SITREP 91


SITREP 91



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Ministry of Health and Social Services
Republic of Namibia
wv‘\\ OWrorgladnizHaetailotnh
NAMIBIA
Outbreak Name
Date & Time of
this report
Prepared by
COVID-19 outbreak
17.06.2020
22:45 hrs
Surveillance Team
Country affected
Investigation start
date
amibia
13 March 2020
1.
SITUATION UPDATE / HIGHLIGHTS
e Five (5) new confirmed cases were recorded today (17 June 2020)
e Cumulatively, 39 confirmed cases have been reported in the country.
e Of the 39 confirmed cases, nineteen 19 (48.7%) have recovered.
o One (1) case has recovered today (17 June 2020)
e Thirty 30 (77%) of the confirmed cases are imported while 9 (23%) are local
transmissions.
e No death has been recorded, case fatality rate is 0%
e On 08 June 2020, His Excellency, The President of the Republic of Namibia
announced the extension of the Stage 1 restrictions imposed on the Walvis Bay
Local Authority Area to the entire Erongo region;
o Effective from midnight 08 June 2020 until midnight 22 June 2020.
e The other regions are still under Stage 3 of national lockdown which covers a period
of 28 days (01 June 2020 — 29 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-years-old male and a 25-years-
old female, arrived from Madrid, Spain on 11 March 2020.
e On 17 June 2020, Namibia recorded five (5) new confirmed cases, bringing the
total number of confirmed cases to 39.
o Case 35 is a 26-years old Namibian male, from Walvis Bay, Erongo region.
He does not have a travel history and no contact with a known confirmed
case. An investigation to identify source of exposure has started.
o Case 36 is a 44-years old male with Malawian citizenship. He entered
Namibia on 05 June 2020 through Wenela Border Post and was put into
supervised quarantine in Katima Mulilo, Zambezi region.
© Case 37 is a 20-years old Namibian male, from Walvis Bay, Erongo region.
He was placed into supervised quarantine on 15 June 2020 in Mariental,
Hardap region.
o Case 38 is a 22-years old Namibian female. She travelled from England on
04 June 2020 and was placed into supervised quarantine in Windhoek,
Khomas region.
o Case 39 is a 55-years old Namibian female from Swakopmund, Erongo
region. She does not have a travel history and no contact with a known
confirmed case. An investigation to identify source of exposure has
commenced.
3. EPIDEMIOLOGY
Since 14 March, 2020 when the COVID-19 outbreak was declared in Namibia, a total of 39
cases have been confirmed. So far, five (5) regions have been affected, of which Khomas region
recorded the highest number of cases; 18 (46.2%), while Zambezi region recorded the least; 1
(2.6%), as per figure 1, below

