{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:05:25Z","timestamp":1784736325774,"version":"3.55.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Gauteng province was at the epicentre of the COVID-19 pandemic in South Africa. An understanding of the experiences of survivors in this setting has the potential to inform South Africa\u2019s preparedness and response in future pandemics. We aimed to explore the experiences of survivors via a qualitative study conducted in Tshwane and Sedibeng districts, Gauteng. One-on-one interviews were conducted on 20 purposefully sampled survivors and carers. Analysis was guided by the framework methods. An explanatory model was developed using the social ecological model. As a result, eight major themes emerged from the study and included participants\u2019 awareness and diagnosis of their illness, personal attitudes, quarantine and home care, in-hospital care, psychosocial support, illness outcomes, COVID-19 aftermath, and returning to normal life. The study findings revealed experiences that were intense and filled with morbid thoughts, fraught with physical and emotional challenges, highlighted the need for psychosocial support, and exposed the vulnerabilities and inadequacies of the current South African health system. These experiences implicate several individual, family\/communal, health systems, and policy\/government level gaps that warrant strengthening for better preparedness for future pandemics.<\/jats:p>","DOI":"10.1093\/heapro\/daag096","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:55:50Z","timestamp":1783684550000},"source":"Crossref","is-referenced-by-count":0,"title":["Experiences of COVID-19 survivors in Gauteng province, South Africa: socioecological implications for South Africa\u2019s preparedness for future pandemics"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3257-0329","authenticated-orcid":false,"given":"Doudou K","family":"Nzaumvila","sequence":"first","affiliation":[{"name":"Family Medicine and Primary Health Care Department, Sefako Makgatho Health Sciences University , PO BOX 60, Medunsa, 0204 Pretoria ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-2683","authenticated-orcid":false,"given":"Joel M","family":"Francis","sequence":"additional","affiliation":[{"name":"Family Medicine Department, University of the Witwatersrand , Private Bag 3 Wits, 2050 Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indiran","family":"Govender","sequence":"additional","affiliation":[{"name":"Family Medicine and Primary Health Care Department, Sefako Makgatho Health Sciences University , PO BOX 60, Medunsa, 0204 Pretoria ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4621-1378","authenticated-orcid":false,"given":"Olufemi B","family":"Omole","sequence":"additional","affiliation":[{"name":"Family Medicine Department, University of the Witwatersrand , Private Bag 3 Wits, 2050 Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"2026072211485215000_daag096-B1","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/safp.v64i1.5341","article-title":"Preparedness level of frontline healthcare professionals in Tshwane regarding the COVID-19 pandemic","volume":"64","author":"Bongongo","year":"2022","journal-title":"S Afr Fam Pract"},{"key":"2026072211485215000_daag096-B2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00425-9","article-title":"Underestimated COVID-19 mortality in WHO African region","volume":"10","author":"Bradshaw","year":"2022","journal-title":"Lancet Glob Health"},{"key":"2026072211485215000_daag096-B3","first-page":"37","volume-title":"Readings on the Development of Children","author":"Bronfenbrenner","year":"1993","edition":"2nd ed"},{"key":"2026072211485215000_daag096-B4","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"2026072211485215000_daag096-B5","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1016\/S0140-6736(20)30154-9","article-title":"A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster","volume":"395","author":"Chan","year":"2020","journal-title":"Lancet"},{"key":"2026072211485215000_daag096-B6","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.jinf.2020.03.004","article-title":"Clinical progression of patients with COVID-19 in Shanghai, China","volume":"80","author":"Chen","year":"2020","journal-title":"J Infect"},{"key":"2026072211485215000_daag096-B7","volume-title":"Qualitative Inquiry and Research Design: Choosing Among Five Approaches","author":"Creswell","year":"2018","edition":"4th ed."},{"key":"2026072211485215000_daag096-B8","doi-asserted-by":"publisher","first-page":"6694","DOI":"10.3390\/ijerph19116694","article-title":"COVID-19 vaccine hesitancy in South Africa: lessons for future pandemics","volume":"19","author":"Engelbrecht","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026072211485215000_daag096-B9","doi-asserted-by":"publisher","first-page":"S50","DOI":"10.3949\/ccjm.91.s1.08","article-title":"Meeting the challenge of vaccine hesitancy","volume":"91","author":"Goje","year":"2024","journal-title":"Cleve Clin J Med"},{"key":"2026072211485215000_daag096-B10","doi-asserted-by":"publisher","first-page":"2061","DOI":"10.46743\/2160-3715\/2021.5011","article-title":"Using framework analysis in applied qualitative research","volume":"26","author":"Goldsmith","year":"2021","journal-title":"Qual Rep"},{"key":"2026072211485215000_daag096-B11","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1016\/j.sapharm.2020.04.013","article-title":"Community pharmacists: on the frontline of health service against COVID-19 in LMICs","volume":"17","author":"Hedima","year":"2021","journal-title":"Res Social Adm Pharm"},{"key":"2026072211485215000_daag096-B12","doi-asserted-by":"publisher","first-page":"155","DOI":"10.47102\/annals-acadmedsg.202043","article-title":"Mental health strategies to combat the psychological impact of coronavirus disease 2019 (COVID-19) beyond paranoia and panic","volume":"49","author":"Ho","year":"2020","journal-title":"Ann Acad