Reporting Period: 8 April – 15 April 2020 Michael Mistone,6, studying at home in Lilongwe | ©UNICEFMalawi/2020/Sukali Highlights Malawi COVID-19 Situation Report No. 3 • On 8 April 2020, the Government of Malawi officially launched the COVID -19 national preparedness and response plan. Situation as of 15 April 2020 • The Government on 14 April 2020 announced a lock down as a measure to contain further spread of the Corona virus. The 21 day lock down shall take effect on the expiry the day on 18 confirmed cases April 2020 until midnight on 9 May 2020. 16 315 suspected cases • UNICEF, in collaboration with the Ministry of Health, is procuring COVID-19 response supplies worth US$ 3,000,000. 2 deaths Together, they have already distributed supplies valued at US$ 278,556. 0 recovered • UNICEF has supported the installation of 20 latrines at 4 7 active cases Emergency Treatment Units (ETUs). The Blantyre ETU has admitted four suspected patients for monitoring, and they have been using the installed water, sanitation and hygiene facilities. © UNICEF Malawi 2020 Situation overview As of 15 April, 16 COVID-19 confirmed cases had been registered in Malawi. Blantyre district has registered the highest number (8 cases) followed by Lilongwe (6 cases) while Nkhotakota and Chikwawa have registered one case each. Of the 16 cases, seven were imported, and eight locally transmitted. One case in Blantyre (55-year old male) has an unknown chain of transmission. This raises concerns of a possible new chain of transmission (See the map). Out of the 16 cases, two are fatalities representing a case fatality rate of 15.4 per cent. As of 12 April, a total of 7,058 high-risk travellers have entered the country since the monitoring started. Of these, 6,268 were being monitored daily, and 790 were discharged after completing the 14-day mandatory self- quarantine. Screening of all travellers entering Malawi is ongoing. The Ministry of Health (MoH), with support from partners, is conducting active case finding and monitoring contacts of COVID-19 identified cases to ensure detection of more cases. However, this is a challenge given the inadequate number of trained Health Surveillance Assistants (HSAs) to conduct extensive contact tracing and follow-up. 1 Preparedness and response actions by UNICEF and partners Government of Malawi • On 8 April 2020, the Government of Malawi (GoM) officially launched the COVID-19 national preparedness and response plan. The plan includes ten operational clusters: health, inter-cluster coordination, protection and social support, water, sanitation and hygiene (WASH), education, food security and transport and logistics. The communication cluster, economic empowerment cluster and enforcement cluster have been included as ad hoc clusters. The GoM, through the Ministry of Disaster Management Affairs and Public Events, is responsible for the overall coordination. At the same time, the Ministry of Health is the technical lead for implementation of the plan. • A special cabinet committee on COVID-19 continues to meet weekly to coordinate measures to respond to the pandemic. • In addition to cluster coordination meetings, surveillance technical committee meetings and the emergency operation centre meetings are taking place daily. • The MoH distributed 20 ventilators to the central hospitals to strengthen case management. • The MoH has also initiated the recruitment of 2,000 health workers to increase case management capacity. • The Government on 14 April 2020 announced a lock down as a measure to contain further spread of the Corona virus. The 21 day lock down shall take effect on the 18 April 2020 until midnight on 9 May 2020. UN System • The Humanitarian Country Team (HCT) continues to meet regularly to discuss the multi-sectoral National COVID-19 Preparedness and Response Plan and to ensure full coordination and support to the Plan the UN and other actors to maximize the response and reach the most affected communities. • The UN is supporting Government with guidance, operational implementation, and resource mobilization efforts by linking with existing development partner and NGO coordination structures; • Clusters that are part of the national preparedness and response plan continue to regularly meet to discuss preparedness and response efforts and to monitor the situation. • Technical working groups that were set up by the United Nations Country Team (UNCT) – health coordination, socio-economic impact, communication, financing and information management – are holding weekly meetings to heighten UN's support to the national coordination mechanism. UNICEF Support Health • With funding from UK Aid, UNICEF has supported the Ministry of Health to train about 80 health workers on COVID-19 case management in the nine UNICEF-supported districts. • With support from UK Aid, UNICEF continues to support screening of all travelers at Points of Entry (POE). Most of the travelers that have arrived recently are Malawians returning home. • The National Reference Laboratory, equipped with a real-time polymerase chain reaction machine, has tested over 330 COVID-19 samples to date. The Laboratory was supported by UNICEF with UK Aid funding. Other partners like College of Medicine (CoM) and Malawi Liverpool Well-come Trust (MLW) have supported additional three laboratories in Blantyre, Lilongwe and Mzuzu. 