SARS-CoV-2 lineage dynamics in England from September to November 2021: high diversity of Delta sub-lineages and increased transmissibility of AY.4.2
Eales O., Page AJ., de Oliveira Martins L., Wang H., Bodinier B., Haw D., Jonnerby J., Atchison C., Robson SC., Connor TR., Loman NJ., Golubchik T., Nunez RTM., Bonsall D., Rambaut A., Snell LB., Livett R., Ludden C., Corden S., Nastouli E., Nebbia G., Johnston I., Lythgoe K., Torok ME., Goodfellow IG., Prieto JA., Saeed K., Jackson DK., Houlihan C., Frampton D., Hamilton WL., Witney AA., Bucca G., Pope CF., Moore C., Thomson EC., Harrison EM., Smith CP., Rogan F., Beckwith SM., Murray A., Singleton D., Eastick K., Sheridan LA., Randell P., Jackson LM., Ariani CV., Gonçalves S., Fairley DJ., Loose MW., Watkins J., Moses S., Nicholls S., Bull M., Amato R., Smith DL., Aanensen DM., Barrett JC., Aggarwal D., Shepherd JG., Curran MD., Parmar S., Parker MD., Williams C., Glaysher S., Underwood AP., Bashton M., Pacchiarini N., Loveson KF., Byott M., Carabelli AM., Templeton KE., de Silva TI., Wang D., Langford CF., Sillitoe J., Gunson RN., Cottrell S., O’Grady J., Kwiatkowski D., Lillie PJ., Cortes N., Moore N., Thomas C., Burns PJ., Mahungu TW., Liggett S., Beckett AH., Holden MTG., Levett LJ., Osman H., Hassan-Ibrahim MO., Simpson DA., Chand M., Gupta RK., Darby AC., Paterson S., Pybus OG., Volz EM., de Angelis D., Robertson DL., Martincorena I., Aigrain L., Bassett AR., Wong N., Taha Y., Erkiert MJ., Chapman MHS., Dewar R., McHugh MP., Mookerjee S., Aplin S., Harvey M., Sass T., Umpleby H., Wheeler H., McKenna JP., Warne B., Taylor JF., Chaudhry Y., Izuagbe R., Jahun AS., Young GR., McMurray C., McCann CM., Nelson A., Elliott S., Lowe H., Price A., Crown MR., Rey S., Roy S., Temperton B., Shaaban S., Hesketh AR., Laing KG., Monahan IM., Heaney J., Pelosi E., Silviera S., Wilson-Davies E., Fryer H., Adams H., du Plessis L., Johnson R., Harvey WT., Hughes J., Orton RJ., Spurgin LG., Bourgeois Y., Ruis C., O’Toole Á., Gourtovaia M., Sanderson T., Fraser C., Edgeworth J., Breuer J., Michell SL., Todd JA., John M., Buck D., Gajee K., Kay GL., Peacock SJ., Heyburn D., Kitchman K., McNally A., Pritchard DT., Dervisevic S., Muir P., Robinson E., Vipond BB., Ramadan NA., Jeanes C., Weldon D., Catalan J., Jones N., da Silva Filipe A., Williams C., Fuchs M., Miskelly J., Jeffries AR., Oliver K., Park NR., Ash A., Koshy C., Barrow M., Buchan SL., Mantzouratou A., Clark G., Holmes CW., Campbell S., Davis T., Tan NK., Brown JR., Harris KA., Kidd SP., Grant PR., Xu-McCrae L., Cox A., Madona P., Pond M., Randell PA., Withell KT., Williams C., Graham C., Denton-Smith R., Swindells E., Turnbull R., Sloan TJ., Bosworth A., Hutchings S., Pymont HM., Casey A., Ratcliffe L., Jones CR., Knight BA., Haque T., Hart J., Irish-Tavares D., Witele E., Mower C., Watson LK., Collins J., Eltringham G., Crudgington D., Macklin B., Iturriza-Gomara M., Lucaci AO., McClure PC., Carlile M., Holmes N., Moore C., Storey N., Rooke S., Yebra G., Craine N., Perry M., Alikhan N-F., Bridgett S., Cook KF., Fearn C., Goudarzi S., Lyons RA., Williams T., Haldenby ST., Durham J., Leonard S., Davies RM., Batra R., Blane B., Spyer MJ., Smith P., Yavus M., Williams RJ., Mahanama AIK., Samaraweera B., Girgis ST., Hansford SE., Green A., Beaver