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-rating for the following countries has been increased: 

• Namibia 
• Uruguay 
• US Virgin Islands

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.

On 14 December 2020, Public Health England (PHE) reported on hepatitis C (HCV) in England and the UK, with the data for Scotland provided by Public Health Scotland (PHS). In this report, PHE review progress towards World Health Organization (WHO) elimination targets, and highlight the actions needed to reach them. There is also a preliminary assessment of the early impact of COVID-19 on hepatitis services and monitoring in the UK.

PHE report that in the UK in 2019, an estimated 118,000 people were chronically infected with HCV, a fall of around one-third since 2015. Injecting drug use continues to be the most important risk factor for HCV infection in the UK, with data from UK surveys of people who inject drugs suggesting that in 2019 just over half of this group tested positive for HCV antibody, and just under one-quarter had evidence of current infection.

Source: PHE, 14 December 2020

Changes to the questions asked of blood donors will ensure more gay and bisexual men are able to donate blood in the future. Currently, men are not able to donate blood in the UK if they have had sex with another man in the past three months, in-line with previous expert advice.

New recommendations, which the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) is satisfied will continue to ensure blood safety, mean men will no longer be automatically barred from giving blood if they have had sex with another man in the last three months. Instead, each person will be given a more individual risk assessment, which will involve all potential donors being asked a few additional questions about their sexual behaviour. The changes follow recommendations by the specialist steering group for Assessment of Individualised Risk (FAIR), made up of leading medical and academic experts and LGBTI+ groups. 

The Scottish National Blood Transfusion Service (SNBTS) will ensure there is information available for donors to explain the reasons for the changes, and to give reassurance that all information provided by donors is kept strictly in confidence.

Source: Scottish Government, 14 December 2020

In 2003, the World Health Organization (WHO) set a target for influenza vaccination coverage to reach 75% of people aged 65 or over each year. The most recent data, published by the European Health Information Gateway for the period 2018 to 2019, finds that out of 28 reporting countries, only Belarus reached this target, with over 60% coverage being achieved by Ireland, Portugal, the Russian Federation and the UK.

The WHO report that most countries recommend vaccination for those aged 65 years and over, but in half of reporting countries, less than 35% of their older population were vaccinated in 2018 to 2019. Many countries also lack mechanisms to monitor vaccination coverage in target groups, such as older people.

Source: WHO, 15 December 2020

The European Centre for Disease Prevention and Control (ECDC) has published an overview of avian influenza for the period August to December 2020. Between 15 August and 7 December 2020, 561 highly pathogenic avian influenza (HPAI) virus detections were reported in 15 EU/EEA countries and the UK in wild birds, poultry and captive birds. The most affected countries were Germany with 370 cases, Denmark with 65 cases and the Netherlands with 57 cases.

The majority of the detections have been reported in wild birds (n=510), primarily in barnacle goose, greylag goose, and Eurasian wigeon. Raptors have also been detected infected, particularly the common buzzard. The majority of the birds had been found dead or moribund, however, there are also reports of HPAI virus infection in apparently healthy ducks or geese. A total of 43 HPAI outbreaks were notified in poultry, with signs of avian influenza infection being observed in at least 33 outbreaks where the most likely source of infection was indirect contact with wild birds.

Source: ECDC, 11 December 2020

The World Health Organization (WHO) produces international norms on water quality and human health, in the form of guidelines that are used as the basis for regulation and standard setting worldwide. The ‘Guidelines for Drinking-water Quality’ (GDWQ) promote the protection of public health by advocating for the development of locally relevant standards and regulations, the adoption of preventive risk management approaches, and independent surveillance to ensure that water safety plans are being implemented and that national standards are being met.

The GDWQ are updated through a rolling revision process, presenting the latest scientific evidence and addressing key concerns raised by countries. Asbestos and manganese are included in the latest  revision of the GDWQ, and the draft revised background documents are now available for review, with comments requested by 8 February 2021.

Source: WHO, 14 December 2020

Food Standards Scotland (FSS) has published a report on diet in Scotland, which used an online tool to collect dietary intake data and compare with dietary recommendations. The report provides detailed dietary intakes from a representative sample of 1,053 people living in Scotland and forms part of FSS’s dietary surveillance programme to assess dietary intakes in Scotland against the Scottish Dietary Goals (SDGs).

In key findings from the report: 

• Reported intakes of saturated fat (12.8%) and non-milk extrinsic sugars (11.9%) need to reduce to meet the SDGs. 
• Reported fruit and vegetable intake (2.9 portions per day) and fibre intake (15.9g per day) need to increase to meet the SDGs. 
• Reported intakes of total fat (33.8%) meet the SDG.

As this is a new methodology for monitoring diet in Scotland, it is not possible to compare directly with previous FSS dietary surveillance, however the results are broadly aligned with findings of other surveys which demonstrate that the majority of the SDGs are not being met and the FSS believe that diet in Scotland needs to change.

Source: FSS, 17 December 2020

The European Environment Agency (EEA) has published a briefing on trends and projections in the EU Emissions Trading System (ETS) in 2020. Greenhouse gas emission from stationary installations covered by the ETS dropped by 9.1% in 2019 compared to 2018 levels, the largest drop in a decade. This change was found to be largely driven by a strong shift in the fuels used for electricity generation, from coal towards less carbon-intensive energy sources such as gas and renewables. However, emissions from aviation continued to increase, reflecting increasing demand for air travel in 2019.

In 2019, the number of EU ETS emission allowances auctioned decreased by 36% compared to 2018, however total revenues from auctions increased by 447 million euros due to higher carbon prices. EU countries project that their emissions under the trading system will continue to decrease in the coming decade, as per current and planned measures, albeit at a considerably slower pace than historically noted. However, these projections do not take into account some of the most recently planned measures, reductions already achieved in 2019, or the impact of the COVID-19 pandemic.

Source: EEA, 14 December 2020

The Scottish Government has launched a consultation on the ‘Climate Change, Net Zero Nation’ draft public engagement strategy, which sets out the overarching framework for engaging the people of Scotland in the transition to a net zero and climate ready nation. The strategy aims to mark a change in how the role of public engagement in climate change is understood, moving from encouraging incremental changes in attitudes and behaviours, to facilitating a society-wide transformation. 

The Scottish Government has published this strategy as a draft for consultation, with the ambition of developing a refreshed approach to collaboration with stakeholders across Scotland. The aim is to maximise the effectiveness and inclusivity of this strategy for the people, communities, and organisations that will be at the heart of delivering it.

The consultation is open until 17 March  2021, and can be viewed on the Scottish Government website.

Health Protection Scotland (HPS), part of Public Health Scotland (PHS), would like to wish all readers a merry Christmas and a happy and healthy New Year. The next HPS Weekly Report will be published on Wednesday 6 January 2021.

We hope you will find these links helpful during the festive season: 

• NHS Inform coronavirus (COVID-19) 
  • self-help guide: flu-like illness 
  • flu vaccine 
  • services directory 
• Scottish Government Ready Scotland (dealing with emergencies) 
• Food Standards Scotland (FSS) Christmas food safety checklist 
  • turkey cooking guide