SITREP 96


SITREP 96



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Ministry of Health and Social Services
Republic of Namibia
(223\\ World Health
Ye Organization
NAMIBIA
Outbreak Name
Date & Time of
this report
Prepared by
COVID-19 outbreak
22.06.2020
20:15 hrs
Surveillance Team
Country affecte
Investigation start
date
amibia
13 March 2020
1.
SITUATION UPDATE / HIGHLIGHTS
e Nine (9) new confirmed cases were recorded today (22 June 2020).
e Cumulatively, 72 confirmed cases have been reported in the country.
e Of the 72 confirmed cases, twenty-one 21 (29.2%) have recovered.
e Thirty-five 35 (51.4%) of the confirmed cases are imported while 37 (48.6%) are
local transmissions.
© No death has been recorded, case fatality rate is 0%
e On 22 June 2020, His Excellency, The President of the Republic of Namibia
announced that all regions will migration to stage 4 of the state of emergency with
the exception of Erongo Region.
a) Stage 3 restrictions will be imposed on three (3) Local Authority Areas of
Erongo Region i.e; Walvis Bay, Swakopmund, and Arandis.
« Effective from midnight 22 June 2020 until midnight 06 July 2020.
b) The other regions including other Local Authority Areas of Erongo region
will migrate to stage 4 of the state of emmergency which covers a period of
10 weeks (30 June 2020 — 17 September 2020).
« Everybody coming into the country including tourists must provide a
negative results valid for 72 hours and will be subjected to a mandatory
supervised quarantine at their own cost.
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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 22 June 2020, Namibia recorded nine (9) new cases bringing the total number
of confirmed cases to 72. Eight (8) of the nine (9) cases are Namibians while one
(1) is a South African citizen:
O° Case 64 is a 71-years old male South African truck driver who arrived in
Namibia on 17 June 2020 through Noordoewer border post. He presented at
Engela Hospital with complains of dizziness, cough, sore throat and
diarrhoea.
Case 65 is a 65-years old male, from Walvis Bay, Erongo region a contact
of case 35. No signs and symptoms.
Case 66 is a 50-years old female, from Walvis Bay, Erongo region a contact
of case 35. No signs and symptoms.
Case 67 is a 51-years old female, from Walvis Bay, Erongo region. She was
swabbed as part of active case search. No signs and symptoms, no known
contact.
Case 68 is a 41-years old female, from Walvis Bay, Erongo region. She was
swabbed as part of active case search. She had complains of general body
pain, no known contact.
Case 69 a 45-years old female, from Walvis Bay, Erongo region. She was
swabbed as part of active case search. She had complains of general body
pain, and running nose, no known contact.
Case 70 a 59-years old female, from Walvis Bay, Erongo region. She was
swabbed as part of active case search. She had complains of cough and flu,
no known contact.
Case 71 a 42-years old female, from Walvis Bay, Erongo region. She was
swabbed as part of active case search. She had complains of sore throat,
vomiting, cough, and shortness of breath, no known contact.

