On 16 November 2021, to coincide with European Antibiotic Awareness Day (EAAD) and World Antibiotic Awareness Week, Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland published the ‘Scottish One Health Antimicrobial Use and Antimicrobial Resistance (SONAAR) in 2020’ report.

The report reflects the One Health approach that encompasses antibiotic use and resistance in humans, animals, environment and food, with the interactions between them required to tackle antimicrobial resistance (AMR) effectively. This report reiterates the importance of human and animal health professionals working together to preserve the effectiveness of antibiotics, while also providing information on the use of antibiotics by humans and in small animal veterinary practices, and levels of antibiotic resistance found in a range of important human and animal infections. ARHAI Scotland will continue to expand these areas in future years.

The report reveals that total antibiotic use by humans continues to fall in Scotland, reflecting the combined efforts of health professionals working together with the public to ensure antibiotics are only prescribed when necessary. The report outlines that, while AMR in humans is generally stable in Scotland, resistance has increased across some bacteria. COVID-19 has impacted healthcare delivery in both hospital and community settings, and the results presented in this report must be interpreted in the context of the impact caused by the pandemic.

The report is intended to support planning, prioritisation and evaluation of initiatives to optimise antimicrobial use and to minimise AMR.

International travel continues to be impacted due to COVID-19, and a number of variant strains have emerged globally, with information on such travel available for people living in Scotland, England, Wales and Northern Ireland.

As of 1 November 2021, there are no countries or territories on the UK’s international travel red list, however the policy is continuing in Scotland, as in the rest of the UK, and some managed quarantine capacity will stay in place in order to react to any change in assessment that would see a country added to the red list. The travel lists do not indicate which destinations are currently allowing UK travellers to enter their country, nor if the Foreign, Commonwealth and Development Office (FCDO) advises against travel to these countries. Information relating to this can be checked on the relevant FCDO foreign travel advice country pages.

Currently, anyone entering Scotland who is over 18 years and fully vaccinated can take a lateral flow test bought from a private provider, instead of a PCR test, on the second day after their arrival, and will also be required to complete a passenger locator form. Travellers who receive a positive lateral flow test result must isolate and book a confirmatory PCR test immediately.

Testing and quarantine rules may differ in Scotland, England, Wales and Northern Ireland, therefore travellers must ensure they comply with the rules appropriate to the UK nation they will be arriving in and reside in, if different.

Country specific COVID-19 risk

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, which identifies the risk of exposure to COVID-19 for UK travellers. 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, previously categorised as either high, moderate or low risk, has been changed, with each country now rated as having either a: 

• high risk of exposure to COVID-19 for UK travellers  
• risk of exposure to COVID-19 for UK travellers

For all countries, travellers should be aware that the risk of COVID-19 may change at short notice. Countries categorised as having a high risk of exposure to COVID-19 either have a high risk of exposure for travellers to COVID-19, or a high risk of emerging or known variants of coronavirus. Travellers should be advised to avoid non-essential travel to high risk countries, even if fully vaccinated against COVID-19.

As of 5 November 2021, the following countries have a FCDO advisory warning against travel and have therefore been classified as having a high risk of exposure to COVID-19: 

• Afghanistan 
• Burundi 
• Democratic People's Republic of Korea 
• Guinea-Bissau 
• Haiti 
• Nicaragua 
• Papua New Guinea 
• Timor Leste 
• Turkmenistan 
• Venezuela 
• Yemen

Advice for travellers

Prior to booking any international travel, travellers must first check if the country they are travelling to is currently accepting UK travellers. 

• The FCDO foreign travel advice country pages have up-to-date information on entry rules, in response to coronavirus (COVID-19), under the ‘Entry Requirements’ section. 
• Travellers should be aware that some countries or territories may require proof of COVID-19 vaccination status for entry. Guidance for demonstrating COVID-19 vaccination status is available for those living in Scotland, England, Wales and Northern Ireland.

It is advised that travellers are aware of all travel restrictions, self-isolation rules and precautions they should take, in order to reduce their risk of exposure to coronavirus (COVID-19) before, during and after travel, as detailed on the fitfortravel COVID-19 health considerations for travel page.

