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.

Travellers arriving directly into Scotland from any country outside the Common Travel Area (UK, Ireland, Isle of Man and Channel Islands) must quarantine for ten days and have a valid Managed Quarantine Facility booked prior to their departure, unless they have an exemption. Travellers who have been in, or travelled through a red list (acute risk) country in the previous ten days, will currently be refused entry to the UK. British or Irish Nationals, and those who have residence rights in the UK, will be able to enter but must quarantine in a government approved managed quarantine hotel for ten days.

The list of countries on the red list (acute risk) is continuously being reviewed and updated based on the risk of new variants of COVID-19 being imported into the UK, and may change at short notice. Travellers should be aware that the rules vary depending on which of the UK four nation countries they arrive in, and should follow the rules both for the UK nation they will be arriving into and for their home nation. More detailed information for travellers arriving in Scotland is available on the Scottish Government website, while information is also available for entry into England, Wales and Northern Ireland.

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 guidance 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.

Advice for travellers

Before planning or booking international travel, travellers should consider if their journey is essential and legally permitted.  The following sources should be consulted both prior to travel and during the trip, as guidance may change at short notice: 

• 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 
• the UK Border Control website, in order to check current rules regarding self-isolation (quarantine) before your planned return to the UK 
• requirements for COVID-19 testing at their destination prior to 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, 19 March 2021

The European Centre for Disease Prevention and Control (ECDC) has published 2019 annual epidemiological reports for: 

• Tick-borne encephalitis (TBE) – 25 EU/EEA countries reported 3,411 cases of TBE in 2019, 3,246 of which were confirmed. 
• Zika virus disease (ZIKV) – 71 cases of ZIKV disease were reported in the EU/EEA in 2019. This included five locally acquired cases, three autochthonous vector-borne cases, one case of sexual transmission, and one case of non-mosquito borne transmission. In total, 92% of cases of ZIKV disease with known importation status were from returning travellers.

Sources: ECDC, 24 March 2021 and ECDC, 24 March 2021

The World Health Organization (WHO) European Regional Office for Europe and the European Centre for Disease Prevention and Control (ECDC) have published an epidemiological situation report on tuberculosis (TB) in Europe for 2019.

In key findings from the report: 

• 49,752 cases of TB were reported in 29 EU/EEA countries, resulting in a notification rate of 9.6 per 100,000 of the population 
• 38,267 (76.9%) of all notified TB cases were newly diagnosed 
• adults aged between 25 and 64 years accounted for 65.3% of all new and relapse TB cases 
• children under 15 years of age accounted for 4.1% of all new and relapse TB cases 
• new and relapse TB cases were more frequently reported in males than females, with a male-to-female ratio of 1.8

Source: ECDC, 22 March 2021

The World Health Organization (WHO) estimates that almost a quarter of the world’s population is infected with the tuberculosis (TB) bacterium, and between five to 10% of those develop active TB disease in their lifetime. To mark World TB Day 2020, the WHO has published two sets of updated guidelines to support efforts in preventing people with TB infection developing active TB disease.

The ‘WHO Consolidated Guidelines on TB’ contains 18 recommendations on preventive TB treatment. The main changes introduced in the updated guidelines include conditional recommendations for a one-month daily rifapentine and isoniazid regimen, and a four-month daily rifampicin regimen as alternative treatment options in all TB burden settings. The guidelines are designed to be used primarily in national TB and HIV programmes.

The ‘WHO Operational Handbook on TB: Prevention’ provides practical advice on how to put the WHO recommendations into place at the scale needed to achieve national and global impact. The chapters of the handbook cover critical steps in programmatic management of TB preventive treatment, following the cascade of preventive care. This includes identifying individuals at highest risk, testing for infection, excluding active TB, choosing the treatment option that is best suited to an individual, managing adverse events, supporting medication adherence, and monitoring programmatic performance.

Source: WHO, 24 March 2021

The World Health Organization (WHO) has validated Côte d'Ivoire as successfully eliminating human African trypanosomiasis, also known as sleeping sickness, as a public health problem, becoming the second African country after Togo to do so.

