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  • On the evolutionary epidemi...
    Day, Troy; Gandon, Sylvain; Lion, Sébastien; Otto, Sarah P.

    Current biology, 08/2020, Volume: 30, Issue: 15
    Journal Article

    There is no doubt that the novel coronavirus SARS-CoV-2 that causes COVID-19 is mutating and thus has the potential to adapt during the current pandemic. Whether this evolution will lead to changes in the transmission, the duration, or the severity of the disease is not clear. This has led to considerable scientific and media debate, from raising alarms about evolutionary change to dismissing it. Here we review what little is currently known about the evolution of SARS-CoV-2 and extend existing evolutionary theory to consider how selection might be acting upon the virus during the COVID-19 pandemic. Although there is currently no definitive evidence that SARS-CoV-2 is undergoing further adaptation, continued evidence-based analysis of evolutionary change is important so that public health measures can be adjusted in response to substantive changes in the infectivity or severity of COVID-19. Evolutionary theory predicts that selection favors increased transmission, longer pre-symptomatic periods, fewer asymptomatic cases, and lower disease severity for SARS-CoV-2. However, viral mutations are expected to affect combinations of these traits, making it challenging to predict the direction and disease impact of evolution.