Libya COVID-19 Surveillance Weekly Bulletin: Epidemiological Week 29 (19 - 25 July)

Situation Report
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• 29 COVID-19 labs (out of 32) reported 32,091 new lab tests done in Epi-week 29. Thus, out of the total 1,265,555 tests in Libya since the beginning of the response, 236,961 (18.7%) were confirmed positive for SARS-CoV-2 (COVID-19).

• Libya has seen a sharp rise in the number of new cases between Week 25 and Week 28: from 246/day to 2486/day, and weekly attack rates rise from 25.1/100,000 to 253.3/100,000. On the other hand, cases declined during week 29 (Eid week) to an average of 1,708/day, mainly due to decreased testing due to holidays.

• Compared to Epi-week 28, there was a 32% decrease in overall national testing: by regions, West (31% decrease), South (42% decrease) and East (48% decrease). Thus, 97.3% (32,091) of national testing was performed in the West as compared to both East (only 269 tests) and South (only 607 tests) Regions. (-see fig. 1)

• There is an increase in the number of tests from 3.1/1000 to 6.7/1000 between weeks 25 and 28. It decreased to 4.2/1000 in Eid week, and the positivity ratio: 8.1% to 37.5% between weeks 25 and 29. The national positivity rate for Epi-week 2 has decreased to 37.5%, which mainly represents the West with a positivity rate of 36.9%. It cannot be generalized based on the positivity rate in the East (34.9%) and South (72%), which differ markedly from the nationallevel positivity rate. National numbers of cases, deaths and lab tests are skewed to West.

• The overall number of new cases reported in EPID week 29 shows a 34% decrease (12,041 cases) compared to the prior week (18,151 cases), with West reporting a 34% decrease in new patients. East reported a 26% decrease, and South a 22% decrease 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 five weeks and remain an underestimate for East and South due to insufficient tested numbers in general and specifically the Eid week. 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 25 and 29 from 2/day to 13/day. In Epi-week 29, the number of new deaths (99) showed a 77% increase compared to last week. As a result, the mortality rate increased to 1.5 deaths per 100,000 cases, with a case fatality rate of 0.8%.

• As compared to last week, West reported a 71% increase in deaths for the reporting week, East (no increase) and 160% increase reported in South (- see table 1)

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

• As a part of PHSM, Libya has suspended schools and universities as of July 11th, 2021. Summer resorts, parks and public gardens have also been closed in some municipalities until further notice. As of July 8th, 2021, borders with Tunisia have remained closed. In addition, GNU has officially issued a curfew from 6 pm to 6 am starting on July 27th, 2021, for two weeks in Tripoli, central and western regions.