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Health Response to COVID-19 in Libya WHO Update # 13 Reporting Period

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Health Response to COVID-19 in Libya WHO Update # 13 Reporting Period Health response to COVID-19 in Libya WHO update # 13 Reporting period: 6 to 19 August 2020 1 | P a g e Highlights o Under WHO’s transmission scenarios, Libya remains classified as “community transmission”. Since the first case of COVID-19 was reported in Libya, a total of 9068 people have been infected with the virus (more than double the number since the last update). Of this number, 7901 people remain actively infected, 1003 people have recovered, and 164 people have died. The national case fatality rate (CFR) is 1.81%, compared with 2.27% reported in the last update (The overall decrease in the CFR is explained by the significant increase in the number of confirmed cases of COVID-19.) The municipalities reporting a large increase are Tripoli, Zliten, Misrata, Khoms, Jansour, Tarhuna and Tobruk. o Thus far, a total of 100 462 specimens have been tested. This number includes 59 542 in Tripoli, 15 003 in Misrata, 13 711 in Benghazi, and 6445 in Sebha. o On 6 August 2020, militia near the town of Al Zawya (western Libya) intercepted a truck on its way to Benghazi and Tobruk (eastern Libya) to deliver WHO humanitarian supplies. The driver was detained overnight and his phone was confiscated. The militia subsequently directed the driver to deliver the supplies to a nearby health care facility. WHO has issued a press release condemning this incident. Collaboration with national authorities o WHO briefed the acting Special Representative of the Secretary-General in Libya on the COVID-19 situation and challenges. Response Pillar 1: Coordination o WHO is continuing to disseminate daily updates showing new and cumulative figures for COVID-19. It also attends the weekly meetings of the National Centre for Disease Control’s (NCDC) COVID-19 steering committee. o WHO has held discussions with the NCDC on conducting a Country COVID-19 Intra-Action Review (IAR). WHO has developed the IAR to guide countries on how to conduct periodic reviews of their national and subnational COVID-19 response, so that they can identify critical opportunities for learning and improvement. o WHO has shortlisted candidates to participate in consultative and planning sessions for a health diplomacy project launched by the United Nations Support Mission in Libya. The project aims to use COVID-19 as an example to build health as a bridge to peace. o WHO is in daily contact with the Sebha crisis committee and the local health authorities. This includes attending committee meetings and providing technical support. o WHO facilitated and participated in a meeting between the crisis committee and COVID-19 advisory group in Tobruk. The outcome was an action plan and agreement on how to resolve issues related to IPC and case management in Tobruk isolation centre. o Also in Tobruk, WHO met with the Libyan Boy Scout movement, the Red Crescent and other civil society institutions to agree on strengthening partnerships to raise awareness of COVID-19. WHO distributed COVID- 19 awareness-raising materials and agreed to participate in future question and answer sessions. 2 | P a g e Pillar 2: Risk communication and community engagement (RCCE) o WHO has distributed COVID-19 information posters, 48 000 flyers and 32 000 medical masks. Billboards have been installed in six locations in Tripoli. The development of TV and radio messages is in process. o WHO is providing technical support to local radio stations and civil society institutions in Tobruk that are working to raise awareness about COVID-19. o WHO organized a three-day training workshop for 22 community health volunteers and team leaders on enhancing community engagement and providing home care for COVID-19 patients. The participants were from 22 municipalities in the western and central regions. Pillar 3: Surveillance, rapid response teams and case investigation o WHO has updated its surveillance guidelines for COVID-19 and shared them with the NCDC. The guidelines contain revised definitions of suspected and probable cases and weekly aggregated data forms to be used by Libya’s national focal point for the International Health Regulations. o Following discussions with WHO, the NCDC has agreed to resume submitting COVID-19 weekly aggregated data to WHO’s Regional Office for the Eastern Mediterranean. o Over the past two weeks, 4888 confirmed cases were registered, which represents 53.9% of the total number of cases. WHO is continuing to follow up on all newly registered cases across the country. o While the number of new cases has increased, contact tracing/following chains of transmission in Tripoli and Sebha remains difficult because of the increasing number of contacts who are lost to follow up. Pillar 4: Points