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Health Sector Bulletin COVID-19 Response

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Health Sector Bulletin COVID-19 Response Health Sector Bulletin June 2020 Point of Entry (PoE) surveillance at Maiduguri Int. Airport Northeast Nigeria Humanitarian Response COVID-19 Response 5.6 Million 4.4 Million 1.9 Million * > 2.0 million people People in need targeted by the IDPs in the reached in 2020*** of health care Health Sector three States HIGHLIGHTS Health Sector • Cholera preparedness activities are ongoing including 45 HEALTH SECTOR PARTNERS mapping of cholera hotspots, prepositioning of Cholera (HRP & NON-HRP) kits, RDT kits and other supplies, the establishment of CTCs/CTUs and ORPs, training of laboratory focal persons HEALTH FACILITIES IN BAY STATE** on the diagnosis of cholera cases, retraining of the health 1529 (58.1%) FULLY FUNCTIONING facility surveillance focal persons, sensitization of health 268 (10.2%) NON-FUNCTIONING workers and communities, printing and distribution of 300 (11.4%) PARTIALLY FUNCTIONING Cholera specific IEC materials. 326 (12.4%) FULLY DAMAGED • Amidst COVID-19 response, Health and WASH Sectors have developed Joint cholera preparedness and CUMULATIVE CONSULTATIONS response plan for BAY states. 4.9 million CONSULTATIONS**** • COVID-19 response partners are supporting the 1,490 REFERRALS ongoing seasonal malaria chemoprevention in 25 LGAs of 72,566 CONSULTATIONS THROUGH HARD TO REACH Borno state. TEAMS • Surveillance and contact tracing activities have been scaled up in all COVID-19 affected wards/settlements. EARLY WARNING & ALERT RESPONSE More than 4,100 listed contacts have successfully exited follow-up in three states i.e. Borno: 3034 (65%); Adamawa 275 EWARS SENTINEL SITES 553 (92%); and Yobe 604 (90%); Partnership with 201 REPORTING SENTINEL SITES community leaders and volunteers to support contact 1,246 TOTAL ALERTS RAISED***** identification and tracking in the communities also to address stigmatization. SECTOR FUNDING, HRP 2019 • Infection Prevention and Control (IPC) practices in communities, IDP camps and health facilities are ongoing 2.30% FUNDED and will be further strengthened to ensure standard GAP: 84.2M USD protocols for care of positive cases and protection of health care staff in isolation facilities and frontline humanitarian workers in communities. • 65% of all LGAs across the BAY states have reported no single case of COVID-19 since the outbreak was confirmed: (59% i.e. 16 LGAs in Borno; 62% i.e.13 LGAs in Adamawa; and 77% i.e. 13 LGAs in Yobe state; • Three LGAs (Maiduguri Metropolitan Council (Borno), Damaturu (Yobe) and Yola North (Adamawa) account for 49% of 746 cases of COVID-19 across the BAY states. * Total number of IDPs in Adamawa, Borno and Yobe States by IOM DTM XXX **MoH/Health Sector BAY State HeRAMS September/October 2019/2020 1 ***Number of health interventions provided by reporting partners as of June 2020. **** Cumulative number of medical consultations from Hard-To-Reach Teams. ***** The number of alerts from Week 1 – 26, 2020. Situation update COVID-19 situation in IDPs camps: The on-going crisis in Northeast Nigeria has affected more than 7.9 million people and over 2 million IDPs across the three northeast states of Borno, Yobe and Adamawa. More than 1.4 million displaced people are residing in camps or camps like settings. The threat of the COVID-19 pandemic looms, particularly for its 1.8 million Internally displaced persons (IDPs) in the three states, and even more for the 413,271 IDPs living in the 51 highly congested camps (28 in Maiduguri metropolitan area and 23 in deep field locations). Health partners are working on ramping up a community-based surveillance system using syndromic approaches for case detection and tracing in all accessible areas. The presence and rapid deployment of an outbreak rapid response teams is ongoing to ensure their presence in camps and hosting communities for investigation of alerts and referrals of suspected cases for diagnostics, potential isolation and case management. The COVID-19 response is based on eight key response pillars to address prevention, preparedness and response actions. WHO and Health Sector Partners are supporting the government led COVID-19 response also in collaboration with WASH, CCCM, Shelter and all other sectors for a coordinated response including the construction of quarantines and isolation centres, social distancing mechanisms, early warning and alert systems for the timely containment of transmission and facilitate joint inter-sectoral interventions. An incident management team is already working at the level of Public Health Emergency Operation Centre (PHEOC), supporting on key priority actions including rapid deployment of designated staff from state and partner organizations in high-risk areas for priority preparedness and response actions, monitoring the POE surveillance, scaling up of IPC measures, development and dissemination of IEC materials etc. Minimum requirements are in place, including functional triage system and isolation rooms, trained staff (for early detection and standard principles