YEMEN COVID-19 PREPAREDNESS AND RESPONSE MONTHLY REPORT HUMANITARIAN COUNTRY TEAM OCTOBER 2020 SITUATION OVERVIEW In October, 29 new confirmed cases of COVID-19 were reported, 13 deaths and 79 recoveries, bringing the total number of reported cases to 2,067 with 601 deaths and 1,367 recoveries. The numbers of reported cases have fallen from 76 new confirmed cases reported in September and 230 new cases reported in August to 19 in October.. Health partners remain concerned that under-reporting continues for various reasons and that the official epi-curve underestimates the extent of COVID-19 in Yemen. Other factors that have had a negative impact on the COVID-19 response include a lack of adaptive behaviour by the population to reduce transmission, severe funding shortages for health workers and personal protective equipment (PPE) and long delays in importing COVID-19 response supplies. Partners continued working towards increasing surveillance; deploying dedicated COVID-19 staff within agencies; tracking the impact of the virus on routine priority health programmes; refining messaging to encourage behavioural change; and boosting intensive care unit (ICU) capacity. Partners have begun to prepare for a second wave of COVID-19, including engaging with excluded and vulnerable groups to keep them safe and supporting essential health facilities to ensure they function throughout winter. The fuel and funding crisis risked exacerbating the COVID-19 and broader humanitarian response. Number of COVID-19 Cases, Deaths, and Recoveries in Yemen COVID-19 Cases by Governorate 2,067 Amanat Al Asimah Total Reported COVID-19 Cases Sa’ada 1,367 601 Reported Recoveries Reported Deaths 49 confirmed 10 deaths 22 recovered Hadramaut 959 confirmed 311 deaths 618 recovered Al Jawf Amran Hajjah Marib 4 confirmed 1 death 2 recovered Al Mahwit Sana’a COVID-19 Cases by Sex and Age Al Maharah 43 confirmed 12 deaths 31 recovered Shabwah 142 confirmed 38 deaths 104 recovered Raymah Dhamar Al Hudaydah Al Bayda 66 confirmed 54 deaths Ibb Female 303 confirmed Taizz 81 deaths 230 recovered Male 26% 74% Reported Cases by Age Female 60+ 8.6% 45 - 59 6.7% 30 - 44 6.6% 15 - 29 3.5% 7.6% Male 135 confirmed 41 deaths 88 recovered Lahj Abyan 20 confirmed 5 deaths 23 recovered 288 confirmed 33 deaths 225 recovered Aden 24.2% APRIL 2020 0.5% 2.5% Confirmed cases MAY 2020 JUNE 2020 JULY 2020 1,530 1500 30 - 44 3.8% 13.8% 15 - 29 1,734 OCTOBER 2020 1,367 1,162 500 Male 31% 358 327 300 1 0 10 8.8% 1,732 SEPTEMBER 2020 2,038 2,043 2,057 2,067 1,862 1,962 1,966 2,020 848 Female 12.5% AUGUST 2020 Recovered Deaths 1,194 1000 45 - 59 * Lab confirmed cases of COVID-19 are limited due to testing capacity and thus absolute numbers are more likely a reflection of surveillance artifact and should not be interpreted as severity of transmission in any particular governorate Number of COVID-19 Cases (Cumulative) 19.9% Reported Deaths by Age 60+ Socotra 19.9% 2000 Others Al Dhale’e 58 confirmed 15 deaths 24 recovered 6 72 30 1 108 16 15 81 85 30 1 209 15 313 319 434 494 495 529 30 1 15 30 1 15 567 571 30 1 584 588 588 15 30 1 597 15 601 30 %26.3 0 % 3.8% 5 - 14 * Age disaggregation for cases and deaths is based on available data to WHO. COVID-19 Funding Status $385.7M FUNDING REQUIRED $354.2M RECEIVED 92% 304.5M $ REQUIRED FOR HEALTH 02 COVID-19 PREPAREDNESS AND RESPONSE MONTHLY REPORT SUPPRESSION To suppress transmission of the virus, aid agencies continued Risk Communication and Community Engagement (RCCE) support. COVID-19 RCCE approaches have been integrated into a “Back to Learning” campaign which was launched in southern and northern governorates. In the