People with many contacts are important - they are likely to get infected, and likely to infect others.
It turns out that R is proportionatl to the average square of the degree divided by the average degree.
So if average degree doubles, R could grow by a lot more.
These hot-spots exist and infection is very hard to control if it gets in.
Hospitals should have different sections set for COVID-19 patients, and the non-COVID-19 patients should be themselves subdivided into separate cohorts.
But it's complicated.
the counter argument is that if the population is heterogeneous, that means shutdowns are even more effective, so stopping a shutdown gives a large bump to R_eff.