From 04:00 on 18 March 2022, the COVID-19 rules for entering the UK from abroad have changed, with all travellers to the UK, regardless of their COVID-19 vaccination status, no longer being required to:

• take pre-departure or post-arrival COVID-19 tests
• show proof of their vaccination status when arriving in the UK
• complete a passenger locator form
• quarantine on arrival to the UK 

It should be noted that these rules only apply to travellers arriving in the UK, as many other countries still have restrictions in place for travellers entering their country from abroad. Therefore, travellers still have a requirement to check and follow the entry requirements and rules for each of the countries they will be travelling to. Details of these rules can be found on the FCDO foreign travel advice pages.

UK travellers are advised to follow the advice below if planning on travelling abroad.

1. Review the FCDO foreign travel advice pages for the latest information on coronavirus, safety and security, entry requirements and travel warnings.
   
   
   • Travellers should check the advice for each of the countries they intend to travel or transit through.
   • Some countries may refuse entry to travellers from the UK if the level of COVID-19 is high in the UK.
   • The FCDO may advise against travelling to a country if their level of COVID-19 is high.
   • Also, note the TRAVAX coronavirus FAQ page provides useful advice on:
     • obtaining proof of vaccination status to travel abroad
     • where travellers can obtain a COVID-19 test to travel abroad
     • travellers who have not been fully vaccinated against COVID-19
     • obtaining a negative PCR test if they recently had COVID-19 infection
     • COVID-19 recovery certificates
       
       
2. Check the risk of exposure to coronavirus (COVID-19) at their destination, which will be listed under the Emerging Health Risks tab of each TRAVAX country page. Travellers should consider their risk of developing severe COVID-19 and check the availability of medical facilities at their destination, while being aware that services may be overwhelmed due to COVID-19.
   
   
3. Travellers should ensure they have adequate travel insurance cover for the duration of their trip.
   
   
4. Travellers should check the UK border force rules for re-entering the UK and be aware of any additional rules depending on if they are travelling to Scotland, England, Northern Ireland or Wales.
   
   
5. Travellers should consider other health risks when travelling during the COVID-19 pandemic, as they may be exposed to a range of illnesses and health risks during travel, other than COVID-19.

Travellers should be advised to review the fitfortravel country pages relevant to their destinations to find:

• up-to-date travel health recommendations for that country
• advice on health risks to be aware of at their destination
• if there is a need to consider receiving any vaccinations, boosters or purchasing antimalarial tablets before travel

All travellers should comply with local public health requirements, such as physical distancing, wearing of face coverings, self-isolation etc in the country they are visiting and to maintain good hand hygiene and respiratory hygiene measures at all times regardless of their vaccination status or if they have recovered from COVID-19 infection. 

Detailed advice on points to consider when planning travel, including advice on reducing the risk of exposure to coronavirus (COVID-19), can be found on the fitfortravel website.

Currently COVID-19 vaccines are not available solely for the purposes of travel, however travellers should be encouraged to participate in the UK COVID-19 vaccination programme. 

Travellers should be advised to always seek medical advice if they develop a fever and have recently travelled abroad and to advise their health care professional about recent travel history, particularly if they have travelled to a malaria-endemic country. 

Source: TRAVAX, 18 March 2022

The Fijian Ministry of Health reports continuing outbreaks of leptospirosis (Weil’s disease) this year, with 991 cases, including 25 deaths, being recorded in Fiji from 1 January until 9 March 2022. 

Leptospirosis is a bacterial infection transmitted to humans from the urine of infected animals, often rodents with infection often occurring from water contaminated by infected animal urine. 

Advice for travellers 

Travellers participating in adventure and ecotourism, water-based sports activities, athletic endurance events, mountain biking and military exercises have an increased chance of exposure, especially if travelling to known-risk destinations. 

Travellers at increased risk of infection should be advised:

• of the risk of infection and to seek medical help after potential exposure if they become symptomatic
• to avoid exposure to potentially contaminated water especially of mucosa (swallowing or inhaling water) and abraded skin, including excoriated insect bites
• to wear protective clothing if exposure is unavoidable
• to cover open skin lesions with waterproof plasters and wash or disinfect any injuries sustained during possible exposure
• to wash or shower thoroughly after possible exposure 

It should be noted there is no licensed vaccine available in the UK to treat leptospirosis. 

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

Source: TRAVAX, 16 March 2022

As of 14 March 2022, the Australian Department of Health reported 18 cases, including two deaths, of Japanese encephalitis virus (JEV) across the states of New South Wales, Queensland, South Australia and Victoria. People in these areas are advised to avoid mosquito bites. 

