SITREP 2


SITREP 2



1 Page 1

▲back to top


Outbreak Name
Date & Time of
report
Prepared by
Ministry of Health and Social Services
Republic of Namibia
COVID-19
17 March 2020 16:00
Surveillance team
District
Region
Country affected
Investigation start date
Windhoek district
Khomas Region,
Namibia
13 March 2020
e Two confirmed cases of COVID-19 were reported from Windhoek district to MoHSS National level
on 13 March 2020. They are a 35-year-old male and 25 year-old female, both Romanians who have
permanent residence in Spain, with a travel history from Madrid, Spain, via Doha, Qatar. They arrived
in Namibia on Qatar Airways flight number 13730n 11 March 2020.
e Samples were taken as follows; Pathcare (private laboratory in Windhoek, Namibia) Regional
Reference Laboratory, Windhoek, Namibia and sent to National Institute of Communicable Diseases
(NICD), South Africa.
e Overview of numbers of cases: There 3 additional suspected cases reported, to date.
e Contacts: 25 people have been listed as contacts so far, with more to be identified.
e Key laboratory results: 2 confirmed cases RT-CRP for COVID-19 tested positive on 13/03/ 2020
e COVID-19 response meetings are held daily, starting on 14/03/2020
e Key Challenges include:
o Inadequate isolation facilities, human resources and material supplies including PPE, ICU
beds and ventilators.
o Lack of clarity regarding where suspected cases should go for testing.
o Insufficient budget for the response.

2 Page 2

▲back to top


Description of cases
= Index cases: Two confirmed cases of COVID-19 were reported from Windhoek district
to MoHSS National level on 13 March 2020. The patients are married couple; a 35year-
old, male and a 25 year-old female, both Romanians who have permanent residence in
Spain, with a travel history from Madrid, Spain, via Doha, Qatar. They arrived in Namibia
via Hosea Kutako International airport on 11 March 2020.
= The couple were seen by a private physician in Windhoek on 11 March 2020, the male
patient complained of fever (>38C) and cough, while the wife had fever only. The onset
date of symptoms was reported as 9 March 2020. When the patients visited the doctor on
11 March, the doctor suspected COVID-19 and took swabs and sent it to National Institute
for Communicable Diseases (NICD) in South Africa through PathCare on the same day.
The results tested positive of COVID-19 on 13 March 2020.
« The couple checked into a local guest house to stay while waiting for the results. They
visited local retailers shop/super market to buy food before check-in the guest-house on
11 March 2020. On Thursday (12 March 2020) the couple stayed in the guesthouse. On
Friday, 13 March 2020 they took a public taxi to see a doctor, and later visited a pharmacy
the same day to buy antibiotics. The results came at 21:00 on 13 March 2020 and the
Ministry of Health and Social Services was informed. The MoHSS informed WHO
Country Office on 14 March 2020 at around 9:00 am.
Description of disease burden globally:
e On 4th February 2020, the World Health Organization declared Coronavirus Disease
(COVID-19) outbreak a Public Health Emergency of International Concern(PHEIC)
and on 11th March 2020 was declared as a Pandemic.
e According to WHO, for the latest update of case burden and affected countries refer to
https://www.who.int/emergencies/diseases/novel-coronavirus-201.
Mode of transmission: The main driver of transmission, based on currently available data, is
symptomatic cases.
Source: Based on current information, an animal source seems the most likely primary source
of this outbreak. Detailed investigations are ongoing to determine it.
Severity: Current information suggests that the virus can cause mild, flu-like symptoms as well
as more severe disease. Patients infected with the disease are presenting with a wide range of
symptoms. Most seem to have mild disease, and about 20% appear to progress to severe
disease, including pneumonia, respiratory failure and in some cases death.
Incubation period: 1-14 days, based on current information
Description of disease burden in the country (Namibia): This is a new strain of coronavirus
and has never been reported in Namibia. These are first cases of COVID-19 in the country.
Date of outbreak declaration of the outbreak: 14 March 2020

