Science brief: Omicron (B.1.1.529) variant. Paediatric hospitalisations due to COVID-19 during the first SARS-CoV-2 omicron (B.1.1.529) variant wave in South Africa: a multicentre observational study. Feb 24 2022;386(8):713-723. doi:10.1056/NEJMoa2117995, Price AM, Olson SM, Newhams MM, et al. BMC Public Health. An infected person can transmit of SARS-CoV-2 before the onset of symptoms. MMWR Morb Mortal Wkly Rep. Mar 4 2022;71(9):335-340. doi:10.15585/mmwr.mm7109a2, Burki TK. according to reports from the CDC. Clin Infect Dis. mRNA Vaccine Effectiveness Against Coronavirus Disease 2019 Hospitalization Among Solid Organ Transplant Recipients. A shorter incubation period "makes a virus much, much, much harder to control," Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security, warned The Atlantic this week . Mar 11 2021;21(1):257. doi:10.1186/s12879-021-05950-x, Grant R, Charmet T, Schaeffer L, et al. Saving Lives, Protecting People, https://www.cdc.gov/coronavirus/2019-ncov/variants/spheres.html, https://covid.cdc.gov/covid-data-tracker/#variant-proportion, https://www.whitehouse.gov/briefing-room/presidential-actions/2021/11/26/a-proclamation-on-suspension-of-entry-as-immigrants-and-nonimmigrants-of-certain-additional-persons-who-pose-a-risk-of-transmitting-coronavirus-disease-2019, https://www.cdc.gov/quarantine/fr-proof-negative-test.html, https://www.cdc.gov/quarantine/order-collect-contact-info.html, https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/overview.html, https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html, https://www.cdc.gov/quarantine/masks/mask-travel-guidance.html, https://www.cdc.gov/coronavirus/2019-ncov/travelers/international-travel/index.html, https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/scientific-brief-omicron-variant.html, https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern, https://covid-19.tacc.utexas.edu/media/filer_public/d9/d9/d9d99a16-704e-4c00-ab41-069957c6c25e/variant_calculator_user_guide.pdf, https://www.thermofisher.com/us/en/home/clinical/clinical-genomics/pathogen-detection-solutions/covid-19-sars-cov-2/multiplex.html, https://doi.org/10.1186/s12916-021-01975-w, https://www.nicd.ac.za/frequently-asked-questions-for-the-b-1-1-529-mutated-sars-cov-2-lineage-in-south-africa/, Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, Shortness of breath or difficulty breathing. Accessed December 2, 2021. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. A study of a small cluster of COVID-19 cases in Nebraska involving Omicron indicates that it may take as little as three days for infected people to develop symptoms, referring to the new variant's incubation period, according to the research published this week by the U.S. Centers for Disease Control and . MMWR Morb Mortal Wkly Rep. Jan 21 2022;71(3):96-102. doi:10.15585/mmwr.mm7103e1, Murthy NC, Zell E, Fast HE, et al. Dr. Edwards adds that it is too early to tell anything about the mortality rate and . Multisystem Inflammatory Syndrome in Children-United States, February 2020-July 2021. Sect. Dec 17 2020;383(25):2477-2478. doi:10.1056/NEJMc2029240, Jordan TB, Meyers CL, Schrading WA, Donnelly JP. The clinical presentation of COVID-19 ranges from asymptomatic to severe illness, and COVID-19 symptoms may change over the course of illness. MMWR Morb Mortal Wkly Rep. Sep 10 2021;70(36):1235-1241. doi:10.15585/mmwr.mm7036a1, Bull-Otterson LB, S.; Saydah, S.; Boehmer, T.; Adjei, S.; Gray, S.; Harris, A. PostCOVID Conditions Among Adult COVID-19 Survivors Aged 1864 and 65 Years United States, March 2020November 2021. The first U.S. case of COVID-19 attributed to the Omicron variant was identified on December 1. World Health Organization. May 1 2022;41(5):424-426. doi:10.1097/inf.0000000000003502, Pellegrino R, Chiappini E, Licari A, Galli L, Marseglia GL. (9), Fever, cough, shortness of breath, fatigue, headache, and myalgia are among the most commonly reported symptoms in people with COVID-19. of pages found at these sites. Mar 2022;10(3):e326-e328. Characteristics of the cases described in this report might also not be generalizable because case findings might be associated with individual characteristics (e.g., persons with recent international travel might be more likely to be younger and vaccinated). (10) Loss of smell and taste may be reported initial symptoms of COVID-19. Even if most infections are mild, a highly transmissible variant could result in enough cases to overwhelm health systems. 