C., Bellis KL., Dorman MJ., Kay S., Prestwood L., Rajatileka S., Quick J., Poplawski R., Reynolds N., Mack A., Morriss A., Whalley T., Patel B., Georgana I., Hosmillo M., Pinckert ML., Stockton J., Henderson JH., Hollis A., Stanley W., Yew WC., Myers R., Thornton A., Adams A., Annett T., Asad H., Birchley A., Coombes J., Evans JM., Fina L., Gatica-Wilcox B., Gilbert L., Graham L., Hey J., Hilvers E., Jones S., Jones H., Kumziene-Summerhayes S., McKerr C., Powell J., Pugh G., Taylor S., Trotter AJ., Williams CA., Kermack LM., Foulkes BH., Gallis M., Hornsby HR., Louka SF., Pohare M., Wolverson P., Zhang P., MacIntyre-Cockett G., Trebes A., Moll RJ., Ferguson L., Goldstein EJ., Maclean A., Tomb R., Starinskij I., Thomson L., Southgate J., Kraemer MUG., Raghwani J., Zarebski AE., Boyd O., Geidelberg L., Illingworth CJ., Jackson C., Pascall D., Vattipally S., Freeman TM., Hsu SN., Lindsey BB., James K., Lewis K., Tonkin-Hill G., Tovar-Corona JM., Cox M., Abudahab K., Menegazzo M., MEng BEWT., Yeats CA., Mukaddas A., Wright DW., Colquhoun R., Hill V., Jackson B., McCrone JT., Medd N., Scher E., Keatley J-P., Curran T., Morgan S., Maxwell P., Smith K., Eldirdiri S., Kenyon A., Holmes AH., Price JR., Wyatt T., Mather AE., Skvortsov T., Hartley JA., Guest M., Kitchen C., Merrick I., Munn R., Bertolusso B., Lynch J., Vernet G., Kirk S., Wastnedge E., Stanley R., Idle G., Bradley DT., Poyner J., Mori M., Jones O., Wright V., Brooks E., Churcher CM., Fragakis M., Galai K., Jermy A., Judges S., McManus GM., Smith KS., Westwick E., Attwood SW., Bolt F., Davies A., De Lacy E., Downing F., Edwards S., Meadows L., Jeremiah S., Smith N., Foulser L., Charalampous T., Patel A., Berry L., Boswell T., Fleming VM., Howson-Wells HC., Joseph A., Khakh M., Lister MM., Bird PW., Fallon K., Helmer T., McMurray CL., Odedra M., Shaw J., Tang JW., Willford NJ., Blakey V., Raviprakash V., Sheriff N., Williams L-A., Feltwell T., Bedford L., Cargill JS., Hughes W., Moore J., Stonehouse S., Atkinson L., Lee JCD., Shah D., Alcolea-Medina A., Ohemeng-Kumi N., Ramble J., Sehmi J., Williams R., Chatterton W., Pusok M., Everson W., Castigador A., Macnaughton E., Bouzidi KE., Lampejo T., Sudhanva M., Breen C., Sluga G., Ahmad SSY., George RP., Machin NW., Binns D., James V., Blacow R., Coupland L., Smith L., Barton E., Padgett D., Scott G., Cross A., Mirfenderesky M., Greenaway J., Cole K., Clarke P., Duckworth N., Walsh S., Bicknell K., Impey R., Wyllie S., Hopes R., Bishop C., Chalker V., Harrison I., Gifford L., Molnar Z., Auckland C., Evans C., Johnson K., Partridge DG., Raza M., Baker P., Bonner S., Essex S., Murray LJ., Lawton AI., Burton-Fanning S., Payne BAI., Waugh S., Gomes AN., Kimuli M., Murray DR., Ashfield P., Dobie D., Ashford F., Best A., Crawford L., Cumley N., Mayhew M., Megram O., Mirza J., Moles-Garcia E., Percival B., Driscoll M., Ensell L., Lowe HL., Maftei L., Mondani M., Chaloner NJ., Cogger BJ., Easton LJ., Huckson H., Lewis J., Lowdon S., Malone CS., Munemo F., Mutingwende M., Nicodemi R., Podplomyk O., Somassa T., Beggs A., Richter A., Cormie C., Dias J., Forrest S., Higginson EE., Maes M., Young J., Davidson RK., Jackson KA., Turtle L., Keeley AJ., Ball J., Byaruhanga T., Chappell JG., Dey J., Hill JD., Park EJ., Fanaie A., Hilson RA., Yaze G., Lo