SITREP 94


SITREP 94



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Ministry of Health and Social Services
Republic of Namibia
WSs ) WOorrgladnizHaetailothn
NAMIBIA
Date & Time of
this report
Prepared by
20.06.2020
23:30 hrs
Surveillance Team
Investigation start
date
amib
13 March 2020
1.
SITUATION UPDATE / HIGHLIGHTS
e Twelve (12) new confirmed cases were recorded today (20 June 2020).
o Ten (10) cases are from Kuisebmund, Walvis Bay in Erongo region
e Cumulatively, 58 confirmed cases have been reported in the country.
e Of the 58 confirmed cases, nineteen 19 (32.8%) have recovered.
e Thirty-four 34 (58.6%) of the confirmed cases are imported while 24 (41.4%) 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
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.
On 20 June 2020, Namibia recorded twelve (12 ) new cases bringing the total
number of confirmed cases to 58. Ten (10) cases are all Namibians from
Kuisebmund, Walvis Bay district in Erongo region
Oo Case 47 is a 28-years old Namibian female, from Walvis Bay, was swabbed
as part of active case search. She had general body pain and back pain.
Case 48 is a 2-years old Namibian male, from Walvis Bay, a contact of case
35. He had flu-like symptoms at the time of swabbing.
Case 49 is a 33-years old Namibian female, from Walvis Bay, was swabbed
as part of active case search. She had no symptoms and no contact with a
known confirmed case.
Case 50 is a 28-years old female with Indian citizenship, travelled from
India via South Africa and arrived in Namibia on 17 June 2020. She was put
into mandatory quarantine in Otjozondjupa region.
Case 51 is a 36-years old Namibian female, from Walvis Bay, was swabbed
as part of active case search. She complained of loss of smell and body
weakness. No contact with a known confirmed case.
Case 52 is a 28-years old Namibian female, from Walvis Bay, was swabbed
as part of active case search. No symptoms and no contact with a known
confirmed case.
Case 53 is 56-years old Namibian male, from Walvis Bay, a contact of case
number 35. He had flu-like symptoms.
Case 54 is a 21-years old Namibian male, from Walvis Bay, a contact of
case 35. He had a cough and a sore throat.
Case 55 is a 65-years old female with South African citizenship, residing in
Namibia. She travelled from South Africa on 18 June 2020 and was
quarantined in Khomas region.
Case 56, 57 and 58 are all Namibians, from Walvisbay linked to case 37:
= Case 56 is a 30-years old male
= Case 57 is a 23-years old female
=» Case 58 is 36-years old female

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3. EPIDEMIOLOGY
Since 14 March 2020, when the COVID-19 outbreak was declared in Namibia, a total of 58
cases have been confirmed. Six (6) regions have so far been affected, of which Erongo region
recorded the highest number of cases; 28 (48.3%) while Zambezi recorded the least 1(1.7%)
as per figure 1 below.
30
25
awn
@
20
G
z6.@
&
15
10
z
0
.
Khomas
Oe.
//Karas
@
Erongo
Ga...
Hardap
Region
_
Zambezi
WTotal number ofcases MActivecases MRecovered
Death
=
Otjozondjupa
Figure 1: Distribution of Confirmed COVID-19 cases in Namibia, by region as of 20 June
2020
Namibia recorded its cases of COVID-19 during the epidemiological weeks displayed in
figure 2 below. Most 25 (43.1%) of the cases were recorded in week 25.
30
20
is
iO
40
#42 #12 #13 14 «15«16
#17 «218+~«192«~«2202«024¢2¢«©22¢«@¢@«23~CC
2A OS
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 20 June 2020
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As presented in figure 3 below, more male cases are recorded; 32 (55.2%) comparing to female
cases; 26 (44.8%).
42
10
8
4
oe
ciHnf i
0-9
10to19 20to29 30%039 40t049 50t059 60to69 70to79
80+
Age group
@ Male
Female
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 20 June
2020
Note:
ARePporienstenits aatiSopnatioafl a case but
not the actual location of
the case
0 100 200 300 400 500km
=
COVID-19 Cases-Namibia
® Positve Cases [58]
Lab Tested by District
C_] No test
<50
GS 50-99
GS 100-700
i >3000
Figure 4: Distribution of suspected and confirmed COVID-19 cases in Namibia by District,
20 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; 935 calls were answered
at the hotline today (20.06.2020) and 19 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).