2021/12/01/ 2021;80:229-238. doi:https://doi.org/10.1016/j.clinimag.2021.06.039, Kanne JP, Bai H, Bernheim A, et al. *** To date, at least one confirmed case attributed to the Omicron variant has been identified in the United States through these aircraft contact investigation efforts. Mar 2 2022;376:e068632. The Lancet Haematology. The first U.S. case of COVID-19 attributed to the Omicron variant was detected on December 1, 2021. All persons aged 5 years should be vaccinated against COVID-19. COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Although there is a shorter incubation period, you still need to test regularly if youve been exposed. Mar 24 2021;21(1):247. doi:10.1186/s12884-021-03685-w, Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. doi:10.1001/jamanetworkopen.2021.43151, Kompaniyets L, Agathis NT, Nelson JM, et al. MMWR and Morbidity and Mortality Weekly Report are service marks of the U.S. Department of Health and Human Services. Clin Infect Dis. Downloads RIS [TXT - 2 KB] . MMWR Morb Mortal Wkly Rep. Nov 6 2020;69(44):1641-1647. doi:10.15585/mmwr.mm6944e3, Jamieson DJ, Rasmussen SA. Cough. Patient data during the BA.1dominant and Delta-dominant periods were obtained from previous studies (6,7). Implementation of concurrent prevention strategies, including vaccination, masking, improving ventilation, testing, quarantine, and isolation are recommended to slow transmission of SARS-CoV-2, including variants such as Omicron, to protect against severe illness and death from COVID-19. This report summarizes U.S. surveillance for SARS-CoV-2 variants, characteristics of the initial persons investigated with COVID-19 attributed to the Omicron variant and public health measures implemented to slow the spread of Omicron in the United States. Two new Omicron subvariantsBA.4 and BA.5now account for 13% of new COVID-19 cases in the United States, a sizable leap from early May when the variants only accounted for 1%, according to data from the Centers for Disease Control and Prevention (CDC). An update on COVID-19 and pregnancy. Atlanta, GA: US Department of Health and Human Services, CDC; 2021. For the most recent updates on COVID-19, visit our coronavirus news page. Fourth, the incubation period was calculated by the calendar date and not by real-time intervals. Jan-Mar 2021;16(1):103-112. doi:10.18502/jovr.v16i1.8256, Tan E, Song J, Deane AM, Plummer MP. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Clin Infect Dis. MMWR Morb Mortal Wkly Rep. May 27, 2022 71(21):713717. BA.2 is a sub-variant of Omicron, which means it is likely that it has a shorter incubation period as well, Oller said. Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. European Journal of Pediatrics. We extracted data for 266 infector/infectee pairs who had 1 definite date of SARS-CoV-2 exposure as follows: 122 infectees from 108 infectors during the Omicron BA.5dominant period, 68 infectees from 49 infectors during the BA.1dominant period, and 76 infectees from 51 infectors during the Delta-dominant period. The most commonly reported symptoms were cough, fatigue, and congestion or runny nose. This interagency group focuses on the rapid characterization of emerging variants and actively monitors their potential impact on critical SARS-CoV-2 countermeasures, including vaccines, therapeutics, and diagnostics. Dec 23 2021;385(26):2487-2489. doi:10.1056/NEJMc2108120, Rossler A, Riepler L, Bante D, von Laer D, Kimpel J. SARS-CoV-2 Omicron Variant Neutralization in Serum from Vaccinated and Convalescent Persons. Incubation period is defined as the interval from