3 Page 3

▲back to top


o Descriptive Epidemiology
= Number of confirmed cases: 2
= Alive and dead: 0 death and 2 cases alive
" Case characteristics (age, sex, occupation): The persons affected are a married
Romanian couple (a 35 year-old male and 25 year-old female) from Madrid, Spain.
= Time trends: Tested on 11 March 2020 and confirmed on 13 March 2020
= Clinical description:
« Patients were taken to a local private doctor 11 March 2020 with a history cough
and fever for the male and fever only for the female.
Contact Tracing Summary
e Number of contacts identified: 25 contacts identified and 19 were traced
e Among contacts being traced, 3 suspected cases have been tested and 2 found negative; 1
results pending
e Further contact tracing ongoing including investigation of other alerts reported.
Samples for the confirmed cases were taken on 11 March 2020 and sent through Pathcare to the
Regional Reference Laboratory, National Institute of Communicable Diseases (NICD) in South
Africa. The results were received on 13 March 2020 and tested positive.
« Samples for 3 suspected cases were collected on 16-17 March 2020 and sent to Namibia Institute
of Pathology; 2 tested negative and | still pending.
o COORDINATION AND LEADERSHIP:
= National Health Emergency Management Committee special committee on COVID-19 response
was activated 14 March 2020 and chaired by the Hon. Minister of Health.
= Declaration of the outbreak was done through a press conference by Hon. Minister of Health on
14 March 2020.
= Incident Management System activated and Incident Manager for COVID-19 have been
appointed.
« Sub-committees, including coordination, logistics, laboratory, surveillance, points of entry,
community engagement, and case management and infection prevention and control, have been
activated and hold regular meetings.
« A high-level meeting was held at the State House with President and precautionary measures
were taken.
» Namibia COVID-19 response plan developed.
o SURVEILLANCE:
" Case contact tracing commenced on 14 March 2020 and is ongoing.
« A telephone hotline center has been activated and staffed with responders to address concerns
from the general public.
= Case definitions:
Suspect 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 with no other aetiology that
3[Page

4 Page 4

▲back to top


fully explains the clinical presentation AND a history of travel to or residence in a
country/area or territory reporting local transmission (See situation report) 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 COVID19 case (see definition of contact) in the last 14 days prior to
onset of symptoms;
OR C. A patient with severe acute respiratory infection (fever and at least one sign/symptom
of respiratory disease (e.g., cough, shortness breath) AND requiring hospitalization AND
with no other etiology 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.
LABORATORY:
« Laboratory has been involved and sensitized about collecting and transporting this
extreme biohazard specimen from suspected patients
« There is a system in place for shipping specimen to NICD reference laboratory in South
Africa.
= NIP laboratory has capacity for local testing and has limited tests for COVID-19.
CASE MANAGEMENT and Infection Prevention and Control:
" The 2 confirmed patients were moved to an Isolation facility and managed as per WHO
recommendations.
= As of 17 March 2020, the male patient was stable and the female patient was asymptomatic.
Points of Entry
= Port Health services (screening) has been intensified at major points of entry
RISK COMMUNICATION, COMMUNITY ENGAGEMENT & SOCIAL
MOBILISATION:
# Risk communication by Office of President and Executive director of Ministry of Health
has been conducted
= The Ministry of Information and Communication has been directed to take a lead in all
communication regarding COVID-19 in the country
= Assorted IEC materials developed; requires further support in development
# COVID-19 messages are currently being shared through various platforms; media, town
hall meetings, etc.
LOGISTICS:
= List of supplementary needed items has been compiled and submitted for procurement;
PPE, Masks, gloves, etc.
" Modification of the entrance/exit of existing the designated isolation facility at Robert
Mugabe clinic is ongoing. It is expected this will be a screening facility.
Lack of fully equipped isolation faci
n the Country
Insufficient Personal Protective Equipment/clothing
Insufficient trained personnel
Insufficient funding for the response plan
Need for technical support in coordination, case management and IPC, surveillance and POE,
risk communication and community engagement
4|Page

5 Page 5

▲back to top


COORDINATION AND LEADERSHIP:
= Improve coordination, Composition of thematic areas
2 Involve all relevant stakeholders with commitment from top management
= Finalization of all relevant SOPs per pillar
# Activation of the IMS in regions
SURVEILLANCE:
# Intensify contact tracing process to identify all contacts
« Strengthen surveillance and detection throughout all districts and regions to detect suspected
cases early
LABORATORY:
= Utilise Namibia Institute of Pathology for local testing
CASE MANAGEMENT:
= Ensure all health workers involved are well trained in COVID-19
» Have clear SOPs of case management readily availably
= Procure and distribute relevant equipment and materials
= Determine screening facility and direct
POINTS OF ENTRY
= Fully equip (Equipment & Human resources) all identified points of entry
RISK COMMUNICATION,
MOBILISATION
COMMUNITY
ENGAGEMENT
& SOCIAL
* Conduct regular risk communication and community engagement through IEC material,
electronic media and direct engagement.
LOGISTICS
= Procurement of IPC and laboratory supplies for Emergency preparedness and response
sao
Incident bores
Date: 17 March 2020
tS
Secretariat
5|Page