SARS-CoV-2 transmission dynamics in Belarus in 2020 revealed by genomic and incidence data analysis.
Alina Nemira, Ayotomiwa Ezekiel Adeniyi, Elena L Gasich, Kirill Y Bulda, Leonid N Valentovich, Anatoly G Krasko, Olga Glebova, Alexander Kirpich, Pavel Skums
Author Information
Alina Nemira: Department of Computer Science, Georgia State University, Atlanta, GA USA. ORCID
Ayotomiwa Ezekiel Adeniyi: Department of Computer Science, Georgia State University, Atlanta, GA USA. ORCID
Elena L Gasich: Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Belarus.
Kirill Y Bulda: Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Belarus.
Leonid N Valentovich: Institute of Microbiology, National Academy of Sciences of Belarus, Minsk, Belarus. ORCID
Anatoly G Krasko: Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Belarus.
Olga Glebova: Department of Computer Science, Georgia State University, Atlanta, GA USA.
Alexander Kirpich: Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA.
Pavel Skums: Department of Computer Science, Georgia State University, Atlanta, GA USA. ORCID
Background: Non-pharmaceutical interventions (NPIs) have been implemented worldwide to curb COVID-19 spread. Belarus is a rare case of a country with a relatively modern healthcare system, where highly limited NPIs have been enacted. Thus, investigation of Belarusian COVID-19 dynamics is essential for the local and global assessment of the impact of NPI strategies. Methods: We integrate genomic epidemiology and surveillance methods to investigate the spread of SARS-CoV-2 in Belarus in 2020. We utilize phylodynamics, phylogeography, and probabilistic bias inference to study the virus import and export routes, the dynamics of the effective reproduction number, and the incidence of SARS-CoV-2 infection. Results: Here we show that the estimated cumulative number of infections by June 2020 exceeds the confirmed case number by a factor of ~4 (95% confidence interval (2; 9)). Intra-country SARS-CoV-2 genomic diversity originates from at least 18 introductions from different regions, with a high proportion of regional transmissions. Phylodynamic analysis indicates a moderate reduction of the effective reproductive number after the introduction of limited NPIs, but its magnitude is lower than for developed countries with large-scale NPIs. On the other hand, the effective reproduction number estimate is comparable with that for the neighboring Ukraine, where NPIs were broader. Conclusions: The example of Belarus demonstrates how countries with relatively low outward population mobility continue to be integral parts of the global epidemiological environment. Comparison of the effective reproduction number dynamics for Belarus and other countries reveals the effect of different NPI strategies but also emphasizes the role of regional Eastern European sociodemographic factors in the virus spread.
