COVID-19: lessons and experiences from South Africa’s first surge

Moonasar, Devanand; Pillay, Anban; Leonard, Elizabeth; Naidoo, Rishendran; Mngemane, Shadrack; Ramkrishna, Wayne; Jamaloodien, Khadija; Lebese, Lebogang; Chetty, Kamy; Bamford, Lesley; Tanna, Gaurang; Ntuli, Nhlanhla; Mlisana, Koleka; Madikizela, Lindiwe; Modisenyane, Moeketsi; Engelbrecht, Christie; Maja, Popo; Bongweni, Funeka; Furumele, Tsakani; Mayet, Natalie; Goga, Ameena; Talisuna, Ambrose; Ramadan, Patrick Otim; Pillay, Yogan

doi:10.1136/bmjgh-2020-004393

Cited by 54 publications

(63 citation statements)

References 2 publications

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“…In two countries, Ethiopia and South Africa, the decentralisation of response to the Sub-national (regional) level took a synergistic approach. For instance, in South Africa, the decentralisation of COVID response to provinces, districts, and sub-districts included creating provincial incident management teams (IMTs) akin to those at the national level, which comprised a variety of workstreams that worked in synergy [ 53 ]. Similarly, in Ethiopia, the humanitarian actions were coordinated by the established EOC, and national and regional task forces were established in all regions [ 54 ].…”

Section: Resultsmentioning

confidence: 99%

Coordination mechanisms for COVID-19 in the WHO Regional office for Africa

Nsenga

Oyugi

Ouma³

et al. 2022

BMC Health Serv Res

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Aim This study describes the coordination mechanisms that have been used for management of the COVID 19 pandemic in the WHO AFRO region; relate the patterns of the disease (length of time between onset of coordination and first case; length of the wave of the disease and peak attack rate) to coordination mechanisms established at the national level, and document best practices and lessons learned. Method We did a retrospective policy tracing of the COVID-19 coordination mechanisms from March 2020 (when first cases of COVID-19 in the AFRO region were reported) to the end of the third wave in September 2021. Data sources were from document and Literature review of COVID-19 response strategies, plans, regulations, press releases, government websites, grey and peer-reviewed literature. The data was extracted to Excel file database and coded then analysed using Stata (version 15). Analysis was done through descriptive statistical analysis (using measures of central tendencies (mean, SD, and median) and measures of central dispersion (range)), multiple linear regression, and thematic analysis of qualitative data. Results There are three distinct layered coordination mechanisms (strategic, operational, and tactical) that were either implemented singularly or in tandem with another coordination mechanism. 87.23% (n = 41) of the countries initiated strategic coordination, and 59.57% (n = 28) initiated some form of operational coordination. Some of countries (n = 26,55.32%) provided operational coordination using functional Public Health Emergency Operation Centres (PHEOCs) which were activated for the response. 31.91% (n = 15) of the countries initiated some form of tactical coordination which involved the decentralisation of the operations at the local/grassroot level/district/ county levels. Decentralisation strategies played a key role in coordination, as was the innovative strategies by the countries; some coordination mechanisms built on already existing coordination systems and the heads of states were effective in the success of the coordination process. Financing posed challenge to majority of the countries in initiating coordination. Conclusion Coordinating an emergency is a multidimensional process that includes having decision-makers and institutional agents define and prioritise policies and norms that contain the spread of the disease, regulate activities and behaviour and citizens, and respond to personnel who coordinate prevention.

