Libya COVID-19 Surveillance Monthly Bulletin: Epidemiological Month of July (1-31 August)

Situation Report
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• Libya achieved the highest number of tests done in the month since the pandemic, with 217,948 tests conducted for August 2021.

• At the national level, Libya reported a declining trend in cases for Aug with overall increased testing compared with July. Although it is important to note that there is still ongoing community transmission in all districts in the country, and case and death numbers, remain very high in most districts of East and South.

• 36 COVID-19 labs (out of 36) reported 217,948 new lab tests done for August.

• This month, two new labs (in the west region) were opened (the total became 36)—Daraj NCDC Lab and Msallata Reference Lab.

• Out of the 1,542,044 tests in Libya since the beginning of the response, 308,972 (20%) were confirmed positive for SARS-CoV-2 (COVID-19).

• Compared to July, there was a 20% increase in overall national testing: by regions, West (17% increase), South (55% increase) and East (212% increase). Thus, 94.4% (205,828) of national testing was performed in the West as compared to both East (only 6598 tests) and South (only 5522 tests) Regions. (-see fig. 1)

• The national positivity rate for August dropped to 25.5% from 32.8% in July, representing the West with a positivity rate of 23.8%. However, it increased in the East (from 28.7% to 38.3%) and South (from 61% to 70%), differing markedly from the national-level positivity rate. Therefore, national numbers of cases, deaths and lab tests are mainly represented. West WHO recommends that positivity rates should be kept below 5% in all districts in a country.

• The overall number of new cases reported in July shows a 7% decrease (55,536 cases) compared to July (59,531 cases), with West reporting a 13% decrease in new patients. East reported a 316% increase, and South had a 78% increase in cases. Although the lab testing has increased in all three regions, only West documents a decrease in cases while cases increase in proportion to the increased number of lab tests conducted in East and South and remain an underestimate for East and South due to insufficient tested numbers. The reasons behind the increased case numbers are weak implementation and adjustment of Public Health and Social Measures. In addition,

• In July, the number of new deaths (699) showed a 100% increase compared with 350 deaths. As a result, the mortality rate for Aug increased from 5.1 to 10.3 deaths per 100,000 cases, with a case fatality rate of 1.3%.

• Compared to July, West reported a 64% increase in deaths for the reporting week, East (595% increase) and 125% increase reported in South (- see table 1). This death is being reported for the increased case numbers reported two weeks back with a lag period.

• Libya has not reported an official confirmation of the Delta or Gamma variant. Delta is suspected because of its circulation in neighbouring Egypt, Tunisia, and Algeria. Neighbouring Sudan has reported a Gamma variant this week. Libya remains classified under community transmission with Alpha and Beta Variants of Concern (VOC) circulation.

• Libya implements PCR testing conducted 72 hours for entry with no testing on arrival or quarantine for arriving passengers. In addition, Libya has not implemented any vaccine exemptions or imposing entry restrictions for any country