Risk communication and community engagement – unlocking the key to South Africa’s response to SARS-CoV-2

Background. COVID-19 has changed the way that governments communicate and engage with citizens. In emergencies, effective communication must be immediate, grounded in science, transparent, easy to understand and in language-appropriate messaging delivered through multiple and varied platforms. For the South African (SA) COVID-19 response, the intent was to design an agile, locally relevant Risk Communication and Community Engagement (RCCE) strategy as the pandemic was unfolding and to constantly evaluate its implementation. Early involvement of communities in the formulation and direction of a risk communication plan is essential to its success. Objective. To outline the significance of the RCCE’s robust communication strategy during the COVID-19 response and the lessons learnt in executing the strategy. Methods. This is a qualitative review of documents and reports generated and utilised by the RCCE Technical Working Group (TWG) and reflects the lessons learnt from discussions and multiple engagements at district, provincial and national levels. The review incorporates lessons learnt from international practice, resource documents from the World Health Organization (WHO), RCCE readiness and response to coronavirus disease, feedback from the Behavioural Science Ministerial Advisory Committee, input from the call centre, website and various established social media platforms. Results. Communication and building trust with multiple stakeholders begin before an outbreak and is a prerequisite to facilitate the timeous flow of information, particularly in the context of a rapidly evolving outbreak of a new disease, where the scientific community does not immediately have all the answers. Initial COVID-19 messages were therefore filled with challenges that ranged from the lack of scientific and epidemiological information to rumours, conspiracy theories and misinformation. The findings validate that empowering communities to act, strengthening public trust and community participation using multiple channels as well as timely responses to rumours and misinformation are important drivers of COVID-19 communication efforts in SA. Communication efforts must be accelerated to translate science into locally relevant languages and the impact of interventions must be measured to appropriately direct limited resources. Conclusion. The risk communication strategy incorporated several key lessons that could be used to improve communication and inform future emergency response communication that is immediate, science-based, transparent, inclusive and encourages community participation.