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o Case 72 a 51-years old male, from Walvis Bay, Erongo region. He was
swabbed as part of active case search. No signs and symptoms, no known
contact.
3. EPIDEMIOLOGY
Since 14 March 2020, when the COVID-19 outbreak was declared in Namibia, a total of 72
cases have been confirmed. Seven (7) regions have so far been affected, of which Erongo
region recorded the highest number of cases; 41 (57 %) while Zambezi and Ohangwena
recorded the least 1(1.4%) as per figure 1 below.
45
40
35
@“ 30
o
“a5 25
3B 20
2=5 15
10
5
6
i
Khomas
|
//Karas
:
Erongo
Bm..
Hardap
Region
on oo
Zambezi
=
Otjozondjupa
—
Ohangwena
@ Total number of cases MActivecases Recovered Death
Figure 1: Distribution of Confirmed COVID-19 cases in Namibia, by region as of 22 June
2020
Namibia recorded its cases of COVID-19 during the epidemiological weeks displayed in
figure 2 below. Most 26 (36.1%) of the cases were recorded in week 25.
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30
25
20
i5
10
40
11
#12
#13
#14
«15
«6
«#17
«218 #«19°«20«240¢6«62206«62306«6240
25
26
Epidemiological week, 2020
Figure 2: Epi-curve for confirmed COVID-19 cases in Namibia as of 22 June 2020
As presented in figure 3 below, more male cases were recorded; 37 (51.4%) compared to
female cases; 35 (48.6%).
14
12
10
8
4
6
:A.
,a
)
‘|
mf a
0-9
10to19
20t029
30to39
40t049
50t059
G60t069
701079
80+
Age group
mMiale © Female
Figure 3: Age and sex distribution of COVID-19 confirmed cases in Namibia as of 22 June
2020
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Note:
A Point is a Spatial
Representation of a
case but not the
actual location of
the case
COVID-19 Cases-Namibia
e@ Positive Cases (45)
Lab Tested Cases by District
(—] No Test
(5 <50
G5 50-99
iGai 1>0209-06000
@ 100 200 300 400 500km
Figure 4: Distribution of suspected and confirmed COVID-19 cases in Namibia by District,
22 June 2020
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, ¢.g., cough, shortness of breath; AND
requiring hospitalization) AND in the absence of an alternative diagnosis that fully
explains the clinical presentation.
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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.
e Surveillance activities
e Call centre continue operations for 24 hours every day; 1213 calls were
answered at the hotline today (22.06.2020).
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).
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
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 Expanded Targeted Testing.
o Isolation of all positive cases is ongoing.
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Table 1: National contacts tracing summary for COVID-19 as of 21 June 2020
Total
Number
o
contacts
|
isted
ss
for follow
up
(potential)
Total Number of contacts identified (cumulative)
Total number of Contacts never reached
Total Number of contacts lost to follow up
329
168
417 | 914
0
0
21
27
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
(Table for 22 June 2020 not yet available)
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).
Table 2: Number of people in mandatory quarantine facilities as of 22 June 2020
Kunene
Omaheke
Kavango
Omusati
56
53
3
109
73
36
82
59
23
110
94
16
Oshana
42
20
22
Ohangwena
230
195
35
Hardap
201
163
38
Otjozondjupa
370
330
40
Khomas
1100
821
Zambezi
402
339
63
//Kharas
3
442
345
97
Erongo
0
201
137
64
Oshikoto
0
48
44
4
Total
82
3393
2673
720
As of 22 June 2020, a total of 3393 persons who came into the country have been placed into
supervised quarantine facilities around the country. Of the total, 2673 have been discharged
and 720 are currently quarantined (Table 2).
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LABORATORY INVESTIGATIONS
e Asof22 June 2020, atotal of 7585 (including 706 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 22 June
2020
Total
le received by the Laborato
Total sample tested
Total sample re-tested
Total
itive results
Total
ive results
Total
le discarded
Invalid results
Total pending results
Total new
cases in last 24 hours
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 72 cumulative confirmed cases, 21 have recovered after testing negative
twice for COVID-19 at 48 hours’ interval.
e Ofthe 46 active cases, | is still in ICU and is clinically stable. His clinical condition
continues to improve.
e Implementation of the 4" version of Case Management SOPs.
e Establishment of support capacity strengthening measures.
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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)
Table 4. Distribution of truck drivers who came into Namibia from neighboring countries
and destination regions on 22 June 2020
//Kharas
Khomas
Omusati
0
Oshana
5
5
Ka
1
Ohangwena
2
2
Kunene
0
Omaheke
2
Oshikoto
1
Zambezi
0
Erongo
6
Total
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e Majority of the truck drivers 100 (57.5%) departed from South Africa to various
regions. The largest number of truck drivers were heading to Khomas 50 (28.7%) and
Erongo region 50 (28.7%).
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.
e Implementation of training sessions for Erongo Region (Swakopmund District to
commence on 23 June 2020).
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
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.
Date: 22 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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