Timor-Leste: COVID-19 Pandemic Response Timor-Leste Red Cross (Cruz Vermelha de Timor-Leste, CVTL) International Federation of Red Cross and Red Crescent Societies Federation-Wide Internal Situation Update for Timor-Leste per 10 July 2020 Reporting period: Week covering 3 – 9 July CVTL personnel provided health and hygiene promotion on COVID-19 prevention to teachers and students as schools are reopening in the country (CVTL/2020) Partners Supporting the Country Movement Partners CVTL is supported by IFRC, ICRC, Australian Red Cross and Singapore Red Cross. Non-Movement Partners Ministry of Health set up inter-ministerial team to respond to the pandemic. Other agencies involved are WHO, IOM, Oxfam, NGO Maluk Timor. Context Global Updates The global daily incidence continues to exhibit an overall increasing trend as confirmed cases have surpassed 12,8 million globally and more than 562,000 people are known to have died from the virus, while over 7.3 million are known to have recovered. The pandemic has been ongoing for 6 months, and it continues its recent trend of exponential growth, largely driven by major epidemics in multiple large countries, such as Brazil, India, Mexico, and the US. In terms of daily incidence, Asia, North America, and South America are reporting approximately the same number of cases, and Africa has surpassed Europe. Africa is now representing more than 8% of the global daily incidence, compared to less than 7% for Europe. Asia, North America, and South America all represent approximately 25-30%. Globally, the top countries in terms of total daily incidence are US, Brazil, India, and South Africa. This week, India reported its highest daily incidence to date with 26,506 new cases and Brazil reported 42,619 new cases, meanwhile South Africa remains rank 4th reporting 13,674 new cases—more than 25% above cases recorded last week. After several weeks of maintaining low levels of transmission, several countries around the world are beginning to report increasing COVID-19 incidence once again including, Australia, Israel, and Japan as well as multiple European countries including Austria, Luxembourg, Iceland, and Serbia as these countries appear to be facing second waves of COVID-19, illustrating the challenge of maintaining containment while relaxing social distancing measures. In the absence of a vaccine, it is likely that any increased social interaction from easing social restrictions will result in increased transmission, and this pattern will continue as countries try to balance economic activity against COVID-19 risk. New WHO Guidance Acknowledges the Airborne Transmission Following the publication of a letter signed by more than 200 researchers and experts calling for the WHO to acknowledge the role of airborne or aerosol transmission during the COVID-19 pandemic, on Thursday, the WHO released new guidelines on the transmission of the novel coronavirus that acknowledge that some outbreak reports, involving crowded indoor spaces, have suggested the possibility of aerosol transmission , such as during choir practice, in restaurants or in fitness classes. However, as stated by WHO, more research is urgently needed to investigate such instances and assess their significance for transmission of COVID-19 as currently there is not sufficient evidence to support that it is a primary transmission route. It remains possible that some exhaled respiratory droplets can form infectious droplet nuclei/aerosols via evaporation; however, the extent to which these contribute to transmission is unclear. The report also includes an overview of the available evidence for other types of transmission including from animals, vertically from mother to fetus, and via other bodily fluids such as urine or faeces and the timing of the infectious period relative to infection and symptom onset. Globally, the number of total confirmed cases has exceeded 10 million. As of 10 July 20201, the total global cases are as follows: Total Confirmed Cases Total Deaths Total Recovered Total Affected Countries 12,618,719 562,039 7,327,391 188 Timor- Leste Updates Meanwhile in Timor-Leste, as of 10 July 2020, the total cases are as follows: Total Confirmed New Confirmed Total Tests Total Active Total Total Deaths Cases Cases Cases Recovered 24 0 3379 0 24 0 Timor-Leste remains free of COVID-19 cases as the country has not registered a new case since 24 April and the last patient of COVID-19 recovered on 15 May. As of 10 July, Timor-Leste had confirmed 24 cases of COVID-19 which all have already recovered with 0 deaths. To date, Timor-Leste has tested 2,882 people which resulted in 2,565 negative tests and 319 pending tests. A total of 2621 people have completed their 14 days mandatory quarantine while 127 people are still in the government’s quarantine facilities (107 are in Dili and 20 in other municipalities) and 92 people in individuals’ houses. The State of Emergency in Timor-Leste has now been dissolved and the responsibility of continuing to respond and prepare for further outbreaks in the country have been handed to Ministry of Health. The government is