Looking back two years later: South Africa’s response to the first two COVID-19 waves

A new series examining South Africa’s response to the COVID-19 pandemic is out now in the South African Medical Journal. CHAI South Africa contributed to the publication of the series, which includes six articles covering topics from governance to epidemiology to community-based interventions and recovery efforts.

The following themes are investigated:

The South African government investigates governance response structures between January 2020 and October 2021 and their effectiveness at the height of the pandemic. The paper evaluates South Africa’s response at district, regional, national, and continental inter-governmental levels to prevent disease transmission, detect public health events, and share information and resources.

The second paper looks at the rapid development and implementation of epidemiological surveillance and modeling systems in response to the pandemic. It investigates data systems for monitoring laboratory-confirmed COVID-19 cases, hospitalizations, mortality, and recoveries at national and provincial levels, and how these systems were used to inform public health decisions during the first two waves of COVID-19.

In South Africa, community screening, testing, and tracing were integral to the country’s control strategy against COVID-19. Drawing from a review of available literature and real-time experiences of national and community response teams, the third article highlights areas where community-based case finding, contact tracing, and movement modeling could be used to ensure reduced transmissions and better access to healthcare services.

In health emergencies, effective communication must be immediate, transparent, grounded in science, and delivered through multiple platforms. The South Africa Ministry of Health designed an agile, locally relevant Risk Communication and Community Engagement (RCCE) strategy as the pandemic was unfolding and constantly evaluated its implementation. The fourth article reflects on lessons learned from engagement at district, provincial and national levels, including call centers, government websites, and various social media platforms.

The fifth paper reflects on the Sisonke vaccine study that aimed to assess the effectiveness of a single dose of the Ad26.COV2.S vaccine (Johnson & Johnson) in healthcare workers during two waves of the pandemic in South Africa. Vaccinated healthcare workers 18 years and older were matched for COVID-19 risk in comparison to unvaccinated members of the general population. Vaccine effectiveness against severe COVID-19 was defined as COVID-19-related admission to hospital, hospitalization requiring critical or intensive care, or death, in healthcare workers compared with the general population, ascertained 28 days or more after vaccination or matching, up to data cutoff.

The final paper reviews the impact of COVID-19 on essential health services and explores the strategies the South African health sector needs to implement to recover and strengthen the resilience of the health system against future health shocks.

CHAI contributing authors: Elizabeth Leonard, Shadrack Mngemane, Marang Matlala, Phyllis Chituku, Tumisho Langa, and Professor Yogan Pillay.

Download the series