SITREP 83


SITREP 83



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Ministry of Health and Social Services
Republic of Namibia
(@) World Health
Organization
NAMIBIA
Outbreak Name
Date & Time of
this report
Prepared by
| COVID-19 outbreak
| 09.06.2020
23:30 hrs
Surveillance Team
Country affected
Investigation start
date
Namibia
13 March 2020
an
SITUATION UPDATE / HIGHLIGHTS
e No new confirmed case was recorded today (09 June 2020)
¢ Cumulatively, 31 confirmed cases have been reported in the country.
° Of the 31 confirmed cases, seventeen 17 (54.8%) have recovered: one (1) case
recovered today (09 June 2020).
¢ Twenty-seven 27 (87.1%) of the confirmed cases are imported while 4 (12.9%) are
local transmissions.
e No death has been recorded, case fatality rate is 0%
¢ There is no evidence of community transmission in the country at the moment.
¢ On 08 June 2020, His Excellency, The President of the Republic of Namibia
announced the extension of t the Stage 1 restrictions imposed on the Walvis Bay
Local Authority Area on 29 May 2020, is extended to the entire Erongo region;
© Effective from midnight 08 June 2020 until mignight 22 June 2020.
¢ The other regions are still under Stage 3 of national lockdown which covers a period
of 28 days/ two incubation periods (01 June 2020 — 29 June 2020).
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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 07 June 2020, Namibia recorded 2 confirmed cases, bringing the total confirmed
cases to 31.
o Case No. 30 and 31 are 27-years old and 50 years old Namibian females
who travelled from India by air via OR Tambo International Airport, South
Africa on 24 May 2020. They arrived in Namibia on 25 May 2020 and were
placed into supervised quarantine in |[Kharas Region.
3. EPIDEMIOLOGY
Since 14 March, 2020 when the COVID-19 outbreak was declared in Namibia, a total of
31 cases have been confirmed. So far, four (4) regions have been affected, of which Khomas
region recorded the highest number of cases; 16 (51.6%), while Hardap region recorded
the least; 2 (6.5%), as per figure 1, below
8
6
iC L
Khomas
//Karas
Erongo
Hardap
Region
Numboe f crases MActivecases Recovered mDeath
Figure 1 Distribution of Confirmed COVID-19 cases in Namibia, by region as of 09 June
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, 23 and 24 and most cases (7) were recorded during
epidemiological week 13.
7
6
3
2
0|
J
10 41 12 13 14415 16 «17 18 19 20 21 22 23 24
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 09 June 2020
Of the 31 confirmed cases, more males; 21 (67.7%) are affected compared to their female
counterparts; 10 (32.3%).
oe
||
Oto9 10to19 20to29 30t039 40t049 S0toS9 G0t069 70to79 80+
Age group
Male mFemale
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 09 June
2020
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9—1— 00 — 200 — 300 — 400 500 km
COVID-19
@ Positive
CCaasseses-Namibia
Lab Tested
C3 No Test
Cases
by
District
lm 5<0s-5099
ll
mi
>12000-03099
Figure 4: Distribution of suspected and confirmed COVID-19 cases in Namibia by District,
09 June 2020
4. PUBLIC HEALTH ACTION / RESPONSE INTERVENTIONS AND
SURVEILLANCE
my
¢ 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. Apatient 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
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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
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.
¢ Surveillance activities
¢ Call centre continue operations for 24 hours every day; 895 calls were answered
at the hotline today (09.06.2020) and 9 alerts were investigated.
¢ 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
¢ Active case search in all regions is on going.
¢ Contact tracing and monitoring is ongoing (see Table 1).
¢ Mandatory supervised quarantine of all persons arriving from abroad is ongoing
(see Table 2).
© All people are tested upon entry into mandatory quarantine for rapid
detection of positive cases.
© 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 09 June 2020, a total of 497 contacts have been identified. Four hundred and twenty-
three (423) contacts have completed their 14 days of follow up and 62 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 09 June 2020
Total Number of contacts listed for follow up (potential)
Total Number of contacts identified (cumulative)
Total number of Contacts never reached
© Total Number of contacts lost to follow up
Total Number of contacts that developed signs & symptoms
163
96
238 | 497
1
0
33
34
0
2
5
7
25
9
9
43
Total Number of contacts that tested positive (became cases)
4
Number of active contacts monitored/followed in the last 24hrs 20
Total number of Contacts completed 14-days follow up
139
Ht
0
5
14
28
62
81
203 | 423
© Seven contacts are lost to follow up, all are non-Namibians and have travelled back to their
countries of origin.
As of 09 June 2020, a total of 2643 persons who came into the country have been placed into
supervised quarantine facilities around the country. Of the 2643, 1884 have been discharged
and 759 are currently quarantined (Table 2).
Table 2: Number of people in mandatory quarantine facilities as of 09 June 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondj
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 09 June 2020
Karas
Khomas
Oshana
Otjozondjupa
Kavango
Ohangwena
Hardap
Kunene
Omaheke
Omusati
Oshikoto
Zambezi
Erongo
Total
214
270
The majority 214 (79.3%) of the truck drivers departed from South Africa to various
destinations, of which the highest number (119) was headed to Khomas Region (Table 3).
LABORATORY INVESTIGATIONS
e As of 08 June 2020, a total of 5085 (including 334 re-tested) 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 09 June
2020
Total sample received by the Laborato:
Total sample tested
Total sample re-tested
Total results positive
Total results negative
Total sample discarded
Total sample missin,
Total results pendin,
Total results inconclusive/indeterminate
Total new si
ted cases in last 24 hours
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COUNTRY COORDINATION, PLANNING AND MONITORING
e Reviewed and incorporated inputs to the COVID19 organogram from the deputy
incident manager, and agreed to submit these through the pillar lead to IM/Senior
executives for their final inputs and endorsement.
e UN Namibia donated assorted flow charts and posters on surveillance covering
contact tracing structure, contact identification and categorization, case definition,
laboratory results sharing structures.
CASE MANAGEMENT:
©
Out of the 31 cumulative confirmed cases,
twice for COVID-19 at 48 hours’ interval.
17 have recovered after testing negative
e Ofthe 14 active cases, | is still in ICU but ina stable and improving condition. The
other 13 are clinically stable.
INFECTION PREVENTION AND CONTROL:
e IPC activities are on going:
o Distribution of PPE according to the Regional plans
© Monitoring of IPC in health facilities
¢ Three additional members have been recruited from CDC and Quality Assurance to
support the national IPC team.
¢ Continous monitoring of nationa IPC stock levels
o Full PPE - 2349
co Respirators - 6087
o Medical masks — 1309
LOGISTICS.
e Facilitation of the allocation of quarantine facilities around the country and
transportation of discharged people from quarantine facilities is ongoing.
POINTS OF ENTRY:
¢ Ongoing screening and inspection of incoming travellers and trucks at points of
entry and check points.
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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.
PSYCHOSOCIAL SUPPORT SERVICES:
¢ Continous provision of health education, psychosocial support services to persons
in need;
© Confirmed cases and their families
© People in quarantine
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.
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.
aye seh
Incident Manager
Date: 09 June 2020
G ane t b,
Secretariat
For enquiries, please contact
Namibia Public Health Emergency Operations Centre;
Email: PHEOC@mhss.gov.na
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