SITREP 74


SITREP 74



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Ministry of Health and Social Services
Republic of Namibia
Bes World Health
= Organization
NAMIBIA
Date & Time of
this report
Prepared by
31.05.2020
23:00 hrs
Surveillance Team
Investigation start date | 13 March 2020
i
SITUATION UPDATE / HIGHLIGHTS
e One new confirmed case was recorded today (31 May 2020).
e Cumulatively, 25 confirmed cases have been reported in the country,
e Of the 25 confirmed cases, Sixteen 16 (64%) have recovered.
e Twenty-two 22 (88%) of the confirmed cases are imported while 3 (12%) 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 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.
© 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 June 2020.

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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.
e¢ On 31 May 2020, Namibia recorded a new case in Khomas Region, bringing the
total number of confirmed cases to 25.
o The new case is a 32 years old Namibian female, a healthcare worker who
returned from South Africa on 29 May 2020. She was put in mandatory
quarantine upon arrival.
e On 29 May 2020, Namibia recorded a new case. The case is a Namibian male who
was part of the 8 crew members on a fishing vessel that returned from DRC on 5
May 2020. This is the same vessel where case number 22 originted from.
3. EPIDEMIOLOGY
Since 14 March, 2020 when the COVID-19 outbreak was declared in Namibia, a total of 25
cases have been confirmed. As of today, four (4) Regions have been affected, of which Khomas
region recorded the highest number of cases; 13 (52%), while Hardap region recorded the least
number of cases; 2 (8%). The distribution of confirmed cases by region is presented in figure
1 below.
14
12
10
0
Khomas
//Karas
Erongo
Hardap
Region
MNumbofecarses mActivecases mRecovered Death
Figure 1 Distribution of Confirmed COVID-19 cases in Namibia, by region as of 31 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, 22 and 23 where most cases (7) were recorded
during epidemiological week 13.
8
7
10
11
12
130«14
«15 16 #17 #18 «#19 20 #21 «#22 «23
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 31 May 2020
Of the 25 confirmed cases, more males; 17 (68%) are affected compared to their female
counterparts; 8 (32%). The age and sex distribution of confirmed COVID-19 cases is presented
in figure 3 below.
8
7
»a
lh , [.
Oto4
5to14
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 31 May
2020
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0— 100 2— 00 300 400 500 km
COVID-19 Cases-Namibia
® Positive Cases
Lab Tested Cases by District
(No Test
1-49
@m™ 512000-111--021008000
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 31 May 2020
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
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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
e 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
= Call centre continue operations for 24 hours every day; 804 calls answered at
the hotline today (31.05.2020) and 10 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.
Contact tracing Summary
As of 31 May 2020, for the 25 confirmed cases, a total number of 380 contacts have been
identified. Two hundred and Sixty (260) contacts have completed their 14 days of follow up
and 107 are still active and being monitored daily for 14 days (Table 1).
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Table 1: National contacts tracing summary for COVID-19 as of 31 May 2020
Total Number of contacts listed for follow up (potential)
119
76
199 394
Total Number of contacts identified (cumulative)
119
76
183
378
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
25
9
9
43
Total Number of contacts that tested positive (became cases)
3
1
0
4
Number of active contacts monitored/followed in the last 24hrs
42
19
46
107
Total number of Contacts completed 14-days follow up
71
57
132 260
© Seven contacts are lost to follow up, all are non-Namibians and have travelled back to their countries of origin.
As of 31 May 2020, a total of 2122 persons who came into the country have been put into
supervised quarantine facilities around the country. Of the 2122, 1488 have been discharged
and 634 are currently quarantined (Table 2)
Table 2: Number of people in mandatory quarantine facilities as of 31 May 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
jozondj
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 31 May 2020.
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
199
33
*A total of 33 truck drivers came into the country via Buitepos from Botswana and South Africa. The
reports from the regions came combined as such.
LABORATORY INVESTIGATIONS
e As of 31 May 2020, a total of 3970 (including 185 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 31 May
2020
Total sample received by the Laborat:
Total sample tested
Total sample re-tested
Total results positive
18
Total results negative
Total sample discarded
58
Total results pendin;
0
Total results inconclusive/indeterminate
0
Total new suspected cases in last 24 hours
178
107
*1 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 to attend the IM Briefing Meetings and agreed to hold regular meetings
with the IM. The team proposed that:
o 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.
CASE MANAGEMENT:
© Out of the 25 cumulative confirmed cases, 16 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e Ofthe 9 active cases, | is still in ICU but ina stable condition, 1 has mild symptoms
and the other 7 are asymptomatic.
INFECTION PREVENTION AND CONTROL:
o IPC activities are on going including 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.
¢ 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 SOP for management and monitoring of cross border road transport at designated
Points of Entry and COVID-19 checkpoints finalised
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RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
The COVID-19 Communication Center continues to update the public on the status
of the outbreak, the impact on different sectors and address rumours around
COVID-19.
Flayers on COVID-19 facts have been translated into 8 local languages, and a total
of 110 000 copies have been printed and they are being distributed to schools.
PSYCHOSOCIAL SUPPORT SERVICES:
Continous provision of health education, psychosocial support services, as well as
food to people in need of shelter.
5. CHALLENGES:
Inadequate isolation units at health facilities in the regions.
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.
Karasburg district is experiencing a shortage of Port Health staff.
6. RECOMMENDATIONS AND WAY FORWARD:
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.
//Kharas region should motivate for new Port Health staff
Approved:
e Incidente Manager
Date: 31 May 2020
Secyetariat