Breach of quarantine procedures warrant extended lockdown

Risky business

15 April 2020 | Health

Kalumbi Shangula; Minister; “With the given scenarios it is clear that the outbreak has not been suppressed and this warrants the implementation of a countrywide lockdown.”

Notwithstanding the noteworthy performance by Namibia in fighting and curbing the spread of the Covid-19 pandemic, the job is not yet done.

The revelation by health minister Kalumbi Shangula that 85 travellers of whom some may have been affected by Covid-19 arrived at Hosea Kutako International Airport from various parts of the world via a flight from Johannesburg on 26 March 2020 and were not sent to quarantine but were allowed to proceed to destinations across Namibia, was met with shock and outrage.

It also emerged that another 33 travellers from Covid-affected countries arrived via Walvis Bay airport on 25 March 2020. They too were allowed to go home without being quarantined.

“In the absence of full quarantine, there is a potential risk that some individuals within these groups may have been infected and in turn transmitted the disease, which is yet to be determined,” the minister told a media briefing.

According to the minister, efforts implemented by government resulted in Namibia recording only six Covid–19 cases during the ongoing lockdown of two regions.

Countrywide lockdown

“So far, Namibia has not recorded any Covid-19 death. However, with a number of scenarios, it is clear that the outbreak has not been suppressed and this warrants the implementation for a countrywide lockdown.”

The minister said that while the lockdown has been effective in minimising the movement of people, the reported cases indicate a slow rise in detected Covid-19 cases in Namibia.

Shangula justified the extension of the lockdown by another 13 days saying it is necessary to suppress the further spread of the illness and to save lives by ensuring that all people remain in localities where they currently are.

Shangula added that 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.

He said that since inbound travel has been suspended, the country expects less importation of the illness, however the lockdown in Khomas and Erongo regions has not been efficient.

“There was a breach of interventions with implications for potential community spread within the regions with confirmed cases, with the risk of wider spread to the entire country.”

Case studies

The minister based this assumption on the following case studies

• Case No 9 was diagnosed on 25 March and had an estimated seven secondary contacts outside the nuclear family. These cases were discharged from quarantine without extended laboratory testing. Thus, there is a small risk that some of the asymptomatic cases discharged from quarantine may be infectious, resulting in an extended period beyond the quarantine period to conduct surveillance to rule out possible infection.

• Case No 15 breached the self-isolation regulations while waiting for results and was out and about in the community when the diagnosis was confirmed. This case took a taxi from his house to Robert Mugabe Clinic for admission to isolation on 7 April 2020. The potential exists that several contacts of this case may not be identified. If these contacts are infected, it could potentially mean some community spread. The minister said that if the last contacts to this case was on 7 April, this would mean that their incubation period would end on 28 April (21 days). This case was accompanied by three South African nationals who may still be within the country and whose whereabouts are unknown.

• Case No 16 was diagnosed on 5 April 2020. He also breached quarantine procedures and continued to work while waiting on test results, interacting with more than 50 people. This case was taken into isolation on 6 April 2020. Assuming 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 his primary contacts have gone through the whole incubation period.

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