Dataset Information

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

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 measures explain the low numbers of recorded COVID-19 cases and deaths in Africa. One of the main aims of control measures is to reduce respiratory pathogen transmission through direct contact with others. In this study, we collect contact data from residents of informal settlements around Nairobi, Kenya, to assess if control measures have changed contact patterns, and estimate the impact of changes on the basic reproduction number (R₀).

Methods

We conducted a social contact survey with 213 residents of five informal settlements around Nairobi in early May 2020, 4 weeks after the Kenyan government introduced enhanced physical distancing measures and a curfew between 7 pm and 5 am. Respondents were asked to report all direct physical and non-physical contacts made the previous day, alongside a questionnaire asking about the social and economic impact of COVID-19 and control measures. We examined contact patterns by demographic factors, including socioeconomic status. We described the impact of COVID-19 and control measures on income and food security. We compared contact patterns during control measures to patterns from non-pandemic periods to estimate the change in R₀.

Results

We estimate that control measures reduced physical contacts by 62% and non-physical contacts by either 63% or 67%, depending on the pre-COVID-19 comparison matrix used. Masks were worn by at least one person in 92% of contacts. Respondents in the poorest socioeconomic quintile reported 1.5 times more contacts than those in the richest. Eighty-six percent of respondents reported a total or partial loss of income due to COVID-19, and 74% reported eating less or skipping meals due to having too little money for food.

Conclusion

COVID-19 control measures have had a large impact on direct contacts and therefore transmission, but have also caused considerable economic and food insecurity. Reductions in R₀ are consistent with the comparatively low epidemic growth in Kenya and other sub-Saharan African countries that implemented similar, early control measures. However, negative and inequitable impacts on economic and food security may mean control measures are not sustainable in the longer term.

SUBMITTER: Quaife M

PROVIDER: S-EPMC7533154 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:The challenges faced by the Global South during the coronavirus disease (COVID-19) pandemic are compounded by the presence of informal settlements, which are typically densely populated and lacking in formalized sanitation infrastructure. Social distancing measures in informal settlements may be difficult to implement due to the density and layout of settlements. This study measures the distance between dwellings in informal settlements in Cape Town to identify the risk of COVID-19 transmission. OBJECTIVE:The aim of this paper is to determine if social distancing measures are achievable in informal settlements in Cape Town, using two settlements as an example. We will first examine the distance between dwellings and their first, second, and third nearest neighbors and then identify clusters of dwellings in which residents would be unable to effectively practice social isolation due to the close proximity of their homes. METHODS:Dwellings in the settlements of Masiphumelele and Klipfontein Glebe were extracted from a geographic information system data set of outlines of all informal dwellings in Cape Town. The distance to each dwelling's first, second, and third nearest neighbors was calculated for each settlement. A social distance measure of 2 m was used (buffer of 1 m, as dwellings less than 2 m apart are joined) to identify clusters of dwellings that are unable to effectively practice social distancing in each settlement. RESULTS:The distance to each dwelling's first 3 nearest neighbors illustrates that the settlement of Masiphumelele is constructed in a denser fashion as compared to the Klipfontein Glebe settlement. This implies that implementing social distancing will likely be more challenging in Masiphumelele than in Klipfontein Glebe. However, using a 2-m social distancing measure, it was demonstrated that large portions of Klipfontein Glebe would also be unable to effectively implement social distancing. CONCLUSIONS:Effectively implementing social distancing may be a challenge in informal settlements due to their density. This paper uses dwelling outlines for informal settlements in the city of Cape Town to demonstrate that with a 2 m measure, effective social distancing will be challenging.

Project description:Countries around the world have taken control measures to mitigate the spread of COVID-19, including Korea. Social distancing is considered an essential strategy to reduce transmission in the absence of vaccination or treatment. While interventions have been successful in controlling COVID-19 in Korea, maintaining the current restrictions incurs great social costs. Thus, it is important to analyze the impact of different polices on the spread of the epidemic. To model the COVID-19 outbreak, we use an extended age-structured SEIR model with quarantine and isolation compartments. The model is calibrated to age-specific cumulative confirmed cases provided by the Korea Disease Control and Prevention Agency (KDCA). Four control measures-school closure, social distancing, quarantine, and isolation-are investigated. Because the infectiousness of the exposed has been controversial, we study two major scenarios, considering contributions to infection of the exposed, the quarantined, and the isolated. Assuming the transmission rate would increase more than 1.7 times after the end of social distancing, a second outbreak is expected in the first scenario. The epidemic threshold for increase of contacts between teenagers after school reopening is 3.3 times, which brings the net reproduction number to 1. The threshold values are higher in the second scenario. If the average time taken until isolation and quarantine reduces from three days to two, cumulative cases are reduced by 60% and 47% in the first scenario, respectively. Meanwhile, the reduction is 33% and 41%, respectively, for rapid isolation and quarantine in the second scenario. Without social distancing, a second wave is possible, irrespective of whether we assume risk of infection by the exposed. In the non-infectivity of the exposed scenario, early detection and isolation are significantly more effective than quarantine. Furthermore, quarantining the exposed is as important as isolating the infectious when we assume that the exposed also contribute to infection.