Mission to support the COVID-19 response in Namibia (Twinning Project) (18 October – 01 November 2020)

Mission participants before departure at Frankfurt Airport, 17 October 2020.

In January 2020, the Namibia Ministry of Health & Social Services (MoHSS) and the Robert Koch Institute (RKI) initiated a Twinning Project with the long-term goal of establishing a Namibia Institute of Public Health. The Twinning Project (TwiNit) is funded by the German Federal Ministry of Health (BMG) within the framework of the Global Health Protection Programme (GHPP).

As the start of the project coincided with the beginning of the COVID-19 pandemic, the focus of the newly established collaboration has been on jointly fighting COVID-19. In the first week of March 2020, a joint mission of the RKI and the German Epidemic Preparedness Team (EPT) conducted a timely training to build up local capacities for SARS-CoV-2 testing in the Namibia Institute of Pathology (NIP), the University of Namibia (UNAM) and the Central Veterinary Laboratory (CVL). One week later, the first COVID-19 cases were detected in Namibia. Due to lockdown and travel restrictions in both countries, RKI’s support of the Namibian COVID-19 response was performed from distance through the provision of urgently needed laboratory equipment, reagents, consumables, personal protective equipment (PPE) as well as IT-equipment for the Public Health Emergency Operation Centre (PHEOC) and technical support.

At the end of August 2020, when the SARS-CoV-2 infection rates had drastically increased in Namibia, RKI’s president Prof. Wieler sent an official letter to the MoHSS, in which he offered additional support from RKI. The offer was well-received in Namibia and followed by an official mission request from the MoHSS in September. In response, RKI organised and conducted a mission to Namibia from 18 October to 1 November 2020. RKI provided ten professionals with various technical expertise coming from four different units (ZIG1, ZIG3, ZIG4 and FG38). Emergency Medical Teams (EMTs) composing of 13 staff members from the humanitarian organizations of I.S.A.R. Germany, humedica, and CADUS joined the mission under the coordination of the German National Focal Point for EMTs at RKI. Additionally, one data scientist from the WHO’s Global Outbreak and Response Network (GOARN) was part of the mission.

Left: Go.Data training of Public Health professionals from regional and national level in Windhoek, 26 October 2020; Right: SARS-CoV-2 serology workshop with laboratory technicians in Windhoek, 28 October 2020 Source: RKI

During the first 3 days of the mission, an intra-action review (IAR) of the COVID-19 response at national level was conducted together with the MoHSS and other stakeholders in Namibia. This provided an opportunity to share experiences and collectively analyze the ongoing activities by identifying achievements, challenges and recommendations. The focus was on

1. country-level coordination, planning and monitoring,
2. surveillance, case investigation and contact tracing,
3. case management,
4. infection prevention and control and
5. the national laboratory system.

The joint review highlighted that the MoHSS had activated the PHEOC and set-up the incidence management system early on in the pandemic. The overall approach was comprehensive with efforts being scaled up in testing capacity, isolation, treatment, and contact tracing. Relevant documents and guidelines were developed or adapted to the situation. The team was impressed by the very committed and engaged work force.

Together with the National PHEOC Team, three expert meetings were held to exchange experiences and lessons learnt, revise the Namibian PHEOC plan/SOP and draft future emergency communication structures, amongst other activities. The work will continue until the end of the year through videoconferences.

Contact tracing teams from national, regional and district level were trained through interactive presentations, exercises and role plays to both refresh existing knowledge, and to improve skills and competencies. Namibian SOPs and other guidance documents were critically reviewed and discussed.

In collaboration with WHO/GOARN’s Go.Data Team and other stakeholders, the implementation of Go.Data, a digital tool for outbreak investigation and contact follow-up, was initiated through training workshops in Windhoek. The hands-on trainings also covered aspects of surveillance, contact training, case management and laboratory and included discussions between regional and national levels on rolling out Go.Data in Namibia. The Go.Data Team piloted the roll-out of Go.Data in the Zambezi Region in Northern Namibia.

We supported the establishment of a COVID-19 serology laboratory at UNAM and conducted trainings on COVID-19 serology for laboratory personnel from UNAM, NIP and CVL. This will be the basis of the planned sero-epidemiological studies amongst health care workers (applied research).

The Emergency Medical Team (EMT) split into two sub-teams and travelled to six hospitals in different regions of Namibia. After initial discussions and hospital assessments, the EMTs provided shadowing and trainings in case management of COVID-19 patients covering ventilation and blood gas analysis. In addition, they trained health care workers in infection prevention & control including hand hygiene and appropriate use of PPE.
Five blood gas analysers for point-of-care use were handed over as permanent loans that will greatly improve the management of severely-ill COVID-19 patients in Windhoek’s Katutura Hospital and intermediate hospitals of Oshakati, Rundu and Walvis Bay.

At the end of the successful mission, Minister Dr. Kalumbi Shangula and Executive Director Mr. Ben Nangombe were debriefed about all the activities and findings. They thanked the mission participants in an official ceremony organized by the MoHSS. The German Embassy and the MoHSS published a media release to inform the national media and the public about our mission to Namibia.

We would like to sincerely thank all the colleagues from the Namibian MoHSS, WHO, GOARN, I.S.A.R. Germany, humedica, CADUS, the Namibian Embassy in Berlin, the German Embassy in Windhoek and the Robert Koch Institut that made this mission possible.

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