Venezuela - October 2020

Situation Report

Cluster Status

Health

34,657
People reached with health services

Needs

Dengue: As of October 24, 2020, Venezuela reported 5,653 dengue cases (an incidence rate of 17.46 cases per 100,000 inhabitants), 229 laboratory-confirmed cases, 24 severe dengue cases and 14 deaths (a fatality rate of 0.248 per cent), being higher than the fatality rates in the Andean (0.070 per cent) and Americas (0.041 percent) subregions. Although there was a 55.6 per cent decrease in reported dengue cases (12,730 cases), the fatality rate rose by 75.9 per cent compared to the same period in 2019 (0.141 per cent).

Chikungunya: As of October 24, 2020, the cumulative number of probable cases is 58, with two confirmed cases, a decrease of 63.5 per cent compared to the same period in 2019 (159 cases).

Zika: As of October 24, 2020, 25 probable cases were reported, with no confirmed cases, a decrease of 60.9 per cent compared to the same period in 2019 (64 cases).

Measles and rubella: As of October 31, 559 suspected cases of measles, rubella and congenital rubella syndrome (CRS) were reported (no confirmed cases). Currently, there are 13,092 notification units for these pathologies with 100 per cent of cases adequately investigated and 94 per cent of samples suitable for case study, but only 14 per cent of blood samples reach the laboratory in five or fewer days. In the last 52 epidemiological weeks (EW 45 2019 to EW 44 2020), a suspected case rate of 0.8 cases/100,000 inhabitants of measles and rubella and 0.3 suspected cases of CRS per 10,000 live births were reported.

Diphtheria: Since the beginning of the diphtheria outbreak in 2018, there was a sustained increase in cases, but a decline started in 2019 and continued in 2020. As of September 22, 2020, 54 suspected cases were reported, of which 5 were confirmed (3 by laboratory and 2 by clinical criteria or epidemiological link), including two deaths. Individuals with confirmed cases were between 2 and 14 years of age. The date of onset of symptoms of the last confirmed case was January 25, 2020 in the Bruzual municipality, in the state of Yaracuy. Confirmed cases were reported in the states of Anzoategui (José Gregorio Monagas municipality), Miranda (Brión municipality) and Yaracuy (Bruzual municipality). PAHO/WHO recommends strengthening surveillance systems and laboratory diagnostic capacity, maintaining a supply of diphtheria antitoxin for its timely use and reduction of the fatality rate, vaccination to prevent cases and outbreaks, and adequate clinical management to reduce complications and fatality.

COVID-19: From March 13 to November 23, Venezuela has reported 94,658 PCR-confirmed cases of COVID-19, which represents an incidence rate of 326.4 cases per 100,000 inhabitants. To date, 871 deaths have been reported, representing a mortality rate of 30 deaths per million inhabitants and a case fatality rate of 0.92 per cent, which is one of the lowest in the region. As of October 31, 89 per cent of the confirmed cases were community-transmitted (81,906) and 11 per cent were imported (10,107), according to information provided by the National Government. Comparing the total number of cases reported up to September (75,122) with the cases reported up to October 31 (92,013), there was an increase of 22.5 per cent. As of November 5, 2020, Venezuela has reported 861 confirmed cases of COVID-19 in indigenous populations, which corresponds to 0.94 per cent of the total number of reported cases, and 34 deaths, representing a case fatality rate of 3.94 per cent.

The diagnostic capacity for COVID-19 confirmatory tests (PCR and antigen) should continue to expand for the general population, health workers and at-risk groups, such as migrant and indigenous populations. Another key element is to continue reorganizing health services to manage the impact of the increase in cases and deaths associated with the probability of underreported cases and delays in surveillance and contact tracing. The provision of PPE for personnel in health facilities, PASI at border entry points, and those carrying out activities in communities, among others, should also continue in order to mitigate the risk of contagion.

Response

In October, Health Cluster partners trained 1,018 healthcare workers (HCWs) in 7 states. In the states of Zulia, Tachira and Bolivar, training focused on COVID-19 care. In Guarico, Monagas, Trujillo, Barinas and Apure, health workers were trained in HIV diagnosis and the prevention of vertical transmission of HIV and syphilis. Additionally, in the states of Barinas, Apure, Cojedes, Guarico, Monagas, Portuguesa and Trujillo, a total of 35 HCWs from the Comprehensive Community Health Areas (Áreas de Salud Integral Comunitaria or ASIC) of each state were trained in the Clinical Management of Sexual Violence through social networks (WhatsApp).

