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The COVID-19 pandemic presented challenges for qualitative researchers since many countries had to implement lockdown policies to control the spread of the virus. Within the South African context, research on sexual minority identities and experiences is automatically sensitive and risky given the extent of intolerance and high regard for heteronormative ideologies and beliefs that continually exclude sexual minorities from the "normal." The sensitivity is intensified during a national lockdown since there is an excessive reliance on digital public spaces to recruit participants and conduct interviews. Based on the experience of Ph.D. fieldwork, this paper pays attention to a sexuality researcher's experience of conducting research on gay men's experiences in the South African military and police services during a national lockdown. Particular attention is given to the dilemmas posed by the government's restriction on physical movement and reliance on digital spaces, particularly social media to identify gay men who work in the two organizations and form virtual relationships of mutual trust. Ultimately, this paper holds that reflexivity is critical to feminist research on vulnerable sexual minorities when the relationships between the researcher and the researched are established and maintained through digital platforms. While digital spaces offer opportunities to reach vulnerable populations, they present some challenges that may compromise the credibility of the study if not identified by the researcher. [ABSTRACT FROM AUTHOR]

The devastation of the Covid-19 pandemic on society raised the question of how best to gauge society's psychological adaptation to continually evolving global disruptor events, such as Covid-19. This paper aims to illustrate the use of different approaches to monitor society's psychological response to Covid-19, in order to argue for a more comprehensive, multi-model, approach. The results from different approaches are presented in two studies employing measures of mental disorders and mental distress, respectively, using South African samples for demonstration. The first study presents findings from repeat administration of measures of common mental disorders (major depressive and generalized anxiety disorders) across three consecutive years, while the second study presents findings from mood response profiles (measured with the Brunel Mood Scale) collected across five time points during the Covid-19 pandemic. Both studies showed that the Covid-19 pandemic was temporally associated with adverse mental health outcomes across the mental health continuum, and that mental health profiles were associated with both time since onset of Covid-19 and subsequent wave occurrence. Elevated prevalence of common mental disorders, as well as fluctuating patterns of mood response profiles, are discussed against the context of Covid-19. The paper concludes that a multi-modal approach, for instance measuring specific mental disorders as well as more general mental distress, is crucial to comprehensively understand society's psychological adaptation to major disruptor events, and guide health sector responses. The paper serves as a reminder to continue to observe mental health more inclusively to appropriately respond to the psychological needs of communities. Plain Language Summary: Measuring mental health across Covid-19 waves The impact of Covid-19 on mental health raised the question of how can we best measure how society adapts, psychologically, to major events that disrupt life. This article looked at two specific ways to measure and monitor society's psychological response to Covid-19. The first study looked at the prevalence of mental disorders, and the second looked at levels of mental distress. Both studies used South African samples to demonstrate this. The first study presented data from a repeat administration of scales that identify depressive and anxiety disorders, completed across three consecutive years. The second study presented findings from mood response profiles (measured with the Brunel Mood Scale) collected across five time points during the Covid-19 pandemic. The results showed that the pandemic was associated with adverse mental health outcomes—across the mental health continuum—and that mental health profiles were associated with both time since the start of Covid-19 and fluctuated with the subsequent waves across the pandemic time-line. This article demonstrated the importance of using a multi-modal approach to fully understand society's psychological response to major life disruptions. It also acted as reminder to monitor mental health continuously to be able to respond to the psychological needs of communities. [ABSTRACT FROM AUTHOR]

In this paper, we explored how vulnerable, immunocompromised groups and caregivers of the elderly experienced and perceived the onset of the Covid-19 pandemic in South Africa. Semi-structured interviews were conducted remotely between the 5th andthe 18th of April 2020 in the three South African provinces hardest hit by Covid-19, namely Gauteng, KwaZulu-Natal and the Western Cape. In total, 60 qualitative key informant interviews and one focus group discussion were conducted. Study participants expressed concerns for elderly people and people with underlying health conditions because of their increased vulnerability to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). People living with HIV expressed an increased fear of infection following the advent of the Covid-19 pandemic in South Africa. The sidelining of healthcare services and stock-outs of medication proved to be an added concern in particular for vulnerable and immunocompromised groups. Overall, the data suggest that the fear of infection is ubiquitous for people who live in unstable environments such as overcrowded townships and informal settlements. Given the increased fears of infection brought on by the Covid-19 pandemic, the mental health of vulnerable communities and those caring for them becomes an added burden for people living in unstable environments. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) has developed into a pandemic. Data-driven techniques can be used to inform and guide public health decision- and policy-makers. In generalizing the spread of a virus over a large area, such as a province, it must be assumed that the transmission occurs as a stochastic process. It is therefore very difficult for policy and decision makers to understand and visualize the location specific dynamics of the virus on a more granular level. A primary concern is exposing local virus hot-spots, in order to inform and implement non-pharmaceutical interventions. A hot-spot is defined as an area experiencing exponential growth relative to the generalised growth of the pandemic. This paper uses the first and second waves of the COVID-19 epidemic in Gauteng Province, South Africa, as a case study. The study aims provide a data-driven methodology and comprehensive case study to expose location specific virus dynamics within a given area. The methodology uses an unsupervised Gaussian Mixture model to cluster cases at a desired granularity. This is combined with an epidemiological analysis to quantify each cluster's severity, progression and whether it can be defined as a hot-spot. [ABSTRACT FROM AUTHOR]

COVID-19 ushered in public health guidelines restricting face-to-face contact and movement, and encouraging social distancing, all of which had implications for conducting field-based research during the pandemic. For qualitative researchers, this meant adapting conventional face-to-face methods and resorting to virtual variations of the same in adherence to stipulated COVID-19 health protocols. Virtual qualitative research introduced new concerns and logistical challenges. This paper presents critical reflections on experiences of conducting qualitative research during the pandemic, from the perspectives of a cohort of postgraduate fellows. A critical reflection framework was utilised to explore fellows experiences and meanings ascribed to their experiences. The research findings illustrate three overarching processes which, in turn, shaped ways of thinking, doing and being. First, explicating tacit assumptions about their anticipated research journeys and interrogating these. Second, shifts in power differentials demonstrated by role reversal between researchers and participants, and between fellows and supervisors as they re-negotiated their positionalities in virtual research spaces. Third, context specific sense-making, in which - narrative accounts support the notion of knowledge as a social construct. Our findings have important implications for qualitative research practice. Our study documents methodological nuances and social implications of conducting qualitative research during COVID-19 and in a-South African context. In addition, our study exemplifies the use of critical reflection in qualitative research practice in the specific context of postgraduate academic research. Further, our study illustrates how the use of technology shapes qualitative research protocol development, data collection and analysis phases. [ABSTRACT FROM AUTHOR]

COVID-19 ushered in public health guidelines restricting face-to-face contact and movement, and encouraging social distancing, all of which had implications for conducting field-based research during the pandemic. For qualitative researchers, this meant adapting conventional face-to-face methods and resorting to virtual variations of the same in adherence to stipulated COVID-19 health protocols. Virtual qualitative research introduced new concerns and logistical challenges. This paper presents critical reflections on experiences of conducting qualitative research during the pandemic, from the perspectives of a cohort of postgraduate fellows. A critical reflection framework was utilised to explore fellows experiences and meanings ascribed to their experiences. The research findings illustrate three overarching processes which, in turn, shaped ways of thinking, doing and being. First, explicating tacit assumptions about their anticipated research journeys and interrogating these. Second, shifts in power differentials demonstrated by role reversal between researchers and participants, and between fellows and supervisors as they re-negotiated their positionalities in virtual research spaces. Third, context specific sense-making, in which - narrative accounts support the notion of knowledge as a social construct. Our findings have important implications for qualitative research practice. Our study documents methodological nuances and social implications of conducting qualitative research during COVID-19 and in a-South African context. In addition, our study exemplifies the use of critical reflection in qualitative research practice in the specific context of postgraduate academic research. Further, our study illustrates how the use of technology shapes qualitative research protocol development, data collection and analysis phases. [ABSTRACT FROM AUTHOR]

This paper provides a brief literature review on the church role in socio-economic transformation in South Africa and employs costly signalling theory to approach religious participation in philanthropy as means to attain fulfilment and meaning in life. Article argues that philanthropy should be broadened to seriously consider the role of religious practices and commitment to charity and highlights the need to reconsider philanthropy not just as institutional corporate social responsibility, but as collective generosity and giving which takes various forms in the African context which takes the role of religion seriously. Challenging paternalistic notions of philanthropy, the paper also notes that despite the waning commitment to traditional practices of hospitality, care and kindness towards the needy which traditionally underpinned Christian mission, recent responses to challenges posed by the COVID-19 revived the African spirit of hospitality and argues that there is a need to re-think philanthropy in the light of various forms of African hospitality as reflected in the traditional practices of religious communities. