COVID-19 transmission dynamics underlying epidemic waves in Kenya.
; Ojal, J; Aziza, R; Were, V; Okiro, EA; Kombe, IK; Mburu, C; Ogero, M; Agweyu, A; Warimwe, GM; +23 more...Nyagwange, J; Karanja, H; Gitonga, JN; Mugo, D; Uyoga, S; Adetifa, IM; Scott, JAG; Otieno, E; Murunga, N; Otiende, M; Ochola-Oyier, LI; Agoti, CN; Githinji, G; Kasera, K; Amoth, P; Mwangangi, M; Aman, R; Ng'ang'a, W; Tsofa, B; Bejon, P; Keeling, MJ; Nokes, DJ; Barasa, E and
(2021)
COVID-19 transmission dynamics underlying epidemic waves in Kenya.
Science (New York, N.Y.), 374 (6570).
pp. 989-994.
ISSN 0036-8075
DOI: 10.1126/science.abk0414
Policy decisions on COVID-19 interventions should be informed by a local, regional and national understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Epidemic waves may result when restrictions are lifted or poorly adhered to, variants with new phenotypic properties successfully invade, or infection spreads to susceptible subpopulations. Three COVID-19 epidemic waves have been observed in Kenya. Using a mechanistic mathematical model, we explain the first two distinct waves by differences in contact rates in high and low social-economic groups, and the third wave by the introduction of higher-transmissibility variants. Reopening schools led to a minor increase in transmission between the second and third waves. Socioeconomic and urban–rural population structure are critical determinants of viral transmission in Kenya.
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