Abstract

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.

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Cite as

da Silva Filipe, A., Shepherd, J., Williams, T., Hughes, J., Aranday-Cortes, E., Asamaphan, P., Ashraf, S., Balcazar, C., Brunker, K., Campbell, A., Carmichael, S., Davis, C., Dewar, R., Gallagher, M., Gunson, R., Hill, V., Ho, A., Jackson, B., James, E., Jesudason, N., Johnson, N., Leitch, E., Li, K., MacLean, A., Mair, D., McAllister, D., McCrone, J., McDonald, S., McHugh, M., Morris, A., Nichols, J., Niebel, M., Nomikou, K., Orton, R., O'Toole, Á., Palmarini, M., Parcell, B., Parr, Y., Rambaut, A., Rooke, S., Shaaban, S., Shah, R., Singer, J., Smollett, K., Starinskij, I., Tong, L., Sreenu, V., Wastnedge, E., Holden, M., Robertson, D., Templeton, K. & Thomson, E. 2021, 'Genomic epidemiology reveals multiple introductions of SARS-CoV-2 from mainland Europe into Scotland', Nature Microbiology, 6(1), pp. 112-122. https://doi.org/10.1038/s41564-020-00838-z

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Last updated: 29 September 2023
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