On may 9, 2020, 5 new cases were confirmed (cumulative = 204) , 2 new recoveries were reported (cumulative = 85), NO new death reported (cumulative = 20)

Highlights

• Five (5) new confirmed cases were reported on 09 May 2020 from 64 samples tested
  • Three of the new confirmed cases came from Montserrado county and two from Gbarpolu county
• Cumulatively, 85 (41.7%) case-patients have been discharged and reintegrated into their communities
  • A total of 62 case-patients remain in admission undergoing treatment including as of 9 May 2020
• Since March 16 -May 9, 2020, a total of 1,330 suspected and probable cases have been reported across 13 counties
  • Of these, two hundred four (204) have been confirmed including 35 health workers
    • Montserrado county remains the hotspot with 88.2% of the confirmed cases
  • A total of 20 deaths (CFR-11.8%) in confirmed cases including two health workers have been recorded
    • 60% of the reported deaths were community deaths that were swabbed by the surveillance system
  • 98.5% of confirmed cases are locally transmitted and 1.5% remains imported
  • The age range among confirmed cases is 1 month to 74 years with a median age 42 years
• A total of 2,321 contacts have been recorded; 66 (2.8%) have tested positive; 1,463 (63%) have completed 14 days follow up; while 892 (38.4%) remains under active follow-up with 97.3% seen in the last 24 hours
• A total of 78 high-risk contacts remain under observation in precautionary observation centers in four counties
• The National Incident Management System (IMS) is coordinating the affected counties led COVID-19 response with support from partners

Situation Context

Liberia reported its first confirmed case of the COVID 19 on 16 March 2020 in Monrovia, the country’s capital. As of 9 May 2020, the country had recorded two hundred-four (204) confirmed cases of COVID-19 including twenty (20) death (CFR=9.8%) with 2,321 contacts registered. Montserrado County remains the Epi center 180 (88.3%) of the confirmed cases including 15 (75%) deaths while the rest of the confirmed cases reported from; Margibi (11) including one (1) death; Nimba County (6) including 3 deaths, Gbarpolu (3) including (1) death; Grand Kru (1), Sinoe (1), River Gee (1) and Mary Land (1). Liberia has begun the testing of community dead bodies of which 12 of the community deaths have tested positive for COVID-19. Due to prompt treatment at the treatment centers, Liberia recovery rate continues to improve at 41.7% as of 9 May 2020.

The risk of transmission remains very high largely due to high population movements in Montserrado as the county is home to approximately 1,500,000 (1/3) of the country’s total population while local transmission mainly from contacts of confirmed cases has accounted for about 98% of the cases.

Public Health Actions initiated following confirmation

1. Coordination
   • The National IMS through the President Office has mandated all citizens to wear masks when leaving their homes in an effort to reduce or mitigate the spread of the COVID-19 outbreak
2. Epidemiology and Surveillance
   • Active case findings at community and health facility levels is ongoing in affected districts across the country
     • A total of 66 health facilities were trained on case detection using the WHO case definition and appropriate filling of investigation forms involving 173 health facility surveillance focal persons on 9 May 2020 in Montserrado county
   • Reclassification of cases are ongoing at national and sub-national levels
3. Case Management
   • A total of 62 case-patients are being managed at seven treatment centers with 89.4% being managed in Montserrado county;
   • Monitoring and testing high-risk contacts for COVID-19 at POCs and isolation centers
4. Laboratory
   • WHO, US-CDC, USAID-IDDS, WAHO, Africa CDC, World Bank, and NIH continue to support the Public Health laboratory ( the national Reference Laboratory of Liberia with COVID-19 test kits which have increased capacity to establish specimens collection centers in Montserrado, the epi center and across the country; over 15,000 reagent COVID-19 (RT-PCR) available in-country;
   • The laboratory has tested over 1,833 samples with 204 testings positive for COVID-19
   • Sample collection materials including swabs/VTM are pre-positioned in counties to support COVID-19 sample collection
5. Infection Prevention and Control (IPC)
   • Reinforcing handwashing in all public areas in the county (markets, health facilities, public offices, checkpoints, etc.)
6. Psychosocial
   • Continuous provision of cognitive-behavioral therapy, interpersonal therapy, motivational therapy Psychoeducation, linking patients with their families and home-based support to cases, contacts and relatives at POCs, Isolation centers, and treatment centers
7. Risk Communication
   • Appropriate messages have been developed and pretested for three (3) emerging concerns, namely: stigmatization, social distancing, and quarantine. The data is currently being analyzed to be followed by finalization of the messages and production of leaflets for mass distribution

Challenges

• Inadequate financial and logistical resources for response activities

Next Steps/Recommendations

• Provide information and test results of people at POC’s and communities in a timely manner
• Continue epidemiological investigations to link all the reported confirmed cases
• Counties to submit immediate response critical gaps to national IMS chair for redress by government and partners
• Mobilize additional resources to support on-going response activities