@article{f44d8c050d684a2a8f60ab14d5944965,
title = "Context-specific emergence and growth of the SARS-CoV-2 Delta variant",
abstract = "The SARS-CoV-2 Delta (Pango lineage B.1.617.2) variant of concern spread globally, causing resurgences of COVID-19 worldwide1,2. The emergence of the Delta variant in the UK occurred on the background of a heterogeneous landscape of immunity and relaxation of non-pharmaceutical interventions. Here we analyse 52,992 SARS-CoV-2 genomes from England together with 93,649 genomes from the rest of the world to reconstruct the emergence of Delta and quantify its introduction to and regional dissemination across England in the context of changing travel and social restrictions. Using analysis of human movement, contact tracing and virus genomic data, we find that the geographic focus of the expansion of Delta shifted from India to a more global pattern in early May 2021. In England, Delta lineages were introduced more than 1,000 times and spread nationally as non-pharmaceutical interventions were relaxed. We find that hotel quarantine for travellers reduced onward transmission from importations; however, the transmission chains that later dominated the Delta wave in England were seeded before travel restrictions were introduced. Increasing inter-regional travel within England drove the nationwide dissemination of Delta, with some cities receiving more than 2,000 observable lineage introductions from elsewhere. Subsequently, increased levels of local population mixing-and not the number of importations-were associated with the faster relative spread of Delta. The invasion dynamics of Delta depended on spatial heterogeneity in contact patterns, and our findings will inform optimal spatial interventions to reduce the transmission of current and future variants of concern, such as Omicron (Pango lineage B.1.1.529).",
keywords = "COVID-19/epidemiology, Cities/epidemiology, Contact Tracing, England/epidemiology, Genome, Viral/genetics, Humans, Quarantine/legislation & jurisprudence, SARS-CoV-2/genetics, Travel/legislation & jurisprudence",
author = "{The COVID-19 Genomics UK (COG-UK) Consortium} and McCrone, {John T} and Verity Hill and Sumali Bajaj and Pena, {Rosario Evans} and Lambert, {Ben C} and Rhys Inward and Samir Bhatt and Erik Volz and Christopher Ruis and Simon Dellicour and Guy Baele and Zarebski, {Alexander E} and Adam Sadilek and Neo Wu and Aaron Schneider and Xiang Ji and Jayna Raghwani and Ben Jackson and Rachel Colquhoun and {\'A}ine O'Toole and Peacock, {Thomas P} and Kate Twohig and Simon Thelwall and Gavin Dabrera and Richard Myers and Faria, {Nuno R} and Carmen Huber and Bogoch, {Isaac I} and Kamran Khan and {du Plessis}, Louis and Barrett, {Jeffrey C} and Aanensen, {David M} and Barclay, {Wendy S} and Meera Chand and Thomas Connor and Loman, {Nicholas J} and Suchard, {Marc A} and Pybus, {Oliver G} and Andrew Rambaut and Kraemer, {Moritz U G} and Matthew Bashton and Darren Smith and Andrew Nelson and Young, {Gregory R.} and Clare McCann",
note = "Matthew Bashton, Andrew Nelson, Clare McCann, Greg Young and Darren Smith are members of the COVID-19 Genomics UK consortium. COG-UK is supported by funding from the Medical Research Council (MRC) part of UK Research and Innovation (UKRI), the National Institute of Health Research (NIHR) (grant code: MC_PC_19027), and Genome Research Limited, operating as the Wellcome Sanger Institute. M.U.G.K. acknowledges support from a Branco Weiss Fellowship, Reuben College Oxford, Google.org, the Foreign, Commonwealth and Development Office and Wellcome (225288/Z/22/Z), and The Rockefeller Foundation. S.D. and M.U.G.K. acknowledge support from the European Union Horizon 2020 project MOOD (grant agreement number 874850). O.G.P., M.U.G.K., L.d.P. and A.E.Z. acknowledge support from the Oxford Martin School. V.H. was supported by the Biotechnology and Biological Sciences Research Council (BBSRC) (grant number BB/M010996/1). S.D. is supported by the Fonds National de la Recherche Scientifique (FNRS) (Belgium). J.T.M., R.C. and A.R. acknowledge support from the Wellcome Trust (Collaborators Award 206298/Z/17/Z—ARTIC network). A.R. is also supported by the European Research Council (grant agreement number 725422—ReservoirDOCS) and Bill and Melinda Gates Foundation (OPP1175094—HIV-PANGEA II). C.R. was supported by a Fondation Botnar Research Award (programme grant 6063). G.B. acknowledges support from the Research Foundation—Flanders (Fonds voor Wetenschappelijk Onderzoek—Vlaanderen) (G0E1420N and G098321N) and from the Interne Fondsen KU Leuven (Internal Funds KU Leuven) under grant agreement C14/18/094. A.O. is supported by the Wellcome Trust Hosts, Pathogens and Global Health Programme (grant number 203783/Z16/Z) and Fast Grants (award number 2236). S. Bajaj is supported by the Clarendon Scholarship, University of Oxford and NERC DTP (grant number NE/S007474/1). M.A.S. acknowledges support from US National Institutes of Health grant R01 AI153044. X.J. acknowledges support from US National Institutes of Health grant U19 AI135995. T.P.P. and W.S.B. acknowledge support from the G2P–UK National Virology Consortium funded by the MRC (MR/W005611/1). I.I.B. is supported by the Canadian Institutes of Health Research (grant 02179-000). N.R.F. acknowledges support from the Wellcome Trust and Royal Society Sir Henry Dale Fellowship (204311/Z/16/Z), Bill and Melinda Gates Foundation (INV-034540), the Medical Research Council-Sao Paulo Research Foundation (FAPESP) CADDE partnership award (MR/S0195/1 and FAPESP 18/14389-0) and the MRC Centre for Global Infectious Disease Analysis (reference MR/R015600/1). E.V. acknowledges support from the Wellcome Trust (220885/Z/20/Z). The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views of the European Commission or any of the other funders.",
year = "2022",
month = oct,
day = "6",
doi = "10.1038/s41586-022-05200-3",
language = "English",
volume = "610",
pages = "154--160",
journal = "Nature",
issn = "0028-0836",
publisher = "Nature Publishing Group",
number = "7930",
}