Abstract

COVID-19 transmission dynamics underlying epidemic waves in Kenya

Brand SPC Ojal J Aziza R Were V Okiro EA Kombe IK Mburu C Ogero M Agweyu A Warimwe GM Nyagwange J Karanja H Gitonga JN Mugo D Uyoga S Adetifa IMO 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
Science. 2021;374989-994

Permenent descriptor

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.