SITREP 95


SITREP 95



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Ministry of Health and Social Services
Republic of Namibia
orld Health
rganization
NAMIBIA
‘Outbreak Name
Date & Time of
this report
Prepared by
outbreak }
21.06.2020
23:30 hrs
Surveillance Team
Investigation start
date
13 March 2020
1.
SITUATION UPDATE / HIGHLIGHTS
e Five (5) new confirmed cases were recorded today (21 June 2020).
o All cases are from Erongo region
e Cumulatively, 63 confirmed cases have been reported in the country.
e Of the 63 confirmed cases, twenty-one 21 (33.3%) have recovered.
© Two (2) cases recovered today (21 June 2020)
e Thirty-four 34 (54%) of the confirmed cases are imported while 29 (46%) 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 | 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 21 June 2020, Namibia recorded five (5) new cases bringing the total number
of confirmed cases to 68. All 5 cases are Namibians from Erongo region :
oO Case 59 is a 14-years old female, from Walvis Bay, a contact of case 37.
No signs and symptoms.
Case 60 is a 34-years old female, from Walvis Bay, a contact of case 35. No
signs and symptoms.
Case 61 is a 24-years old female, from Walvis Bay. She was swabbed as a
part of active case search. No signs and symptoms, and no known contact.
Case 62 is a 65-years old male, Walvis Bay. He was part of active case
search. She compalined of headache and fever. No known contact, no travel
history.
Case 63 is a 43-years old male, from Swakopmund. He was swabbed as part
of active case search. No signs and symptoms, no known contact and no
travel history.
3. EPIDEMIOLOGY
Since 14 March 2020, when the COVID-19 outbreak was declared in Namibia, a total of 63
cases have been confirmed. Six (6) regions have so far been affected, of which Erongo region
recorded the highest number of cases; 33 (52.4%) while Zambezi recorded the least 1(1.6%)
as per figure 1 below.

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35
30
25
20
0i
Khomas
ia.
//Karas
:
Erongo
Be.
Hardap
om
Zambezi
ae
Otjozondjupa
Total number of cases Active cases
Recovered m Death
Figure 1: Distribution of Confirmed COVID-19 cases in Namibia, by region as of 21 June
2020
Namibia recorded its cases of COVID-19 during the epidemiological weeks displayed in
figure 2 below. Most 25 (39.7%) of the cases were recorded in week 25.
30
25
20
45
10
10 41 12 #43 #14 «415 «#16 «2172«»«218@«~«€©192«©200¢=«©21«02«©222¢«2238s 2A 25
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 21 June 2020
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As presented in figure 3 below, more male cases were recorded; 34 (54%) compared to female
cases; 29 (46%).
Q-9
10 to 19
20 to 29
30 to 39
40 to 49
50 to 59
60 to 69
70 to 79
80+
Age group
@ Male = Female
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 21 June
2020
Note:
A Point is a Spatial
Representation of a
case but not the
actual location of
the case
COVID-19 Cases-Namibia
® Positive Cases (45)
Lab Tested Cases by District
[No Test
C7 <50
i 50-99
G@@ 100-600
Gi >2900
0 100 200 300 400 500km
=
_
Figure 4: Distribution of suspected and confirmed COVID-19 cases in Namibia by District,
21 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; 1216 calls were
answered at the hotline today (21.06.2020) and 17 alerts were investigated.
e Namibia COVID-19 dashboard accessible via a link on the MoHSS’s website
http:/Avww.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).
e Regions have intensified surveillance on travellers from Erongo region for early
case detection.
CONTACT TRACING SUMMARY
Table 1: National contacts tracing summary for COVID-19 as of 21 June 2020
Total Number of contacts listed for follow up (potential)
329
168
444 | 9A]
Total Number of contacts identified (cumulative)
329
168
417 | 914
Total number of Contacts never reached
0
0
27
27
Total Number of contacts lost to follow up
0
2
5
7
Total Number of contacts that developed signs & symptoms
38
5
12
55
Total Number of contacts that tested positive (became cases)
10
1
0
11
Number of active contacts monitored/followed in the last 24hrs | 78
47
98 | 223
Total number of Contacts completed 14-days follow up
189
104
285 | 578
As of 21 June 2020, a total of 914 contacts of confirmed cases have been identified. A total of
578 contacts have completed their 14 days of follow up, and 223 active contacts were
monitored today (Table 1).
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 21 June 2020
Kunene
Omaheke
Kavango
Omusati
Oshana
Ohangwena
Hardap
Otjozondjupa
Khomas
Zambezi
//Kharas
Erongo
Oshikoto
Total
56
53
3
104
70
34
82
59
23
109
94
15
42
20
ZZ
228
194
34
199
163
36
370
330
40
1033
796
400
325
75
439
337
201
137
64
48
44
4
3311
2622
689
As of 21 June 2020, a total of 3311 persons who came into the country have been placed into
supervised quarantine facilities around the country. Of the total, 2622 have been discharged
and 689 are currently quarantined (Table 2).
LABORATORY INVESTIGATIONS
e Asof21 June 2020, a total of 7098 (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 21 June
2020
|
Total
le received by the Labo
Total sam
tested
Total
le re-tested
Total
e results
Total
ive results
Total
le 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 63 cumulative confirmed cases, 21 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e Ofthe 42 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 21 June 2020
Karas
Khomas
Omusati
Oshana
Otjozondj
Ka
oO
Kunene
Omaheke
Oshikoto
Zambezi
Total
2
5
7
0
3
0
0
2
2
1
16
167
41
The majority 167 (71.4%) of the truck drivers departed from South Africa to various regions.
The largest number 110 (47%) of truck drivers were headed to Khomas Region.
RISK COMMUNICATION AND COMMUNITY ENGAGEMENT:
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 i.e;
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 Inadequate 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:
oat
Incident Manager
Date: 21 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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