School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China.
Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in the Universities of Shandong, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China.
Nature. 2021 Dec;600(7889):408-418. doi: 10.1038/s41586-021-04188-6. Epub 2021 Dec 8.
Since the first cases of COVID-19 were documented in Wuhan, China in 2019, the world has witnessed a devastating global pandemic, with more than 238 million cases, nearly 5 million fatalities and the daily number of people infected increasing rapidly. Here we describe the currently available data on the emergence of the SARS-CoV-2 virus, the causative agent of COVID-19, outline the early viral spread in Wuhan and its transmission patterns in China and across the rest of the world, and highlight how genomic surveillance, together with other data such as those on human mobility, has helped to trace the spread and genetic variation of the virus and has also comprised a key element for the control of the pandemic. We pay particular attention to characterizing and describing the international spread of the major variants of concern of SARS-CoV-2 that were first identified in late 2020 and demonstrate that virus evolution has entered a new phase. More broadly, we highlight our currently limited understanding of coronavirus diversity in nature, the rapid spread of the virus and its variants in such an increasingly connected world, the reduced protection of vaccines, and the urgent need for coordinated global surveillance using genomic techniques. In summary, we provide important information for the prevention and control of both the ongoing COVID-19 pandemic and any new diseases that will inevitably emerge in the human population in future generations.
自 2019 年中国武汉首次记录到 COVID-19 病例以来,全球经历了一场破坏性极强的大流行,确诊病例超过 2.38 亿例,死亡人数接近 500 万,感染人数每天都在迅速增加。在此,我们描述了目前关于 COVID-19 病原体 SARS-CoV-2 病毒的出现的数据,概述了该病毒在武汉的早期传播及其在中国和世界其他地区的传播模式,并强调了基因组监测如何与人类流动等其他数据一起,帮助追踪病毒的传播和遗传变异,并成为控制大流行的关键要素。我们特别关注描述和表征于 2020 年底首次发现的 SARS-CoV-2 主要关切变异株的国际传播,并表明病毒进化已进入一个新阶段。更广泛地说,我们强调我们目前对自然界中冠状病毒多样性的认识有限、病毒及其变异在这样一个日益互联的世界中的快速传播、疫苗保护作用的降低,以及迫切需要使用基因组技术进行协调的全球监测。总之,我们为预防和控制当前的 COVID-19 大流行以及未来人类必然会出现的任何新疾病提供了重要信息。