Libya COVID-19 Surveillance Weekly Bulletin: Epidemiological Week 46 (15 – 21 Nov)

Situation Report
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• After a decreasing trend since mid-August 2021, case and death incidence rates in the country have begun to plateau.
At the national level, Libya has stabilised cases and COVID-19 testing in the last two weeks, with a moderate to a high incidence of community transmission and adequate lab testing capacity.

• 30 COVID-19 labs (out of 40) reported 27,624 (27,035 PCR and 589 Ag-RDT) new lab tests done in Epi-week 46. Thus, out of the 1,897,015 tests in Libya since the beginning of the response, 368,392 (19.4%) were confirmed positive for SARS-CoV-2 (COVID-19).

• Compared to Epi-week 45, there was a 0.9% increase in overall national testing: by regions, West (4% increase), East (31% decrease) and South (63% decrease). Thus, 95.3% (26,324) of national testing was performed in the West as compared to both East (only 1206 tests) and South (only 94 tests) Regions. (-see fig. 1). The decrease in East is attributable to low reporting of cases by RRTs and constraints in lab supplies in all districts in the East. In the South, testing was only done in Sabha and Aljufra in the last three weeks due to the above reasons.

• The national positivity rate for Epi-week remained stable after a decreasing trend since week 28. It decreased from 12.9% in week 45 to 11.4 in week 46, in the West, with a positivity rate of 10.9%. It cannot be generalised based on the positivity rate in the East (20.9%) and South (25.5%), 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 51.80 in week 45 to 46.32 in week 46. The overall number of new cases reported in EPID week 46 shows an 11% decrease (3,155 cases) from 3,528 cases last week, with West reporting a 4% decrease in new patients. East reported a 40% decrease, and South had a 77% decrease in cases.

• In Epi-week 46, the number of new deaths (83) showed a 7% decrease compared to last week (89). As a result, the mortality rate decreased from 1.31 to 1.2 deaths per 100,000 cases, with a case fatality rate of 2.6%. However, the CFR remained high in the East (16.7), showing increased disease severity. Compared to last week, West reported an 8% increase in deaths for the reporting week, East (9% decrease) and no deaths reported in South (- see table 1).

• Libya remains classified under moderate to high community transmission (CT2 - CT3) with Alpha, Beta and Delta Variants of Concern (VOC) circulation. Verification request ongoing regarding Delta VOC presence in Libya by EMRO through IHR National Focal Point.