International travel continues to be impacted due to COVID-19, and the number of variant strains which have emerged globally. Guidance on international travel is available for people living in Scotland, England, Wales and Northern Ireland.

On 15 December 2021, all countries were removed from the international travel red list, meaning travellers to the UK from countries previously on the list will no longer have to stay in hotel quarantine for ten days on arrival. Despite no countries remaining on the red list, the policy is continuing in Scotland 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 list.

It should be noted that the travel lists may be amended at short notice, and 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.

All passengers aged 12 years or over, arriving in Scotland, must take a pre-departure COVID-19 test in the two days before they depart for the UK, and must take a PCR test on or before day two, and self-isolate until they receive a negative result. They must also complete a Passenger Locator Form (PLF).

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 include a COVID-19 country specific risk-rating, which identifies the risk of exposure to COVID-19 for UK travellers. This information is 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 identifies each country as having either: 

• a high risk of exposure to COVID-19 for UK travellers, or 
• a 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.

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, December 2021

On 14 December 2021, the Scottish Government published the terms of reference for the public inquiry into the handling of coronavirus (COVID-19) in Scotland.

The terms of reference were informed by public engagement and are subject to a period of reflection by the chair, Lady Poole, who will be able to suggest adjustments, which may include taking the remit of the UK-wide COVID-19 inquiry into account.

The period covered by the inquiry will be from 1 January 2020 to 31 December 2022, but it will also consider pandemic planning undertaken prior to this. The chair will now begin the process of appointing staff so the inquiry can begin considering evidence.

Source: Scottish Government, 14 December 2021

The Africa Cup of Nations football tournament takes place in Cameroon from 9 January until 6 February 2022, with matches due to be played in the cities of Yaounde, Doula, Bafoussam, Garoua and Limbe.

Advice for travellers

International travel continues to be impacted by COVID-19, and with the emergence of the Omicron variant, many countries have put new travel restrictions in place. Travellers should be aware that there is the ongoing risk of further restrictions being announced at very short notice.

During the tournament, stadiums and surrounding areas are likely to be crowded and travellers should be aware that this increases the risk of respiratory illnesses, such as COVID-19.

Before booking travel, travellers should be advised to consider the following guidance.

• Review the Foreign, Commonwealth and Development Office (FCDO) guidance for entry requirements, restrictions, screening and quarantine requirements for travel to Cameroon, and any other countries visited or transited through. 
• Check the risk of exposure to coronavirus in Cameroon on the TRAVAX country page (for health professionals) or the fitfortravel country page (for the general public). 
• Consider the risk of developing severe COVID-19 and the availability of medical facilities in Cameroon. 
• Ensure they have adequate travel insurance cover for the duration of their trip. 
• Consider how they will arrange COVID-19 testing at their destination prior to return to the UK. 
• Be aware of UK Border Force rules for entering the UK during return travel.

Aside from COVID-19, a full risk assessment of the different health risks a traveller may potentially be exposed to during their trip is required. The risks may vary depending on the amount of time spent in Cameroon, further travel around the country, onward travel to another destination, and leisure pursuits.

Following the assessment, travellers should be advised on: 

• yellow fever entry requirements 
• polio exit requirements 
• vaccine preventable disease risks 
• malaria 
• non-vaccine preventable disease risks

Travellers should be reminded to always seek medical advice if they develop a fever either during travel or after they return home, and inform their health professional regarding recent travel history, particularly if they have been in a malaria endemic country such as Cameroon.

Source: TRAVAX, 13 December 2021

The Winter Olympic Games are scheduled to be held in China between 4 and 20 February 2022, with the Winter Paralympic Games scheduled between 4 and 13 March 2022. Winter sport events are to be held in various venues across the cities of Beijing, Zhangjiakou and Yanqing district.

The Beijing 2022 Playbooks outline the responsibilities of all participants and health and safety rules that must be followed, including information specific to COVID-19 precautions. The Playbooks are jointly developed by Beijing 2022, the International Olympic Committee (IOC) and the International Paralympic Committee (IPC), in close collaboration with the Chinese Government and relevant authorities, and will be regularly updated as guidelines change.

The UK Foreign, Commonwealth and Development Office (FCDO) currently advise that all direct flights from the UK to mainland China have been suspended, and a future review date has not yet been given.

Source: TRAVAX, 10 December 2021

The Times of India has reported that a case of Zika virus disease was identified in Shadipur, northeast Delhi, in late November 2021, the first known occurrence of the disease in the Delhi area.

