Early introductions and community transmission of SARS-CoV-2 variant B.1.1.7 in the United States

Alpert, Tara; Lasek-Nesselquist, Erica; Brito, Anderson F.; Valesano, Andrew L.; Rothman, Jessica; MacKay, Matthew J.; Petrone, Mary E.; Breban, Mallery I.; Watkins, Anne E.; Vogels, Chantal B.F.; Russell, Alexis; Kelly, John P.; Shudt, Matthew; Plitnick, Jonathan; Schneider, Erasmus; Fitzsimmons, William J.; Khullar, Gaurav; Metti, Jessica; Dudley, Joel T.; Nash, Megan; Wang, Jianhui; Liu, Chen; Hui, Pei; Muyombwe, Anthony; Downing, Randy; Razeq, Jafar; Bart, Stephen M.; Murphy, Steven; Neal, Caleb; Laszlo, Eva; Landry, Marie L.; Cook, Peter W.; Fauver, Joseph R.; Mason, Christopher E.; Lauring, Adam S.; St. George, Kirsten; MacCannell, Duncan R.; Grubaugh, Nathan D.

The emergence and spread of SARS-CoV-2 lineage B.1.1.7, first detected in the United Kingdom, has become a national public health concern in the United States because of its increased transmissibility. Over 500 COVID-19 cases associated with this variant have been detected since December 2020, but its local establishment and pathways of spread are relatively unknown. Using travel, genomic, and diagnostic testing data, we highlight the primary ports of entry for B.1.1.7 in the US and locations of possible underreporting of B.1.1.7 cases. New York, which receives the most international travel from the UK, is likely one of the key hubs for introductions and domestic spread. Finally, we provide evidence for increased community transmission in several states. Thus, genomic surveillance for B.1.1.7 and other variants urgently needs to be enhanced to better inform the public health response.