Libya COVID-19 Surveillance Monthly Bulletin: Epidemiological Week 35 (30 Aug – 5 Sep)



• Libya reported a declining trend in cases for the fifth week proportional to the lab testing. Although it is important to note that there is still ongoing community transmission in all districts in the country, and case numbers, while declining, remain high in most districts, especially in the East and South.

• 33 COVID-19 labs (out of 34) reported 39,156 new lab tests done in Epi-week 35. Thus, out of the 1,575,440 tests in Libya since the beginning of the response, 316,797 (20.1%) were confirmed positive for SARS-CoV-2 (COVID-19).

• This week, NCDC started reporting for Antigen Rapid Diagnostic Tests (Ag-RDT) to be included in the COVID-19 daily announcement. However, there are no official guidelines for the use of Ag RDTs in the country and the use of WHO case definitions for confirmed cases by Ag RDTs cannot be confirmed.

• Compared to Epi-week 34, there was a 6% decrease in overall national testing: by regions, West (9% decrease), South (31% decrease) and East (74% increase). Thus, 86.8% (33,994) of national testing was performed in the West as compared to both East (only 3824 tests) and South (only 1338 tests) Regions. (-see fig. 1)

• The national positivity rate for Epi-week has a decreasing trend since week 28. It decreased from 25.4% in week 34 to 23.8 in week 35, mainly representing the West with a positivity rate of 21.5%. It cannot be generalized based on the positivity rate in the East (38.2%) and South (42%), which differ markedly from the national-level positivity rate. It is recommended that positivity rates should be kept below 5% in all districts. National numbers of cases, deaths and lab tests are skewed to West.

• The overall number of new cases reported in EPID week 35 shows a 12% decrease (9,326 cases) from 10,592 cases last week. Case incidence per 100,000 decreased from 155.5 in week 34 to 136.9 in week 35, with West reporting a 15% decrease in new patients. East reported a 73% increase proportional to increased testing in week 35, and South had a 50% decrease in cases. The lab testing remained a limiting factor and underestimated 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.

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

• In Epi-week 35, the number of new deaths (130) showed a 5% decrease compared to last week. As a result, the mortality rate decreased from 2 to 1.9 deaths per 100,000 cases, with a case fatality rate of 1.4%. As compared to last week, West reported a 5% decrease in deaths for the reporting week, East (19% increase) and 59% decrease reported in South (- see table 1)