Travel restrictions and self-isolation (quarantine) rules have been implemented across the UK since the start of the coronavirus pandemic in March 2020, in order to reduce the spread of COVID-19 and protect the health of the public. To help achieve this, the range and type of measures have varied over time as the pandemic has evolved. In recent months, new variants of SARS-CoV-2, the virus causing COVID-19, have been detected around the world, including the UK, with some, including the UK variant, able to transmit more easily between people. Concern remains that further virus variants could emerge that may cause more severe illness, or evade immunity provided by COVID-19 vaccines. The stringency of current UK travel restrictions is aimed at avoiding new variants being imported into the UK, while also stopping travellers exporting the UK variant during international travel.

The Foreign, Commonwealth & Development Office (FCDO) provides guidance on travelling abroad, including the latest information on COVID-19 and other non-COVID-19 risks such as safety and security, entry requirements and travel warnings. This advice is being kept under constant review and may change at short notice.

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, 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.

In January 2021, the COVID-19 risk for UK travellers was increased in 20 countries. As of 29 January 2021, Rwanda was the latest country to be added to this list. The outbreaks index on the TRAVAX (for healthcare practitioners) and the news section of the fitfortravel (for the public) websites can be consulted for further details.

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 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

COVID-19: Health Considerations for Travel

Travellers from international destinations, including returning UK nationals, must have proof of a negative COVID-19 test prior to arrival in Scotland, England, Wales and Northern Ireland. The test must be undertaken a maximum of 72 hours prior to departure for the UK. Travellers will have to make arrangements in the destination country to access testing. Failure to provide proof of a negative COVID-19 test, or a valid exemption, may result in boarding being denied for the journey, or a fine on arrival. This measure is in addition to the need to self-isolate on return to the UK.

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.

Source: TRAVAX, 29 January 2021

The European Centre for Disease Prevention and Control (ECDC) reports continued transmission of dengue in islands of the French Antilles. The islands affected so far are: 

• Guadeloupe, which has reported 22,800 cases, including two deaths, from October 2019 and 9 January 2021. 
• Saint Martin, which has reported 2,700 cases, including one death, from January 2020 to 9 January 2021. 
• Saint Barthelemy, which has reported 1,435 cases from April 2020 to 9 January 2021. 
• Martinique, which has reported 32,650 cases, including 17 deaths, from November 2019 to 9 January 2021.

Dengue is the second most common identified cause of febrile illness in returning travellers and the number of cases continues to increase. All travellers to endemic regions are potentially at risk of dengue fever and should be aware of this infection. Prevention relies on avoiding mosquito bites at all times.

Travellers developing a fever during or on return from travel are advised to seek medical attention as soon as possible.

Information and advice for travellers on dengue is available from the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 29 January 2021

The European Centre for Disease Prevention and Control (ECDC) has published two annual epidemiological reports on communicable diseases in Europe for 2019. 

• The Lassa fever annual report for 2019 reported two imported cases of Lassa fever in the Netherlands. No further cases of Lassa fever or other viral haemorrhagic fevers caused by arenaviruses were reported in the EU/EEA. 
• The yersiniosis annual report for 2019 reported 7,048 confirmed cases of yersiniosis in the EU/EEA. The overall notification rate of 1.7 per 100,000 of the population has remained stable from 2015 to 2019. The highest rates were reported by Finland, Lithuania and the Czech Republic.

Sources: ECDC, 25 January 2021 and ECDC, 25 January 2021

The European Centre for Disease Prevention and Control (ECDC) has published its annual epidemiological report on leptospirosis for 2016. In total, 26 EU/EEA countries reported 783 confirmed cases of leptospirosis, with a notification rate of 0.17 cases per 100,000 of the population. Human leptospirosis was reported more commonly in adults, with notification rates being higher for males than females in all age groups. Leptospirosis shows a strong seasonality, with higher rates in summer and autumn.

Source: ECDC, 25 January 2021

The World Health Organization’s (WHO) Global Tuberculosis (TB) Programme has revised the definition of extensively drug-resistant TB (XDR-TB), and also defined pre-XDR-TB for the first time.

The new definition of pre-XDR-TB is: 

• TB caused by Mycobacterium tuberculosis (M. tuberculosis) strains that fulfil the definition of multidrug resistant and rifampicin-resistant TB (MDR/RR-TB), and which are also resistant to any fluoroquinolone.