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) has highlighted the scope of heroin dependence and need for evidence-based treatment amongst marginalised people in South Africa. Acute opioid withdrawal management without maintenance therapy carries risks of increased morbidity and mortality. Due to the high costs of methadone, Tshwane's Community Oriented Substance Use Programme (COSUP) used tramadol for opioid withdrawal management during the initial COVID-19 response. Aim: To describe demographics, route of heroin administration and medication-related experiences amongst people accessing tramadol for treatment of opioid withdrawal. Setting: Three community-based COSUP sites in Mamelodi (Tshwane, South Africa). Methods: A retrospective cross-sectional study was conducted. Data were collected using an interviewer-administered paper-based tool between April and August 2020. Descriptive statistics were used to analyse data. Results: Of the 220 service users initiated onto tramadol, almost half (n = 104, 47%) were not contactable. Fifty-eight (26%) people participated, amongst whom most were male (n = 55, 95%). Participants' median age was 32 years. Most participants injected heroin (n = 36, 62.1%). Most participants experienced at least one side effect (n = 47, 81%) with 37 (64%) experiencing two or more side effects from tramadol. Insomnia occurred most frequently (n = 26, 45%). One person without a history of seizures experienced a seizure. Opioid withdrawal symptoms were experienced by 54 participants (93%) whilst taking tramadol. Over half (n = 38, 66%) reported using less heroin whilst on tramadol. Conclusion: Tramadol reduced heroin use but was associated with withdrawal symptoms and unfavourable side effects. Findings point to the limitations of tramadol as opioid withdrawal management to retain people in care and the importance of access to first-line opioid agonists. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) declared the COVID-19 pandemic a public health emergency of international concern. South Africa, like many other countries, initiated a multifaceted national response to the pandemic. Self-isolation and quarantine are essential components of the public health response in the country. This paper examined perceptions and preparedness for self-isolation or quarantine during the initial phase of the pandemic in South Africa.Methods: The analysis used data obtained from an online quantitative survey conducted in all nine provinces using a data-free platform. Descriptive statistics and multivariable logistic regression models were used to analyse the data.Results: Of 55,823 respondents, 40.1% reported that they may end up in self-isolation or quarantine, 32.6% did not think that they would and 27.4% were unsure. Preparedness for self-isolation or quarantine was 59.0% for self, 53.8% for child and 59.9% for elderly. The odds of perceived possibility for self-isolation or quarantine were significantly higher among Coloureds, Whites, and Indians/Asians than Black Africans, and among those with moderate or high self-perceived risk of contracting COVID-19 than those with low risk perception. The odds were significantly lower among older age groups than those aged 18-29 years, and those unemployed than fully employed. The odds of preparedness for self-isolation or quarantine were significantly less likely among females than males. Preparedness for self, child and elderly isolation or quarantine was significantly more likely among other population groups than Black Africans and among older age groups than those aged 18-29 years. Preparedness for self, child and elderly isolation or quarantine was significantly less likely among those self-employed than fully employed and those residing in informal dwellings than formal dwellings. In addition, preparedness for self-isolation or quarantine was significantly less likely among those with moderate and high self-perceived risk of contracting COVID-19 than low risk perception.Conclusion: The findings highlight the challenge of implementing self-isolation or quarantine in a country with different and unique social contexts. There is a need for public awareness regarding the importance of self-isolation or quarantine as well as counter measures against contextual factors inhibiting this intervention, especially in impoverished communities. [ABSTRACT FROM AUTHOR]

• The early COVID-19 epidemic in South Africa was highly heterogeneous looking at the epidemiological progression between major provinces. • Early transmission in KwaZulu-Natal (KZN) was associated with multiple international introductions of SARS-CoV-2. • The dominating lineages during this time of the epidemic were B.1 and B, which mainly originated from Europe. • Evidence for transmission clusters during the first month of the epidemic suggested locally acquired infection. • A clustered outbreak was linked to a major hospital outbreak in Durban, which inflated the early mortality in KZN. The Network for Genomic Surveillance in South Africa (NGS-SA) was formed to investigate the introduction and understand the early transmission dynamics of the SARS-CoV-2 epidemic in South-Africa. This paper presents the first results from this group, which is a molecular epidemiological study of the first 21 SARS-CoV-2 whole genomes sampled in the first port of entry – KwaZulu-Natal (KZN) – during the first month of the epidemic. By combining this with calculations of the effective reproduction number (R), it aimed to shed light on the patterns of infections in South Africa. Two of the largest provinces – Gauteng and KZN – had a slow growth rate for the number of detected cases, while the epidemic spread faster in the Western Cape and Eastern Cape. The estimates of transmission potential suggested a decrease towards R = 1 since the first cases and deaths, but a subsequent estimated R average of 1.39 between 6–18 May 2020. It was also demonstrated that early transmission in KZN was associated with multiple international introductions and dominated by lineages B1 and B. Evidence for locally acquired infections in a hospital in Durban within the first month of the epidemic was also provided. The COVID-19 pandemic in South Africa was very heterogeneous in its spatial dimension, with many distinct introductions of SARS-CoV2 in KZN and evidence of nosocomial transmission, which inflated early mortality in KZN. The epidemic at the local level was still developing and NGS-SA aimed to clarify the dynamics in South Africa and devise the most effective measures as the outbreak evolved. