How Covid-19 got to the UK via 79 countries: Where NHS patients had traveled in the hospital

Covid-19 may have entered the UK through at least 79 countries, and Croatia is not one of them, according to NHS statistics released today.

Data provided to SAGE – Number 10's scientific advisory body – found that 800 patients hospitalized between March and August had traveled abroad in the previous 14 days.

This doesn't necessarily mean they caught the virus overseas, but Covid-19 has an incubation period of up to 14 days, which suggests they may have brought the virus back to the UK.

A quarter of hospitalized patients (200) had been in Spain, which was at the epicenter of the European coronavirus crisis, before the deadly pathogen reached British soil. It was followed by Italy (92), where thousands of families came to ski in February.

Amazingly, only three patients told doctors they had visited China, where the coronavirus was first discovered in December 2019. Eight were from Thailand, five from the Philippines and zero from Vietnam – all countries on the high-risk list at the start of the pandemic.

Covid-19 may also have been imported from several luxury vacation destinations, including Barbados, the Bahamas, and the Dominican Republic.

The data released today by the government were presented to SAGE. It is just one of dozens of papers presented to the advisors in recent months to guide ministers through the crisis.

Covid-19 traveled to the UK through at least 79 countries, NHS data for hospital patients shows. The most frequently reported patients went to Spain (205), other parts of the United Kingdom (116), Italy (92), France (35) and Germany (35) in the two weeks prior to being infected



Cases, 371,000

Deaths, 27,797

United Kingdom

Cases, 322,000

Deaths, 41,403


Cases, 256,000

Deaths, 35,418


Cases, 230,000

Deaths, 30,480


Cases, 5.59 million

Deaths, 174,000


Cases, 1,359

Deaths, 20


Cases, 54,992

Deaths, 1,788


Cases, 24,431

Deaths, 729


Cases, 155

Deaths, 7


Cases, 2.91 million

Deaths, 54,849


Cases, 292,000

Deaths, 6,219

The COVID-19 Clinical Information Network (CO-CIN) gathers information from NHS hospitals across the UK to get an idea of ​​the symptoms, characteristics and outcomes of the sickest patients.

Between March 10 and August 5, CO-CIN had recorded information for 77,676 patients who were confirmed to have Covid-19.

Patients provide information at the time of their admission. However, it is not possible to get a complete dataset because some patients are too uncomfortable to answer basic questions about their travel history or background.

A total of 23,392 patients answered the question: "Did you travel in the two weeks before your symptoms started?"

A third (825) said they had done so, but only 797 mentioned the country they had been to.

The other 54,284 patients did not answer the question or there were no data. Therefore, the information below only provides an overview of where hospital patients traveled to before they became infected.

And the data only pertains to those who ended up in the hospital, not the hundreds of thousands of people who suffered a mild infection.

The most reported travel destination was Spain, where cases soared two weeks before the UK in March.

Neighboring Italy and France (35) were also at the high end of the scale after thousands of cases emerged at the height of the crisis, just before the UK was stuck. It can be assumed that these European locations were reported so frequently because they are so often visited by the British.

It took the government three weeks after the first two cases were uncovered in Rome to announce that anyone who feels sick after returning from northern Italy should self-isolate.

The second most common country was the United Kingdom, suggesting that domestic travel for vacation or work may have played an important role in the spread of the disease.

Croatia was not on the list, however, and none of the patients said they had traveled there before the disease struck them at any point during the pandemic.

Croatia is the youngest country to be added to the UK's quarantine list after a surge in infections.

Travelers arriving in the UK after 4 a.m. on Saturday will have to self-isolate for 14 days, as was revealed yesterday evening, along with Austria, Trinidad and Tobago.

At the same time, Portugal, to which eight hospital patients have traveled, is exempt from the UK's quarantine obligation.

The quarantine list is based on diagnosed cases reported in that country.

At the beginning of the month, there was a significant increase in Covid-19 infections across Croatia, as well as Spain, the Netherlands and France.


British vacationers have seen them climb into airports in Croatia to get home before facing a two-week quarantine on their return to the UK.

In scenes similar to those seen at French airports and ferry terminals last week, tourists were spotted in numbers at Croatia's Split airport yesterday as the rush begins to come home by the deadline on Saturday.

There are currently around 20,000 British tourists in Croatia.

The pictures were taken hours after the UK government announced that Croatia, along with Austria and Trinidad, would be removed from the quarantine-free travel list – meaning tourists will have to be quarantined for two weeks on their return.

The decision is made after an increase in cases in each of the three countries.

Figures released by the Ministry of Transport (DfT) show that the weekly incidence (cases) per 100,000 for Croatia increased from 10.4 on August 12 to 27.4 on August 19, an increase of 164%.