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18
16
a 14
«3°
12
10
a
a 64
;
|
Khomas
/ {Karas
Erongo
Region
ie
Hardap
Si Totalnumber of cases MActivecases Recovered Death
|
:
;
Zambezi
Figure 1; Distribution of Confirmed COVID-19 cases in Namibia, by region as of 17 June
2020
Namibia recorded its cases of COVID-19 during the epidemiological weeks displayed in
figure 2 below:
10
i1
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 17 June 2020
As presented in figure 3 below, more male cases are recorded; 25 (64.1%) comparing to female
cases; 14 (35.9%).
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3
8
7
6
5
4
3
ai
0-
iil
.
10to 19 Z0to 29 30 to 39 4010 49 501059 601069 70t0 79 8680+
Age group
w Male @& Female
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 17 June
2020
Note:
A Point is a spatial
representation of a
case but not the actual
location of the case
0 100 200 300 400 500km
a
COVID-19 Cases-Namibia
®@ Positive Cases
Lab Tested Cases by District
[1 No Test
1 <50
[2 50-99
G8 100-600
ma >2800
Figure 4: Distribution of suspected and confirmed COVID-19 cases in Namibia by District,
17 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
e Call centre continue operations for 24 hours every day; 769 calls were answered
at the hotline today (17.06.2020) and 9 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 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 twice ( upon arrival and on day 12 before release on day 15 if they
test negative).
o Keetmanshoop NIP is ready to test specimens from truck drivers.
o Stakeholders meeting with the Walvis Bay District and Correctional
facility was conducted to discuss the current outbreak and
recommendations on the situation at hand.
CONTACT TRACING SUMMARY
Table 1: National contacts tracing summary for COVID-19 as of 17 June 2020
Total Number of contacts listed for follow up (potential)
138
Total Number of contacts identified (cumulative)
137
Total number of Contacts never reached
1
Total Number of contacts lost to follow up
0
Total Number of contacts that developed signs & symptoms
25
Total Number of contacts that tested positive (became cases)
4
Number of active contacts monitored/followed in the last 24hrs | 46
Total number of Contacts completed 14-days follow up
87
88 a 268 | 494
88
225 | 450
0
43
Ae
2
5
7
9
9
43
1
0
5
26
69
141
61
149 | 297
As of 17 June 2020, a total of 450 contacts of confirmed cases have been identified. A total of
297 contacts have completed their 14 days of follow up, 141 are still active and being monitored
daily for 14 days and all were monitored today. (Table 1).
The National and Regional team is supporting the Walvis Bay district team in reviewing recent
cases and contacts to rule out possible community transmission and to identify possible
COVID-19 transmission hot spots for enhanced response:
oO Kuisebmund area and prison identified as hot spots.
o Plans ongoing to test more people through targeting testing.
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Table 2: Number of people in mandatory quarantine facilities as of 17 June 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Kharas
Erongo
Oshikoto
Total
53
33
0
95
63
32
74
56
18
105
87
18
33
20
13
213
167
46
156
142
14
340
328
12
972
630
381
311
70
416
330
86
146
114
32
44
42
2
3028
2343
685
As of 17 June 2020, a total of 3028 persons who came into the country have been placed into
supervised quarantine facilities around the country. Of the 3028, 2343 have been discharged
and 685 are currently quarantined (Table 2).
LABORATORY INVESTIGATIONS
e Keetmanshoop NIP is ready to test specimens taken from truck drivers.
e As of 17 June 2020, a total of 6352 (including 646 re-tested) COVID-19 specimens
have been tested in the two laboratories (NIP and Path Care) as per Table 3 below:
Table 3: COVID-19 specimens recorded at NIP and Path care Laboratories as of 17 June
2020
Total
le received by the
Total sam
tested
Total sample re-tested
Total
results
Total negative results
Total
le discarded
Total
ding results
Total new
cases in last 24 hours
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COUNTRY COORDINATION, PLANNING AND MONITORING
e Provision of support to the Walvis Bay and Swakopmund districts from the
National and Erongo Regional team.
e Development of the draft-organogram lead by Deputy Executive Director, Regional
Director, Chief Medical Officer and Senior Medical Officer.
e Two meetings held with the Walvis Bay District COVID-19 Emergency
Management Team. Support is being provided to the district to carry out the
revision of their emergency response plan and resource mobilization.
e Arragements of an integrated support visits to other regions (Zambezi, Kavango,
Ohangwena, Omusati, Kunene, and Oshana region) ongoing.
CASE MANAGEMENT:
e Out of the 39 cumulative confirmed cases, 19 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e Of the 20 active cases, 1 is still in ICU but in a stable and improving condition. The
other 19 are clinically stable.
INFECTION PREVENTION AND CONTROL:
e IPC activities are ongoing:
© Distribution of PPE according to the Regional plans.
o Monitoring of IPC in health facilities
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:
e Ongoing screening and inspection of incoming travellers and trucks at points of
entry and check points.
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Table 4. Distribution of truck drivers who came into Namibia from neighboring countries
and destination regions on 17 June 2020
Karas
Khomas
Oshana
4
8
Ka
oO
0
5
5
Kunene
1
Omaheke
4
Omusati
0
Oshikoto
0
Zambezi
1
oO
8
Total
167
247
The majority 167 (67.6%) of the truck drivers departed from South Africa to various regions.
The largest number 94 (38.1%) of truck drivers were headed to Khomas Region (Table 4).
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e With the current status of the COVID-19 outbreak in Erongo region, the RCCE
pillar has prioritised the training of the Community Health Workers to ensure
intensified risk communication activities in the region.
e Street drive announcements of COVID-19 messages are being done in Walvis Bay
district.
e The Commununication center continues to engage other sectors on COVID-19
response. Distribution of IEC materials is ongoing. A total of 6000 copies of printed
IEC have been given to Kavango East and West regions.
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PSYCHOSOCIAL SUPPORT SERVICES:
e Continous provision of health education, psychosocial support services to persons
in need i.e;
o Confirmed cases and their families
© People in quarantine
© Persons in need of shelter
o Health Care Workers
5. CHALLENGES:
e Inadequate isolation units at health facilities in the regions.
e Inadquate PPE
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.
Approved:
oft
Incident Manager
Date: 17 June 2020
eet
:
(-
s Wt "
y.
Secretariat
For enquiries, please contact
Namibia Public Health Emergency Operations Centre;
Email: PHEOC@mhss.gov.na
Hotline Toll-free: 0800 100 100
Hotline Whatsapp: 085 1100 100
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