AI Article Synopsis
- Despite strict measures to control COVID-19, Sweden faced a severe outbreak as the virus spread undetected, with early cases identified just before community transmission began.
- Researchers analyzed nearly 2,000 respiratory samples and found clades 20A, 20B, and 20C were introduced mainly from Italy and Austria, with clade 20C eventually dominating the outbreak in Sweden.
- The study highlights the importance of early detection and large-scale diagnostics to better prepare for future pandemics, as the delayed response to community transmission contributed to the outbreak's severity.
Article Abstract
BackgroundDespite the unprecedented measures implemented globally in early 2020 to prevent the spread of SARS-CoV-2, Sweden, as many other countries, experienced a severe first wave during the COVID-19 pandemic.AimWe investigated the introduction and spread of SARS-CoV-2 into Sweden.MethodsWe analysed stored respiratory specimens (n = 1,979), sampled 7 February-2 April 2020, by PCR for SARS-CoV-2 and sequenced PCR-positive specimens. Sequences generated from newly detected cases and stored positive specimens February-June 2020 (n = 954) were combined with sequences (Sweden: n = 730; other countries: n = 129,913) retrieved from other sources for Nextstrain clade assignment and phylogenetic analyses.ResultsTwelve previously unrecognised SARS-CoV-2 cases were identified: the earliest was sampled on 3 March, 1 week before recognised community transmission. We showed an early influx of clades 20A and 20B from Italy (201/328, 61% of cases exposed abroad) and clades 19A and 20C from Austria (61/328, 19%). Clade 20C dominated the first wave (20C: 908/1,684, 54%; 20B: 438/1,684, 26%; 20A: 263/1,684, 16%), and 800 of 1,684 (48%) Swedish sequences formed a country-specific 20C cluster defined by a spike mutation (G24368T). At the regional level, the proportion of clade 20C sequences correlated with an earlier weighted mean date of COVID-19 deaths.ConclusionCommunity transmission in Sweden started when mitigation efforts still focused on preventing influx. This created a transmission advantage for clade 20C, likely introduced from ongoing cryptic spread in Austria. Therefore, pandemic preparedness should have a comprehensive approach, including capacity for large-scale diagnostics to allow early detection of travel-related cases and community transmission.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484920 | PMC |
| http://dx.doi.org/10.2807/1560-7917.ES.2024.29.41.2400021 | DOI Listing |
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