2 WASH • Since the last report, four additional emergency prefabricated latrines (2 in Blantyre, 2 in Mwanza) have been installed. Cumulatively, 20 (10 Male, 10 Female) latrines have been installed at the four Emergency Treatment Units (ETU)s – 6 at Blantyre ETU, 6 at Mwanza ETU, 4 at Mchinji ETU and 4 at Mzuzu ETU. Each latrine has a functional handwashing facility with soap. During the reporting period, Blantyre ETU had four suspected patients admitted at the ETU for monitoring, and they have been using the installed WASH facilities. • UNICEF, through its partner United Purpose, is working in close coordination with hospital maintenance staff to install 5,000-litre tanks and undertake some plumbing works. • Additionally, they conducted handwashing promotion in Blantyre, Mwanza, Mzuzu and Mchinji. The handwashing promotion campaigns were held in places like markets, hospital entrances and border posts. Communities surrounding ETUs continue to receive hygiene promotion messages through mobile vans with support from UNICEF. As of 9 April, 42,862 people in four districts were reached with these messages. • In addition, the United Purpose also disseminated the Ministry of Health approved COVID-19 prevention messages through community radios reaching up to 10,500 people. UP also engaged a local community radio station in Mwanza District to broadcast COVID-19 jingle. • With UNICEF support, 1,000 posters and leaflets have been distributed to people around ETUs in Mwanza and Mchinji markets and at the border posts. In Blantyre, 200 posters have been distributed at Ndirande high-density low-income settlement markets and Blantyre Central Business District and Wenela bus depot. • To date, a total of 40 health front line workers have been trained on "Safeguarding and Prevention of Sexual Exploitation and Abuse during the response". • Regular WASH Cluster meetings are ongoing. During the reporting period, UNICEF facilitated the engagement of the country's Water Boards to develop and share plans to ensure uninterrupted water supply, especially in hot spots of urban areas as part of the COVID-19 response. Child Protection • Blantyre and Machinga districts have received technical and financial support from UNICEF for delivery of child protection services, including online counselling, psychosocial support and referral services through telephones. • UNICEF continues to work with government counterparts including Social Welfare, Malawi Police and the Judiciary, at national and district levels on COVID-19 preparedness and response, to ensure continuity of essential services for child protection and gender-based violence (GBV) prevention and response. • An analysis is underway of data collected in Mzimba, Nkhatabay, Ntchisi, Dowa, Nsanje, and Machinga districts, with support from UNICEF, to assess the needs on mental health and psychosocial (MHPSS) including the capacity to deal with the increased caseload. • Basic MHPSS content was shared for integration in health worker training, which is currently underway. The content includes an impact on children's mental health and psychosocial wellbeing. • Psychological First Aid (PFA) training for UNICEF staff and partners is planned and alternative ways of delivering the training, using online platforms, are being explored. • UNICEF has integrated child protection and GBV mitigation and MHPSS elements into Communication for Development (C4D) messaging. • UNICEF, as co-lead of Protection Cluster, continues to support the Ministry of Gender in preparedness and response efforts. 3 Nutrition • Health workers in Nutrition Rehabilitation Units (NRUs) and Outpatient Therapeutic Programme (OTP) sites are undergoing orientation on COVID-19 and its implication on the nutrition status of children and women and the guidance on infection prevention. The training is targeting 200 health workers in the various NRUs in Blantyre, Lilongwe, Mzuzu, Mwanza, and Mchinji, Lilongwe, Dowa, Blantyre, Phalombe, Nsanje, Salima, Thyolo, Mulanje, Chikwawa, Mangochi, Nkhatabay, Kasungu, Mzimba, Karonga, Chitipa and Nkhotakota. • The health workers are also being oriented on the modifications to Community Management of Acute Malnutrition guidelines.