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Libya COVID-19 Surveillance Monthly Bulletin: Epidemiological Month of October (1 – 7 November)

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• At the national level, Libya reported a minimal change in the trend of cases, deaths and COVID-19 testing in Week 44 compared with Week 43, with a high incidence of community transmission and adequate lab testing capacity.

• 29 COVID-19 labs (out of 40) reported 28,485 (27,813 PCR and 672 Ag-RDT) new lab tests done in Epi-week 44. Thus, out of the 1,842,001tests in Libya since the beginning of the response, 361,709 (19.6%) were confirmed positive for SARS-CoV-2 (COVID-19).

• The total number of COVID-19 Labs increased to 40. To note that the new lab (Al Khums Reference Lab) was reported during this week.

• Compared to Epi-week 43, there was a 0.004% increase in overall national testing: by regions, West (3% increase),
South (43% increase) and East (29% decrease). Thus, 92.7% (26,413) of national testing was performed in the West as compared to both East (only 1946 tests) and South (only 126 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 week 44.

• The national positivity rate for Epi-week remained stable after a decreasing trend since week 28. It decreased from 13.2% in week 43 to 13.1 in week 44, in the West, with a positivity rate of 12.1%. It cannot be generalized based on the positivity rate in the East (25.4%) and South (47.6%), 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 55.05 in week 43 to 54.99 in week 44. The overall number of new cases reported in EPID week 44 shows a 0.1% decrease (3.745 cases) from 3,749 cases last week, with West reporting a 5% increase in new patients. East reported a 27% decrease, and South had a 30% increase in cases.

• In Epi-week 44, the number of new deaths (96) showed a 2% increase compared to last week (94). As a result, the mortality rate increased from 1.38 to 1.41 deaths per 100,000 cases, with a case fatality rate of 2.6%. The CFR remained high in the East (10.9) and South (6.7), showing increased disease severity. Compared to last week, West reported a 15% increase in deaths for the reporting week, East (4% decrease) and 20% decrease reported in South (- see table 1).

• Libya remains classified under the high incidence of community transmission (CT3) with Alpha, Beta and Delta Variants of Concern (VOC) circulation.