turning its attention towards economic recovery. A combination of an assertive immigration strategy, mandatory quarantine in re-purposed hotels, identified by the government and expanded surveillance with in-country testing capabilities have kept the virus at bay. This is a commendable achievement; however, this is just an interlude as the fight against COVID-19 is not yet over with cases increasing globally and some countries in Asia and Africa emerging as hotspots. As border restrictions are relaxed—particularly now as the government has started opening key borders point to Indonesia for a few hours every Wednesday, surveillance needs to be enhanced as the greatest risk of importation of new cases in the country is from entry points across borders shared with Indonesia. Border communities and village chiefs have been assigned to support the community surveillance by providing immediate information about illegal entries along the porous border with Indonesia so that health officials can take timely action. It is important to closely monitor the land border and other points of entry along with 1 Source: https://www.worldometers.info/coronavirus/?utm_campaign=homeAdvegas1?%22%20%5Cl%20%22countri accessed on 10 July 2 [Timor-Leste]: COVID-19 Pandemic Response continuing to aggressively pursue the ‘test, treat, isolate, trace and quarantine’ policy as recommended by WHO. Schools Reopening in the Country As the government continues its strategy of staggering the reopening of school across the country, 50 high schools reopened since June, have complied with the list of safety measure requirements released by Ministry of Education (MoE) and Ministry of Health (MoH), while another 80 schools are still preparing to meet the requirements. Currently, a total of 947 schools ranging from kindergarten to general and vocational/technical high schools are reopened, while 855 remains close. This pandemic has robbed the ability of schools to plan with certainty, not only in learning process but also in how to provide protective equipment and keep a clean sanitized environment amid the pandemic. Furthermore, the reopening of schools has brought concerns as most students have not been in engaged in learning activities for three months due to the state of emergency. Unlike other countries that have been able to conduct online learnings, most of students in Timor-Leste are unable to do so due to internet limitations. Although access to mobile phones and internet connections have been increasing in the past years, it is still relatively limited and expensive for the majority of people, especially in rural areas. In the most recent data from World Bank2, there were only 27,493 people who have access to the internet with population of 1,243 million in the country (2017). Humanitarian Agencies in the Country The Malaysian Commercial cargo aircraft coordinated by the World Food Programme (WFP) arrived at Nicolau Lobato Airport in Dili on 8 July, bringing 16 passengers of humanitarian workers and 76 kilograms of cargo consisting of vital medical supplies. Previously, WFP’s Aviation Global Air Passenger Services, with authorization from the government, launched WFP’s chartered flight linking Dili to Kuala Lumpur to enable bringing the vital medical supplies and humanitarian workers in response to COVID-19. During June, three flights have ferried 48 passengers, 1,6 tons of medical supplies on behalf of WHO, 165 kgs from WFP and 25 kgs from World Vision. This week, continued trainings for professional health workers were provided by MoH, Hospyal Nacional Guido Valaderes and (NHGV) supported by WHO, St. John of God Health Care, and USAID conducted COVID-19 Case Management Training at Maubiesse Referral Hospital in Ainaro municipality, participated by 15 health care workers. In addition, the training was expanded to include health professionals of Rita-bou community health centres (CHC) in Bobonaro district. Fifteen health care workersparticipated int he training which covered a range of topics including safe use of personal protective equipment, introduction to COVID- 19, and psychological support. CVTL Response Update In response to COVID-19 pandemic, as of 10 July 2020, CVTL COVID-19 preparedness operations have been conducting the following programs: Health and Hygiene Promotion and Services • Continuing efforts to disseminate information related to COVID-19 pandemic to the community in rural and urban areas, and distributing posters on COVID-19 prevention to 13 municipalities—especially strengthening the dissemination activities in Dili as it shares borders with high-risk areas such as Covalima, Oessue, Bobonaro Municipalities and also Indonesia. • Conducting the door to door approach for disseminating information related to OCVID-19 to ensure that all communities understand the pandemic situation, along with public sensitization on COVID-19 prevention through megaphones in all 13 municipalities • Providing health and hygiene promotion on COVID-19 prevention to students and teachers in several schools as the country has reopened schools that meet the standard during COVID-19.