SITREP 79


SITREP 79



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Ministry of Health and Social Services
Republic of Namibia
Be World Health
7 Organization
NAMIBIA
Outbreak Name | COVID-19 outbreak
Date & Time of
05.06.2020
this report
21:30 hrs
Prepared by
Surveillance Team
Country affected
Investigation start
date
Namibia
13 March 2020
d.
SITUATION UPDATE / HIGHLIGHTS
e Over the past two weeks (20 May — 05 June 2020), Namibia has recorded an
increase in number of new cases; 13 new cases have been reported during this
period.
e Four (4) new confirmed case were recorded today (05 June 2020)
e Cumulatively, 29 confirmed cases have been reported in the country.
e Of the 29 confirmed cases, Sixteen 16 (55.2%) have recovered.
e Twenty-five 25 (86.2%) of the confirmed cases are imported while 4 (13.8%) 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.
© Stage 3 of lockdown covers a period of 28 days/ two incubation periods.
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o Walvis Bay Local Authority Area has reverted to stage 1 of lockdown on 29
May 2020 until midnight, 08 June 2020.
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 05 June 2020, Namibia recorded 4 new confirmed cases, bringing the total
confirmed cases to 29.
o Case 26 is a 44 year old Namibian male from Erongo Region, Walvis Bay
District. No travel history and no contact with other known positive cases.
Investigations on the source of infection are ongoing.
o Cases 27, 28 and 29 are Namibian male students aged 23, 21 and 21
respectively. They travelled from South Africa on 29 May 2020 on the same
flight and were quarantined in the same facility in Khomas region,
Windhoek District.
3. EPIDEMIOLOGY
Since 14 March, 2020 when the COVID-19 outbreak was declared in Namibia, a total of 29
cases have been confirmed. As of today, four (4) Regions have been affected, of which Khomas
region recorded the highest number of cases; 16 (55.2%), while Hardap region recorded the
least number of cases; 2 (6.9%). The distribution of confirmed cases by region is presented in
figure 1 below.
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18
16
w 14
5a2S
12
10
5s
2Es 4
;
Khomas
7 ie
f
//Karas
Region
Erongo
/
Hardap
MNumber of cases MActivecases
Recovered m Death
Figure 1 Distribution of Confirmed COVID-19 cases in Namibia, by region as of 05 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.
3
0O
10 11 #12 #13 «14 «15 «16 «17: :«18:«€©619 «620 «21 «222 «223
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 05 June 2020
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Of the 29 confirmed cases, more males; 21 (72.4%) are affected compared to their female
counterparts; 8 (27.6%). The age and sex distribution of confirmed COVID-19 cases is
presented in figure 3 below.
9
8
g7
86
3°
B4
53
2
1
0
Oto4
Sto 14
15 to 34
35 to 59
60 to 79
80+
Age group
mMale Female
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 05 June
2020
0— 100 — 200 S 300 400 500km
COVID-19 Cases-Namibia
@ Positive Cases
Lab Tested Cases by District
(No Test
Co <50
@ 50-99
@® 100-399
m@ >2000
Figure 4: Suspected and confirmed COVID-19 cases in Namibia per District, 05 June 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; 775 calls were answered
at the hotline today (05.06.2020) and 10 alerts were investigated.
e Namibia COVID-19 dashboard accessible via a link on the MoHSS’s website
http://www.mhss.gov.na/ or 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 Mandatory supervised quarantine of all persons arriving from abroad is ongoing
(see Table 2).
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o As from 29 May 2020, all people are tested upon entry into mandatory
quarantine for rapid detection of positive cases.
o All people in quarantine are monitored daily for 14 days and are being
tested on day 12 before release on day 15 if they test negative.
Contact tracing Summary
As of 05 June 2020, for the 29 confirmed cases, a total number of 455 contacts have been
identified. Two hundred and ninety-seven (297) contacts have completed their 14 days of
follow up and 146 are still active and being monitored daily for 14 days (Table 1).
Table 1: National contacts tracing summary for COVID-19 as of 05 June 2020
Total Number of contacts listed for follow up (potential)
138
93
268
Total Number of contacts identified (cumulative)
137
93
225 455
Total number of Contacts never reached
1
0
43
44
© Total Number of contacts lost to follow up
0
2
2
a
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
46
31
69
146
Total number of Contacts completed 14-days follow up
87
61
149
297
© Seven contacts are lost to follow up, all are non-Namibians and have travelled back to their
countries of origin.
As of 05 June 2020, a total of 2460 persons who came into the country have been put into
supervised quarantine facilities throughout the country. Of the 2454, 1660 have been
discharged and 800 are currently quarantined (Table 2).
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Table 2: Number of people in mandatory quarantine facilities as of 05 June 2020
Kunene
Omaheke
*Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Karas
Erongo
Oshikoto
Total
53
51
2
70
56
14
58
44
14
90
80
10
20
9
i
178
137
41
138
ty:
21
323
267
56
761
347
319
283
36
280
189
91
142
59
83
28
21
i
2460
1660
800
Table 3, Distribution of truck drivers who came into Namibia from neighboring countries
and their destination regions on 05 June 2020.
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
LABORATORY INVESTIGATIONS
e Asof05 June 2020, a total of 4581 (including 317 re-tested) COVID-19 specimens
have been tested in the two laboratories (NIP and Path Care) as per table 5 below:
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Table 5: COVID-19 specimens recorded at NIP and Path care Laboratories as of 05 June
2020
Total sample received by the Laborato
Total sample tested
Total sample re-tested
Total results positive
29
Total results negative
Total sample discarded
67
Total sample missing
0
0
0
Total results pending
1
0
1
Total results inconclusive/indeterminate
1
0
1
Total new suspected cases in last 24 hours
91
17
108
*] 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:
CASE MANAGEMENT:
e Out of the 29 cumulative confirmed cases, 16 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e Ofthe 13 active cases, | is still in ICU but in a stable condition and the other 12 are
clinically stable.
INFECTION PREVENTION AND CONTROL:
e IPC activities are on going:
o Distribution of PPE according to the Regional plans
o Monitoring of IPC in health facilities
LOGISTICS.
e A 12 bed capacity ICU AT Windhoek Central Hospital was inaugurated by His
Excellency, The President on 03 June 2020.
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e Facilitation of the allocation of quarantine facilities in the country and
transportation for discharged people from quarantine facilities is ongoing.
POINTS OF ENTRY:
e Screening and inspection of incoming travellers and trucks at points of entry and
check points is ongoing.
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.
PSYCHOSOCIAL SUPPORT SERVICES:
e 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.
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.
Incident Manager
Date: 05 June 2020
Secretariat
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