JEV is a mosquito-borne virus which affects the central nervous system and is most commonly found around areas of rice and pig farming, with transmission occurring from animals, mainly pigs or birds, to humans through the bite of an infected Culex mosquito which feeds in the hours around dusk. No human-to human transmission occurs. 

Advice for travellers 

All travellers to endemic countries or outbreak areas are potentially at risk of infection. This risk is greatest for those:

• travelling to rural areas during transmission seasons
• participating in outdoor activities during twilight hours
• travelling for a prolonged period of time

All travellers should be advised on:

• the risks and potentially severe consequences of JEV
• practicing strict mosquito bite avoidance measures, including correct use of insect repellents
• minimising outdoor activities during twilight hours when Culex mosquitoes bite 

Travellers at increased risk of developing severe clinical disease are those:

• with pre-existing chronic medical conditions
• younger than 10 years of age
• older than 50 years of age 

For most travellers the risk of acquiring infection will be very small, but vaccination should be considered among those:

• frequently exposed to bites in rural infected areas, such as backpackers, agricultural workers and volunteers
• at ongoing risk or repeatedly visiting high risk areas, such as flood plains, rice paddies, marshlands and pig farms
• staying for short periods during epidemics
• staying for long periods in infected areas
• going to live in an endemic area 

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

Source: TRAVAX, 16 March 2022

On 9 March 2022, the Global Polio Eradication Initiative (GPEI) reported one case of polio in an unvaccinated person in Israel. 

Advice for travellers

• Poliomyelitis is spread mainly through person-to-person contact via the faecal-oral route, and travellers should be offered a booster dose of poliomyelitis vaccine if it has been more than ten years since their last dose. 

More information can be found on the TRAVAX Israel and Occupied Palestinian Territories and poliomyelitis webpages (for health professionals) and on the fitfortravel Israel and Occupied Palestinian Territories and poliomyelitis webpages (for the general public). 

Source: TRAVAX, 11 March 2022

The thirty-first meeting of the Emergency Committee under the International Health Regulations (IHR) (2005), regarding the international spread of wild poliovirus (WPV), was convened via video conference by World Health Organization (WHO) Director-General, Dr Tedros Adhanom Ghebreyesus, on 28 February 2022. 

The committee agreed that the situation still constitutes a Public Health Emergency of International Concern (PHEIC) and recommended the extension of the temporary recommendations for a further three months, although the committee noted concerns regarding the lengthy duration of the polio PHEIC and the importance of exploring alternative IHR measures in the future. 

Under IHR (2005), proof of polio vaccination recorded on an International Certificate of Vaccination or Prophylaxis (ICVP), given between four weeks to 12 months before departure, may be required on exit from the following countries:

• Afghanistan
• Pakistan
• Madagascar
• Malawi
• Yemen

The global situation with polio virus is ongoing and TRAVAX users are urged to check the polio vaccination recommendations and documentation requirements on individual country pages. 

Advice for travellers 

Travellers should be encouraged to take strict precautions with food, water and personal hygiene. Further information can be found on the TRAVAX poliomyelitis page. 

In order to comply with the latest WHO temporary recommendations and to ensure travellers do not receive the live oral polio vaccine (OPV) unnecessarily when departing polio-infected countries, authorities in the UK have made a number of vaccination recommendations.

• Travellers should consider receiving a booster dose of a polio-containing vaccine if they have not had one in the past 12 months and will be visiting one of the polio-infected or potentially exporting countries for longer than four weeks. This supersedes current advice given in the Green Book.
• Travellers should acquire this booster dose within 12 months of the date they plan to leave the polio-infected country.
• Travellers visiting one of these countries for less than four weeks should ensure they are up-to-date with routine polio vaccination, including ten-yearly boosters.
• Travellers should carry proof of vaccination. For countries listed above, proof of vaccination should be documented on the standard ICVP. 

International Certificate of Vaccination or Prophylaxis (ICVP) 

The ICVP is the yellow booklet normally used for yellow fever vaccination. Failure to produce an ICVP when departing a polio-endemic country may result in the traveller being vaccinated on their departure, often using live OPV, which may cause problems for individuals with weakened immune systems, including pregnancy, who should not receive live OPV. 

In Scotland, paper ICVP’s can be obtained from Public Health Scotland (PHS) by emailing your full name and postal address to the TRAVAX administration team, with TRAVAX polio FAQs providing further clarification. For the rest of the UK, paper ICVP's can be obtained from the National Travel Health Network and Centre (NaTHNaC). 

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

Source: TRAVAX, 16 March 2022

The World Health Organization (WHO) has announced that it is providing guidance to, and working with, countries of the European Region to strengthen health system capacity in order to accommodate large numbers of refugees and ensure provision of essential health services, in particular access to vaccinations. 