Med"},{"key":"2026072211485215000_daag096-B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2020.102430","article-title":"Post COVID-19 pandemic mental health challenges","volume":"53","author":"Kathirvel","year":"2020","journal-title":"Asian J Psychiatr"},{"key":"2026072211485215000_daag096-B14","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.24038","article-title":"Psychosocial stress, adult suicidal ideation, and the mediating effect of poor sleep quality during the COVID-19 pandemic in South Africa","volume":"36","author":"Kim","year":"2024","journal-title":"Am J Hum Biol"},{"key":"2026072211485215000_daag096-B15","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1002\/jmv.25678","article-title":"Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle","volume":"92","author":"Lu","year":"2020","journal-title":"J Med Virol"},{"key":"2026072211485215000_daag096-B16","unstructured":"Lumivero\n          . (2023). NVivo Version 14 [Computer software]. https:\/\/lumivero.com\/products\/nvivo\/ (30 May 2026, last date accessed)."},{"key":"2026072211485215000_daag096-B17","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: guided by information power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual Health Res"},{"key":"2026072211485215000_daag096-B18","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/safp.v66i1.5988","article-title":"COVID-19 vaccine hesitancy among unvaccinated individuals in a primary care setting, Pretoria","volume":"66","author":"Moeti","year":"2024","journal-title":"S Afr Fam Pract"},{"key":"2026072211485215000_daag096-B19","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20043651","article-title":"Factors affecting access to public healthcare facilities in the City of Tshwane, South Africa","volume":"20","author":"Moeti","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2026072211485215000_daag096-B20","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-56334-5","article-title":"The impact understanding of exosome therapy in COVID-19 and preparations for the future approaches in dealing with infectious diseases and inflammation","volume":"14","author":"Nasiri","year":"2024","journal-title":"Sci Rep"},{"key":"2026072211485215000_daag096-B21","author":"National Institute for Communicable Diseases (NICD)"},{"key":"2026072211485215000_daag096-B22","doi-asserted-by":"publisher","DOI":"10.1080\/17482631.2023.2247622","article-title":"Exploring the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa: a descriptive phenomenological study","volume":"18","author":"Nxumalo","year":"2023","journal-title":"Int J Qual Stud Health Well-being"},{"key":"2026072211485215000_daag096-B23","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1117464","article-title":"Long COVID-19: a review and proposed visualization of the complexity of long COVID-19","volume":"14","author":"Perumal","year":"2023","journal-title":"Front Immunol"},{"key":"2026072211485215000_daag096-B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcsop.2023.100336","article-title":"Patient care and customer services during the COVID-19 pandemic at accredited pharmacies: pharmacists and patients\u2019 perspectives","volume":"12","author":"Phanudulkitti","year":"2023","journal-title":"Explor Res Clin Soc Pharm"},{"key":"2026072211485215000_daag096-B25","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1041459","article-title":"Universal health coverage evolution, ongoing trend, and future challenge: a conceptual and historical policy review","volume":"11","author":"Ranabhat","year":"2023","journal-title":"Front Public Health"},{"key":"2026072211485215000_daag096-B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2020.102433","article-title":"The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak","volume":"109","author":"Rothan","year":"2020","journal-title":"J Autoimmun"},{"key":"2026072211485215000_daag096-B27","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13398","article-title":"The effect of quarantine and isolation for COVID-19 in general population and dermatologic treatments","volume":"33","author":"Sharma","year":"2020","journal-title":"Dermatol Ther"},{"key":"2026072211485215000_daag096-B28","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1007\/s40847-020-00133-x","article-title":"Pandemic resilience and health systems preparedness: lessons from COVID-19 for the twenty-first century","volume":"23","author":"Sundararaman","year":"2021","journal-title":"J Soc Econ Dev"},{"key":"2026072211485215000_daag096-B29","doi-asserted-by":"publisher","DOI":"10.4102\/sajid.v38i1.571","article-title":"After action review of the COVID-19 pandemic response in North West province, South Africa","volume":"38","author":"Tumbo","year":"2023","journal-title":"S Afr J Infect Dis"},{"key":"2026072211485215000_daag096-B30","volume-title":"MAXQDA 24\u2014Qualitative Data Analysis Software","author":"VERBI Software","year":"2023"},{"key":"2026072211485215000_daag096-B31","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1016\/S0140-6736(21)02796-3","article-title":"Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020\u201321","volume":"399","author":"Wang","year":"2022","journal-title":"Lancet"},{"key":"2026072211485215000_daag096-B32","volume-title":"Critical Preparedness, Readiness and Response Actions for COVID-19: Interim Guidance, 22 March 2020","author":"World Health Organization"}],"container-title":["Health Promotion International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/41\/4\/daag096\/69793084\/daag096.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/41\/4\/daag096\/69793084\/daag096.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:48:59Z","timestamp":1784735339000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapro\/article\/doi\/10.1093\/heapro\/daag096\/8739883"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/heapro\/daag096","relation":{},"ISSN":["0957-4824","1460-2245"],"issn-type":[{"value":"0957-4824","type":"print"},{"value":"1460-2245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,1]]},"article-number":"daag096"}}