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Health consideration

Courtesy : who.int

Health consideration

Many countries have halted some or all international travel since the onset of the COVID-19 pandemic but now have plans to re-open travel. This document outlines key considerations for national health authorities when considering or implementing the gradual return to international travel operations.

The decision-making process should be multisectoral and ensure coordination of the measures implemented by national and international transport authorities and other relevant sectors and be aligned with the overall national strategies for adjusting public health and social measures.

The gradual lifting of travel measures (or temporary restrictions) should be based on a thorough risk assessment, taking into account country context, the local epidemiology and transmission patterns, the national health and social measures to control the outbreak, and the capacities of health systems in both departure and destination countries, including at points of entry.  Any subsequent measure must be proportionate to public health risks and should be adjusted based on a risk assessment, conducted regularly and systematically as the COVID-19 situation evolves and communicated regularly to the public.

2. OBJECTIVE

The objective of this document is to provide governments, health authorities of WHO Member States and relevant stakeholders with elements to consider in adjusting international travel measures to the changing epidemiological situation of the COVID-19 pandemic, national public health and health service capacity available in countries and evolving understanding of the virus. This document should be read in conjunction with other relevant WHO guidance, particularly WHO COVID-19 Strategy update 14 April 2020,  Considerations for adjusting public health and social measures, the Scientific Brief on transmission of SARS-CoV-2, 09 July 2020 and the WHO Strategic Preparedness and Response Plan (SPRP) .

3. FACTORS TO BE CONSIDERED FOR RESUMING INTERNATIONAL TRAVEL

Each country should conduct a risk-benefit analysis and decide on its priorities.

WHO recommends that priority should be given to essential travel for emergencies, humanitarian actions (including emergency medical flights and medical evacuation), travel of essential personnel (including emergency responders and providers of public health technical support, critical personnel in transport sector such as seafarersand diplomatic officers), and repatriation. Cargo transport should also be prioritized for essential medical, food and energy supplies. Sick travellers and persons at risk including elderly travellers and people with chronic diseases or underlying health conditions, should delay or avoid travelling internationally to and from areas with community transmission.

There is no “zero risk” when considering the potential importation or exportation of cases in the context of international travel. Therefore, thorough and continuous risk assessment and management will help identify, reduce and mitigate those risks, while balancing the socio-economic consequences of travel measures (or temporary restrictions) against potential adverse public health consequences.

The decision process should include an analysis of the situation, taking into account the local context in countries of departure and destination. The following factors should be considered: local epidemiology and transmission patterns, the national public health and social measures for controlling the outbreaks in both departure and in destination countries; public health and health service capacity at national and subnational levels to manage suspect and confirmed cases among travellers, including at points of entry (ports, airports, ground crossings) to mitigate and manage the risk of importation or exportation of the disease; and the evolving knowledge about COVID-19 transmission and its clinical features.

3.1 Epidemiological situation and transmission patterns at origin and destination countries

Because the COVID-19 epidemiological situation will vary among countries, international travel, carries different levels of risk of exportation/importation of SARS-CoV-2 virus, depending on the passenger’s country of departure and country of arrival. The epidemiological situation of COVID-19 in each country is available through WHO Situation Reports, which follow the transmission scenarios defined in the Interim Guidance WHO Global surveillance for COVID-19 caused by human infection with COVID-19 virus, 20 March 2020[6]. Four scenarios are considered:

Many countries have halted some or all international travel since the onset of the COVID-19 pandemic but now have plans to re-open travel. This document outlines key considerations for national health authorities when considering or implementing the gradual return to international travel operations.

The decision-making process should be multisectoral and ensure coordination of the measures implemented by national and international transport authorities and other relevant sectors and be aligned with the overall national strategies for adjusting public health and social measures.

The gradual lifting of travel measures (or temporary restrictions) should be based on a thorough risk assessment, taking into account country context, the local epidemiology and transmission patterns, the national health and social measures to control the outbreak, and the capacities of health systems in both departure and destination countries, including at points of entry.  Any subsequent measure must be proportionate to public health risks and should be adjusted based on a risk assessment, conducted regularly and systematically as the COVID-19 situation evolves and communicated regularly to the public.

2. OBJECTIVE

The objective of this document is to provide governments, health authorities of WHO Member States and relevant stakeholders with elements to consider in adjusting international travel measures to the changing epidemiological situation of the COVID-19 pandemic, national public health and health service capacity available in countries and evolving understanding of the virus. This document should be read in conjunction with other relevant WHO guidance, particularly WHO COVID-19 Strategy update 14 April 2020,  Considerations for adjusting public health and social measures, the Scientific Brief on transmission of SARS-CoV-2, 09 July 2020 and the WHO Strategic Preparedness and Response Plan (SPRP) .

3. FACTORS TO BE CONSIDERED FOR RESUMING INTERNATIONAL TRAVEL

Each country should conduct a risk-benefit analysis and decide on its priorities.

WHO recommends that priority should be given to essential travel for emergencies, humanitarian actions (including emergency medical flights and medical evacuation), travel of essential personnel (including emergency responders and providers of public health technical support, critical personnel in transport sector such as seafarersand diplomatic officers), and repatriation. Cargo transport should also be prioritized for essential medical, food and energy supplies. Sick travellers and persons at risk including elderly travellers and people with chronic diseases or underlying health conditions, should delay or avoid travelling internationally to and from areas with community transmission.

There is no “zero risk” when considering the potential importation or exportation of cases in the context of international travel. Therefore, thorough and continuous risk assessment and management will help identify, reduce and mitigate those risks, while balancing the socio-economic consequences of travel measures (or temporary restrictions) against potential adverse public health consequences.

The decision process should include an analysis of the situation, taking into account the local context in countries of departure and destination. The following factors should be considered: local epidemiology and transmission patterns, the national public health and social measures for controlling the outbreaks in both departure and in destination countries; public health and health service capacity at national and subnational levels to manage suspect and confirmed cases among travellers, including at points of entry (ports, airports, ground crossings) to mitigate and manage the risk of importation or exportation of the disease; and the evolving knowledge about COVID-19 transmission and its clinical features.

3.1 Epidemiological situation and transmission patterns at origin and destination countries

Because the COVID-19 epidemiological situation will vary among countries, international travel, carries different levels of risk of exportation/importation of SARS-CoV-2 virus, depending on the passenger’s country of departure and country of arrival. The epidemiological situation of COVID-19 in each country is available through WHO Situation Reports, which follow the transmission scenarios defined in the Interim Guidance WHO Global surveillance for COVID-19 caused by human infection with COVID-19 virus, 20 March 2020[6]. Four scenarios are considered:

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