As of 31 December 2020, Zimbabwe had cumulatively 13,625 conﬁrmed cases, 11,154 recoveries and 360 deaths. Harare, Bulawayo, Matabeleland South, Midlands and Manicaland provinces account for 81 per cent of all conﬁrmed COVID-19 cases in Zimbabwe. Children of school going age (5-19 years) account for 7.6 per cent of all reported cases.
A declining access and utilization of essential services was reported earlier including preventive, curative and rehabilitation services across the country. Furthermore, outpatient consultation declined by 49 per cent in 2020 (April - October) compared to the same period in 2019. For maternal health services, attendance at the fourth antenatal visit declined by 55 per cent in 2020 (April-October) compared to the same period in 2019. On access to HIV services, there was a 45 per cent decrease of the number of people tested for HIV in 2020 (April-October) compared to the same period in 2019.
The proportion of doctors at duty stations in week 45 was 61 per cent (decrease from 63 per cent in week 44). In week 45, nurses on flexi-hours increased to 63 per cent from 46 per cent the previous week. There has been an increasing number of institutional deliveries, cesarean sections, major operations, and community deaths. PPE availability at health facility level remains very variable, ranging from 90 per cent in some locations to much less in others such as 12 per cent in Centenary district, Mutare City, Mashonaland Central province.
To address the COVID-19 resurgence, there is a need for risk communication and community engagement to increase awareness particularly with opening of borders and approaching festive season; increased vigilance about potential amplification and super spreading opportunities associated with crowding, increased travel, closed communities such as schools, barracks, prisons; enhanced capacity for surveillance, laboratory testing; maintain capacity for case management, infection prevention and control; and advocate for strict lockdown and enforcement measures as last resort.
For essential health services, priorities include: continued advocacy for health worker conditions of service and safety; in-depth review to address issues raised by MOHCC weekly monitoring reports; document lessons learned and scale up best practices in the delivery of essential health services; support ongoing preparations for COVID-19 vaccine introduction.
There is a need for enhanced preparedness for other health emergencies (outbreaks, floods) including: timely investigation of all suspect cases of epidemic-prone diseases; updated provincial and district emergency preparedness plans; and intensified surveillance, pre-positioning of emergency logistics and supplies.
Major recent developments under the national COVID-19 response include:
Enhanced risk communication efforts by Inter-Ministerial Task Force and stakeholders at all levels;
Conﬁrmed COVID-19 outbreaks in nine educational institutions (high schools and universities) contributing to increased number of conﬁrmed cases in Matabeleland North, Matabeleland South, Midlands, Mashonaland West, Mashonaland East;
Joint MOPSE-MOHCC outbreak response efforts in affected schools and surrounding communities;
Enhanced level of preparedness in all educational institutions in line with national SOPs;
UNICEF and other partners providing masks, hand sanitizers to schools;
Increased number of operational Rapid Response Teams in Bulawayo and Harare;
Roll out of updated laboratory testing guidelines and logistical support for COVID-19 testing laboratories;
Enhanced capacity-additional staff, IPC capacity, sample collection capacity at all land borders;
Publication of Statutory Instrument (SI) 282 of 2020 (With effect from 1 December all ports of entry will be opened; Travelers with COVID-19 free certiﬁcate issued within previous 48 hours and who do not have signs, symptoms of COVID-19 will be allowed entry into Zimbabwe);
MOHCC, with support of National Immunization Technical Advisory Group (NITAG) partners, is preparing for the introduction of the COVID-19 vaccine when available.
Delivery of essential services was continued through:
Health workers occupational health and safety with 658 front-line health workers infected with COVID-19, including on the job mentoring in IPC practices, and IPC quantiﬁcation and monitoring at health facility level;
Enhanced emergency preparedness, with six suspect typhoid cases; 8,783 diarrhoea cases; 584 dysentery cases; 16 anthrax cases; 3,797 inﬂuenza-like illness cases reported during the epidemiological week 42, including integrated intensiﬁed disease surveillance, pre-positioning of emergency logistics and supplies;
A total of 54,407 people in Chegutu received free oral cholera vaccination. The ﬁve-day oral cholera vaccination campaign was conducted by the Ministry of Health and Child Care (MoHCC) and Chegutu Rural District Council with support from UNICEF and WHO. The campaign also provided other routine immunization and nutritional services such as measles, polio and Vitamin A supplements.
Preparedness of COVID-19 resurgence needs to be enhanced through the implementation of recommendations from intra-action review with scale-up identiﬁed best practices and local innovations, and for updated guidelines on quantiﬁcation, use and monitoring of essential COVID-19 supplies (lab supplies, PPE, clinical equipment and supplies).
Enhanced preparedness for other health emergencies (outbreaks, ﬂoods) is needed through the updating of provincial and district emergency preparedness plans, intensiﬁed surveillance, pre-positioning of emergency logistics and supplies.