COVID-19 transmission dynamics underlying epidemic waves in Kenya

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.

Automated summary

Policy decisions on COVID-19 interventions should take into account local, regional, and national understanding of SARS-CoV-2 transmission. Three epidemic waves have been observed in Kenya, with the first two attributed to differences in contact rates among high and low socioeconomic groups, and the third wave to the introduction of highly transmissible variants. Reopening of schools led to a slight increase in transmission between the second and third waves. Socioeconomic status and urban-rural population structure play critical roles in viral transmission in Kenya.