Cryptic transmission of SARS-CoV-2 in Washington State
Dr. Keith R. Jerome and Dr. Trevor Bedford describe the silent spread of the novel coronavirus, SARS-CoV-2 in Washington state in January and February of 2020. While the first death in the United States was thought to be in Washington state, the viral evolution and results to date (April 25, 2020) have shown deaths in California prior to the case in Washington. The analysis described in this publication reveals that the exponential doubling and spread to be as short as 2 days. It also underscores the importance of early detection and surveillance sampling for respiratory pathogens.
More information on Dr. Jerome’s research focus can be found here.
AUTHORS: Bedford T, Greninger AL, Roychoudhury P, Lea M Starita, Famulare M, Huang M, Nalla A, Pepper G, Reinhardt A, Xie H, Shrestha L, Nguyen TN, Adler A, Brandstetter E, Cho S, Giroux D, Peter D Han, Fay K, Frazar CD, Ilcisin M, Lacombe K, Lee J, Kiavand A, Richardson M, Sibley TR, Truong M, Wolf CR, Nickerson DA, Rieder MJ, Englund JA, Hadfield J, Hodcroft EB, Huddleston J, Moncla LH, Müller NF, Neher RA, Deng X, Gu W, Federman S, Chiu C, Duchin J, Gautom R, Melly G, Hiatt B, Dykema P, Lindquist S, Queen K, Tao Y, Uehara A, Tong S, MacCannell D, Armstrong GL, Baird GS, Chu HY, Shendure J, Jerome KR.
2020. medRxiv: 2020.04.02.20051417.
ABSTRACT: Following its emergence in Wuhan, China, in late November or early December 2019, the SARS-CoV-2 virus has rapidly spread throughout the world. On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic. Genome sequencing of SARS-CoV-2 strains allows for the reconstruction of transmission history connecting these infections. Here, we analyze 346 SARS-CoV-2 genomes from samples collected between 20 February and 15 March 2020 from infected patients in Washington State, USA. We found that the large majority of SARS-CoV-2 infections sampled during this time frame appeared to have derived from a single introduction event into the state in late January or early February 2020 and subsequent local spread, strongly suggesting cryptic spread of COVID-19 during the months of January and February 2020, before active community surveillance was implemented. We estimate a common ancestor of this outbreak clade as occurring between 18 January and 9 February 2020. From genomic data, we estimate an exponential doubling between 2.4 and 5.1 days. These results highlight the need for large-scale community surveillance for SARS-CoV-2 introductions and spread and the power of pathogen genomics to inform epidemiological understanding.