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Section: Resultsmentioning

confidence: 99%

Coordination mechanisms for COVID-19 in the WHO Regional office for Africa

Nsenga

Oyugi

Ouma³

et al. 2022

BMC Health Serv Res

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“…COVID-19 testing was limited and challenging in South Africa in the initial stages of the COVID-19 pandemic. This was due to the limited supply and global competition for the resources to perform COVID-19 testing such as reagents, equipment and assays [81]. COVID-19 testing increased up to 57 000 tests per day in South Africa in the period of 2020/03/13 to 2020/07/17.…”

Section: South Africa Covid-19 First Epidemic Wave Testingmentioning

confidence: 99%

The Impact of Non-Pharmaceutical Interventions on the First COVID-19 Epidemic Wave in South Africa

Mabuka¹,

Ncube²,

Ross³

et al. 2021

Preprint

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On the 5th of March 2020, South Africa reported its first cases of COVID-19. This signalled the onset of the first COVID-19 epidemic wave in South Africa. The response by the Government of South Africa to the COVID-19 epidemic in South Africa was the use of non-pharmaceutical interventions (NPIs). In this study, a semi-reactive COVID-19 model, the ARI COVID-19 SEIR model, was used to investigate the impact of NPIs in South Africa to understand their effectiveness in the reduction of COVID-19 transmission in the South African population. This study also investigated the COVID-19 testing, reporting, hospitalised cases and excess deaths in the first COVID-19 epidemic wave in South Africa.

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“…On March 5, 2020, South Africa reported its first COVID-19 case, which was followed by the detection of clusters of cases and high rates of community transmission (Moonasar et al . 2021).…”

Section: Introductionmentioning

confidence: 99%

“…On March 5, 2020, South Africa reported its first COVID-19 case, which was followed by the detection of clusters of cases and high rates of community transmission (Moonasar et al 2021). In response to the pandemic, South Africa introduced a stringent set of restrictions, called (level 5) "lockdown" on March 27, 2020, entailing the suspension of all non-essential activities and a complete ban of tobacco and alcohol sales.…”

Section: Introductionmentioning

confidence: 99%

The effect of the COVID-19 lockdown on mental health care use in South Africa: an interrupted time series analysis

Wettstein

Tlali

Joska³

et al. 2022

Preprint

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Aims In March 2020, South Africa introduced a lockdown in response to the COVID-19 pandemic, entailing the suspension of all non-essential activities and a complete ban of tobacco and alcohol sales. We studied the effect of the lockdown on mental health care utilisation rates in private-sector care in South Africa. Methods We did an interrupted time series analysis using insurance claims from January 1, 2017, to June 1, 2020 of beneficiaries 18 years or older from a large private sector medical aid scheme. We calculated weekly outpatient consultation and hospital admission rates for organic mental disorders, substance use disorders, serious mental disorders, depression, anxiety, other mental disorders, any mental disorder, and alcohol withdrawal syndrome. We calculated adjusted odds ratios (OR) for the effect of the lockdown on weekly outpatient consultation and hospital admission rates and the weekly change in rates during the lockdown until June 1, 2020. Results 710,367 persons were followed up for a median of 153 weeks. Hospital admission rates (OR 0.38; 95% CI 0.33-0.44) and outpatient consultation rates (OR 0.74; 95% CI 0.63-0.87) for any mental disorder decreased substantially after the lockdown and did not recover to pre-lockdown levels until June 1, 2020. Health care utilisation rates for alcohol withdrawal syndrome doubled after the introduction of the lockdown, but the statistical uncertainty around the estimates was large (OR 2.24; 95% CI 0.69-7.24). Conclusions Reduced mental health care contact rates during the COVID-19 lockdown likely reflect a substantial unmet need for mental health services with potential long-term consequences for mental health patients and their families. Steps to ensure access and continuity of mental health services during future lockdowns should be considered.

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COVID-19: lessons and experiences from South Africa’s first surge

Cited by 54 publications

References 2 publications

Coordination mechanisms for COVID-19 in the WHO Regional office for Africa

Coordination mechanisms for COVID-19 in the WHO Regional office for Africa

The Impact of Non-Pharmaceutical Interventions on the First COVID-19 Epidemic Wave in South Africa

The effect of the COVID-19 lockdown on mental health care use in South Africa: an interrupted time series analysis

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