ABSTRACT
Background. Global genomic surveillance has allowed identification of SARS-CoV-2 circulating variants responsible for the COVID-19 pandemic. Statewide variant characterization can guide local public health mitigations and provide educational opportunities. We characterized statewide evolution of SARS-CoV-2 variants in Rhode Island (RI). Methods. De identified RI SARS-CoV-2 sequences since 2/2020, generated at authors, CDC and commercial laboratories, were extracted from https://www.gisaid. org. Genomic and phylogenetic analyses were conducted with available tools and custom python scripts and, after quality control, sequences were classified as variants of Concern (VOC), variants being monitored (VBM), or non-VOC/ non-VBM, per CDC definitions. Specific mutations that are characteristic of the most recent VOCs (Delta or Omicron) were explored outside of their designated lineages. Results. Of the 1.1 million RI population, 14,933 SARS-CoV-2 sequences were available between 2/2020 and 3/2022. These included 1,542 (11%) sequences from 37 non-VOC/non-VBM lineages until 2/2021, most commonly B.1.2 (21%), B.1.375 (13%), and B.1.517 (6%);2,910 (19%) sequences from 7VBM lineages between 3-6/2021, most commonly Alpha (48%), Iota (34%), and Gamma (10%);and 10,481 (70%) sequences from 2 VOC lineages, including 7,574 (72%) Delta mostly between 6/2021 and 12/2021, and 2,907 (28%) Omicron mostly between 1/2022 and 3/2022. Phylogeny showed expected clustering of local variants within regional and global sequences, and continued viral evolution over time. Further VOC evolution was observed, including 87 Delta sub-lineages, most commonly AY.103 (17%), AY.3 (15%), and AY.44 (12%);and 4 Omicron sub-lineages BA.1 (61%), BA.1.1 (32%), BA.2 (7%), and BA.3 (< 1%). Omicron-associated mutations S:del69/70, S:H655Y, or N: P13L were observed in 219 Delta sequences, and Delta-associated mutations ORF1b: G662S, N:D377Y, or M:I82T were observed in 16 Omicron sequences. Conclusion. Statewide SARS-CoV-2 genomic surveillance allows for continued characterization of locally circulating variants and monitoring of viral evolution. Such data guide public health policies, inform the local health force, and mitigate the impact of SARS-CoV-2 on public health.
ABSTRACT
The COVID-19 public health emergency caused widespread economic shutdown and unemployment. The resulting surge in Unemployment Insurance claims threatened to overwhelm the legacy systems state workforce agencies rely on to collect, process, and pay claims. In Rhode Island, we developed a scalable cloud solution to collect Pandemic Unemployment Assistance claims as part of a new program created under the Coronavirus Aid, Relief and Economic Security Act to extend unemployment benefits to independent contractors and gig-economy workers not covered by traditional Unemployment Insurance. Our new system was developed, tested, and deployed within 10 days following the passage of the Coronavirus Aid, Relief and Economic Security Act, making Rhode Island the first state in the nation to collect, validate, and pay Pandemic Unemployment Assistance claims. A cloud-enhanced interactive voice response system was deployed a week later to handle the corresponding surge in weekly certifications for continuing unemployment benefits. Cloud solutions can augment legacy systems by offloading processes that are more efficiently handled in modern scalable systems, reserving the limited resources of legacy systems for what they were originally designed. This agile use of combined technologies allowed Rhode Island to deliver timely Pandemic Unemployment Assistance benefits with an estimated cost savings of $502,000 (representing a 411% return on investment). © 2020 Owner/Author.
ABSTRACT
COVID-19 is a worldwide public health emergency caused by SARS-CoV-2. Genomic surveillance of SARS-CoV-2 emerging variants is important for pandemic monitoring and informing public health responses. Through an interstate academic-public health partnership, we established Rhode Island's capacity to sequence SARS-CoV-2 genomes and created a systematic surveillance program to monitor the prevalence of SARS-CoV-2 variants in the state. We describe circulating SARS-CoV-2 lineages in Rhode Island;provide a timeline for the emerging and expanding contribution of variants of concern (VOC) and variants of interest (VOI), from their first introduction to their eventual predominance over other lineages;and outline the frequent identification of known adaptively beneficial spike protein mutations that appear to have independently arisen in non-VOC/non-VOI lineages. Overall, the described Rhode Island- centric genomic surveillance initiative provides a valuable perspective on SARS-CoV-2 in the state and contributes data of interest for future epidemiological studies and state-to-state comparisons.