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SARS-CoV-2 Variants of Concern in the United States—Challenges and Opportunities

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

On January 10, 2020, the first genomic sequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated from a patient in Wuhan, China, was posted online. As of February 3, 2021, 468 000 sequences of SARS-CoV-2 from COVID-19 cases globally have been uploaded into publicly available databases, including more than 93 000 from individuals in the US. SARS-CoV-2, like other RNA viruses, constantly changes through mutation, with new variants occurring over time. Generally, when new variants become more common, they do so because of some selective advantage to the virus. Among the numerous SARS-CoV-2 variants that have been detected, only a very small proportion are of public health concern because they are more transmissible, cause more severe illness, or can elude the immune response that develops following infection and possibly from vaccination. In the recent months, 3 specific viral lineages reflecting variants of concern have emerged and merit close monitoring: B.1.1.7, B.1.351, and P.1.

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Article Information

Corresponding Author: Henry T. Walke, MD, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333 (hfw3@cdc.gov).

Published Online: February 17, 2021. doi:10.1001/jama.2021.2294

Conflict of Interest Disclosures: None reported.

References
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World Health Organization. Weekly epidemiological update—2 February 2021. Accessed February 5, 2021. https://www.who.int/publications/m/item/weekly-epidemiological-update---2-february-2021
2.
Faria  NR , Claro  IM , Candido  D ,  et al. Genomic characterisation of an emergent SARS-CoV-2 lineage in Manaus: preliminary findings. Virological.org. Published January 12, 2021. Accessed January 31, 2021. https://virological.org/t/genomic-characterisation-of-an-emergent-sars-cov-2-lineage-in-manaus-preliminary-findings/586
3.
Horby  P , Huntley  C , Davies  N ,  et al. NERVTAG note on B.1.1.7 severity. Paper presented at: SAGE meeting report; January 21, 2021. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/955239/NERVTAG_paper_on_variant_of_concern__VOC__B.1.1.7.pdf
4.
Wibmer  CK , Ayres  F , Hernamus  T ,  et al.  SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma.   BioRxiv. Preprint published online January 19, 2021. doi:10.1101/2021.01.18.427166Google Scholar
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Wang  P , Liu  L , Iketani  S ,  et al.  Increased resistance of SARS-CoV-2 variants B.1.351 and B.1.1.7 to antibody neutralization.   BioRxiv. Preprint published online January 26, 2021. doi:10.1101/2021.01.25.428137Google Scholar
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Galloway  SE , Paul  P , MacCannell  DR ,  et al.  Emergence of SARS-CoV-2 B.1.1.7 lineage—United States, December 29, 2020-January 12, 2021.   MMWR Morb Mortal Wkly Rep. 2021;70(3):95-99. doi:10.15585/mmwr.mm7003e2 PubMedGoogle ScholarCrossref
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Washington  NL , Gangavarapu  K , Zeller  M ,  et al.  Genomic epidemiology identifies emergence and rapid transmission of SARS-CoV-2 B.1.1.7 in the United States.   medRxiv. Preprint published online February 7, 2021. doi:10.1101/2021.02.06.21251159Google Scholar
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9.
Mwenda  M , Saasa  N , Sinyange  N ,  et al.  Detection of B.1.351 SARS-CoV-2 variant strain—Zambia, December 2020.   MMWR Morb Mortal Wkly Rep. Published online February 17, 2021. doi:10.15585/mmwr.mm7008e2Google Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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