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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.

Original publication

DOI

10.1126/science.abk0414

Type

Journal

Science (New York, N.Y.)

Publication Date

11/2021

Volume

374

Pages

989 - 994

Addresses

Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.

Keywords

Humans, Incidence, Seroepidemiologic Studies, Communicable Disease Control, Models, Biological, Social Class, Socioeconomic Factors, Kenya, Epidemics, COVID-19, COVID-19 Nucleic Acid Testing