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e Mandatory supervised quarantine of all persons arriving from abroad is ongoing
(see Table 2).
o 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 twice ( upon arrival and on day 12 before release on day 15 if they
test negative).
CONTACT TRACING SUMMARY
Table 1; National contacts tracing summary for COVID-19 as of 20 June 2020
Total Number of contacts listed for follow up (potential)
325
Total Number of contacts identified (cumulative)
325
Total number of Contacts never reached
0
Total Number of contacts lost to follow up
0
Total Number of contacts that developed signs & symptoms
38
Total Number of contacts that tested positive (became cases)
10
Number of active contacts monitored/followed in the last 24hrs | 113
Total number of Contacts completed 14-days follow up
183
168
441 | 934
168
414 | 907
0
Ze
27
2
5
7
5
12
55
1
0
il
63
113 | 289
104
285 | 572
As of 20 June 2020, a total of 907 contacts of confirmed cases have been identified. A total of
572 contacts have completed their 14 days of follow up, and 289 active contacts were
monitored today.
The National and Regional teams are supporting the Walvis Bay district team in reviewing
recent cases and contacts to identify possible COVID-19 transmission hot spots for enhanced
response:
o Kuisebmund area and prison identified as hot spots.
o Plans ongoing to test more people through targeted testing.
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Table 2: Number of people in mandatory quarantine facilities as of 20 June 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Kharas
Erongo
Oshikoto
Total
56
53
3
102
70
32
82
59
23
109
94
15
36
20
16
221
167
54
196
161
35
370
329
4]
1033
796
389
315
74
439
337
201
137
64
48
44
4
3282
2382
700
As of 19 June 2020, a total of 3282 persons who came into the country have been placed into
supervised quarantine facilities around the country. Of the total, 2582 have been discharged
and 700 are currently quarantined (Table 2).
LABORATORY INVESTIGATIONS
e Asof20 June 2020, a total of 7091 (including 693 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 20 June
2020
Total
le received by the
Total sam
tested
Total
le re-tested
Total
results
Total
ive results
Total sample discarded
Total
ing results
Total new
cases in last 24 hours
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COUNTRY COORDINATION, PLANNING AND MONITORING
e Plans are under way for integrated support visits to other regions (Zambezi,
Kavango, Ohangwena, Omusati, Kunene, and Oshana region).
e Preparatory work for the Health Development Partners virtual meeting on 24 June
2020 are ongoing. A template has been shared with pillar leads for inputs.
CASE MANAGEMENT:
e Out of the 58 cumulative confirmed cases, 19 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e Ofthe 39 active cases, | is still in ICU and is clinically stable. His clinical condition
continues to emprove.
INFECTION PREVENTION AND CONTROL:
e IPC activities are ongoing:
o 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.
e Sourcing, procuring, receiving and distributing commodities.
e Updating commitment and stock registers daily.
e Distributed medical commodities (suction machines and ventilators) to Erongo
region.
POINTS OF ENTRY:
e Screening of incoming travellers and inspection of trucks at points of entry and
check points are ongoing.
e Daily reporting on ground crossing transports at all designated Points of Entry is
ongoing (Table 4)

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Table 4. Distribution of truck drivers who came into Namibia from neighboring countries
and destination regions on 20 June 2020
Karas
0
Khomas
0
Omusati
0
Oshana
0
0
Kav
0
0
0
Kunene
0
Omaheke
0
Oshikoto
0
Zambezi
0
0
Total
0
The majority 211 (87.6%) of the truck drivers departed from South Africa to various regions.
The largest number 132 (54.8%) of truck drivers were headed to Khomas Region.
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
e Street drive announcements of COVID-19 messages are being done in Walvis Bay
district.
e The Commununication Center continues to engage stakeholders on issues around
the COVID-19 response.
e Distribution of IEC materials is ongoing.
PSYCHOSOCIAL SUPPORT SERVICES:
e Continous provision of health education and psychosocial support services to
persons in need 1.¢;
o Confirmed cases and their families
o People in quarantine
o Persons in need of shelter
o Health Care Workers
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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:
ft. srceectllco
Incident Manager
Date: 20 June 2020
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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