Many of the countries in the European Region receiving refugees from Ukraine are already offering vaccination services to children and adults. This is necessary in mitigating the risk of COVID-19 transmission among people travelling or living in close quarters, in protecting refugees from diseases that may be circulating in the host country and preventing any outbreaks of vaccine-preventable diseases, such as measles and polio. 

Hungary, Poland, the Republic of Moldova and Romania in particular have seen large numbers of refugees crossing the border from Ukraine over the past weeks. The WHO is working with these and other countries to strengthen disease surveillance and to ensure provision of immunization services, in line with the immunization schedules and policies of the host countries. 

WHO/Europe recommends that all countries in the region:

• continue efforts to ensure their resident populations are fully vaccinated
• ensure refugee populations are fully included in any mass vaccination or routine immunization activities against polio, measles, rubella, COVID-19 and other vaccine-preventable diseases
• consider offering vaccination against polio, measles and rubella as a priority to incoming refugee children under the age six years who have missed any routine vaccinations
• prepare user-friendly communication tools in a language understood by the refugees on benefits of vaccination, recommended vaccines, possible side effects and ways to access the vaccines 

To maintain high population immunity against polio and to mitigate the risk of importation and circulation of poliovirus, the WHO say all individuals and population groups should receive equitable access to, and administration of, polio vaccines in accordance with the national immunization schedules for children and adults of the host country. 

As some countries of the region are still considered endemic for measles and rubella, refugees should be vaccinated against these diseases as a priority to protect them from infection in host countries, in line with national vaccination schedules of the host country. 

To prevent severe COVID-19 disease and deaths and reduce morbidity, including post-COVID-19 conditions, COVID-19 vaccines should be offered to all refugees according to eligibility criteria defined in national COVID-19 vaccination policies of each host country. 

Furthermore, access to vaccination services shall be facilitated both for individuals at temporary common shelter sites and for those who stay within local communities. Administered doses for any of the above vaccines shall be recorded and documentation shall be made available to vaccinated individuals for further reference. 

Source: WHO/Europe, 10 March 2022

On 15 March 2022, Scotland's Chief Statistician published a report detailing Scotland’s carbon footprint between 1998 and 2018. The report provides estimates of Scotland’s greenhouse gas emissions on a consumption basis, covering emissions associated with spending by Scottish residents on goods and services, wherever in the world these emissions arise, together with emissions directly generated by Scottish households. 

The report examines the following key points.

• Between 2017 and 2018, Scotland’s carbon footprint, consisting of emissions from all greenhouse gases, increased by 2.6% from 68.7 to 70.4 million tonnes carbon dioxide equivalent (MtCO2e) from 2017 to 2018. This increase was mainly related to emissions associated with imported goods and services, although domestic emissions also increased in 2018.
• Between 1998 and 2017, Scotland’s carbon footprint fell by 30.5%, from 101.3 MtCO2e in 1998 to 70.4 MtCO2e in 2018.
• Scotland’s carbon footprint rose from 2004 onwards to a peak of 107.6 MtCO2e in 2007, before falling sharply in the following years and, with the exception of 2012 and 2018, fell each subsequent year. The overall reduction between the 2007 peak and 2018 was 34.5%. 

Source: Scottish Government, 15 March 2022

On 17 March 2022, the European Environment Agency (EEA) published a briefing, which found that Europe’s drive towards sustainability may benefit from a wider and joint approach to the use of the vital resources which underpin the functioning of core production and consumption systems. 

The briefing puts forward the concept of the resource nexus, which specifically looks at the interlinkages between resources, and further examines the role the nexus can play in supporting policy coherence and integration in the context of the European Green Deal. 

Applying the resource nexus to policies can help generate information on synergies and trade-offs across multiple resource-related goals. The briefing uses case studies on organic farming, advanced biofuels and electric vehicles to illustrate. 

The briefing reports that natural resources have been under increased and unprecedented pressure for decades amid growing populations, economic development and changing lifestyles, which in turn has put pressure on the earth’s life-support systems through climate change, biodiversity loss, and changes in the chemical composition of the atmosphere. It is further believed that wise use and management of our natural resources, along with conservation strategies, are central to Europe’s environmental sustainability policy framework, notably through the European Green Deal. 

Source: EEA, 17 March 2022

The Committee on the Medical Effects of Air Pollutants (COMEAP) have announced they are updating their recommendations for quantification of hospital admissions associated with short-term exposures to air pollutants, specifically particulate matter (PM), nitrogen dioxide (NO2) and ozone (O3). These recommendations are intended to inform cost-benefit analyses that will be undertaken to support the development of air quality targets under the Environment Act 2021, formerly the Environment Bill 2020. COMEAP have adopted an approach to evaluating the evidence which has allowed revised recommendations to be made in a timely manner. 

