Over the course of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the clinical, scientific, and public health communities have had to respond to new viral genetic variants. Each one has triggered a flurry of media attention, a range of reactions from the scientific community, and calls from governments to either “stay calm” or pursue immediate countermeasures. While many scientists were initially skeptical about the significance of the D614G alteration, the emergence of the new “UK variant”—lineage B.1.1.7—has raised widespread concern. Understanding which variants are concerning, and why, requires an appreciation of virus evolution and the genomic epidemiology of SARS-CoV-2.
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Corresponding Author: Adam S. Lauring, MD, PhD, Division of Infectious Diseases, Department of Internal Medicine and Department of Microbiology and Immunology, University of Michigan, 1150 W Medical Center Dr, MSRB1 5510B, Ann Arbor, MI 48109-5680 (firstname.lastname@example.org).
Published Online: January 6, 2021. doi:10.1001/jama.2020.27124
Correction: This article was corrected on February 15, 2021, to fix the heading “Spike N453Y and Mink” to the correct substitution of Y453F.
Conflict of Interest Disclosures: Dr Lauring reported receiving personal fees from Sanofi as a consultant on oseltamivir and influenza and personal fees from Roche as a member of a steering committee for a clinical trial of baloxavir and influenza, outside the submitted work. No other disclosures were reported.
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