SITREP 72


SITREP 72



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Ministry of Health and Social Services
Republic of Namibia
Be World Health
SY Organization
NAMIBIA
Date & Time of
this report
Prepared by
29.05.2020
22:30 hrs
Surveillance Team
Investigation start date 13 March 2020
1.
SITUATION UPDATE / HIGHLIGHTS
e¢ No new confirmed case was recorded today (29 May 2020).
e Cumulatively, 23 confirmed cases have been reported in the country,
e Of the 23 confirmed cases, fourteen 14 (60.9%) have recovered.
© Twenty 20 (87%) of the confirmed cases are imported while 3 (13%) are local
transmissions.
¢ No death has been recorded, case fatality rate is 0%
© 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.
© On 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.
o Stage 3 of lockdown covers a period of 28 days/ two incubation periods.
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© 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, 29 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
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 28 May 2020, Namibia recorded a new case in Khomas Region, bringing the
total number of confirmed cases to 23.
o The new case is a 38 years 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.
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.
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: i.
Khomas
//Karas
Erongo
Region
.
Hardap
WNumber of cases mActivecases mRecovered m Death
Figure 1 Distribution of Confirmed COVID-19 cases in Namibia, by region as of 29 May
2020
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.
7
0
a
10 11 12 #13
#414
«45
«#16
«#17
#18
#19
L
20 21 22
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 29 May 2020
Of the 23 confirmed cases, more males; 16 (69.6%) are affected compared to their female
counterparts; 7 (30.4%). 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.
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Oto4
5to14
15 to 34
35 to 59
60to79
80+
Age group
m=Male = Female
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 29 May
2020
0 — 100—2—00 3a 00 400 500 km
C®OVPIoDsi-t1iv9e CCaasseses-Namibia
Lab Tested Cases by District
(No1-49Test
50-100
@®@ 101-200
@@ 201-1800
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 29 May 2020
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4. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS AND
SURVEILLANCE
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
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; 987 calls answered at
the hotline today (29.05.2020) and 7 alerts investigated.
= Data entry is ongoing, realtime data dashboard will be launched on | June 2020.

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= 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.
Contact tracing Summary
As of 29 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 29 May 2020
Total Number of contacts listed for follow up (potential)
105
71
210
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
7
Al
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.
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As of 29 May 2020, a total of 2008 persons who came into the country have been put into
supervised quarantine facilities around the country. Of the 2008, 1448 have been discharged
and 560 are currently quarantined (Table 2)
Table 2: Number of people in mandatory quarantine facilities as of 29 May 2020
Kunene
52
42
10
Omaheke
57
44
13
Kavango
13
4
9
Omusati
83
74
9
Oshana
Ohangwena
18
8
10
138
114
24
Hardap
134
116
18
Otjozondju
298
215
83
Khomas
517
315
Zambezi
295
258
37
*//Karas
Erongo
Oshikoto
280
189
91
101
48
53
22
21
1
Total
68
2008
1448
560
*Karas region had admitted people in mandatory quarantine but were never reported to national
level
Table 3. Distribution of truck drivers who came into Namibia from neighboring countries
and their destination regions on 29 May 2020.
Karas
Khomas
Oshana
Otjozondjupa
07
Kavango
0
Ohangwena
7
Hardap
ze
Kunene
0
Omaheke
2
Omusati
Oshikoto
0
4
Zambezi
0
Erongo
9
Total
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LABORATORY INVESTIGATIONS
e As of 29 May 2020, a total of 3544 (including 176 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 29 May
2020
Total sample received by the Laborato:
Total sample tested
Total sample re-tested
24
Total results positive
16
6
Total results negative
Total sample discarded
58
8
Total results pendin;
1
0
Total results inconclusive/indeterminate
0
0
Total new suspected cases in last 24 hours
85
45
*] Patient specimen collected and tested in South Africa, he travelled back before results came out
COUNTRY COORDINATION, PLANNING AND MONITORING
e Continues to attend the IM Briefing Meetings and agreed to hold regular meetings
with the IM. The team proposed that:
co. The National level consider urgent deployment of an integrated team of
technical experts to the following priority border regions (Erongo, Karas,
Hardap, Zambezi, Omaheke, Kavango, Ohangwena, Omusati and
Kunene).
o An integrated team of technical experts should be representative of the key
pillars — IPC/Case Management, Coordination, RCCE, Psychosocial
support, PoE as well as Surveillance/RRT.
e SoPs and Organogram with inputs from pillar leads has been submitted to incident
manager for further guidance and approval.
e Continue to obtain completed updated regional checklists from all 14 regions (due
by 29 May 2020).
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CASE MANAGEMENT:
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, 1 is still in ICU but in a stable condition. The 8 are all
asymptomatic.
INFECTION PREVENTION AND CONTROL:
o IPC activities are on going including distribution of PPE according to
Regional plans .
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.
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
Plans are underway to prepare the regions to collect and submit daily reports at the
points of entry.
SOP for management and monitoting of cross border road transport at designated
Points of Entry and COVID-19 checkpoints finalised
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
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.
Flayers on COVID-19 facts have been translated into 8 local languages, anda total
of 110 000 copies have been printed and they are already being distributed to
schools.
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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.
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.
¢ NIP to continue sourcing for swabs and appropriate transport media for all districts.
“Incident anager
Date: 29 May 2020
Secretariat
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