Libya COVID-19 Surveillance Weekly Bulletin: Epidemiological Week 28 (12 - 18 July 2021)

Situation Report
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• Libya has seen a sharp rise in the number of new cases between Week 25 and Week 27: from 246/day to 1,293/day (425% increase), and weekly attack rates rise from 25.1/100,000 to 131.7/100,000.

• 29 COVID-19 labs (out of 32) reported 46,864 new lab tests done in Epi-week 28. Thus, out of the total 1,233,464 tests in Libya since the beginning of the response, 224,920 (18.2%) were confirmed positive for SARS-CoV-2 (COVID-19).

• Compared to Epi-week 27, there was a 44% increase in overall national testing: by regions, West (44% increase), South (88% increase) and East (0.4% decrease). Thus, 96.7% (45,310) of national testing was performed in the West as compared to both East (only 516 tests) and South (only 1038 tests)
Regions. (-see fig. 1).

• There has been an increase in the number of tests from 3.1/1000 to 4.3/1000, and positivity ratio: 8.1% to 33.6% between weeks 25 and 27. The national positivity rate for Epi-week 28 has increased) to 38.7%, which mainly represents the West with a positivity rate of 38.5%. It cannot be generalized based on the positivity rate in the East (24.6%) and South (53.8%) than the national-level positivity rate. Due to low lab testing and positive cases in East and South, national numbers have now skewed to data of the West.

• The overall number of new cases reported in EPID week 28 shows a 66% increase (18,151 cases) compared to the prior week (10,945 cases), with West reporting a 65% increase in new patients. East reported a 20% increase, and South a 106% increase in the number of cases. Although the lab testing remains a limiting factor in East and South, cases numbers have significantly increased in the last three weeks 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, Libya has not reported an official confirmation of the Delta variant. Delta is suspected because of its circulation in neighbouring Tunisia.

• There has been an increase in deaths between Weeks 22 and 27 from 51/day to 144/day. In Epi-week 28, the number of new deaths (56) showed an 87% increase compared to last week. As a result, the mortality rate increased to 0.8 deaths per 100,000 cases, with a case fatality rate of 0.3%.

• As compared to last week, West reported a 133% increase in deaths for the reporting week, East (100% increase) and 38% decrease reported in South (- see table 1)

• Libya remains classified under community transmission with the circulation of Alpha and Beta Variants of Concern (VOC).