- Worobey, Michael;
- Levy, Joshua I;
- Serrano, Lorena Malpica;
- Crits-Christoph, Alexander;
- Pekar, Jonathan E;
- Goldstein, Stephen A;
- Rasmussen, Angela L;
- Kraemer, Moritz UG;
- Newman, Chris;
- Koopmans, Marion PG;
- Suchard, Marc A;
- Wertheim, Joel O;
- Lemey, Philippe;
- Robertson, David L;
- Garry, Robert F;
- Holmes, Edward C;
- Rambaut, Andrew;
- Andersen, Kristian G
Understanding how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 is critical to preventing future zoonotic outbreaks before they become the next pandemic. The Huanan Seafood Wholesale Market in Wuhan, China, was identified as a likely source of cases in early reports, but later this conclusion became controversial. We show here that the earliest known COVID-19 cases from December 2019, including those without reported direct links, were geographically centered on this market. We report that live SARS-CoV-2-susceptible mammals were sold at the market in late 2019 and that within the market, SARS-CoV-2-positive environmental samples were spatially associated with vendors selling live mammals. Although there is insufficient evidence to define upstream events, and exact circumstances remain obscure, our analyses indicate that the emergence of SARS-CoV-2 occurred through the live wildlife trade in China and show that the Huanan market was the epicenter of the COVID-19 pandemic.