When the first case in New York State (NYS) was diagnosed in New York City (NYC) on 29 February 2020 4, the NYC metropolitan area quickly emerged as an early epicenter of the pandemic. During the following weeks, sporadic cases were reported throughout the US. ![]() In the United States (US), the first SARS-CoV-2 infection was confirmed by the US Centers for Disease Control and Prevention (CDC) on 20 January 2020 3. Within weeks, cases were reported in other countries in Asia, as well as in Europe and North America. The first cases of coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were observed in China in December 2019 1, 2. Our results provide evidence of sporadic SARS-CoV-2 infections a full month before both the first officially documented case and emergence of New York as a COVID-19 epicenter in March 2020. We identify SARS-CoV-2 RNA from specimens collected as early as 25 January 2020, and complete SARS-CoV-2 genome sequences from multiple pools of samples collected between late February and early March, documenting an increase prior to the later surge. The patients had been previously evaluated for respiratory symptoms or influenza-like illness during the first 10 weeks of 2020. Here, we utilize a sample pooling strategy to screen for previously undetected SARS-CoV-2 in de-identified, respiratory pathogen-negative nasopharyngeal specimens from 3,040 patients across the Mount Sinai Health System in New York. ![]() This may lead to incorrect assumptions when modeling viral origins and transmission. ![]() Numerous reports document the spread of SARS-CoV-2, but there is limited information on its introduction before the identification of a local case. Nature Communications volume 12, Article number: 3463 ( 2021) Molecular evidence of SARS-CoV-2 in New York before the first pandemic wave
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