Kristian G. AndersenVerified account

I think it's important for the US to have a system in place - managed and overseen by e.g., @CDC_AMD with an external committee. I see the need for four main classifications: Variant Variant of Interest (VOI) Variant under Investigations (VUI) Variant of Concern (VOC)

The need for coordination is critical. Too many examples lately of scientists finding something (they find) interesting and then heading straight to the media - with limited data, no studies available, and no coordination with local health departments. Don't do this. Seriously.

It's key to remember that there is often a big difference between what's *interesting* vs what's *unusual*. If unusual, there's a difference between what's unusual vs what's *important*. Often, what's seen as interesting, isn't unusual, and unusual isn't necessarily important.

We have only three variants that fall into the "VOC" category - those first identified in the UK (B.1.1.7), Brazil (P.1), and South Africa (B.1.351). I have already talked about these a lot, so head over to this thread if you're interested:https://twitter.com/K_G_Andersen/status/1355689990487896065?s=20 …

Now, recent "Variants of Interest" (VOIs). There are many, incl. those identified in California (B.1.429/427) and New York (B.1.526). VOIs are about identifying variants that *may* be important - which is different than monitoring the ones we *know* are important (the VOCs).

To move from VOI VOC requires evidence. A lot of evidence. The UK provides a stellar example of how exactly to go from VOI VUC VOC. Investigate, investigate, and continue to investigate - while accurately communicating importance and uncertainty through the process.

Let's look at the two recent CA/NY variants (NOT VOCs!!) - all sloppy science and bad reporting, or is there something to it? I think there's something there - and consider both VOIs. The CA may be slightly more transmissible (~10-15%?) and the NY evade some immunity.

So what's going on here? Probably the surge is the primary driver of increasing frequency, but possibly also helped along by a slight increase in inherent transmissibility. The data is not conclusive though. Also, association with virulence and immunity = null. = VOI.

Like the "CA" variant, terrible reporting, however, given the rapid increase in frequency of two independent sub-lineages carrying mutations that we know can evade some Ab immunity, in a part of the country with high levels of immunity = VOI that should immediately VUI.

In summary, we need to be *much* better at communicating research around SARS-CoV-2 variants - whether known or novel - especially as it relates to data, findings, interpretations, and importance. Finally, a collaborative and coordinated effort to confusion and impact.