for IPC); and adequate IPC materials, including personal protective equipment (PPE) and WASH services/hand hygiene stations. A 100 beds capacity isolation centre is functional in Maiduguri with all necessary equipment including ventilators, PPE and other supplies are available. Another 300 beds capacity isolation centre is functional for the treatment of low-mild cases. An isolation ward and ICU is also functional in University of Maiduguri with a functional lab for testing of suspected cases. An additional molecular lab will be functional very soon to scale up the testing capacity to identify the confirmed cases and support enhanced contact tracing measures. The protection and safety of frontline health workers and also other humanitarian workers is paramount in this situation as there are reports of more than 40 health workers infected with the virus as they are more exposed to the virus while working in health facilities and communities. In order to protect health and other humanitarian workers on the request of RC/HC WHO has approached the Nigerian Humanitarian Fund (NHF) for funding to procure protective gear and supplies for around 4000 humanitarian workers in northeast Nigeria. Health Sector is working with IOM, CCCM & Shelter Sector partners on the design and layout of the quarantine and isolation centres more in line with needs on the ground and adaptable to the local context. Construction work on quarantine centers has been completed in more than six IDP camps in deep field locations. The existing infrastructure will be repurposed to serve as a safe quarantine space such as government and other abandoned buildings which will improve the reception capacity for new arrivals and enable self-quarantine of IDPs before proceeding to the camps. Construction and repair of emergency shelters, rehabilitation, and refurbishment of damaged structures like latrines, water points, drainage system etc. are all prioritized in all high-risk IDP camps. There’s still no indication of widespread community transmission in the IDPs camp based on the active case search that is ongoing presently. There were 31 confirmed cases reported in conflict affected areas of Borno state while 11 of the confirmed cases were from IDP camps. Active case search teams were engaged and deployed across the camps to conduct household sensitization and risk communication activities. This is in addition to the contact tracing teams deployed to track cases whenever there is any positive case. All suspected cases were referred to the mobile testing teams for sample collection and transportation to the lab for analysis. Holding area tents were identified to keep patients before transporting them to isolation centers. Preventive measures such as provision of hand washing points and distribution of face mask was done to complement the continuous risk communication activities among the vulnerable population. Infection Prevention and Control (IPC) practices in communities, IDP camps and health facilities are ongoing and will be further strengthened to ensure standard protocols for care of positive cases and protection of health care staff 2 in isolation facilities and frontline humanitarian workers in communities. There were total of 245 tests conducted, 214 of which are negative while 31 are positive. Early Warning Alert and Response System (EWARS) Number of reporting sites in week 26: A total of 201 out of 275 reporting sites (including 32 IDP camps) submitted their weekly reports. The timeliness and completeness of reporting this week were both 70% respectively (target 80%) Total number of consultations in week 26: Total consultations were 37,425 marking a 9% increase in comparison to the previous week (n=34,225) Leading cause of morbidity and mortality in week 26: Malaria (suspected n= 8,932; confirmed n= 5,046) was the leading cause of morbidity reported through EWARS accounting for 34% of the reported cases. No mortality reported through EWARS this week Number of alerts in week 26: Thirty-eight (38) indicator-based alerts were generated with 89% of them verified Figure 1: Morbidity Patterns Malaria: In Epi week 26, 5,046 cases of confirmed malaria were reported through EWARS. Of the reported cases, 420 were from General Hospital Biu, 200 were from Uba General Hospital in Askira-Uba, 138 were from Algon Clinic in Monguno, 134 were from PUI Waterboard Extension IDP Camp Clinic in Monguno, 122 were from ICRC FSP Clinic in Monguno, 121 were from PUI Mobile Clinics in MMC and 120 were from Shuwari Host Community Clinic in Damboa. No associated death was reported 3 Figure 2: Trend of malaria cases by week, Borno State, week 34 2016 – 26 2020 Acute watery diarrhea: In Epi week 26, 893 cases of acute watery diarrhea were reported through EWARS. Of the reported cases, 155 were from PUI Mobile Clinics in MMC, 148 were from Ngaranam PHC in MMC, 88 were from Herwa Peace PHC in MMC, 74 were FHI360 clinic Banki in Bama, 64 were from Gwoza Wakane IDP Camp Clinic in Gwoza, 56 were from Sabon Gari Lowcost IDP Camp Clinic (MDM) in Damboa and 51 were from Mafa Central IDP Camp Clinic (TDH).
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