Surveillance Team
Country affected
Investigation start date
Ni
ia
13 March 2020
iL.
SITUATION UPDATE / HIGHLIGHTS
e One (1) new confirmed case was recorded today (28 May 2020).
e Cumulatively, 23 confirmed cases have been reported in the country,
e Regions affected; Khomas (12), Erongo (6), //Karas (3) and Hardap (2)
e Of the 23 confirmed cases, fourteen -14 (60.9%) have recovered.
e Twenty -20 (87%) of the confirmed cases are imported while 3 (13%) are local
transmissions.
e No death has been recorded, case fatality rate is 0%
e There is no evidence of community transmission in the country at the moment.
e The National Rapid Response Teams (RRT) deployed to give technical support to
Hardap and //Karas Regions trained the Regional RRTs on surveillance, lab
management, case management and IPC.
e Today (28 May 2020) His Excellency, The President of the Republic of Namibia
announced a transition of all the regions (with exeption of the Walvis Bay Local
Authority Area) from stage 2 of lockdown to stage 3 with effect at midnight 01 June
2020 until 29 June 2020.
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© Stage 3 of lockdown covers a period of 28 days/ two incubation periods.
co Due to the two recent confirmed cases in Walvis Bay District, The Walvis
Bay Local Authority Area will revert to stage 1 of lockdown with effect
from 19h00, 28 May 2020 until midnight, 08 May 2020.
" The decision was made to facilitate the process of identifying and
tracing contacts of the two latest confirmed cases.
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 28 May 2020, Namibia recorded a new case in Khomas Region, bringing the
total number of confirmed cases to 23.
o The case a 38 year old Namibian woman who travelled from Tanzania on
23 May 2020. She was put under mandatory quarantine and got tested on 27
May after alerting the quarantine monitoring team that she had COVID-19
related symptoms when she was in Tanzania.
On 26 May 2020, Namibia recorded a new case in Erongo Region, Walvis Bay
District.
©. The case is a 63 years old Namibian male who was part of eight (8) crew
members on a fishing vessel that departed the shores of Walvis Bay on 25
April 2020 to DRC.
co Thecase did not disembark the vessel in DRC but Congolese nationals have
entered the vessel. He was released from the vessel into Namibia on 8 May
2020 after he complained of shoulder pain to his GP who then motivated his
immediate release from the vessel. He went home for self monitoring. He
was never seen by a doctor
o On 24 May 2020, he developed difficulties in breathing. He got tested for
COVID-19 and results came out positive.
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3. EPIDEMIOLOGY
Since 14 March, 2020 when the COVID-19 outbreak was declared in Namibia, a total of 23
cases have been confirmed. As of today, four (4) Regions have been affected, of which Khomas
region recorded the highest number of cases; 12 (52.2%), while Hardap region recorded the
least number of cases; 2 (8.7%). The distribution of confirmed cases by region is presented in
figure 1 below.
14
12
:
Khomas
.
//Karas
li
Erongo
Region
=
Hardap
Number ofcases mActivecases mRecovered mDeath
Figure 1 Distribution of Confirmed COVID-19 cases in Namibia, by region as of 28 May
2020
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As presented in figure 2 below, Namibia recorded its cases of COVID-19 during epidemiological
weeks 11, 12,13, 14, 21 and 22, where most cases (7) were recorded during epidemiological week 13.
8
iT;
10
1
az
13
14
15
16
17
18
19 20
21
22
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 28 May 2020
Of the 23 confirmed cases, more males; 16 (69.6%) are affected compared to their female
counterparts; 6 (26.1%). The age group 15-34 is more affected (9 cases) than all the other age
groups. The age and sex distribution of confirmed COVID-19 cases is presented in figure 3
below.
7
6
.1 a
Oto4d
Stoi4
15 to 34
35 to 59
60 to 79
80+
Age group
Male mFemale
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 28 May
2020
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0— 100 2— 00 300 400 500 km
COVID-19 Cases-Namibia
@ Positive Cases
(LaNbo TeTsetsetd Cases by District
1-49
@G@™@B 512000-111--021008000
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 28 May 2020
4. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS AND
SURVEILLANCE
e Case definitions as of 20 March 2020:
Suspected 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
= Call centre continue operations for 24 hours every day; 508 calls answered at
the hotline today (28.05.2020) and 9 alerts investigated.
