Dispersal Patterns and Influence of Air Travel During the Global Expansion of SARS-CoV-2 Variants of Concern

07 June 2023


Houriiyah Tegally, Eduan Wilkinson, Joseph L.-H. Tsui, Monika Moir, Darren Martin, Anderson Fernandes Brito, Marta Giovanetti, Kamran Khan, Carmen Huber, Isaac I. Bogoch, James Emmanuel San, Jenicca Poongavanan, Joicymara S. Xavier, Darlan da S. Candido, Filipe Romero, Cheryl Baxter, Oliver G. Pybus, Richard Lessells, Nuno R. Faria, Moritz U.G. Kraemer & Tulio de Oliveira

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The Alpha, Beta and Gamma SARS-CoV-2 Variants of Concern (VOCs) co-circulated globally during 2020-21, fueling waves of infections. They were displaced by Delta during a third wave worldwide in 2021, in turn displaced by Omicron in late 2021. In this study, we use phylogenetic and phylogeographic methods to reconstruct the dispersal patterns of VOCs worldwide. We find that source-sink dynamics varied substantially by VOC, and identify countries that acted as global and regional hubs of dissemination. We demonstrate a declining role of presumed origin countries of VOCs to their global dispersal, estimating that India contributed <15% of Delta exports and South Africa <1-2% of Omicron dispersal. We estimate that >80 countries had received introductions of Omicron within 100 days of emergence, associated with accelerating passenger air travel and higher transmissibility. Our study highlights the rapid dispersal of highly transmissible variants with implications for genomic surveillance along the hierarchical airline network.