The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements

• DOI: 10.1101/2020.06.06.20122689
• Publication Date: 2020-06-07T14:15:13Z
• Authors: Matthew Quaife; Kevin van Zandvoort; Amy Gimma; Kashvi Shah; Nicky McCreesh; Kiesha Prem; Edwine Barasa; Daniel Mwanga; Beth Kangwana; Jessie Pinchoff; ; W. John Edmunds; Christopher I Jarvis; Karen Austrian
• Keywords: Kenya; Human settlement; Curfew; Social distance; Pandemic; Contact tracing

Abstract Background Many low- and middle-income countries have implemented control measures against coronavirus disease 2019 (COVID-19). However, it is not clear to what extent these explain the low numbers of recorded COVID-19 cases deaths in Africa. One main aims reduce respiratory pathogen transmission through direct contact with others. In this study we collect data from residents informal settlements around Nairobi, Kenya assess if changed patterns, estimate impact changes on basic reproduction number ( R 0 ). Methods We conducted a social survey 213 five Nairobi early May 2020, four weeks after Kenyan government introduced enhanced physical distancing curfew between 7pm 5am. Respondents were asked report all non-physical contacts made previous day, alongside questionnaire asking about economic measures. examined patterns by demographic factors, including socioeconomic status. described income food security. compared during non-pandemic periods change . Findings that reduced contacts, reducing 2.6 0.5 0.7, depending pre-COVID-19 comparison matrix used. Masks worn at least one person 92% contacts. poorest quintile reported 1.5 times more than those richest. 86% respondents total or partial loss due COVID-19, 74% eating less skipping meals having too little money for food. Interpretation had large therefore transmission, but also caused considerable insecurity. Reductions are consistent linear epidemic growth other sub-Saharan African similar, negative inequitable impacts security may mean sustainable longer term. Research context Evidence before PubMed search 6 June 2020 no language restrictions studies published since inception, using terms (“social mix*” OR “social cont*” “contact pattern*) AND (“covid*”). The yielded 53 articles, two which first Wuhan Shanghai, second UK. found examining Africa, disaggregating Added value This under Africa primary data. moves beyond existing work i) measure densely populated settlements, ii) explore how vary across status, iii) areas. Implications evidence substantially transmission. People lower status face greater risk as they Control led insecurity, be long term without efforts burden households.