Statement at the declaration of country-wide lockdown


Statement at the declaration of country-wide lockdown



1 Page 1

▲back to top


Republic of Namibia
COUNTRYWIDE LOCKDOWN ON ACCOUNT OF COVID-19 PANDEMIC
DR KALUMBI SHANGULA, MP
MINISTER
WINDHOEK
APRIL, 2020

2 Page 2

▲back to top


On the 31 December 2019, China notified WHO about covid-19 outbreak in Wuhan
City, Hubei Province of China. On the 30" January 2020, the outbreak was declared a
Public Health Emergency of International concern (PHEIC) by the WHO Director
General. Since then, the COVID-19 situation has evolved rapidly within and outside
China, involving over 180 countries. The risk of international spread has been
determined to be very high and the outbreak has spread to all the regions of the world.
Namibia registered her first two confirmed cases of COVID-19 on 13" March 2020.
By the 4" April 2020, the number of confirmed cases increased to sixteen (16). Twelve
(13) of the cases are travel related while three (3) are local transmission. Namibia has
not registered any COVID-19 related deaths. COVID-19 cases have been contained to
three regions during the current lock down, namely Khomas, Erongo and //Kharas.
On the 17" March 2020, H. E. Dr Hage G. Geingob declared a State of Emergency for
the whole country on account of Covid-19. On the 27" March 2020 at 23:59, two
regions, namely Khomas and Erongo were put under lockdown to last until the 17"
April 2020. The reason for putting the two regions under lockdown is to maintain
maximum suppression of transmission as a result of exposure of these regions to
international travel.
When Covid-19 was announced to the world, the Ministry of Health and Social Services
activated the Health Emergency Management Committee to prepare the country for a
possible outbreak of Covid-19 in the country. On the 3" February 2020, the Rt Hon
Prime Minister established a multi-sectoral and multi-skilled National Health
Emergency Management Committee, chaired by the Executive Director of the Ministry
of Health and Social Services to spearhead the national response to coronavirus.
A costed Response Plan was developed and is being implemented. It involved public
awareness and information dissemination about the disease and preventive measures.
Health personnel was trained in various aspects of Covid-19. The Namibia Institute of
Pathology was capacitated to do confirmatory tests locally. Infrastructure development
was undertaken to provide facilities for quarantine, screening, diagnosis, treatment and
counselling. Contact tracing was intensified. Medical equipment, medicines and
personal protective equipment were sourced. At all material time, the public was
informed of all development.
The public sector was joined by the private health sector, the business community and
individuals in terms of cash and in-kind support. The contribution of the media has
been indispensable. The response benefitted from the exceptional leadership of H. E.
President Dr Hage G. Geingob and the support of the Rt Hon Prime Minister and the
entire Cabinet. Individual countries and development partners continue to play a big
role in terms of financial, material and moral support. The sum total of these efforts
resulted in the fact that Namibia recorded only six cases during the currency of the
lockdown of two regions. Three covid-19 patients were cured and discharged. So far,
we have not recorded any Covid-19 death, a mean feat indeed!