earliest possible exposure of household contacts to the index patient until symptom onset. doi:https://doi.org/10.1016/S2352-3026(20)30145-9, Sadiq Z, Rana S, Mahfoud Z, Raoof A. Classification of Omicron (B.1.1.529): SARS-CoV-2 variant of concern. Am J Emerg Med. Incubation period correlated with shared meals and adult infectors. JAMA Intern Med. But some scientists who've studied Omicron and. May 2020;38(5):925-928. doi:10.1016/j.ajem.2019.07.020, Iuliano AD, Brunkard JM, Boehmer TK, et al. The number of confirmed COVID-19 cases from July 4 through August 19, 2022, was 12,577 in the PHCs jurisdiction, which has a population of 265,000 persons (5). MMWR Morb Mortal Wkly Rep. Apr 10 2020;69(14):416-418. doi:10.15585/mmwr.mm6914e2, Kimball A, Hatfield KM, Arons M, et al. As the dominant circulating strain of SARS-CoV-2 evolved from Alpha to Omicron, the incubation period from infection to symptoms or first positive COVID-19 test result gradually decreased, from 5 to 3.4 days, according to a systematic review and meta-analysis published today in JAMA Network Open.. Centers for Disease Control and Prevention. Implementation of concurrent prevention strategies, including vaccination, masking, increasing ventilation, testing, quarantine, and isolation, are recommended to slow transmission of SARS-CoV-2, including variants such as Omicron, and to protect against severe illness and death from COVID-19. Muscle or body aches. The clinical severity of infection with the Omicron variant will become better understood as additional cases are identified and investigated. Risk Factors for Intensive Care Unit Admission and In-hospital Mortality among Hospitalized Adults Identified through the U.S. Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020-March 2021. For those without symptoms, CDC guidance states they are considered contagious at least two days before their positive test. OToole , Scher E, Underwood A, et al. COVID-19 Vaccination Coverage Among Insured Persons Aged >/=16 Years, by Race/Ethnicity and Other Selected Characteristics - Eight Integrated Health Care Organizations, United States, December 14, 2020-May 15, 2021. More information is available, Recommendations for Fully Vaccinated People, people who are up to date with their vaccines, Clinical Progression, Management, and Treatment, Alene M, Yismaw L, Assemie MA, Ketema DB, Gietaneh W, Birhan TY. MMWR Morb Mortal Wkly Rep. Dec 31 2021;70(5152):1782-1784. doi:10.15585/mmwr.mm705152e3, Song JS, Lee J, Kim M, et al. 2022/09/15 2022;doi:10.1007/s00431-022-04600-x, Zimmermann P, Pittet LF, Curtis N. How Common is Long COVID in Children and Adolescents? Demographic Disparities in Clinical Outcomes of COVID-19: Data From a Statewide Cohort in South Carolina. Omicron made up an estimated 73% of new coronavirus cases between Dec. 12 and Dec. 18, according to the CDC. If You Have COVID-19, Is It Really Safe to Only Isolate for 5 Days? Shorter incubation period among unvaccinated Delta variant coronavirus disease 2019 patients in Japan. Gronvall said when people are infectious, a rapid . 2021:n385. Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years experience in consumer-oriented health and wellness content. There are arguments that could be made both towards shortening or lengthening, Weiss said. Characteristics, Outcomes, and Severity Risk Factors Associated With SARS-CoV-2 Infection Among Children in the US National COVID Cohort Collaborative. Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19. Dr. Roy Gulick, the chief of infectious diseases at Weill Cornell Medical Center and NewYork-Presbyterian, said typical symptoms of the omicron subvariants include: Sore throat. Aug 4 2022;doi:10.1093/cid/ciac637, Levy M, Recher M, Hubert H, et al. (17,18) Clinicians should consider encouraging all people to test for COVID-19 as recommended by CDC, protect themselves and others from infection by getting vaccinated, wear a high-quality maskwhen recommended, and follow guidance based on community risk. The omicron variant may create mild COVID-19 symptoms and reinfect previously infected COVID-19 patients, but it could have a shorter incubation time than previous COVID-19 strains, according to a new Centers for Disease Control and Prevention report.. CDC investigates omicron variant spread. A study released Tuesday by the CDC suggestes that the omicron variant may have a shorter incubation period 72 hours than previous variants of the disease, which typically took four days . Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19. Regarding the isolation period for COVID-19 generally, the CDC states that people must isolate for 10 days after symptoms first show up and can stop after that as long as they haven't had a. Detection of SARS-CoV-2 Among Residents and Staff Members of an Independent and Assisted Living Community for Older Adults - Seattle, Washington, 2020. Five pools collected November 30December 6, representing 59 travelers, had evidence of SGTF. Sep 1 2020;370:m3320. Open Forum Infect Dis. TaqPath COVID-19 Multiplex Diagnostic Solution. The first patient infected with SARS-CoV-2 Omicron BA.5 was reported on July 4, 2022, to the Itako PHC in Ibaraki Prefecture, Japan. https://www.ncbi.nlm.nih.gov/sars-cov-2external icon, https://www.cdc.gov/coronavirus/2019-ncov/variants/spheres.html, ** https://covid.cdc.gov/covid-data-tracker/#variant-proportion. Cmaj. The incubation period might be influenced by various factors, such as viral load, environmental setting, patient immune response, severity of disease, and selection biases. When Are You No Longer Contagious With COVID-19? Similar to previous variants, just because you dont have symptoms does not mean that you are not spreading the virus to other people. J Ophthalmic Vis Res. Estimating the duration of infectiousness is more challenging than measuring incubation periods; one study that measured viral load of Omicron suggested that viral load had diminished by days 10-13, which is in line with our findings ( 6 ). N Engl J Med. The Lancet Regional Health - Europe. Annu Rev Med. Jul 15 2021;73(Suppl 1):S5-S16. Among the 14 persons who were vaccinated and had received an additional dose, five had received the additional dose <14 days before symptom onset. part 46.102(l)(2); 21 C.F.R. Post-COVID-19 Symptoms and Conditions Among Children and Adolescents - United States, March 1, 2020-January 31, 2022. N Engl J Med. We take your privacy seriously. International Journal of Infectious Diseases. Compare this with Delta and other strains . Third, exposures from sources other than the infector of the pair might have been missed. 2020/09/01/ 2020;98:180-186. doi:https://doi.org/10.1016/j.ijid.2020.06.052, Yang J, Zheng Y, Gou X, et al. If a pair shared meals on July 4 and the infectee had COVID-19 symptoms on July 7, we calculated an incubation period of 3 days. CDC recommends prioritizing case investigation and contact tracing for confirmed COVID-19 cases attributed to the Omicron variant. We performed multivariate gamma regression analyses; transmission during shared meals (p = 0.03) and age of infector (p = 0.007) correlated significantly with incubation period (Table 2). Among the cases described in this report, the earliest report of symptom onset was November 15. This is in part because Omicron is far better at circumventing the current vaccines than the Delta variant, . Overall, the average incubation period of all the variants was 6.57 days, ranging from 1.8 to 18.87 days. Incubation periods can. Hoarse voice. May 2022;28(5):986-989. doi:10.3201/eid2805.220166, Saelee R, Zell E, Murthy BP, et al. A 2021 study published in BMC Public Health found that the incubation period of the virus may vary by age. The earliest date of symptom onset was November 15 in a person with a history of international travel. We thank the staff of the Itako Public Health Center, Ibaraki Prefectural Institute of Public Health, and government of Ibaraki Prefecture for their contributions to our study. CDC twenty four seven. National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: lessons from the first wave. The risk of severe COVID-19 increases with increasing age over 40 years and with increasing number of certain, Shortness of breath or difficulty breathing. Statistics OfN. Incubation period correlated with shared meals and adult infectors. Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review. The average incubation period tends to differ among COVID-19 variants, and data suggest that it may be shorter for Omicron. Characteristics of Adult Outpatients and Inpatients with COVID-19 - 11 Academic Medical Centers, United States, March-May 2020. 2021/08/01/ 2021;46:520-524. doi:https://doi.org/10.1016/j.ajem.2020.11.006, Nasiri N, Sharifi H, Bazrafshan A, Noori A, Karamouzian M, Sharifi A. Ocular Manifestations of COVID-19: A Systematic Review and Meta-analysis. EClinicalMedicine. Six (14%) persons had a documented previous SARS-CoV-2 infection. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. . Omicron has numerous mutations with potential to increase transmissibility, confer resistance to therapeutics, or partially escape infection- or vaccine-induced immunity (2). Ogata T, Tanaka H. SARS-CoV-2 Incubation Period during the Omicron BA.5Dominant Period in Japan. The pre-Omicron incubation period for COVID-19 had been estimated to range from 2 to 14 days, with a median of 4-7 days from . Accessed December 3, 2021. "Omicron has the shortest incubation period. Feb 1 2021;72(3):521-533. doi:10.1093/cid/ciaa828, Dubey P, Thakur B, Reddy S, et al. Probability densities for incubation period distribution during different SARS-CoV-2 variant-dominant periods in study of SARS-CoV-2 incubation period during the Omicron BA.5dominant period in Japan. Centers for Disease Control and Prevention. JAMA Network Open. 2021;73(10):1882-1886. doi:10.1093/cid/ciab234, Kronbichler A, Kresse D, Yoon S, Lee KH, Effenberger M, Shin JI. Omicron is the dominant variant in the United States, making up about 59 percent of infections for the week ending Dec. 25, the Centers for Disease Control and Prevention said Tuesday. The CDC released early information on 43 cases attributed to omicron in the U.S. from Dec. 1 to 8, saying 34 of those individuals were fully vaccinated, including 14 who had gotten a booster dose . doi:10.5888/pcd18.210123, Ko JY, Danielson ML, Town M, et al. 2021:2021.02.27.21252169. doi:10.1101/2021.02.27.21252169, Jering KS, Claggett BL, Cunningham JW, et al. Reports on incubation periods for BA.5 are sparse. October 2021; The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. doi:10.1148/radiol.2021204522, Doerschug KC, Schmidt GA. Accessed December 3, 2021. To receive email updates about COVID-19, enter your email address: We take your privacy seriously. Pediatr Infect Dis J. Mar 1 2022;41(3):e81-e86. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. 2021;21(1):1762. doi:10.1186/s12889-021-11761-1. A small study from CDC also . 2022;6(5):294-302. doi:10.1016/s2352-4642(22)00027-x, Torjesen I. Covid-19: Omicron variant is linked to steep rise in hospital admissions of very young children. They help us to know which pages are the most and least popular and see how visitors move around the site. Mutations in Omicron might increase transmissibility, confer resistance to therapeutics, or partially escape infection- or vaccine-induced immunity. View data is from . Aug 24 2022;75(1):e741-e748. There was an unexpected error. BMJ. Reports on incubation periods for BA.5 are sparse. Jul 2022;6(7):459-465. doi:10.1016/s2352-4642(22)00100-6, Belay ED, Godfred Cato S, Rao AK, et al. Centers for Disease Control and Prevention. Multisystem Inflammatory Syndrome in Adults After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and Coronavirus Disease 2019 (COVID-19) Vaccination. A study of the Oslo Christmas party outbreak found the incubation period could be about three days, compared with 4.3 days for delta and five days for other variants. Conclusions. 