This article explores the perceptions of COVID-19 among faith communities in north-eastern DR Congo and their intersection with public health responses to disease outbreaks. In a situation of a political and economic insecurity and significant unaddressed health needs, faith communities have a strong trusted public presence and offer resilience in the face of political insecurity, limited state intervention and outbreaks of disease. Semi-structured interviews of members, leaders and medical professionals from seven faith communities in Ituri and North-Kivu were analysed using a thematic framework. The article demonstrates that faith communities and their leaders have a range of opinions on the causes of and responses to COVID-19 that illuminate long term trends in a complex faith-health landscape. It identifies that all faith communities have spiritual responses to disease. Some of those responses cohere with public health messages. Others run counter to them. It argues that understanding the nature, range and variability of these perceptions and their impact on public behaviour is valuable to enable those engaged in public health to work with trusted, resilient communities even where their perceptions of disease are contradictory.