3 Page 3

▲back to top


Notwithstanding the noteworthy performance by Namibia, the job is not yet done. We
are facing a new disease of which much is still to be learned and to be understood.
COVID-19 is characterized by high intensity of transmission, extremely low immunity
of the population, abundance of infective and susceptible individuals and a wide
geographical distribution.
The rate at which Covid-19 infection spreads depends on the basic reproduction ratio,
which is a measure of expected number of cases directly generated by one case in a
population where all individuals are susceptible to infection. Epidemiologically, to
keep the outbreak under control, the basic reproduction ratio (Ro) must be kept below
one (R<1). While the lockdown has been effective in minimising the movement of
people, the reported cases indicates a slow rise in detected COVID-19 cases in Namibia.
If one takes the mean value of 2.3 as the basic reproduction ratio, five (5) cases of
Covid-19 will generate 244 cases after 4 cycles and 36 643 cases after ten (10) cycles.
This observation makes a compelling case for a country-wide lockdown and an
extension of the lockdown period in order for the new regions to benefit from the
lockdown process and the existing region to consolidate the gains made so far.
The purpose of a lockdown is to suppress transmission by reducing the possibility of
asymptomatic people with COVID-19 from further infecting others in the community.
Whilst a lockdown inevitably limits people’s right to freedom of movement, such
limitation is justified to protect public health. The goal is to ensure that each confirmed
case infects less than one person, on average. It is proven that this level of transmission
interrupts the growth of the epidemic, commonly referred to as flattening the curve.
10. The current lockdown in /Khomas and Erongo regions has not been efficient. There
has been a breach of interventions with implications for potential community spread
within the regions with confirmed cases, with the risk of wider spread in the entire
country. I will give few examples.
10.1. Case Number 9
Case No 9 was diagnosed on 25" of March, 2 days before the lockdown came into
effect. The case had a total of about 7 secondary contacts outside the nuclear family.
These cases were discharged from quarantine without extended laboratory testing.
There is therefore a small but practical risk that some of the asymptomatic cases
discharged from quarantine might be infectious thus needing an extended period
beyond the quarantine period to conduct surveillance to rule out possible infection.
10.2. Case Number 15
Case No 15 breached the self-isolation regulations while waiting for his results and was
out and about in the community when the diagnosis was confirmed. Against
recommendations for not using public transport when seeking health care, the case took
a taxi from his house to Robert Mugabe Clinic for admission to isolation on the 7" April
2020. There is a potential that several contacts of this case may not be identified, and
if these contacts became infected it could potentially mean some community spread
might have been seeded by this case. If the last contacts to this case was on 7" April,
3

4 Page 4

▲back to top


this would mean that their incubation period would end on the 28" April (21 days).
This case was accompanied by 3 South African nationals who may still be within the
country and their whereabouts are not known.
10.2. Case Number 16
Case No 16 was diagnosed on 5“ April 2020. He too breached quarantine procedures
and continued to work while waiting for his test results, interacting with more than 50
people. This case was taken into isolation on 6 April 2020. Furthermore, the travel
history of this case and the interactions with visitors remain disjointed, leaving a
potential that this case could either have been travel-related or acquired locally. If we
assume that the last contacts of this case before going into isolation was 6 April, it
would mean that his last contacts would need up to April 27" to be sure that we have
confidence that his primary contacts have gone through the whole incubation period.
10.3. Release of travellers arriving at Hosea Kutako International Airport from COVID
affected countries
About 85 travellers arrived at HKIA via a flight from Johannesburg on 26 March 2020.
These travellers were coming from various parts of the world some of which might
have been affected by COVID-19. This group was not sent into quarantine and went
on to complete their destinations across Namibia. In the absence of full quarantine for
this group there is a potential risk that some individuals within this group might have
been infected and in turn seeded community transmission of the disease which is yet to
be determined.
10.4. Release of travellers arriving at Walvis Bay International Airport from COVID affected
countries
On the 25" March 2020, thirty-three (33) travellers from COVID affected countries
arrived via Walvis bay but were allowed to go home without be quarantined. This goup
poses the same risk those described above.
11. Given the scenario above, it is clear that the outbreak has not be suppressed. There is
a case for a country-wide lockdown.
A further 13 days country-wide lockdown is required to suppress the further spread and
save lives by ensuring that all people remain in localities where they currently are. This
is to ensure that people who are not yet exposed will not be exposed by coming into
contact with persons who may be infected. This also ensures that those who might have
been exposed remain where they are in order to suppress transmission from infected to
uninfected persons. Since inbound travel has been suspended, we expect less
importation of COVID-19. The country will capitalize on the time during the
countrywide lockdown and understand the dynamics of the disease spread patterns, in
terms of places and persons. The information is crucial in developing additional
targeted interventions focusing on persons and geographic locations or potential
COVID-19 “hotspots”.