In the 1990s, Côte d'Ivoire reported hundreds of cases of sleeping sickness every year. Cases have progressively declined over the last two decades, and in the past few years, the country has reported fewer than ten cases per year. At this low level, Côte d'Ivoire qualifies as having eliminated the disease as a public health problem. Treatment of infected people meant that the vector, the tsetse fly, could no longer transmit the disease to others. This had to be maintained over years in order to progressively eliminate the disease.

Sleeping sickness is a potentially fatal disease spread by the bite of an infected tsetse fly, a species native to the African continent. More than 60 million people living mainly in rural parts of 36 countries across East, Central and West Africa are at risk of contracting the disease.

Source: WHO, 25 March 2021

A collaborative study between the European Centre for Disease Prevention and Control (ECDC), the European Food Safety Authority (EFSA), and the European Union Reference Laboratory (EURL) has published their report describing molecular epidemiology of listeriosis in humans and Listeria monocytogenes in food. After ingestion of L. monocytogenes bacteria via contaminated food, infection can cause severe, life-threatening disease, often manifested as septicaemia and/or meningitis, particularly among elderly and immunocompromised people, as well as complications related to pregnancy.

This collaborative study was initiated in 2010, with the aim of describing using a one health approach the molecular epidemiology of listeriosis in humans and food in a two-year period. The study on L. monocytogenes in food was conducted on three categories of ready-to-eat food, including packaged hot or cold smoked or cured fish, soft or semi-soft cheeses, and packaged heat-treated meat products. The report presents the objectives, methods, results, and conclusions of the study, as well as recommendations for further studies.

Source: ECDC, 24 March 2021

From 1 April 2021, Food Standards Scotland (FSS) will take on formal responsibility for making sure businesses comply with laws ensuring feed for animals is safe in Scotland. FSS will pick up this role from Scottish local authorities, who have been responsible for delivering the service at present.

FSS will provide additional support and funding to organisations involved in this work and, under new regulations introduced by the Scottish Parliament, will be able to delegate functions to other qualified organisations to help with delivery. 

Source: FSS, 23 March 2021

Since 26 March 2021, the law around organ and tissue donation in Scotland changed to an opt-out system, meaning most adults who die in circumstances where they are able to donate, will be considered as having agreed to be a donor, unless they have recorded a decision not to.

The ‘Donation and Transplantation Plan for Scotland: 2021 to 2026’ outlines further steps to help those in need of operations, including the use of new technology to allow more organs to be used for transplant. There are many factors which affect whether donation can go ahead, and only around 1% of people die in circumstances where that is possible. The plan, developed with the Scottish Donation and Transplant Group (SDTG), also makes recommendations to help ensure Scotland can increase the numbers of people who donate tissue after they die, and to help improve the care given to patients in the years after their transplant.

The plan covers recommendations in seven priority areas: 

• implementation and evaluation of the Human Tissue (Authorisation) (Scotland) Act 2019 
• increasing organ transplantation, including through novel technologies 
• reducing missed referrals and other missed opportunities for deceased organ and tissue donation 
• increasing living donation and reducing the wait for a kidney transplant, with a focus on living donation being the first option patients should consider 
• improving transplant recipient support and aftercare 
• research and innovation 
• public health improvement

Source: Scottish Government, 24 March 2021

The European Environment Agency (EEA) has published its annual transport and environment report for 2020, assessing the impact of travel by train and aircraft. The European Green Deal includes an objective to reduce greenhouse gas emission from transport by 90% by 2050, when compared with figures from 1990, and shifting to more sustainable transport may help in achieving this objective.

Transport accounted for 25% of EU greenhouse gas emissions in 2018, with road transport accounting for 72% of transport emissions, while marine transport and aviation represented 14% and 13% of emissions respectively, and rail a share of 0.4%. Apart from their direct contribution to global warming and air pollution, emissions that take place during the production, transmission and distribution of energy used by trains and aircraft are also considered.

The EEA assessment concludes that rail travel is the best and most sensible mode of travel, apart from walking or cycling.  Aviation’s emission impacts are much higher on a passenger per kilometre basis, although the report notes that flying is not necessarily the most harmful choice. Travel by a petrol or diesel-powered car, especially if traveling alone, can be more harmful. 

Source: EEA, 24 March 2021