SITREP 7


SITREP 7



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Date & Time of
report
Prepared by
Ministry of Health and Social Services
Republic of Namibia
(ie ») World Health
Sy Organization
“NAMIBIA
24 March 2020 19:30
Surveillance team
istric
Region
Country affected
Investigation start date
indhoe!
Khomas
Namibia
13 March 2020
e Two new cases reported today the 24 March 2020
e Cumulative 6 confirmed cases (RT-CPR for COVID-19) and one inconclusive (probable case), four
are in isolation, last two cases confirmed on 24 March 2020 to be admitted at isolation facility
e To date, 179 suspected cases were reported with samples collected
e A total of 77 contacts have been identified to date
e Thematic group meetings continue to be held daily, since the 14 March 2020
e His Excellency announced COVID-19 lockdown, which includes) 30 days international travel ban;
ii) All borders closed except Hosea Kutako International airport and essential supplies from
neighbouring countries; and iii) 21-day travel restriction (27 March-16 April 2020) in Khomas and
Erongo regions.
e Key Challenges include:
© Inadequate isolation and quarantine facilities, human resources and material supplies
including PPE, ICU units and ventilators.
o Inadequate infrastructure at some key points of entry (working space for port health staff,
equipment and supplies):
o Private testing facility not reporting or delaying reporting to MoHSS resulting in delayed
start to contact tracing
= Description of cases
= Index cases: Two confirmed cases of COVID-19 were reported in Windhoek district on
13 March 2020. The married couple; a 35year-old male and a 25-year-old female, arrived
from Madrid, Spain on 11 February 2020.
« A third confirmed case was recorded on 19.03.2020; a 61 years old male, a Germany
national with travelling history via Amsterdam on 26 February 2020 and Zimbabwe on
4th March 2020 and arrived in Namibia on 13 March 2020 by Air from Cape Town.
= Aclose contact of the third case (above) has been tested twice and received inconclusive
results. This probable case is in self-quarantine and contacts have been listed.
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= The Fourth case was confirmed on 23 March 2020, a 19-year-old Namibian male, who
returned from London, UK on the 18th March, 2020 and got tested on the 19th of March
2020.
= The fifth case is a 44-year-old male Namibian citizen with no travelling history. The onset
of signs and symptom was on 13 March 2020, and he visited 3 health care facilities in
Windhoek on 17, 20 and 21 March 2020. The result was reported on 24 March 2020.
= A sixth case is a 21 years old male Namibian with a history of travelling from South
Africa. The onset of symptom was on 15 March 2020 in South Africa. A sample was
collected in South Africa on 17 March 2020 and the patient flew to Namibia on 20 March
2020 and received positive result on 23 March 2020.
= All the first four cases are at the isolation facility at Hosea Kutako International Airport,
while arrangements are being made to transport the latest two cases to the isolation
facility.
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 As of 23 March 2020 (WHO SITREP), 332 930 confirmed cases globally with 14 510
deaths,
Mode of transmission: The main 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 in Namibia: 14 March 2020
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= Number of Laboratory confirmed cases: 6; and 1 probable case
= Alive and dead: 0 death and 6 cases alive
Contact Tracing Summary
Table 1: Contacts tracing summary as of 24.03.2020
Contact risk level
Variables
High
Medium
Low
Potential number of contacts
10
13
54
Number of contact reached
10
10
44
Number of contact monitored
today
10 (100%)
10 (77%)
40 (74)
Number of contact that
0
0
developed signs & symptoms | 0
Number of contact with signs
1
8
and symptoms tested
1
Number of contact without
0
1
signs and symptoms tested
2,
Total
77
64
60 (78%)
0
5
3
4. LABORATORY INVESTIGATIONS
= The samples of five cases were taken by Path-Care and tested in South Africa, while one case
was taken and tested in South Africa and the result was sent to Namibia. The probable case was
tested at NIP. The turnaround time range between 2 to 5 days for test done by Path-care, while
for test by NIP is 2 days.
= As of 24/03/2020 a total of 179 COVID-19 specimens were recorded in the two laboratories (NIP
and Path-care) as per table below:
Table 2: COVID-19 specimens recorded in at NIP and Path care as of 23.03.2020
As of 23/03/2020
Laboratory
NIP
Path care
Total sample sent to the Laboratory | 44
135
Total sample tested
43
118
Total results positive
0
5
Total results Negative
36
112
Total results inconclusive
1
0
Total results pending
7
18
Discarded
0
1
The sixth case was tested in South Africa (not included on the table).
Total
179
161
5
148
1
25
1
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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. The last meeting was
held on the 20 March 2020 chaired by the Incident Manager.
The outbreak was declared by Hon. Minister of Health on 14 March 2020.
The Ministry continue to conduct press briefing as the situation progress. Last press briefing
conducted on 24 March 2020
On the 23 March 2020, Dr Bernard Haufiku was appointed as a national Coordinator for
COVID-19.
A meeting with a national coordinator was held today and recommended the lockdown of
Khomas Region and Erongo Region.
