The World Health Organization (WHO) continues to produce daily situation reports containing the latest numbers of confirmed cases of COVID-19. As of 8 March 2020, 105,586 cases, including 3,584 deaths, had been confirmed globally.

The outbreak now affects countries in all regions of the world. Outside of China, the Republic of Korea, Italy and Iran have seen the greatest number of cases. A full list of affected countries can be viewed on the Public Health England (PHE) website.

While the WHO has reported that most people who have COVID-19 will experience a mild illness, elderly people and those with existing health problems are at greatest risk of severe illness.

Advice for travellers

Prior to travel, the following should be checked: 

• The Foreign and Commonwealth Office (FCO) website, which provides guidance for UK nationals travelling overseas, including how to seek consular assistance if required. 
• Travel agents or airlines, to access the latest information on local travel restrictions and local authority guidance relating to COVID-19. 
• Travel insurance policies, as the COVID-19 outbreak may impact travel insurance coverage. 
• The FCO countries or territories pages, for the latest travel advice, including: 
  • Travel advisories and restrictions, as these are subject to change they should be checked regularly. The FCO currently advise against all travel to Hubei Province and all but essential travel to the rest of mainland China (not including Hong Kong and Macao). 
  • Entry requirements for the destination, as a number of countries have announced restrictions on entry by travellers from China in response to the outbreak. 
  • Reports of COVID-19 at the destination. Travellers to countries reporting cases of COVID-19 should follow local public health advice.

Returning travellers can check the latest advice on risk areas, including information about self-isolation, from the Health Protection Scotland (HPS) website (travellers returning to Scotland) and the PHE website (travellers returning to other parts of UK).

Travellers from risk areas who develop symptoms on return to the UK, that are compatible with COVID-19, should self-isolate and contact one of the following:

• their General Practitioner or NHS24 out-of-hours (Call 111) (Scotland) 
• NHS 111 (England and Wales) 
• 0300 200 7885 (Northern Ireland)

Travellers can access information on COVID-19, including prevention advice, on the fitfortravel and NHS Inform websites.

Advice for healthcare practitioners

Health professionals should remain vigilant for symptomatic individuals who may have COVID-19.

Guidance on testing, as well as a range of other resource materials, is available from the HPS (for Scotland) and PHE (for the rest of the UK) websites.

Health professionals can access information on COVID-19, including prevention advice, on the TRAVAX website.

Source: TRAVAX, 5 March 2020

The latest report on antimicrobial resistance (AMR) in zoonotic and indicator bacteria from humans, animals and food has been published by the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA), covering the period 2017–2018.

The data show that a large proportion of Salmonella bacteria are multidrug-resistant, meaning they are resistant to three or more antimicrobials. In humans, resistance to ciprofloxacin is common, particularly in certain types of Salmonella, and resistance to high concentrations of ciprofloxacin increased overall from 1.7% in 2016 to 4.6% in 2018. For Campylobacter, 16 out of 19 countries report very high or extremely high percentages of ciprofloxacin resistance.

High levels of resistance to ciprofloxacin are also reported in Salmonella and Escherichia coli (E. coli) bacteria from poultry. Ciprofloxacin is a fluoroquinolone, a class of antimicrobials categorised as critically important for use in humans. If fluoroquinolones lose their effectiveness, the impact on human health could be significant. However, combined resistance to fluoroquinolones and third generation cephalosporines in Salmonella, and to fluoroquinolones and macrolides in Campylobacter, remains low.

In food-producing animals, the summary indicator of susceptibility to all antimicrobials has increased in E. coli across six EU member states over the period 2014-2018. This is seen as a positive development, as it means that, in these countries, treatments with antimicrobials would have a higher chance of being successful, if required.

Source: ECDC, 3 March 2020 and EFSA, 3 March 2020

The European Food Safety Authority (EFSA) has published an epidemiological update on Rift Valley Fever (RVF), including an assessment of the risk of its introduction into the EU.

RVF is a viral zoonosis that primarily affects animals, but also has the capacity to infect humans if they come into contact with the blood, body fluids or tissues of infected animals, or through bites from infected mosquitoes.

RVF is endemic in sub-Saharan Africa and the Arabian Peninsula. Recent outbreaks in a French overseas department and the detection of seropositive cases – animals with RVF antibodies in their blood, indicating previous exposure to the virus - in countries close to Europe, have raised the possibility of incursion into EU territory.

