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COVID-19 transmission dynamics underlying epidemic waves in Kenya
Science  (IF47.728),  Pub Date : 2021-10-07, DOI: 10.1126/science.abk0414
Samuel P. C. Brand, John Ojal, Rabia Aziza, Vincent Were, Emelda A. Okiro, Ivy K Kombe, Caroline Mburu, Morris Ogero, Ambrose Agweyu, George M. Warimwe, James Nyagwange, Henry Karanja, John N. Gitonga, Daisy Mugo, Sophie Uyoga, Ifedayo M. O. Adetifa, J. Anthony G. Scott, Edward Otieno, Nickson Murunga, Mark Otiende, Lynette I. Ochola-Oyier, Charles N. Agoti, George Githinji, Kadondi Kasera, Patrick Amoth, Mercy Mwangangi, Rashid Aman, Wangari Ng’ang’a, Benjamin Tsofa, Philip Bejon, Matt. J. Keeling, D. James Nokes, Edwine Barasa

Policy decisions on COVID-19 interventions should be informed by a local, regional and national understanding of SARS-CoV-2 transmission. Epidemic waves may result when restrictions are lifted or poorly adhered to, variants with new phenotypic properties successfully invade, or when infection spreads to susceptible sub-populations. 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. Socio-economic and urban/rural population structure are critical determinants of viral transmission in Kenya.