(A) Maximum likelihood tree. Filled tips belong to sequences generated in this study. Major phylogenetic lineages (defined as lineages from the Pango nomenclature system (14) found in greater than 5% of samples in our subsampled global data set) are indicated by color blocks and labeled. (B) Evolutionary divergence in geographic groups. Violin plots represent the distribution of pairwise genetic distances between all sequences for samples collected in each listed geographic group. Colors are as in A, with filled violins containing sequences from this study. Black vertical lines depict the mean pairwise genetic distance between all samples in each regional group. (C) Map of the Baltimore–Washington metropolitan area. The number of sequences in this study with home locations in each area as defined by the first 3 digits of the patient zip code (ZIP3 area; Washington, DC outlined in black, all others gray) is indicated by shading of that region (darker, more sequences) and pie chart area. Pie charts show the proportion of sequences from each ZIP3 area belonging to each major lineage. Sequence counts between 1 and 5 are shown as 5 sequences. MD, Maryland; VA, Virginia; DC, District of Columbia; WA, Washington; CA, California; ID, Idaho; LA, Louisiana; NY, New York.