As the coronavirus (COVID-19) outbreak continues to evolve, the Foreign, Commonwealth & Development Office (FCDO) advises British nationals against all but essential travel, exempting some countries that no longer pose an unacceptably high risk for British travellers. This advice is being kept under constant review and may change at short notice.

The fitfortravel (for the general public) and TRAVAX (for health professionals) country pages have been updated to include a COVID-19 country specific risk-rating, with every country being identified as high, moderate or low risk and each rating accompanied by appropriate travel advice. This information will be listed in the ‘Alerts’ section on each country page of fitfortravel and the 'Emerging Health Risks' section of every TRAVAX country page. This risk-rating is based on a robust public health assessment of the COVID-19 risks for travellers to each country and is regularly reviewed.

This week, the risk-ratings for the following countries have increased: 

• Estonia (now high risk) 
• Latvia (now high risk) 
• Saint Barthelemy (now moderate risk)

The COVID-19 risk rating and travel advice from the FCDO is being kept under constant review and may change at short notice. All travellers are advised to continue following sensible precautions and consider the following sources of information listed below.

Advice for travellers

Before planning or booking international travel, please check: 

• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• the FCDO website, for country specific Travel Advisory Notices regarding travel and entry restrictions, and review the local medical care available at your destination 
• the COVID-19 risk-rating at your destination, which will be listed in the ‘Alerts’ section of all fitfortravel country pages and the ‘Emerging Health Risks’ section of all TRAVAX country pages 
• the TRAVAX travel insurance page, as such insurance should be considered essential 
• the fitfortravel COVID-19 health considerations for travel page 
• physical distancing and hygiene measures in the country you are visiting

Information relating to travel and COVID-19 is available on the TRAVAX (for healthcare practitioners) and fitfortravel (for the public) websites.

Information on COVID-19 for the general public is available on the NHS Inform (Scotland) and the NHS.UK (rest of the UK) websites.

Information and resources on COVID-19 for health professionals is available on the Health Protection Scotland (HPS) (Scotland) and Public Health England (PHE) (rest of the UK) websites.

World AIDS Day, which falls on 1 December 2020, serves as a yearly reminder of the global HIV and AIDS epidemic. The most recent worldwide report of the UN Joint Programme on HIV/AIDS (UNAIDS) estimated that 38 million people were living with HIV in 2019. As of the end of June 2020, around 26 million people were accessing antiretroviral therapy, up from 6.4 million in 2009. Approximately 1.7 million people were newly infected with HIV in 2019, representing a 40% decrease compared to the peak in 1998. There were around 690,000 AIDS-related deaths worldwide last year, representing a decline of 39% in AIDS-related mortality since 2010.

Information and data on HIV in Scotland is available on the Health Protection Scotland (HPS) website. According to the latest data, which covers the period up to 31 December 2019, an estimated 6,100 people are living with HIV in Scotland, of whom 92% (5,617) are diagnosed.

More information about the campaign and how to get involved is available on the World AIDS Day website.

On 26 November 2020, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe published surveillance data on HIV and AIDS in the European Region for 2019.

HIV transmission remains a major public health concern and affects more than two million people in the WHO European Region, particularly in the eastern countries. The report finds that, while epidemic patterns and trends vary widely across European countries, nearly 137,000 people were diagnosed with HIV in the region in 2019, including 25,000 in the EU/EEA.

Source: ECDC, 26 November 2020

The European Centre for Disease Prevention and Control (EDCD) has published a report on the prevention of hepatitis B and C in the EU/EEA and the UK.

In key messages from the report:

Hepatitis B

• In the EU/EEA and the UK, there are an estimated 4.7 million cases of chronic hepatitis B.
• Hepatitis B disproportionately affects migrants, people in prison settings, men who have sex with men (MSM) and people living with HIV. Prevention efforts should focus on these key affected populations as well as pregnant women and healthcare workers.
• Monitoring data on hepatitis B prevention show that coverage of vaccination programmes for children and key selected adult populations, antenatal screening and birth dose vaccination to prevent vertical transmission, haemovigilance, and sexual and nosocomial transmission prevention must be improved in many countries to reach the 2020 targets set by the World Health Organization (WHO).

Hepatitis C

• In the EU/EEA and the UK, there are an estimated 3.9 million cases of chronic hepatitis C.
• Hepatitis C disproportionately affects people who inject drugs (PWID), people in prison settings, MSM and people living with HIV. Prevention efforts are most critically needed for PWID, including in harm reduction settings and prisons.
• Data on hepatitis C prevention targets show that significant improvements in implementation of prevention strategies among PWID, including needle and syringe programmes and opioid substitution therapy, will be needed in many countries to reach the WHO targets for 2020.

Source: ECDC, 24 November 2020

On 20 November 2020, the European Food Safety Authority (EFSA) reported a high-risk of avian influenza moving into previously unaffected European countries. In the month previous to this report, more than 300 cases have been reported in Belgium, Denmark, France, Germany, Ireland, the Netherlands, Sweden and the UK. The majority of the detections were in wild birds, although there have been a handful of outbreaks in poultry. The new report rates the likelihood of the virus spreading from wild birds to poultry as high.

No human cases have been detected in the new outbreaks so far, and the EFSA highlight that the risk of transmission to the general public remains very low.

Source: EFSA, 20 November 2020

The Food Standards Authority (FSA) has published the results of an EU survey monitoring antimicrobial-resistant bacteria in beef and pork sold at retail in the UK. The annual survey, which was carried out between January and December 2019, tests meat products on sale in the UK for the presence of certain types of antimicrobial resistant (AMR) Escherichia coli (E. coli).

The FSA report that levels of AMR E. coli contamination in retail beef and pork have held steady, with less than 1% of samples having E. coli with the types of AMR being monitored. These findings are similar to those made in previous beef and pork surveys in 2015 and 2017.

Source: FSA, 24 November 2020

An assessment by the European Food Safety Authority (EFSA) has concluded that genome editing techniques that modify the DNA of plants do not pose more hazards than conventional breeding or techniques that introduce new DNA into a plant.

Genome editing changes the DNA of animals, plants and microorganisms with high precision. The technology has a wide range of applications, from new therapies for cancer and inherited diseases, to increasing the muscle mass of livestock, and can also be used to produce plants with desired traits, such as disease resistance, drought tolerance, or enhanced nutritional profiles. However, there is a societal concern genome editing may lead to adverse effects to human health and the environment.

Currently, in the EU, genome edited organisms are required to undergo a safety assessment according to the provisions laid down in legislation before being authorised.

Source: EFSA, 24 November 2020

The European Environment Agency (EEA) has published its report on air quality in Europe for 2020, which shows that six member states, Bulgaria, Croatia, Czech Republic, Italy, Poland, and Romania, exceeded the EU's limit value for fine particulate matter (PM2.5) in 2018. Only Estonia, Finland, Iceland and Ireland had fine particulate matter concentrations that were below the World Health Organization's (WHO) stricter guideline values.

The EEA report notes that there remains a gap between the EU's legal air quality limits and WHO guidelines, an issue that the European Commission seeks to address with a revision of the EU standards under the Zero Pollution Action Plan.

Source: EEA, 23 November 2020