On 30 November 2021, the Indian Minister of State for Health reported that India had reported 231 other cases of Zika virus infection so far this year, with 147 in Uttar Pradesh, 83 in Kerala, and one in Maharashtra. 

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 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, 14 December 2021

On 16 December 2021, the World Health Organization (WHO) announced that the outbreak of Ebola Virus Disease (EVD), which began on 10 October 2021 in North Kivu Province of the Democratic Republic of the Congo (DRC), is now over. The last case was discharged from hospital on 4 November 2021, with the total number of cases reported as 11, which included nine deaths.

EVD is a type of viral haemorrhagic fever (VHF), which is spread through contact with the blood, body fluids or organs of a person or animal with the infection.

Advice for travellers

When Ebola outbreaks occur, generally the risk of travellers becoming infected or developing EVD is extremely low.

Travellers returning home from an Ebola outbreak area should seek rapid medical attention by contacting NHS 24 (Scotland) or NHS 111 (rest of UK) for advice prior to attending UK medical facilities if they develop a high temperature (fever) and have: 

• returned to the UK within 21 days from a region or area with a known outbreak of EVD 
• had contact with individuals infected with a viral haemorrhagic fever (VHF)

Further information and advice on VHFs are available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Source: TRAVAX, 16 December 2021

Food Standards Scotland (FSS) and the Food Standards Agency (FSA) are reminding reptile owners who have purchased certain frozen feeder mice for their pets to take extra precautions in order to avoid contracting salmonellosis. An outbreak of Salmonella has been linked to specific frozen mice products and as a result, a product recall information notice detailing affected products has been issued. 

FSS and the FSA are instructing reptile owners and others who have a supply of the affected frozen mice to return them to the place of purchase so they can be carefully disposed of. They are also warning people to be extra careful when handling any frozen rodents, not just the batches identified, due to the risk of Salmonella from other batches linked to this recall.

Since the outbreak was first reported in 2015, there have been almost 900 cases of illness. FSS and the FSA advise that the risk to the general public is considered to be very low.

Source: FSS, 14 December 2021

The Scottish Environment Protection Agency (SEPA) has announced that Scotland’s bathing water quality is the best it has been since 2015, when tighter standards first came into force, with almost all sites now classified as ‘sufficient’ or ‘better’ for next season.

The SEPA report has highlighted several key points. 

• 99% of Scotland’s designated bathing waters met the required environmental water quality standards for the 2021 bathing water season. 
• 38% of bathing waters achieved ‘excellent’ status, the highest number since new standards first came into force in 2015. 
• Significant improvement was achieved at Ayr (South Beach), which achieved ‘good’ status. 
• Farmers and land managers have continued to show good compliance with environmental protection measures.

Source: SEPA, 13 December 2021

The UK’s first deposit return scheme will go live across Scotland on 16 August 2023, with the aim of recycling billions of bottles and cans every year. People will pay a 20 pence deposit when they buy a drink that comes in a single-use container made of polyethylene terephthalate (PET) plastic, steel and aluminium, or glass, and will get their money back when they return the empty container to a return point.

Key milestones for delivery of the scheme include: 

• a public awareness campaign will be launched by August 2022, while counting and sorting centres will start to be built 
• rolling out the return infrastructure by retailers, which will start from summer 2022 
• a community-run return scheme operating in Orkney by November 2022 
• the process to register producers will be undertaken by Circularity Scotland and the Scottish Environment Protection Agency (SEPA) in January 2023 
• end-to-end testing of containers through the system will occur by July 2023

Source: Scottish Government, 14 December 2021

The Scottish Government, in partnership with Zero Waste Scotland, Keep Scotland Beautiful and the Scottish Environment Protection Agency (SEPA), is seeking views on the aims, objectives and actions that will sit under the new National Litter and Flytipping Strategy for Scotland.

These proposed actions sit within three strategic themes that were agreed by stakeholders, these being: 

• behaviour change 
• services and infrastructure 
• enforcement

The consultation is open until 31 March 2022 and can be completed online.

Source: Scottish Government, 13 December 2021

Public Health Scotland (PHS) would like to wish all readers a merry Christmas and a happy and healthy New Year. The next weekly report will be published on 11 January 2022.

We hope you will find these links helpful during the festive season: 

• NHS Inform 
  • coronavirus (COVID-19)
  • booster vaccination  
  • self-help guide: flu-like illness
  • flu vaccine  
  • services directory 
• Scottish Government 
  • Ready Scotland (dealing with emergencies)  
• Food Standards Scotland (FSS)  
  • Christmas food safety checklist
  • turkey cooking guide