Background: On the 5th of March 2020, South Africa reported its first case of COVID-19. This signaled 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). This study investigated the impact of NPIs and the COVID-19 testing, reporting, hospitalised cases, and excess deaths in the first COVID-19 epidemic wave in South Africa.

Methods: To investigate the COVID-19 transmissions and impact of NPIs in South Africa, a semi-reactive COVID-19 SEIR model (the ARI COVID-19 SEIR Model) was used. Linear regression analysis was performed to determine the COVID-19 hospital admission status, discharge rate, case fatality rate, and the cumulative age-adjusted death risk ratio.

Findings: Due to implemented NPIs, the effective SARS-CoV-2 daily contact number in the first COVID-19 epidemic wave in South Africa was reduced by 58.1-71.1 % while the peak was delayed by 84 days. The estimated reproductive number was between 1.98 to 0.40. The estimated mean South African COVID-19 patient discharge rate was 11.9 days per patient. While the estimated mean of the South African COVID-19 patient case fatality rate (CFR) in hospitals and outside the hospital was 2.06 %, 95% CI [1.86,2.25] and 2.30 %, 95% CI [1.12,3.83] respectively.

Conclusions: The COVID-19 NPI policies implemented by the Government of South Africa played a significant role in the reduction of COVID-19 active, hospitalised cases and deaths in South first COVID-19 epidemic wave.

Keywords: COVD-19, NPIs, Epidemiology, Modelling, SEIR, South Africa, Africa, Policy

Abbreviations: Confidence Interval (CI), SEIR (Susceptible-Exposed-Infected-Recovered)