Recent meta-analyses of studies evaluating the associations between (total, all-cause) respiratory and cardiovascular hospital admissions and short-term exposures to PM, NO2 and O3 have been examined and COMEAP have further considered summary effects estimates (coefficients) from single pollutant models derived in meta-analyses of the global literature, undertaken by St George’s, University of London, as the most suitable for use as concentration-response functions to quantify hospital admissions associated with short-term exposures to air pollutants. 

COMEAP recommend that the 24-hour effect estimates for NO2 are used in health impact assessments of interventions to improve air quality. However, concentration response functions for one-hour average concentrations of NO2 might be appropriate for some uses. 

Concentrations of PM2.5 and NO2 are often highly correlated, meaning that associations reported from epidemiological studies likely reflect the effect of both pollutants to some extent. Therefore, using coefficients for both PM2.5 and NO2, for the same health endpoint, within the same assessment would result in an over-estimation of the effect of the air pollution mixture, or of the benefits of interventions to reduce emissions. However, on balance, COMEAP consider that the coefficients for all-year O3 are likely to be independent of those for either PM2.5 or NO2, meaning that that there is less concern about possible over-estimation when using them in a combined assessment. In addition, policy makers should be aware that localised interventions designed to reduce NO2 may have the unintended consequence of increasing localised concentrations of O3. 

COMEAP also draw attention to the uncertainties regarding causality for some pollutant-outcome pairs, notably cardiovascular hospital admissions associated with NO2, as these uncertainties will need to be considered when deciding which pollutant-outcome pairs to include in core assessments or in sensitivity analyses. 

Source: UK Health Security Agency (UKHSA), 16 March 2022

The Committee on the Medical Effects of Air Pollutants (COMEAP) has previously provided advice on how the mortality effects of particulate air pollution can be quantified, with their recommendation being based on the link between levels of fine particulate air pollution (PM2.5) and deaths found in a large population study undertaken in the US. Since that time, a number of other studies have been undertaken, in the UK and elsewhere in Europe, and it is believed that a summary estimate of the results from available studies, published in the peer-reviewed scientific literature in 2013, is suitable to update their recommendation. 

COMEAP report there is good evidence that PM2.5 plays a causal role in shortening life, however sources of pollutants, such as traffic, tend to emit a range of different pollutants, which makes it difficult, in population studies, to disentangle the effects of individual pollutants from each other. Therefore, it is likely that the coefficient linking PM2.5 concentrations with an increased risk of death reflects the effect of both PM2.5 and also, to some extent, of other pollutants, such as other size fractions of PM, nitrogen dioxide (NO2) and other components of the air pollution mixture.

The updated concentration-response function coefficient linking concentrations of PM2.5 with mortality is the same as COMEAP's previous recommendation, with a relative risk of mortality of 1.06 per 10 μg/m3 increase in PM2.5. However, the new summary coefficient has less statistical uncertainty associated with it (95% confidence interval 1.04 - 1.08) than their previous recommendation. This greater precision reflects the larger number of people included when the results of several studies are combined. However, the confidence interval does not reflect other uncertainties in interpreting the available evidence. 

Source: UK Health Security Agency (UKHSA), 16 March 2022

On 15 March 2022, the Scottish Government published their latest quarterly report on the number of suspected drug deaths during 2021. Suspected drug death management information from Police Scotland show there were 1,295 deaths between January and December 2021, indicating a fall of 8%, or 116 deaths, from 2020, when the equivalent number of suspected drug deaths had been recorded at 1,411, though official statistics from National Records of Scotland (NRS) showed the confirmed number of drug-related deaths in 2020 was 1,339. 

For 2021, the figures show that:

• males accounted for 73% of suspected drug deaths, which represents a 3% decrease from 2020
• just over two-thirds of suspected drug deaths were in people aged between 35 and 54 years old
• the number of suspected drug deaths in the under-25 age group was 68, which is 20 fewer than 2020
• there were 288 suspected drug deaths in the last quarter of 2021, between October and December, an increase of three from the previous calendar quarter of July to September, though a decrease of 76 deaths from October to December 2020 

The quarterly management information from Police Scotland presents deaths that the police suspect involves illicit drugs based on reports of attending officers’ observations and initial enquiries at the scene of death, which differs from the annual NRS national statistics on drug-related deaths, as the NRS use data from death registration records supplemented with information from the Crown Office, the Procurator Fiscal Service and forensic pathologists. However, the Police Scotland suspected drug deaths correlate closely with the NRS drug-related death statistics. Since the period ending in December 2018, the rolling 12-month Police Scotland figures have ranged between 3% and 6% above the NRS drug-related death figures. 

Source: Scottish Government, 15 March 2022