2 "BA.2 is a sub-variant of Omicron, which means it is likely that it has a shorter incubation period as well," Oller said. This is shorter than with Delta and earlier variants. How long are. On 26 November 2021, WHO designated the variant B.1.1.529 a variant of concern, named Omicron, on the advice of WHO's Technical Advisory Group on Virus Evolution (TAG-VE). Incubation periods for Omicron BA.1 were reported to be 3.3 days in Norway, 4.6 days in South Korea, 3.2 days in the Netherlands, 3.1 days in Spain, and 2.9 days in Japan ( 6, 10, 11 ); incubation period for BA.2 was 4.4 days in Hong Kong ( 12 ). SARS-CoV-2 shedding dynamics across the respiratory tract, sex, and disease severity for adult and pediatric COVID-19. doi:10.1093/cid/ciab991, Davis HE, Assaf GS, McCorkell L, et al. Genomic surveillance is implemented in partnership with state and local public health laboratories, the Association of Public Health Laboratories, and other academic and government partners. As of the week ending December 4, the SARS-CoV-2 B.1.617.2 (Delta) variant was estimated to account for 99.9% of SARS-CoV-2 circulating in the United States. (1) A study conducted during high levels of Delta variant transmission reported an incubation period of 4.3 days,(2) and studies performed during high levels of Omicron variant transmission reported a median incubation period of 34 days.(3,4). Oct 1 2021;4(10):e2128568. As of December 8, a total of 22 states had identified at least one Omicron variant case, including some that indicate community transmission. According to clinical guidance from the Centers for Disease Control and Prevention. 2021;237(1):1-12. doi:10.1159/000512932, Thompson HA, Mousa A, Dighe A, et al. You will be subject to the destination website's privacy policy when you follow the link. The Altmetric Attention Score for a research output provides an indicator of the amount of attention that it has received. Dermatology. Pulmonary Aspects of COVID-19. May 19 2021;373:n1098. MMWR Morb Mortal Wkly Rep. Dec 31 2021;70(5152):1766-1772. doi:10.15585/mmwr.mm705152a3, Woodruff RC, Campbell AP, Taylor CA, et al. The incubation period is the time from exposure to a pathogen like a virus to the time of first . Questions or messages regarding errors in formatting should be addressed to All information these cookies collect is aggregated and therefore anonymous. doi:http://dx.doi.org/10.15585/mmwr.mm7121e1, Sudre CH, Murray B, Varsavsky T, et al. Omicron is swifter still, with an incubation period of roughly three days, according to a recent C.D.C. We defined patients in the BA.1dominant period as those who had symptom onset during January 1February 2, 2022. American Journal of Clinical Pathology. CDC is not responsible for the content A negative test result closer to the time of travel enhances reduction in transmission risk during travel (6). Overall, its important to get vaccinated and boosted against COVID-19 to have protection against severe outcomes of the virus. 2022/02/01/ 2022;13:100278. doi:https://doi.org/10.1016/j.lanepe.2021.100278, Jansen L, Tegomoh B, Lange K, et al. CDC COVID-19 Response Team (View author affiliations). This system obtains genomic surveillance data from 1) National SARS-CoV-2 Strain Surveillance, 2) CDC-supported contracts with several commercial diagnostic laboratories, and 3) public repositories (the Global Initiative on Sharing Avian Influenza Data [GISAID] and the National Center for Biotechnology Information [NCBI]) of randomly sampled viruses with metadata tagging of sequences by various partners. Suggested citation for this article: . Euro Surveill. MMWR Morb Mortal Wkly Rep. Jun 19 2020;69(24):759-765. doi:10.15585/mmwr.mm6924e2, Roxby AC, Greninger AL, Hatfield KM, et al. Incubation period of COVID-19 caused by unique SARS-CoV-2 strains: a systematic review and meta-analysis. Distribution of Omicron variant SARS-CoV-2 cases, Cantabria, Spain, December 2021. Pediatr Infect Dis J. Dec 1 2021;40(12):e482-e487. MMWR Morb Mortal Wkly Rep. Feb 4 2022;71(5):177-181. doi:10.15585/mmwr.mm7105e1, Olson SM, Newhams MM, Halasa NB, et al.

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