of entry o Points of entry at land borders remain closed. o One-way flights from Libya to other countries resumed on 26 July 2020. Pillar 5: National laboratory o There are acute shortages of virus extraction reagents and GeneXpert cartridges across the country. The MoH announced that a new batch of COVID-19 virus extraction reagents including 100 000 kits had arrived at Mitiga airport. Pillar 6: Infection prevention and control (IPC) o WHO facilitated two two-day workshops on IPC and case management for 50 physicians (25 in Tobruk from 12-13 August and 25 in Al-Abyar from 17-18 August). o WHO is supervising the implementation of IPC measures in the isolation centre in Tobruk and is visiting the centre daily. It also coordinated an online training workshop on IPC for staff in the centre. o Over the past two weeks, two doctors, a pharmacist, two dentists and three nurses from private health facilities in the south have tested positive for COVID-19. This indicates that health care staff in the south are at high risk of COVID-19 due to either lack of PPE or lack of IPC training or both. WHO is hiring four local consultants to strengthen IPC training. Pillar 7: Case management o Triage and isolation centres and health facilities in Sebha (a hotspot for the virus) are faced with acute shortages of fuel and PPE, hand sanitizer, pulse oximeters and oxygen cylinders and other medicines and supplies. 3 | P a g e o Of the 42 isolation facilities in the whole country, only 10 have sufficient human resources. See table in Annex 1. Pillar 8: Operational support and logistics o 1120 kits (each containing 10 tests) recently arrived at Misrata airport and are undergoing customs clearance. Pillar 9: Maintaining essential health services o WHO distributed 13 supplementary and 15 basic modules of its Inter-Agency Emergency Health kit to health facilities in 13 municipalities, as well as 3000 vials of insulin to primary health care facilities in six municipalities. o WHO dispatched laboratory reagents and IEHK modules to health facilities in Sebha, Brak and Murzuk, and psychotropic and other medicines to Alrazi psychiatric hospital. o Currently, WHO Emergency Medical Teams (EMTs) are supporting the provision of primary and health care services in 27 health facilities across the country. Between 1 and 15 August 2020, the EMTs provided 678 surgical interventions and 8431 consultations. 4 | P a g e FUNDS RECEIVED BY WHO WHO has requested USD 22 300 000 to support the response to COVID-19 in Libya. Thus far, it has received USD 2 362 300 in contributions and firm pledges. It has submitted funding proposals to the African Development Bank (USD 500 000), USAID (USD 925 550) and the EU (EUR 6 million each for WHO, UNICEF and IOM). Amount received China UK Department for International Development Bill & Melinda Gates Foundation EMRO Central Emergency Response Fund France Canada Germany Funding gap Donor Amount received China 162,500 UK Department for International Development 145,000 Bill & Melinda Gates Foundation 400,000 EMRO 20,000 Central Emergency Response Fund 1,000,000 France 300,000 Canada 200,000 Germany 134,800 Funding gap 19,937,700 5 | P a g e Annex 1. Status of isolation centres District Municipality Facility name Facility type Bed Bed Human Resources status COVID19 Laboratory Government capacity capacity isolation ICU Tripoli Ain-Zara Tripoli university hospital Public hospital + Triage center 0 9 Available HR Functional GeneXpert GNA Tripoli Tripoli center Ophthalmology hospital Tripoli Public hospital 30 20 Available HR Functional No GNA Tripoli Tripoli center Souq-Altulataa isolation center Adapted building 38 15 Pending for HR Ready No GNA Tripoli Souq-Aljumma Mitiga isolation center Adapted building 60 60 Available HR Functional GeneXpert GNA Tripoli Souq-Aljumma Ibn-Aouf battelship Adapted battelship for quarantine 100 0 Pending for HR Ready No GNA Almerghib Alkhomus Alkhomus isolation center Adapted building 23 7 Available HR Functional NO GNA Misurata Zletin Zletin isolation center Adapted building 28 12 Available HR Ready Zliten NCDC Lab GNA Misurata Zletin Zletin teaching hospital Public Hospital (isolated department) 35 15 Available HR Functional Zliten NCDC Lab GNA Misurata Misurata Misurata medical center Public Hospital (isolated department) 30 14 Available HR Functional Misurat NCDC lab GNA Misurata Misurata Misurata isolation center 1 Adapted building 20 5 Limited HR Functional Misurat NCDC lab GNA Misurata Misurata Misurata isolation center 2 Adapted building 20 5 Limited HR Functional Misurat NCDC lab GNA Misurata Misurata Misurata TB center Public Hospital (isolated department) 30 10 Limited HR Ready Misurat NCDC lab GNA Subratha Subratha Unknown Adapted building 25 0 No HR 80% ready Info not available GNA Azzawia Azzawia Abusourra isolation center Adapted building 15 0 No HR Ready Info not available
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