The updated definition of XDR-TB is: 

• TB caused by M. tuberculosis strains that fulfil the definition of MDR/RR-TB and which are also resistant to any fluoroquinolone and at least one additional Group A drug. Group A drugs are the most potent group of drugs in the ranking of second-line medicines for the treatment of drug-resistant forms of TB, using longer treatment regimens and comprise levofloxacin, moxifloxacin, bedaquiline, and linezolid.

The new definitions for pre-XDR and XDR-TB aim to help define more precisely groups of TB patients who require complex treatment regimens. The WHO hope that these new definitions will also lead to better reporting, surveillance and monitoring of drug-resistant TB.

Source: WHO, 27 January 2021

The World Health Organization (WHO) has launched a new ten-year plan for neglected tropical diseases (NTDs), setting ambitious targets and innovative approaches toward tackling 20 diseases which affect more than a billion mainly poor people and thrive in areas where access to quality health services, clean water and sanitation is scarce.

The overarching 2030 global targets are: 

• reduce by 90% the number of people requiring treatment for NTDs 
• eliminate at least one NTD in 100 countries or more 
• eradicate two diseases (dracunculiasis and yaws) 
• reduce by 75% the disability-adjusted life years (DALYs) related to NTD

Additionally, the road map will track 10 cross-cutting targets and disease specific targets that include a reduction by more than 75% in the number of deaths from vector-borne NTDs such as dengue, leishmaniasis and others, promote full access to basic water supply, sanitation and hygiene in areas endemic for NTDs and achieve greater improvement in collecting and reporting NTD data disaggregated by gender.

Source: WHO, 28 January 2021

The European Centre for Disease Prevention and Control (ECDC) has published its strategy for 2021 to 2027, with the stated goal of ensuring that decision-makers continue to receive the necessary advice and scientific evidence to support changes in policy and practice in the area of communicable disease prevention and control.

Source: ECDC, 29 January 2021

World Cancer Day is a global initiative led by the Union for International Cancer Control (UICC), and 2021 marks the final year of the ‘I Am and I Will’ campaign. The campaign is a call-to-action, urging personal commitment and emphasising that individual action taken now will impact on the future. The multi-year campaign hopes to create a long-lasting impact by increasing public awareness and engagement, building global awareness, and focusing on impact-driven action.

In 2021, the campaign will focus on the power of cooperation and collective action to achieve a healthier, brighter world without cancer. 

Source: World Cancer Day, February 2021

The Scottish Government has announced an additional £250 million in funding over the next five years, with the aim of improving and increasing services for people affected by drug addiction. The funding follows the publication in December 2020 of statistics which showed that, in 2019, there were 1,264 drug related deaths in Scotland.

The proposed actions include: 

• substantially increasing the number of residential rehabilitation beds across Scotland 
• reducing stigma and increasing the number of people in treatment for their addiction 
• allocating funding directly to alcohol and drug partnerships, third sector, and grassroots organisations to improve work in communities 
• widening the distribution of naloxone 
• implementing new standards for medicine-assisted treatment to ensure equitable services for all drug users 
• reassessing how overdose prevention facilities might be established, despite legal barriers

Source: Scottish Government, 20 January 2021

The European Environment Agency (EEA) has published a briefing measuring the extent and condition of European ecosystems. Protecting ecosystems and biodiversity are key policy targets in both the EU’s biodiversity strategy for 2030, and the European Green Deal. Both EU and national policymaking require approaches to be developed, in order to measure the extent and condition of ecosystems, with the aim of improving their management. This briefing presents the EEA’s work on ecosystem extent accounts and pilot ecosystem condition accounts in the EU INCA project.

The EEA has developed a set of ecosystem extent accounts that aim to provide good spatial insight into the distribution and trends of up to 30 ecosystem types in Europe. Pilot accounts on ecosystem condition have been produced for species trends, freshwater quality, and nutrient pressures.

Source: EEA, 26 January 2021

The European Environment Agency (EEA) has published a report outlining the effect of plastics on the environment and climate, and examines their place in a European circular economy. The report looks at plastics production, consumption and trade, the environmental and climate impact of plastics during their life cycle, and explores the transition towards a circular plastics economy through pathways involving policymakers, industry, and consumers.

The report shows that the production, use, and trade of plastics continue to grow. The EEA point to three pathways to address the challenges posted by plastics, including smarter use, increased circularity, and the use of renewable raw materials.

Source: EEA, 28 January 2021