SITREP 76


SITREP 76



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Ministry of Health and Social Services
Republic of Namibia
ae World Health
#7 Organization
NAMIBIA
Date & Time of
this report
Prepared by
02.06.2020
21:30 hrs
Surveillance Team
Investigation start date | 13 March 2020
1
SITUATION UPDATE / HIGHLIGHTS
e No new confirmed case was recorded today (02 June 2020).
¢ Cumulatively, 25 confirmed cases have been reported in the country,
© Of the 25 confirmed cases, Sixteen 16 (64%) have recovered.
¢ 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.
o Walvis Bay Local Authority Area has reverted to stage 1 of
lockdown on 29 May 2020 until midnight, 04 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.
© On 31 May 2020, Namibia recorded a case in Khomas Region, bringing the total
number of confirmed cases to 25.
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
Khomas
ia.
//Karas
Erongo
Region
om
Hardap
MNumberofcases mActivecases mRecovered mDeath
Figure 1 Distribution of Confirmed COVID-19 cases in Namibia, by region as of 02 June
2020
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.
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10 11 #12 #13 «#414 «#115 16 #17 #18 #19 20 21 22 23
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 02 June 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
-382&£5w%Sn 34526
0.
a
toa
i
5to14
15 to 34
35 to 59
60 to 79
80+
Age group
m=Male mFemale
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 02 June
2020
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0a 100 200 300 400 500km
COVID-19 Cases-Namibia
© Positive Cases
Lab Tested Cases by District
(J No test
1-49
Gi 50-200
@@ 201-400
@ 401-2000
Figure 3: Suspected and confirmed COVID-19 cases in Namibia per District, 02 June 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; 842 calls answered at
the hotline today (02.06.2020) and 12 alerts and rumours investigated.
e Data entry is ongoing, realtime data dashboard launched on 01 June 2020. The
Dashboard is accessible at https://cutt.ly/Covid-19-situation-Namibia
e Active case search in all regions is ongoing.
e Contact tracing and monitoring is ongoing (see Table 1).
e 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.
e Online Data management training started today (02 June 2020) and expected to
end on 04 June 2020.
Contact tracing Summary
As of 02 June 2020, for the 25 confirmed cases, a total number of 434 contacts have been
identified. Two hundred and eighty five (285) contacts have completed their 14 days of follow
up and 137 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 02 June 2020
Total Number of contacts listed for follow up (potential)
137
86
255:
Total Number of contacts identified (cumulative)
136
86
212
434
Total number of Contacts never reached
1
0
43
44
© 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)
4
1
0
5
Number of active contacts monitored/followed in the last 24hrs
52
24
61
137
Total number of Contacts completed 14-days follow up
80
61
144
285
© Seven contacts are lost to follow up, all are non-Namibians and have travelled back to their countries of origin.
As of 02 June 2020, a total of 2228 persons who came into the country have been put into
supervised quarantine facilities around the country. Of the 2228, 1572 have been discharged
and 656 are currently quarantined (Table 2)
Table 2: Number of people in mandatory quarantine facilities as of 02 June 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjuy
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 02 June 2020.
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
178
LABORATORY INVESTIGATIONS
e As of 02 June 2020, a total of 4102 (including 187 re-tests) COVID-19 specimens
have been 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 02 June
2020
Total sample received by the Laborat
3128
Total sample tested
2894
Total sample re-tested
163
Total results positive
18
Total results negative
2876
Total
le discarded
#59
Total sample missin;
1
Total results pending
12
Total results inconclusive/indeterminate
0
Total new si
cases in last 24 hours
75
19
*! Patient specimen collected and tested in South Africa, he travelled back before results came out
@ The total sample received by the lab in 24 hours is 89, but the new test were only 75.
# On 1 June 2020 two samples that were missing (case investigation form received but no samples received) were recorded
as discarded, but one was found on 2 June and therefor removed from the discarded number. .
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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:
© 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.
©. The last recoveries are those of the index cases ( case 1 and 2) on 01 June
2020.
Of the 9 active cases, | is still in ICU but in a stable condition, 1 has mild symptoms
and the other 7 are asymptomatic.
INFECTION PREVENTION AND CONTROL:
IPC activities are on going including distribution of PPE to the 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
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:
e¢ 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.
e 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:
e Continous provision of health education, psychosocial support services, as well as
food to people in need of shelter.
e Effective parenting, suicide prevention & tobacco use prevention are conducted at
both centres.
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.
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.
Approved:
Incident/Manager
Date: 02| June 2020
Secretariat
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