Libya COVID-19 Surveillance Monthly Bulletin: Epidemiological Week 37 (13 – 19 September 2021)

Situation Report
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• Libya reported a declining trend in cases for the seventh week proportional to a decrease in lab testing, especially in the South. However, it is essential to note that there is still an ongoing high to a very high incidence of community transmission in all districts in the country based on positivity rates.

• 29 COVID-19 labs (out of 36) reported 32,038 new lab tests done in Epi-week 37. Thus, out of the 1,643,667 tests in Libya since the beginning of the response, 332,026 (20.2%) were confirmed positive for SARS-CoV-2 (COVID-19).

• Compared to Epi-week 36, there was an 11% decrease in overall national testing: by regions, West (9% decrease),
South (61% decrease) and East (11% decrease). Thus, 86.2% (27,626) of national testing was performed in the West as compared to both East (only 3787 tests) and South (only 625 tests) Regions. (-see fig. 1)

• The national positivity rate for Epi-week has a decreasing trend since week 28. It decreased from 23.3% in week 36 to 21.2 in week 37, mainly in the West, with a positivity rate of 18.9%. It cannot be generalized based on the positivity rate in the East (36%) and South (36.3%), 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.

• Case incidence per 100,000 decreased from 124 in week 36 to 100 in week 37. The decreased case incidence in some of the districts is mainly due to lower testing capacity this week. The overall number of new cases reported in EPID week 37 shows a 19% decrease (6,805 cases) from 8,424 cases last week, with West reporting a 17% decrease in new patients. East reported a 3% decrease, and South had a 68% decrease in cases.

• 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. In addition, neighbouring Sudan has reported a Gamma variant. Therefore, Libya stays classified under community transmission (high to very high incidence) with Alpha and Beta Variants of Concern (VOC) circulation.

• In Epi-week 37, the number of new deaths (76) showed a 22% decrease compared to last week. As a result, the mortality rate decreased from 1.4 to 1.1 deaths per 100,000 cases, with a case fatality rate of 1.12%. As compared to last week, West reported a 35% decrease in deaths for the reporting week, East (17% decrease) and 29% increase reported in South