TY - JOUR AU - da Silva Filipe, Ana AU - Shepherd, James G. AU - Williams, Thomas AU - Hughes, Joseph AU - Aranday-Cortes, Elihu AU - Asamaphan, Patawee AU - Ashraf, Shirin AU - Balcazar, Carlos E. AU - Brunker, Kirstyn AU - Campbell, Alasdair AU - Carmichael, Stephen AU - Davis, Chris AU - Dewar, Rebecca AU - Gallagher, Michael D. AU - Gunson, Rory N. AU - Hill, Verity AU - Ho, Antonia AU - Jackson, Ben AU - James, Edward AU - Jesudason, Natasha AU - Johnson, Natasha AU - Leitch, E. Carol McWilliam AU - Li, Kathy K. AU - MacLean, Alasdair AU - Mair, Daniel AU - McAllister, David A. AU - McCrone, John T. AU - McDonald, Sarah E. AU - McHugh, Martin P. AU - Morris, A. Keith AU - Nichols, Jenna AU - Niebel, Marc O. AU - Nomikou, Kyriaki AU - Orton, Richard J. AU - O'Toole, Áine Niamh AU - Palmarini, Massimo AU - Parcell, Benjamin J. AU - Parr, Yasmin A. AU - Rambaut, Andrew AU - Rooke, Stefan AU - Shaaban, Sharif AU - Shah, Rajiv AU - Singer, Joshua B. AU - Smollett, Katherine AU - Starinskij, Igor AU - Tong, Lily AU - Sreenu, Vattipally B. AU - Wastnedge, Elizabeth AU - Holden, Matthew T.G. AU - Robertson, David L. AU - Templeton, Kate E. AU - Thomson, Emma C. PY - 2021 DA - January TI - Genomic epidemiology reveals multiple introductions of SARS-CoV-2 from mainland Europe into Scotland JO - Nature Microbiology EP - 122 VL - 6 IS - 1 DO - https://doi.org/10.1038/s41564-020-00838-z AB - Coronavirus disease 2019 (COVID-19) was first diagnosed in Scotland on 1 March 2020. During the first month of the outbreak, 2,641 cases of COVID-19 led to 1,832 hospital admissions, 207 intensive care admissions and 126 deaths. We aimed to identify the source and number of introductions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into Scotland using a combined phylogenetic and epidemiological approach. Sequencing of 1,314 SARS-CoV-2 viral genomes from available patient samples enabled us to estimate that SARS-CoV-2 was introduced to Scotland on at least 283 occasions during February and March 2020. Epidemiological analysis confirmed that early introductions of SARS-CoV-2 originated from mainland Europe (the majority from Italy and Spain). We identified subsequent early outbreaks in the community, within healthcare facilities and at an international conference. Community transmission occurred after 2 March, 3 weeks before control measures were introduced. Earlier travel restrictions or quarantine measures, both locally and internationally, would have reduced the number of COVID-19 cases in Scotland. The risk of multiple reintroduction events in future waves of infection remains high in the absence of population immunity. PB - Springer Nature PB - Wellcome Trust UR - http://eprints.gla.ac.uk/231918/ KW - Coronavirus (COVID-19) ER