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Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa

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This manuscript has been peer reviewed and accepted for publication in Nature and is provided in this format here as a response to the exceptional public-health crisis. This accepted manuscript will continue through the processes of copy editing and formatting to publication of a finalized version of record on nature.com. Please note there may be errors present in this version, which may affect the content, and all legal disclaimers apply.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in southern Africa has been characterised by three distinct waves. The first was associated with a mix of SARS-CoV-2 lineages, whilst the second and third waves were driven by the Beta and Delta variants, respectively1–3. In November 2021, genomic surveillance teams in South Africa and Botswana detected a new SARS-CoV-2 variant associated with a rapid resurgence of infections in Gauteng Province, South Africa. Within three days of the first genome being uploaded, it was designated a variant of concern (Omicron) by the World Health Organization and, within three weeks, had been identified in 87 countries. The Omicron variant is exceptional for carrying over 30 mutations in the spike glycoprotein, predicted to influence antibody neutralization and spike function4. Here, we describe the genomic profile and early transmission dynamics of Omicron, highlighting the rapid spread in regions with high levels of population immunity.



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