The overall risk of introduction of the disease into the EU through the movement of infected animals is considered to be very low, given the strict policies on animal imports. Despite this, EFSA has recommended that EU authorities and member states should strengthen and improve their surveillance and response capability, as well as their scientific and technical expertise, to ensure better preparation in the event of RVF introduction.

Source: EFSA, 4 March 2020

The Food Standards Agency (FSA) has tightened the controls it expects to see in the production of raw drinking milk in England and Wales.

Raw drinking milk is not pasteurised, the process that kills off harmful bacteria, and instead goes straight from the animal to the bottle. The raw drinking milk guidance document has been developed in response to an increase in raw drinking milk sales in recent years, alongside an increase in outbreaks of illness related to this product.

The guidance outlines the safety measures raw drinking milk producers must follow. They are legally required to devise and implement a safety system, assessing issues which may affect the safety of their product, and identify controls to stop such problems arising.

The guidance, which will be applied from 1 April 2020, does not extend to dairy products made using raw drinking milk.

FSA advice remains that pregnant women, infants and small children, elderly people, and those with weaker immune systems caused by health problems, should not consume raw drinking milk.

Source: FSA, 5 March 2020

According to a new report published by the European Environment Agency (EEA), road traffic is the top source of noise pollution in Europe, with rail, aircraft and industry the other main sources of environmental noise pollution. 

The report provides an update of noise pollution trends over the 2012-2017 period. Additionally, the report estimates future noise projections as well as the associated health impacts in Europe, based on new World Health Organization (WHO) guidelines on the health effects from exposure to noise. Building on the previous EEA assessment of noise in Europe from 2014, the report also looks at actions  taken to manage and reduce noise exposure and reviews progress made to meet EU objectives on noise pollution.

Long-term exposure to noise has significant health impacts. On the basis of the new WHO information, the EEA estimates that such exposure causes 12,000 premature deaths and contributes to 48,000 new cases of ischemic heart disease per year across Europe. It is also estimated that 22 million people suffer chronic high annoyance and 6.5 million people suffer chronic high sleep disturbance.

Source: EEA, 5 March 2020

Production at the Mossmorran ethylene plant in Fife resumed on 21 February 2020, after a five month shutdown. 

On 3 March 2020, the Scottish Environment Protection Agency (SEPA) was notified by ExxonMobil Chemical Ltd of unplanned and elevated flaring at the complex, with normal operations reported to have resumed the following day. SEPA reported that their officers deployed air and noise monitoring during this period of unplanned flaring, with initial data suggesting no breach of UK air quality standards.

Whilst recognising that flaring is an important safety mechanism, SEPA highlight that this incident is a reminder that the plant operator should take short- and medium-term steps to mitigate the flaring, including noise-reducing flare tips and bringing forward plans for fully enclosed ground flares.

Source: SEPA, 4 March 2020

The Climate Change (Emissions Reduction Targets) (Scotland) Act 2019 aims to reduce emissions of all greenhouse gases in Scotland to net-zero by 2045, with incremental targets to be met in the interim period.

Against this backdrop, calls for fairness in climate change action and securing a ‘just transition’ have grown, referring to the need for governments to take action to reduce emissions in a way which is fair and leaves no-one behind. The Just Transition Commission has been established with the aim of providing Scottish ministers with practical, realistic, and affordable recommendations for action that will:

• maximise the economic and social opportunities that the move to a net-zero economy offers 
• build-on Scotland’s existing strengths and assets 
• understand and mitigate risks that could arise in relation to regional cohesion, equalities, poverty (including fuel poverty), and a sustainable and inclusive labour market

The commission is tasked to work and engage with workers, communities, non-governmental organisations, businesses and other relevant bodies across Scotland. Written submissions to inform the development of the commission’s recommendations are invited to support this work.

More information and the online response form are available on the Scottish Government website.

The Scottish Environmental Incident Surveillance System (SEISS) recorded the following incident in the past week: 

• On 4 March 2020, BBC news reported that a primary school in Bishopbriggs was evacuated after a carbon monoxide leak. Pupils and staff temporarily left Wester Cleddens School after a new alarm picked up traces of the gas. The Scottish Fire and Rescue Service (SFRS) later confirmed a gas boiler had been at fault. The carbon monoxide alarm was fitted after nearby Balmuildy primary was evacuated and closed for several days following a leak in February 2020. East Dunbartonshire Council said children and staff had not been at risk during the Wester Cleddens incident. The gas boiler, which is a back-up to a biomass boiler, will be repaired.

More detailed information can be found on the SEISS website.