Genomic Surveillance for SARS-CoV-2 Variants: Delta and Omicron

Genomic Surveillance for SARS-CoV-2 Variants: Predominance of the Delta (B.1.617.2) and Omicron (B.1.1.529) Variants

United States, June 2021-January 2022

Anastasia S. Lambrou, PhD; Philip Shirk, PhD; Molly K. Steele, PhD; Prabasaj Paul, PhD; Clinton R. Paden, PhD; Betsy Cadwell, MSPH; Heather E. Reese, PhD; Yutaka Aoki, PhD; Norman Hassell, MS; Xiao-yu Zheng, PhD; Sarah Talarico, PhD; Jessica C. Chen, PhD; M. Steven Oberste, PhD; Dhwani Batra, MS, MBA; Laura K. McMullan, PhD; Alison Laufer Halpin, PhD; Summer E. Galloway, PhD; Duncan R. MacCannell, PhD; Rebecca Kondor, PhD; John Barnes, PhD; Adam MacNeil, PhD; Benjamin J. Silk, PhD; Vivien G. Dugan, PhD; Heather M. Scobie, PhD; David E. Wentworth, PhD

Disclosures

Morbidity and Mortality Weekly Report. 2022;71(6):206-211. 

In This Article

Abstract and Introduction

Introduction

Genomic surveillance is a critical tool for tracking emerging variants of SARS-CoV-2 (the virus that causes COVID-19), which can exhibit characteristics that potentially affect public health and clinical interventions, including increased transmissibility, illness severity, and capacity for immune escape. During June 2021–January 2022, CDC expanded genomic surveillance data sources to incorporate sequence data from public repositories to produce weighted estimates of variant proportions at the jurisdiction level and refined analytic methods to enhance the timeliness and accuracy of national and regional variant proportion estimates. These changes also allowed for more comprehensive variant proportion estimation at the jurisdictional level (i.e., U.S. state, district, territory, and freely associated state). The data in this report are a summary of findings of recent proportions of circulating variants that are updated weekly on CDC's COVID Data Tracker website to enable timely public health action.The SARS-CoV-2 Delta (B.1.617.2 and AY sublineages) variant rose from 1% to >50% of viral lineages circulating nationally during 8 weeks, from May 1–June 26, 2021. Delta-associated infections remained predominant until being rapidly overtaken by infections associated with the Omicron (B.1.1.529 and BA sublineages) variant in December 2021, when Omicron increased from 1% to >50% of circulating viral lineages during a 2-week period. As of the week ending January 22, 2022, Omicron was estimated to account for 99.2% (95% CI = 99.0%–99.5%) of SARS-CoV-2 infections nationwide, and Delta for 0.7% (95% CI = 0.5%–1.0%). The dynamic landscape of SARS-CoV-2 variants in 2021, including Delta- and Omicron-driven resurgences of SARS-CoV-2 transmission across the United States, underscores the importance of robust genomic surveillance efforts to inform public health planning and practice.

*These authors contributed equally to this report.
Estimates on CDC COVID Data Tracker may vary slightly from those in this report because the estimates were calculated on different days. https://covid.cdc.gov/covid-data-tracker/#variant-proportions
§ https://www.cdc.gov/coronavirus/2019-ncov/variants/spheres.html
https://www.aphl.org/programs/preparedness/Crisis-Management/COVID-19-Response/Pages/Sequence-Based-Surveillance-Submission.aspx
**Sequence tagging allows for sequencing partners to tag or label randomly sampled SARS-CoV-2 sequences submitted via GISAID EpiCov and NCBI GenBank to be used in CDC genomic surveillance estimates. https://www.aphl.org/programs/preparedness/Crisis-Management/Documents/Technical-Assistance-for-Categorizing-Baseline-Surveillance-Update-Oct2021.pdf
††A consensus sequence is produced by aligning SARS-CoV-2 nucleotide sequences produced through sequencing a sample and then determining the most common nucleotide at each position. It is an interoperable genomic surveillance unit that can be combined from laboratory sources.
§§ https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/variant-surveillance/variant-info.html
¶¶ https://github.com/CDCgov/SARS-CoV-2_Genomic_Surveillance
***Flagged estimates are presented with a note indicating they might be less reliable. https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf
†††CIs show uncertainty around an estimate describing observed data; prediction intervals show uncertainty around predictions of unobserved data, such as the nowcast variant proportions.
§§§45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. Sect.241(d); 5 U.S.C.0 Sect.552a; 44 U.S.C. Sect. 3501 et seq.
¶¶¶Sequences are first excluded if they are not assigned a PANGO lineage, and then are filtered to include only human hosts and U.S.-specific sequences. This pool of sequences is then deduplicated, and finally, sequences with invalid state names, laboratory sources, and weights are dropped.
****Predominance refers to a variant accounting for >50% of national circulating SARS-CoV-2 lineages among infections.
†††† Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont; Region 2: New Jersey, New York, Puerto Rico, and U.S. Virgin Islands; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas; Region 7: Iowa, Kansas, Missouri, and Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming; Region 9: American Samoa, Arizona, California, Guam, Hawaii, Marshall Islands, Nevada, Northern Mariana Islands, Federated States of Micronesia, and Palau, Region 10: Alaska, Idaho, Oregon, and Washington.

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