Over the same period, the weekly incidence in Trinidad and Tobago rose 232 percent per 100,000, while Austria saw a 93 percent increase between August 13 and 20 (from 10.5 per 100,000 to 20.3).

Portugal has now been added to the list, which means that tourists can travel quarantine-free to popular holiday destinations such as the Algarve from Saturday.

On Thursday afternoon, Transport Minister Grant Shapps tweeted: "Data shows that we need to remove Croatia, Austria and Trinidad & Tobago from our list of #coronavirus travel corridors to keep infection rates down."

Several countries in the "travel corridor" – those where the British can vacation freely without having to isolate themselves afterwards – were on the list of countries from which cases were imported.

The top 10 included Cyprus, Portugal, and Austria nearby, reported by patients 26, 22, and 21 times, respectively.

Also at the top of the list were India, Pakistan and South Africa, all of which are currently grappling with the world's worst outbreaks.

The data do not indicate whether there is a relationship between the timing of the epidemic in each country and the timing of patients' travel.

In other words, all 11 cases from India could have been imported in March. Or they could have been in the past couple of months as the outbreak is still ongoing.

The list also included distant tourist spots famous for their hot climates and crystal clear oceans – Barbados (18), the Bahamas (6), Antigua and Barbuda (4), Jamaica (3) and the Dominican Republic (3) .

Some were reported more frequently than nearby countries such as Belgium (4), Malta (1) and Denmark (1).

The data extend over several months. During this time, the spread of the disease has changed dramatically. It first focused on Asia before moving to Europe and now America.

Despite the coronavirus emerging in China for the first time, only three of nearly 23,000 patients said they had been there in the two weeks before symptoms developed.

Likewise, fewer than ten patients reported traveling to Thailand and the Philippines, where Covid-19 first spread from China.

Very few countries were on the original list of high-risk Covid-19 hotspots identified by the government in February.

In early February, travelers from Thailand, Japan, South Korea, Hong Kong, Taiwan, Singapore, Malaysia, Macau, and mainland China were advised to call NHS 111 if they felt even slightly uncomfortable.

The government said it had identified nine countries "based on the volume of air traffic from the affected areas, understanding of other travel routes and the number of cases reported".

Six NHS hospital patients said they had returned from Japan, four each from Singapore and Malaysia and only one each from South Korea and Hong Kong.

But no patients said they were from Taiwan, Macau, Vietnam or Japan. Fewer cases may be reported from these countries considering how far they are from the UK.

In addition, the British are unlikely to travel there after the January and February returns brought large numbers of citizens back to the UK – while people were still traveling freely to and from Europe.

Or, it could be due to a lack of data – several other hospital patients may have visited one of these early hotspots, but this was not recorded.

Conversely, the government's announcement at the beginning of March that people from France, Spain and Germany should not be classified as at risk for the coronavirus has not aged well.

The official advice was changed on February 25 to let everyone know they are feeling sick after coming home from northern Italy to self-isolate – at the time, the country had 229 diagnosed cases.

In contrast, Asian countries that the Foreign Office warned about had only dozen cases at the time.

For example, vacationers returning from Cambodia were told to self-isolate if they felt sick, even though the country only had two confirmed cases.

The same was true for Vietnam with 31 cases and Thailand with 53 cases.

country Number of patients who reported travel
Spain 205
United Kingdom 116
Italy 92
France 35
US 32
Cyprus 26th
Portugal 22nd
Austria 21st
Barbados 18th
India 11
Pakistan 10
South Africa 10
UAE 10
Egypt 9
Netherlands 9
Germany 8th
Ireland 8th
Switzerland 8th
Thailand 8th
Turkey 8th
Bahamas 6th
Iran 6th
Japan 6th
Romania 6th
Philippines 5
Antigua and Barbuda 4th
Belgium 4th
Hungary 4th
Malaysia 4th
Mexico 4th
Morocco 4th
Singapore 4th
Australia 3
Brazil 3
Bulgaria 3
China 3
Dominican Republic 3
Jamaica 3
Nepal 3
New Zealand 3
Poland 3
Azerbaijan 2
Canada 2
Czech Republic 2
Ghana 2
Greece 2
Nigeria 2
Norway 2
Saudi Arabia 2
Somalia 2
Andorra 1
Argentina 1
Bangladesh 1
Cambodia 1
Cameroon 1
Cabo Verde 1
Central African Republic 1
Chile 1
Cuba 1
Denmark 1
Hong Kong 1
Iceland 1
Indonesia 1
Jordan 1
Kenya 1
Kuwait 1
Madagascar 1
Maldives 1
Malta 1
Mauritius 1
Panama 1
Qatar 1
Sierra Leone 1
Slovakia 1
Slovenia 1
South Korea 1
Swaziland 1
Yemen 1
Zimbabwe 1

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