Understanding patterns of variant emergence and spread in an ongoing epidemic.

The COVID-19 pandemic saw successive emergence and global spread of novel viral variants, exhibiting enhanced transmissibility or evasion of immunity. While the genotypic and phenotypic basis of SARS-CoV-2 variants have been extensively characterized, the evolutionary factors governing their patterns of emergence are less well understood. In this study we systematically investigated how the invasion dynamics of viral variants depend on variant phenotype (increased transmissibility or immune evasion), source (local evolution vs importation), the timing of introduction, the distribution of population susceptibility, and the contact network structure. Using a stochastic multi-strain epidemic model, we find that strains with only a transmission advantage are more likely to emerge earlier in the epidemic, and rapidly and predictably dominate the viral population. In contrast, immune-escape variants tend to linger at low prevalence for extended time periods after emergence, avoiding detection, until a critical amount of immunity has built up in the population and they begin to rapidly outcompete existing strains. We find that two common features of realistic human contact networks-heterogeneity in contacts (overdispersion) and clustering-lead to more punctuated evolutionary dynamics. This work provides insight into past dynamics of SARS-CoV-2 variants and can help define planning scenarios for future epidemic modeling efforts.