Scotland is home to most of the worst coronavirus hotspots in Europe, data analysed by The National reveals.
The region of Lanarkshire in Scotland has a higher infection rate than any comparable area in the EU, excluding the French overseas territory of Guadeloupe.
In a ranking of 242 European regions by their recent infection rates, Scottish areas take up eight of the top 11 places.
Only Scotland’s outlying islands were outside the top 25 regions in Europe, according to data from the European Centre for Disease Control and Prevention.
Scotland’s summer surge has been blamed partly on children returning to schools in mid-August — earlier than in England.
Ministers say that transmission linked to schools is not just because of the virus spreading in classrooms, but also due to adults mixing more when they drop off and pick up their children.
The surge has raised fears of a looming wave of infections in England, where schools returned this week with many of last year’s restrictions gone.
Prof Christina Pagel, a health expert at University College London who reviewed the Scottish data, said cases were rapidly rising among school-aged children.
But scientists are not certain that schools are the only factor. Cases began to rise before students went back to class in Scotland.
“There are other possible reasons for this such as increased mixing generally in areas where there had been relatively low past disease incidence,” said Prof Paul Hunter at the University of East Anglia.
“In my view transmission within schools will certainly be occurring but how important that is compared to other transmission pathways, I at least am not sure about.”
Scottish First Minister Nicola Sturgeon said last week that some increase had been expected but that the scale of the rise was “extremely concerning”.
Deaths in Scotland have risen much less sharply, with more than 82 per cent of adults having received two vaccine doses.
Prof Pagel said a lower peak of hospital admissions compared to January was due to a mixture of the vaccination rate and many Covid patients being young.
Ms Sturgeon said she was “hopeful that we can turn the corner without having to reimpose any restrictions”. Most curbs were lifted in August, with large crowds allowed back into football grounds and other venues.
Scotland delayed the lifting of restrictions compared to England, where limits on social gatherings ended three weeks earlier.
The devolved government in Edinburgh sets its own health and education policy, and has sometimes taken a more cautious approach than London.
As of early September, more than half of Scotland’s health regions had two-week infection rates higher than 1,000 new cases per 100,000 people.
Parts of Wales and Northern Ireland were also above this line. None of England’s nine regions were above the threshold.
In the EU, only a handful of French regions had such high rates. Parts of England, Wales and Greece were also near the top of the table.
Outbreaks in France’s overseas territories have been blamed for travel restrictions that affect the mainland.
In England, ministers hope that a £25 million ($34.5m) investment in air quality monitors will limit infections in schools this term.
The equipment will be used to check ventilation in classrooms. Experts say that good ventilation can reduce the spread of the virus.
A report on England published on Wednesday found that people in the north were more likely to die of Covid-19 and suffer more severe economic effects.
The Northern Health Science Alliance, which published the report, said the mortality rate was 17 per cent higher in the economically poorer north.
“Our report shows how regional health inequalities before Covid have resulted in an unequal pandemic,” said Prof Clare Bambra, one of the authors of the report.
“The economic impact of the lockdown is also looking likely to exacerbate the regional economic divide. The government’s levelling up agenda needs to seriously address health inequalities in the north — for all generations.”