= 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 1).
= People under mandatory quarantine are being monitored daily (see Table 2) 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.
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Contact tracing Summary
As of 28 May 2020, for the 23 confirmed cases, a total number of 370 contacts have been
identified. Two hundred and forty-one (241) have completed their 14 days of follow up and
106 are still active and being monitored daily for 14 days (Table 1).
Table 1; National contacts tracing summary for COVID-19 as of 28 May 2020
Total Number of contacts listed for follow up (potential)
105
71
210
386
Total Number of contacts identified (cumulative)
105
71
194 | 370
Total number of Contacts never reached
0
0
16
16
© Total Number of contacts lost to follow up
0
2
5
7
Total Number of contacts that developed signs & symptoms
26
8
oh
41
Total Number of contacts that tested positive (became cases)
3
1
0
4
Number of active contacts monitored/followed in the last 24hrs
33
14
59
106
Total number of Contacts completed 14-days follow up
65
57
119 241
© Seven contacts are lost to follow up, all are non-Namibians and have travelled back to their countries of origin.
As of 28 May 2020, a total of 1850 persons have been put into supervised quarantine facilities
around the country. Of the 1850, 1350 have been discharged and 500 are currently quarantined
(Table 2)
Table 2: Number of people in mandatory quarantine facilities as of 28 May 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondju;
Khomas
Zambezi
//Karas
Erongo
Oshikoto
Total
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Table 3. Distribution of truck drivers who came into Namibia from neighboring countries
and their destination regions on 28 May 2020.
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
191
LABORATORY INVESTIGATIONS
e Asof28 May 2020, a total of 3412 (including 174 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 28 May
2020
Total sample received by the Laborato:
2640
838
Total sample tested
2432
806
Total sample re-tested
150
24
Total results positive
16
6
Total results negative
2416
800
Total sample discarded
358
8
Total results pending
0
0
Total results inconclusive/indeterminate
0
0
Total new
ted cases in last 24 hours
57
0
*! Patient specimen collected and tested in South Africa, he travelled back before results came out
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COUNTRY COORDINATION, PLANNING AND MONITORING
Continues with efforts to make the IM Briefing Meeting with Pillars more
effective; and agreed on regular and adhoc meetings to take place between IM and
the coordination pillar.
Finalized SoPs and Organogram with inputs from pillar leads has been submitted
to incident manager for further guidance and approval.
Facilitated the finalization of the completion of updated National readiness
checklist by all pillars and continue to obtain completed updated regional
checklists from all 14 regions (due by 29 May 2020)
Held a meeting with pillar leads on 28 May 2020 and discussed current challenges
that are related to inadequate/lack of training on COVID-19, Coordination, Risk
communication, Psychosocial Support, Quarantine facilities and general
unpreparedness (readiness) for covid-19 in most regions. The meeting proposed
that:
o The National level consider urgent deployment of technical experts to
address the above challenges in the following priority border regions
(Erongo, Karas, Hardap, Zambezi, Omaheke, Kavango, Ohangwena,
Omusati and Kunene). Khomas should not be forgotten, though.
o An integrated team of technical experts should be representative of the key
pillars — IPC/Case Management, Coordination, RCCE, Psychosocial
support, PoE in addition to Surveillance/RRT, as appropriate.
CASE MANAGEME
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 23 cumulative confirmed cases, 14 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
Of the 9 active cases, | is critically ill in ICU. The 8 are all asymptomatic.
INFECTION PREVENTION AND CONTROL:
IPC activities are on going as part of IPC preparedness plan;
o Distribution of PPE according to Regional plans
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LOGISTICS.
e 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.
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
RISK COMMUNICATION AND COMMUNITY ENGAGEME
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
co 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.
5. 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.
© Inadequate nasopharyngeal swabs and appropriate transport media.
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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.
6. 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:
v
LA
Incident! Manager
Date: 28 May 2020
KROL fETH/
Secretariat
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