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) has resulted in an enormous dislocation of society especially in South Africa. The South African government has imposed a number of measures aimed at controlling the pandemic, chief being a nationwide lockdown. This has resulted in income loss for individuals and firms, with vulnerable populations (low earners, those in informal and precarious employment, etc.) more likely to be adversely affected through job losses and the resulting income loss. Income loss will likely result in reduced ability to access healthcare and a nutritious diet, thus adversely affecting health outcomes. Given the foregoing, we hypothesize that the economic dislocation caused by the coronavirus will disproportionately affect the health of the poor. Methods: Using the fifth wave of the National Income Dynamics Study (NIDS) dataset conducted in 2017 and the first wave of the NIDS-Coronavirus Rapid Mobile Survey (NIDS-CRAM) dataset conducted in May/June 2020, this paper estimated income-related health inequalities in South Africa before and during the COVID-19 pandemic. Health was a dichotomized self-assessed health measure, with fair and poor health categorized as "poor" health, while excellent, very good and good health were categorized as "better" health. Household per capita income was used as the ranking variable. Concentration curves and indices were used to depict the income-related health inequalities. Furthermore, we decomposed the COVID-19 era income-related health inequality in order to ascertain the significant predictors of such inequality. Results: The results indicate that poor health was pro-poor in the pre-COVID-19 and COVID-19 periods, with the latter six times the value of the former. Being African (relative to white), per capita household income and household experience of hunger significantly predicted income-related health inequalities in the COVID-19 era (contributing 130%, 46% and 9% respectively to the inequalities), while being in paid employment had a nontrivial but statistically insignificant contribution (13%) to health inequality. Conclusions: Given the significance and magnitude of race, hunger, income and employment in determining socioeconomic inequalities in poor health, addressing racial disparities and hunger, income inequality and unemployment will likely mitigate income-related health inequalities in South Africa during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Aim/Purpose The paper's objective is to examine the challenges of using the mobile phone to mine location data for effective contact tracing of symptomatic, pre-symptomatic, and asymptomatic individuals and the implications of this technology for public health governance. Background: The COVID-19 crisis has created an unprecedented need for contact tracing across South Africa, requiring thousands of people to be traced and their details captured in government health databases as part of public health efforts aimed at breaking the chains of transmission. Contact tracing for COVID-19 requires the identification of persons who may have been exposed to the virus and following them up daily for 14 days from the last point of exposure. Mining mobile phone location data can play a critical role in locating people from the time they were identified as contacts to the time they access medical assistance. In this case, it aids data flow to various databases designated for COVID-19 work. Methodology: The researchers conducted a review of the available literature on this subject drawing from academic articles published in peer-reviewed journals, research reports, and other relevant national and international government documents reporting on public health and COVID-19. Document analysis was used as the primary research method, drawing on the case studies. Contribution: Contact tracing remains a critical strategy in curbing the deadly COVID-19 pandemic in South Africa and elsewhere in the world. However, given increasing concern regarding its invasive nature and possible infringement of individual liberties, it is imperative to interrogate the challenges related to its implementation to ensure a balance with public governance. The research findings can thus be used to inform policies and practices associated with contact tracing in South Africa. Findings: The study found that contact tracing using mobile phone location data mining can be used to enforce quarantine measures such as lockdowns aimed at mitigating a public health emergency such as COVID-19. However, the use of technology can expose the public to criminal activities by exposing their locations. From a public governance point of view, any exposure of the public to social ills is highly undesirable. Recommendations for Practitioners: In using contact tracing apps to provide pertinent data location caution needs to be exercised to ensure that sensitive private information is not made public to the extent that it compromises citizens' safety and security. The study recommends the development and implementation of data use protocols to support the use of this technology, in order to mitigate against infringement of individual privacy and other civil liberties. Recommendations for Researchers: Researchers should explore ways of improving digital applications in order to improve the acceptability of the use of contact tracing technology to manage pandemics such as COVID-19, paying attention to ethical considerations. Impact on Society: Since contact tracing has implications for privacy and confidentiality it must be conducted with caution. This research highlights the challenges that the authorities must address to ensure that the right to privacy and confidentiality is upheld. Future Research: Future research could focus on collecting primary data to provide insight on contact tracing through mining mobile phone location data. Research could also be conducted on how app-based technology can enhance the effectiveness of contact tracing in order to optimize testing and tracing coverage. This has the potential to minimize transmission whilst also minimizing tracing delays. Moreover, it is important to develop contact tracing apps that are universally interoperable and privacy-preserving. [ABSTRACT FROM AUTHOR]