The hypothesis that this new variant came about after months of replication and selective pressure in an immunocomprised patient is fascinating for a number of reasons.

First, it must have real implications for how you treat and manage those patients. Hopefully vaccination will reduce the need for these antibody treatments to be used but, in the meantime, I guess it suggests those patients need to be treated with extreme care.

Most interesting, for me, is this graph. It shows how far the new variant (top right) has diverged from the closest related group of samples (the group below). Because mutations accrue at a ~ constant rate, you’d expect a continuous line. The separation of the groups is *weird*

In forensic terms, there’s a gap in the timeline of the crime that can’t be accounted for! This suggests that the variant has been quietly evolving elsewhere. Because surveillance is so good, we can probably say this wasn’t occurring in the community.