Source: TRAVAX, 2 November 2021

The BBC has reported that at least 89 people, including 17 children, have tested positive for Zika virus infection in a district in Uttar Pradesh, India's most populous state. The first case in Kanpur city was detected on 23 October 2021, and a state health official from the public health department has reported a surge in cases since. This is the first outbreak of the virus in Uttar Pradesh.

Zika virus infection is caused by the Zika virus (ZIKV), and is spread by mosquito bites which in pregnancy may result in congenital Zika syndrome, with potentially severe consequences for babies.

Advice for travellers

All travellers to countries that have reported ZIKV infection should be made aware of the following health advice. 

• Follow mosquito bite avoidance measures, especially travellers who are pregnant or planning pregnancy. 
• If sexually active, using condoms and contraception will help reduce the risk of sexual transmission of ZIKV and the risk of ZIKV in pregnancy, and should be practiced during travel and on return for two months if female, or three months if male. 
• If pregnant, travellers should check with their travel insurance company that they are covered under the policy before booking their trip, and be aware that the risk of ZIKV in any country may change during the time between planning the trip and travelling. 
• For travellers who are pregnant, planning pregnancy and to prevent onward sexual transmission, additional travel recommendations will be listed under the 'Emerging Health Risks' tab of TRAVAX country pages and the ‘Alerts’ section of the fitfortravel country pages.

Further information on ZIKV can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 9 November 2021

The World Health Organization (WHO) and the United States Centres for Disease Control and Prevention (CDC) have published a joint report on progress towards worldwide measles elimination. The report finds that while recorded measles cases have fallen compared to previous years, progress towards measles elimination continues to decline and the potential risk of outbreaks is mounting. During 2020, more than 22 million infants missed their first dose of measles vaccine, three million more than in 2019, marking the largest increase in two decades. Major measles outbreaks occurred in 26 countries and accounted for 84% of all reported cases in 2020.

The WHO and CDC report that compared with the previous year, reported measles cases decreased by more than 80% in 2020. However, during this period measles surveillance also deteriorated, with the lowest number of specimens sent for laboratory testing in over a decade. Weak measles monitoring, testing, and reporting has the potential to risk the ability of countries to prevent outbreaks of measles.

Source: WHO, 10 November 2021

The World Health Organization (WHO) reports that a record number of countries are now monitoring and reporting on antibiotic resistance, with 163 countries responding to the latest global survey on implementation of the Global Action Plan on addressing antimicrobial resistance (AMR). However, more than 90% of those countries noted that COVID-19 has had a negative impact on development and implementation of national plans to tackle AMR, with challenges including reduced funding and a lack of support for coordination meetings, as well as deferred activities in data collection, capacity building, and campaigns.

The WHO report that data from the survey highlights the need to expedite the prioritisation, costing, implementation and monitoring of AMR activities, and to build capacity to ensure the effective functioning of multi-sectoral coordination structures. The report also finds an overall need is required to strengthen political commitment, provide more resources, and build awareness about AMR.

Source: WHO, 11 November 2021

From 1 June 2022, legislation will ban some of the most environmentally damaging single-use plastic items in Scotland.

The ban will mean it is unlawful to make and supply commercially any of the following single-use items: 

• plastic cutlery (forks, knives, spoons, chopsticks and other similar utensils) 
• plastic plates 
• plastic beverage stirrers 
• food containers made of expanded polystyrene 
• cups made of expanded polystyrene

The regulations will also make it unlawful to supply single-use plastic straws and plastic balloon sticks commercially, although these will be subject to exemptions which allow them to be supplied in particular settings and circumstances.

All the restrictions apply to both online and in-store sales, whether free or charged for.

Source: Scottish Government, 11 November 2021

The Scottish Government has launched a consultation on a draft hydrogen action plan, outlining the measures that will be taken over the next five years to support the development of the hydrogen economy in Scotland. The overall aim of the plan is to reduce greenhouse gas emissions from energy systems, homes, industry and transport. The environmental report and partial business and regulatory impact assessment that accompany the draft action plan consider the likely environmental and business and regulatory effects, and compare these against its viable alternatives. 

The consultation paper is available from the Scottish Government website, and participants can fill in the online form to give their views. The consultation closes on 19 January 2022.