south, about 3 million people were reached through 18 community radios and 45,620 people through interpersonal communication activities, while 12,000 colouring and comic books about COVID-19 were distributed to children in IDP camps in Aden. The RCCE interventions included distribution of masks and hygiene materials in schools. Imams and female religious leaders continued to engage with people at gatherings and social events to sensitize them to COVID-19 prevention practices and physical distancing guidelines reaching 1.52 million, while over 4 million people were reached through 639,392 house-to-house visits and Mother-to-Mother sessions. Community volunteers also commemorated Global Handwashing Day this year with events in open public places to raise awareness about the importance of handwashing with soap to prevent COVID-19. To support the adoption of COVID-19 prevention measures, community volunteers and members of Mother-to-Mother clubs supported the distribution of hygiene kits to 17,400 families. COVID-19 trend analysis People heard about coronavírus People know it is a virus that can cause disease 97% 83% Round 1 80% Round 2 People believe they are likely to become sick with coronavirus 90% 31% 51% 1.52 million people reached in 42,500 community gatherings and women social events Number of people reached 16.5 million 4 million people reached through mass media engaged through house-to-house visits Over 17,400 3.6 million 160,000 people engaged through Mosque events in 5,000 Mousques students and parents reached through school health facilitators intervention at community level Families received hygiene kits by community volunteers and members of Mother-to-Mother clubs 3.5 million Number people reached in October: people engaged through WhatsApp groups/trees created and managed by CVs,RLs,M2M members Safe water: 4.1 million 12,000 Over copies of colouring and comic books on COVID-19 were distributed to children in the south. calls to hotlines and radio phone-ins 32,030 Hygiene Items: 319 k COVID-19 Household kits: 10.5 k Mass Media reach by Hub 1,330 refugees participated in risk communication surveys in Ibb, Hajjah & Hudaydah. 16.5M Total Mass Media reach 5,000 Amanat Al Asimah screenings were conducted at Kharaz Refugee Camp 0.7M Sa’ada Hajjah Hadramaut Al Maharah Al Jawf Amran hand-washing stations installed Marib Al Mahwit Sana’a 3M 6M Raymah Dhamar Al Hudaydah 3M Ibb Shabwah 17 Al Bayda Al Dhale’e Taizz Lahj 2,695 water systems are being installed Abyan Socotra Aden 3.8M 03 COVID-19 PREPAREDNESS AND RESPONSE MONTHLY REPORT SUPPLIES The United Nations has procured more than 17,202 metric tons of medical equipment, testing kits and medicine from a highly competitive global market; 16,301 metric tons have already arrived in country and another 901 metric tons were in the pipeline at end of October. Still more is urgently needed, especially oxygen and personal protective equipment. Inbound from suppliers SAUDI ARABIA WHO/WFP dispatch flows Arrived > 980 ICU beds Interationally Procured 376 604 > 640 Ventilators 490 150 Locally Procured Sana’a > 294.4 K > 23,438 Face shield Testing kits 241.2 K 53.2K > 3.7 M Face masks 2.4 M 1.3 M Aden Djibouti > 1.2 M Respirator masks 1.1 M 129.6 K >5M Gloves 4.7 M 309.7 K > 230.7 K Sanitizers (Litres) 37.6 K 193.1 K Procured 16,301 M3 arrived Over 521 Oxygen concentrators 2,189 521 - Oxygen Cylinders 941 1,248 2,320 Hospital Beds 500 1,820 17,202 M3 of medical equipment and medicine Transport Air 4,110 M3 arrived Sea 12,149 M3 arrived 901 M3 in pipeline Land 42 M3 arrived 901M3 in pipeline 04 COVID-19 PREPAREDNESS AND RESPONSE MONTHLY REPORT SAVING LIVES The UN