Blueprint of a pandemic: Insights from SARS-CoV-2 genomics surveillance in Meghalaya, India.

The Covid-19 pandemic uncovered several lacunae in healthcare systems exposing global unpreparedness and triggering unprecedented challenges worldwide- necessitating a shift towards mitigation and robust surveillance strategies. Here, we report the use of Whole Genome Sequencing (WGS) to detect SARS-CoV-2 variants in clinical samples of Meghalaya, India, using Oxford Nanopore Technology. SARS-CoV-2 positive samples collected from various districts of Meghalaya from August 2021 to May 2023 were subjected to WGS. Out of a total of 965 samples, Alpha (0.1 %), Delta (47.2 %) and Omicron (52.7 %) variants were detected. The Delta variant affected 53 % of individuals under the age of 18 years, while the Omicron sub variant BA.2 affected all age groups in a similar manner. The study underscores the efficacy of using a user-friendly sequencing device coupled with simplified bioinformatics, enabling remote regions to effectively combat Covid-19. This approach, characterized by rapidity, simplicity and accuracy, holds promise in confronting future health crises.