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As of February 2021, 3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern with worrisome characteristics have emerged, each on a different continent. The B.1.1.7 variant, first identified in the United Kingdom, is substantially more transmissible than previously circulating variants. The B.1.351 and P.1 variants, first identified in South Africa and Brazil, respectively, both exhibit some degree of immune escape. Each of these variants has precipitated resurgences in the communities where they have become dominant. All 3 have already been identified at low levels in the United States. If they gain a foothold, the same resurgences can be expected here.

Funding for increased genomic surveillance is expected in the next Congressional supplemental, among several investments in SARS-CoV-2 research. Key efforts to expand capacity and improve surveillance systems should be funded with this money. New guidance and policies are also needed to maximize the response. Notably, investments made now to build genomic surveillance infrastructure for coronavirus disease 2019 (COVID-19) will not only help us respond to the pandemic now but will also improve response for outbreaks of other pathogens in the future.

This document explains the current status of SARS-CoV-2 surveillance, sequencing, and variant characterization and provides recommendations for increasing the United States’ capacity to respond to new variants.

Priority Recommendations

1. Maintain Policies that Slow Transmission: Variants will continue to emerge as the pandemic unfolds, but the best chance of minimizing their frequency and impact will be to continue public health measures that reduce transmission. This includes mask mandates, social distancing requirements, and limited gatherings.
    
2. Prioritize Contact Tracing and Case Investigation for Data Collection: Cases of variants of concern should be prioritized for contact tracing and case investigation so that public health officials can observe how the new variant behaves compared to previously circulating versions.
    
3. Develop a Genomic Surveillance Strategy: To guide the public health response, maximize resources, and ensure an equitable distribution of benefits, the US Department of Health and Human Services should develop a national strategy for genomic surveillance to implement and direct a robust SARS-CoV-2 genomic surveillance program, drawing on resources and expertise from across the US government.  
    
4. Improve Coordination for Genomic Surveillance and Characterization: There are several factors in creating a successful genomic surveillance and characterization network. Clear leadership and coordination will be necessary.