S., Afifi S., Beer R., Maksimovic J., McCluggage K., Spellman K., Bresner C., Fuller W., Marchbank A., Workman T., Shelest E., Debebe J., Sang F., Zamudio ME., Francois S., Gutierrez B., Vasylyeva TI., Flaviani F., Ragonnet-Cronin M., Smollett KL., Broos A., Mair D., Nichols J., Nomikou K., Tong L., Tsatsani I., O’Brien PS., Rushton S., Sanderson R., Perkins J., Cotton S., Gallagher A., Allara E., Pearson C., Bibby D., Dabrera G., Ellaby N., Gallagher E., Hubb J., Lackenby A., Lee D., Manesis N., Mbisa T., Platt S., Twohig KA., Morgan M., Aydin A., Baker DJ., Foster-Nyarko E., Prosolek SJ., Rudder S., Baxter C., Carvalho SF., Lavin D., Mariappan A., Radulescu C., Singh A., Tang M., Morcrette H., Bayzid N., Cotic M., Balcazar CE., Gallagher MD., Maloney D., Stanton TD., Williamson KA., Manley R., Michelsen ML., Sambles CM., Studholme DJ., Warwick-Dugdale J., Eccles R., Gemmell M., Gregory R., Hughes M., Nelson C., Rainbow L., Vamos EE., Webster HJ., Whitehead M., Wierzbicki C., Angyal A., Green LR., Whiteley M., Betteridge E., Bronner IF., Farr BW., Goodwin S., Lensing SV., McCarthy SA., Quail MA., Rajan D., Redshaw NM., Scott C., Shirley L., Thurston SAJ., Rowe W., Gaskin A., Le-Viet T., Bonfield J., Liddle J., Whitwham A., Ashby D., Barclay W., Taylor G., Cooke G., Ward H., Darzi A., Riley S., Chadeau-Hyam M., Donnelly CA., Elliott P.
Abstract Background Since the emergence of SARS-CoV-2, evolutionary pressure has driven large increases in the transmissibility of the virus. However, with increasing levels of immunity through vaccination and natural infection the evolutionary pressure will switch towards immune escape. Genomic surveillance in regions of high immunity is crucial in detecting emerging variants that can more successfully navigate the immune landscape. Methods We present phylogenetic relationships and lineage dynamics within England (a country with high levels of immunity), as inferred from a random community sample of individuals who provided a self-administered throat and nose swab for rt-PCR testing as part of the REal-time Assessment of Community Transmission-1 (REACT-1) study. During round 14 (9 September–27 September 2021) and 15 (19 October–5 November 2021) lineages were determined for 1322 positive individuals, with 27.1% of those which reported their symptom status reporting no symptoms in the previous month. Results We identified 44 unique lineages, all of which were Delta or Delta sub-lineages, and found a reduction in their mutation rate over the study period. The proportion of the Delta sub-lineage AY.4.2 was increasing, with a reproduction number 15% (95% CI 8–23%) greater than the most prevalent lineage, AY.4. Further, AY.4.2 was less associated with the most predictive COVID-19 symptoms (p = 0.029) and had a reduced mutation rate (p = 0.050). Both AY.4.2 and AY.4 were found to be geographically clustered in September but this was no longer the case by late October/early November, with only the lineage AY.6 exhibiting clustering towards the South of England. Conclusions As SARS-CoV-2 moves towards endemicity and new variants emerge, genomic data obtained from random community samples can augment routine surveillance data without the potential biases introduced due to higher sampling rates of symptomatic individuals.