On 5 March 2020, South Africa recorded its first case of
imported COVID-19. Since then, cases in South Africa
have increased exponentially with significant community
transmission. A multisectoral approach to containing and
mitigating the spread of SARS-CoV-2 was instituted, led
by the South African National Department of Health. A
National COVID-19 Command Council was established to
take government-wide decisions. An adapted World Health
Organiszion (WHO) COVID-19 strategy for containing and
mitigating the spread of the virus was implemented by the
National Department of Health. The strategy included the
creation of national and provincial incident management
teams (IMTs), which comprised of a variety of work
streams, namely, governance and leadership; medical
supplies; port and environmental health; epidemiology
and response; facility readiness and case management;
emergency medical services; information systems; risk
communication and community engagement; occupational
health and safety and human resources. The following
were the most salient lessons learnt between March and
September 2020: strengthened command and control were
achieved through both centralised and decentralised IMTs;
swift evidenced-based decision-making from the highest
political levels for instituting lockdowns to buy time to
prepare the health system; the stringent lockdown enabled
the health sector to increase its healthcare capacity.
Despite these successes, the stringent lockdown measures
resulted in economic hardship particularly for the most
vulnerable sections of the population.