A joint press conference was held by the President of the Republic of Namibia Dr Hage Geingob
and the Minister of Health and Social Services, Dr Kalumbi Shangula in which the lockdown of
Khomas Region and Erongo Region was announced, with effect from 27 March 2020.
SURVEILLANCE:
= Training on surveillance and contact trancing planned on 25-26 March 2020 targeting
Regional surveillance officer, Environmental Health Practitioners and Tutors responsible for
continuous development from MoHSS training network
= Daily meetings are held to discuss daily progress, gaps and way forward, last meeting was
held on 23 March 2020.
= A meeting was held between the national coordinator and the families of the 35 Namibians
who arrived on 21March 2020 and are in supervised quarantine, they are being monitored
daily until 4 April 2020
= Case definitions as of 20 March 2020:
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 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 (see definition of contact) 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.
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o 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 continue to test the collected samples and provide daily updates on the results
o CASE MANAGEMENT and Infection Prevention and Control:
Two new confirmed cases were reported today (24, March).
All 4 cases are admitted in isolation wards and managed as per WHO recommendations.
Of the 2 index cases, 1 has no more symptoms and the other one is in stable condition. The
3" case is classified as mild-moderate and needed close monitoring.
As of 24 March 2020, all patients are stable.
SOP on both case management and IPC is readily available on soft copy and has been
distributed to all sub-committees as well as on social media platforms but needs to
periodically be revised.
Training on case management and IPC has already begun at WCH and KIJH. The plan is to
tap into ZOOM platforms and have regular presentations nationwide. First ZOOM
presentation was on 20/03/20 at 5PM
Integrated case management and IPC Plan is available for distribution.
Robert Mugabe Clinic functioning as a 24-hour screening/testing and admission facility for
COVID19 cases (suspected or confirmed). WCH casualty still under renovation
o POINTS OF ENTRY
Port Health services (screening) has been intensified at major points of entry and is
ongoing.
o RISK COMMUNICATION,
COMMUNITY
ENGAGEMENT
& SOCIAL
MOBILISATION:
Risk communication by Office of President and the Ministry of Health has been
conducted
NBC airing health education messages related to COVID-19 on TV and all 11 Radio
stations
Namibian placing COVID—19 health education messages daily in their paper
Risk communication team have scheduled radio talks in 11 radio languages stations of
the national broadcaster.
Media interviews with private and public media houses conducted daily
Press Conferences and subsequent engagement with the media is frequent and facilitated
by the Minister’s office
Namibia Airports Company is airing COVID-19 messages on all the screens at the
airports
Rumour management system is being set-up through media monitoring, social media
posts and press conferences
Health Education sessions on COVID-19 in workplaces is ongoing
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oO LOGISTICS:
» List of needed items has been compiled and submitted for procurement; PPE, Masks,
gloves, etc.
= Modification of the entrance/exit of existing designated isolation facility at Robert Mugabe
clinic, which is now operating as screening facility is ongoing. The facility will be
operating 24 hours.
‘Country coordination
communication related challenges (beyond MoHSS) for implementing
IMS and multi-sectoral coordination
Communication information sharing related to supervised quarantine arrangements
Lack of fully equipped isolation facilities in the regions at health facilities and points of entry in
the regions
Insufficient Personal Protective Equipment/clothing
Insufficient trained personnel
Delay in finalising the costed response plan
Delay in receiving lab results sent to South Africa
COORDINATION AND LEADERSHIP:
= Need for improving country coordination, planning and monitoring,
= Involve all relevant stakeholders with commitment from top management
= Finalization of all relevant SOPs per pillar
= Activation of the IMS at the national level and in regions
= Need for complete Rapid Response Team
SURVEILLANCE:
= Continue contact tracing process to identify all contacts
= Strengthen surveillance and detection throughout all districts and regions to detect suspected
cases early
= Include regions and other stakeholders to support timely and effective contact tracing
= Enhance systematic approach to collecting and reporting timely surveillance data
= Conduct contact tracing via phone where possible to minimize risk of exposure for COVID-
19
LABORATORY:
® Utilise Namibia Institute of Pathology for local testing
= Improve communication and share SOPs of results for notifiable disease by private
laboratories (Pathcare) with MoHSS
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o CASE MANAGEMENT:
= Ensure all health workers involved are well trained in COVID-19
= Have clear SOPs of case management readily available
" Procure and distribute relevant equipment and materials
= Determine screening facility and direct
o POINTS OF ENTRY
= Fully equip (Equipment & Human resources) all identified points of entry
Enhance screening so persons with symptoms receive secondary screening at POE sites
Report number of persons screened and secondary screening at POE daily to include in
SITREP
o RISK
COMMUNICATION,
COMMUNITY
ENGAGEMENT
& SOCIAL
MOBILISATION
Conduct regular risk communication and community engagement through IEC material,
electronic media and direct engagement.
o LOGISTICS
Procurement of IPC and laboratory supplies for Emergency preparedness and response
Strengthen participation of logistic/procurement/operations/financial experts from
MoHSS, WHO, CDC, UNICEF, etc in the coordination group that coordinates these.
Cleared by:
Incident Manager
Date: 24.03.2020
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