Equipment, supplies, essential medicines and sexual and reproductive health medicines were provided to more than 50 outpatient clinics, 17 community clinics, 8 maternity hospitals and 38 hospitals in 24 states, benefiting 77,445 people, 22,839 of which benefited from COVID-19-related services. In the context of COVID-19, the delivery of PPE and the respective training in its proper use was carried out in the state of Miranda, benefiting 400 HCWs belonging to 7 Integral Diagnostic Centers and the Luis Razetti Hospital in Miranda.

The work of partners has improved access to health services for 34,657 people in greater vulnerability (children, adolescents, pregnant women, indigenous people, people with disabilities), facilitating consultations on various health promotion and prevention services in basic healthcare specialties in 131 health facilities (including 3 PASI) and 8 communities in 14 states and the Capital District. Of the total number of beneficiaries, 4.4 per cent (1,522 people) benefited in the context of COVID-19 through the provision of sexual and reproductive health care, focusing on HIV and syphilis prevention, contraception, and breast cancer prevention.

Community capacity building in disease prevention and health promotion (SRH, NCDs, CD, MH and Psychosocial) benefited 12,498 people through awareness raising and information on COVID-19 prevention measures in sexual and reproductive health, contraceptive methods, pregnancy, warning signs and COVID-19 in 41 health facilities, 12 PASI and 5 communities in 6 states.

In Bolivar, 4,021 people benefited from the delivery and distribution of COVID-19 information material for prevention and control. Also, 9,819 people benefited from the strengthening of information and epidemiological surveillance systems, including community health actors, in 7 states and the Capital District in the context of COVID-19 and humanitarian response.

A total of 340,000 antigen detection tests and 27 reading devices arrived in Venezuela, managed by the Pan American Health Organization (PAHO), with the aim of bringing COVID-19 confirmatory diagnosis to all the states of the country and improving the time it takes to obtain the results. During the first days of October, PAHO also delivered 20 invasive mechanical respirators for intensive care patients, 133 oxygen concentrators and 1,585,000 disposable masks.

On October 28 and 29, authorities from the MPPS and PAHO-VEN visited the cities of San Cristóbal and San Antonio in the state of Tachira, located on the border with Colombia, to fine-tune the response to the challenges of the COVID-19 pandemic. PAHO/WHO is accompanying Venezuelan authorities in the dialogue with their Colombian counterparts, aiming to improve the health conditions of migrants and protect them from the transmission of COVID-19. During the working sessions, priority was given to migrants’ healthcare, their health status, their stay at the PASIs, as well as their return to their places of origin, in an effort to interrupt community transmission of COVID-19. They also visited the mobile laboratory for COVID-19 diagnosis and held coordination meetings with other international organizations present in the state, such as UNHCR, OCHA, IOM and UNICEF.

On October 11, the United Nations Population Fund (UNFPA) in Venezuela held a virtual discussion forum in the framework of the International Day of the Girl entitled “My voice, our future in equality and free of violence”, which addressed the challenges faced by Venezuelan girls to live free of gender-based violence, harmful practices, and HIV and AIDS.

During the month of October, the Health Cluster held regular virtual meetings focusing on updating and formulating the HRP2021. Also, the subnational health clusters of Tachira and Bolivar held meetings led by PAHO, gathering approximately 30 partners from the national and subnational levels.

Note: As of October, the Health Cluster reported that between January and November 2020 it had reached 3.6 million people. This figure is higher than the 1.6 million included in the September report. The increase by 2 million from one month to the next is due to the reporting in October of official MPPS figures for the year that had not been previously accounted for. However, this data was not disaggregated by sex and age, so it was not included in the multi-sectoral aggregate of people reached as it is not possible to guarantee that it did not include data duplication. As the situation was rectified, this figure has been updated.

Gaps

Fuel shortages continue to pose a constant challenge for the development of response activities of humanitarian partners, especially in border states.

It is necessary to continue strengthening the capacity for early detection, timely care and epidemiological surveillance of vector-borne and vaccine preventable diseases, especially in vulnerable groups in the context of COVID-19, as well as the capacity for timely detection of COVID-19 outbreaks, case diagnosis and care.

COVID-19 in migrant populations should be monitored, ensuring the capacity to detect cases in this group and providing the necessary supplies and PPE to health personnel caring for this population.

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