and partners continue to work on expanding hospital capacity in key population centres. Aid agencies scaled up the number of intensive care units (ICUs) in COVID-19 designated hospitals from 38 beginning of May, and are equipping an additional 21 ICUs, bringing the total to 59. In line with the COVID-19 strategy refresh, the focus was on triage, keeping patients and healthcare workers safe, referral pathways and capacity building. Activities and Items Provided 52 Isolation Units (IU) 29 are in the north 23 in the south 21 of these are new ICUs 675 259 333 ICU Beds Ventilators health rapid in 63 districts in 52 districts response teams (1,665 staff) 6 laboratories 11,7k 300k oxygen cylinders PPE refilled each month items delivered with COVID-19 testing capacity 4 in the south (Aden, Al Mukalla, Seyoun & Taiz) 2 in the north (Sanaa city & Al Hudaydah) UN to provide per diem and danger pay to 26 85% Emergency Operations Centres of entry points (22 of 26) have screening capacity 9,000 frontline health-care workers repurposed for COVID-19 52 22 in Governorates Isolation Units *WHO has finalized rehabilitation works or these are in process, delivered material and equipment and conducted staff training. The main criteria for operationalization depends on staff incentives. AMANAT AL ASIMAH " HAJJAH " "" SA'ADA " " AL JAWF SANA'A HADRAMAUT " AMRAN " " " " AL MAHWIT " " SANA'A " TAIZZ " LAHJ " " " " ADEN " " MARIB " " SHABWAH " " " DHAMAR AL HUDAYDAHRAYMAH " IBB "" " AL BAYDA "" " AL DHALE'E " " LAHJ " " AL MAHARAH " " " Isolation Unit ABYAN " Governorate Boundary " SOCOTRA 05 COVID-19 PREPAREDNESS AND RESPONSE MONTHLY REPORT SAFEGUARDING THE PUBLIC HEALTH SYSTEM Safeguarding the public health system at more than 4,300 non-COVID health care facilities to ensure available facilities are not overwhelmed by COVID-19 cases remains a priority for humanitarian partners. These facilities continue to provide non-COVID health care services to prevent deaths from other deadly diseases and causes, including cholera, diphtheria, dengue and malaria, and to provide nutrition treatment to pregnant women and malnourished children. In August, 2,779 health facilities continued to provide health services for malaria, and 956 health facilities provided cholera response services. Throughout the COVID-19 crisis, Health Cluster partners and the private sector continue to safeguard the public health system by: • • • • • Triaging acute and chronically ill people and treating them outside the 4,300 non-COVID health facilities. Maintaining provision of the Minimum Service Package in non-COVID health facilities. Providing essential medicines and vaccines to the people who need them the most, including cancer patients and children. Maintaining routine immunization activities and containing and responding to deadly disease outbreaks including cholera, diphtheria, dengue and malaria. Providing nutrition treatment to pregnant women and malnourished children. Support Provided for 5,049 2,528 1,865 2,779 1,257 health facilities fully functioning health facilities partially functioning health facilities health facilities providing health services for malaria health facilities providing cholera response services 4,966 50% Health Facilities (HFs) HFs fully functional* 35% HFs partially functional 15% HFs non-functional *Fully functioning HFs may have some lack of services Functioning HFs per Governorate and per 100,000 people Amanat Al Asimah > 30 20 - 30 15 - 20 5 - 15 Sa’ada 2-5 Hadramaut Al Jawf Al Maharah Amran Hajjah Marib Al Mahwit Sana’a Shabwah Dhamar Raymah Al Hudaydah Ibb Al Bayda Abyan Taizz Socotra Lahj Aden Al Dhale’e 22 in Governorates