It has been over a year since the World Health Organisation (WHO) declared COVID-19 a pandemic. During this time, we have with ease, but sometimes with difficulty, adjusted to the new norm of working remotely while ensuring at all costs that we save lives and livelihoods. There have been areas of hope during this time. We have seen innovations in delivering public services, as new collaborations have forged new and better ways of managing the pandemic. Sadly, there have also been areas of despair, with the public sector struggling to roll out vaccines at the pace required to save lives. We have also witnessed cases of malpractice, maladministration and outright corruption during this time. A characteristic of these two diametrically opposed phenomena of hope and despair is the calibre of leadership. Good leaders inspire hope in the renewal and recovery of a post-COVID-19 world, while abysmal leadership engenders despair and a breakdown in public service provision processes. For Stoller (2020), the pandemic is an opportunity to reflect on leading healthcare through a crisis, cataloguing best practices, and cascading these leadership practices broadly. In this Editorial, we reflect on these diametrically opposed cases of hope and of despair.