Interim advice for preparedness and response to cases of COVID-19 at points of entry in the European Union (EU)/EEA Member States (MS)
The interim advice documents listed below were prepared after a request from the European Commission's Directorate-General for Health and Food Safety (DG SANTE). An ad-hoc working group was established with members from the EU HEALTHY GATEWAYS joint action consortium.
The scope of the advice provided in the documents listed below is to assist public health authorities in developing their short-term and long-term national and local preparedness plans. It further contains useful advice for the air, maritime and ground transport sectors.
POINTS OF ENTRY
and general advice at points of entry for public health measures and screening:
Interim advice for restarting cruise ship operations after lifting restrictive measures in response to the COVID-19 pandemic (Version 1 - 30 June 2020)
Interim advice for preparedness and response to cases of COVID-19 on board ferries after lifting restrictive measures in response to the COVID-19 pandemic.
Advice for ship operators for preparedness and response to the outbreak of COVID-19
It is recommended that the EU HEALTHY GATEWAYS document “Advice for ship operators for preparedness and response to the outbreak of COVID-19” should be read and used also considering the following Commission Guidelines on protection of health, repatriation and travel arrangements for seafarers, passengers and other persons on board ships:
- Commission Guidelines on protection of health, repatriation and travel arrangements for seafarers, passengers and other persons on board ships. (08 April 2020). Available here
Advice for health authorities and ship operators who have decided to suspend sailings and for the long-term docking of ships at the ports of EU/EEA MS during COVID-19 pandemic
It is recommended that the EU HEALTHY GATEWAYS document “Advice for health authorities and ship operators who have decided to suspend sailings and for the long-term docking of ships at the ports of EU/EEA MS during COVID-19 pandemic” should be read and used also considering the following Commission Guidelines on protection of health, repatriation and travel arrangements for seafarers, passengers and other persons on board ships:
- Commission Guidelines on protection of health, repatriation and travel arrangements for seafarers, passengers and other persons on board ships. (08 April 2020). Available here
WHO, WHERE, HOW: Overview of personal protective equipment (PPE) recommended for personnel, crew and passengers at points of entry and on board conveyances in the context of the COVID-19 pandemic (VERSION 4 – 20/05/2020)
and general advice at points of entry for public health measures and screening:
- Buses and bus stations
and general advice at points of entry for public health measures and screening:
- Trains and rail stations
and general advice at points of entry for public health measures and screening:
Communications from the Commission about COVID-19 and transport
Training resources for COVID-19
Online training resources for COVID-19
- EU HEALTHY GATEWAYS JOINT ACTION
- Training of the trainers’ course “Preparedness and response to public health events at airports” (EU HEALTHY GATEWAYS 2019);
- Training of the trainers’ course “Preparedness and response to public health events at ports” (EU HEALTHY GATEWAYS 2019);
- Evidence-based best practices on entry/exit screening for infectious diseases in humans (DG SANTE 2019).
The training materials of the training course are available to the EU MS and access can be given by the EU HEALTHY GATEWAYS joint action (contact email: firstname.lastname@example.org).
All past webinars are listed here https://www.healthygateways.eu/Core-work-packages/Training
To access the available for play-back viewing webinars please apply on the link below by completing the webinar(s) you are interested in: https://www.healthygateways.eu/Contact-Us
Q & A
Τhe following questions were made by participants during the webinars conducted by the EU HEALTHY GATEWAYS joint action in response to the COVID-19 outbreak. Answers are based on guidelines from ECDC and WHO considering the current knowledge about SARS-CoV-2 as of 5 March 2020. Answers were updated to include latest available guidance from ECDC and WHO as of 01 April 2020. For any further information or comment please contact email@example.com
Environmental persistence of SARS-CoV-2
The survival time of SARS-CoV-2 in the environment has been evaluated in recent publications reporting experimental studies that estimated the environmental stability of SARS-CoV-2 as up to three hours in the air post-aerosolisation, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel, albeit with significantly decreased titres . SARS-CoV-2 RNA was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic COVID-19 infected passengers, up to 17 days after cabins were vacated on the Diamond Princess, but prior to conducting disinfection procedures . SARS-CoV-2 has been isolated from respiratory specimens, stool, urine and gastrointestinal mucosa [3-5]. SARS-CoV-2 has also been detected by PCR in rooms where COVID-19 patients were hospitalised, specifically from surfaces of the toilet bowl and sink, and the air exhaust outlets . Furthermore, SARS-CoV-2 was also detected on different objects such as self-service printers used by patients to print the results of their own exams, desktop keyboards, doorknobs and on gloves . In an analysis of 75,465 COVID-19 cases in China, airborne transmission was not reported . There have been no reports of faecal−oral transmission of the COVID-19 virus to date .
Interim guidance for environmental cleaning in non-healthcare facilities exposed to SARS-CoV-2 can be found at: https://www.ecdc.europa.eu/en/publications-data/interim-guidance-environmental-cleaning-non-healthcare-facilities-exposed-2019 .
Guidance on disinfection of environments in healthcare and non-healthcare settings potentially contaminated with SARS-CoV-2 can be found at:
Technical recommendations for cleaning and disinfection on ships
The EU HEALTHY GATEWAYS has developed suggested procedures for cleaning and disinfection of ships during the pandemic or when a case of COVID-19 has been identified on board and are available here: https://www.healthygateways.eu/LinkClick.aspx?fileticket=_qOvPmjVu_E%3d&tabid=97&portalid=0
Technical recommendations for cleaning and disinfection on aircrafts
Following an event of an Acute Respiratory Illness (ARI) case on board, the airline should ensure that cleaning and disinfection procedures are followed consistently and correctly using the licenced products suitable for the aircraft at the highest acceptable concentrations [22, 23]. Special attention should be given to the zone of risk in the cabin area (e.g. seats, headrests, table-tops, handsets, and other materials coming in contact with the suspect case) where the case was seated, as well as all shared facilities and high-touched surfaces[11, 23, 24]. According to EASA guidance, after disembarkation of passenger and crew, the cabin doors should be closed and the air conditioning adjusted to the maximum volume to ensure all air exchange is completed. The service staff who will clean and disinfect the aircraft should be specially trained and apply the standard procedures for cleaning and disinfecting contaminated surfaces with infectious agents using the appropriate PPE.
WHO advises the following procedures for cleaning and disinfection in case a public health event has occurred on board :
- Ensure any disinfection is conducted using products licensed for use in the country occupied. The disinfectants must be tested by a certified laboratory according to the specifications of the aircraft manufacturers for material compatibility tests.
- Any contaminated items must be handled appropriately to mitigate the risk of transmission:
- Disposable items (hand towels, gloves, tissues) should be double bagged and sent to incineration or similar final disposal, according to the States Parties guidelines for infectious waste management.
- Reusable items that can be washed and treated/disinfected (gowns or linens) must be tagged and sent to a facility for washing and treatment, as recommended according to infection control procedures, depending on the type of contamination/infectious agent, if known.
Based on recommended disinfectants for aircrafts during the previous 2003 SARS outbreak and for MERS CoV, the recommended disinfectants are products containing ethanol in concentration of 70% or 0.1% sodium hypochlorite, provided that these products have been tested by a certified laboratory according to the specifications of the aircraft manufacturers for material compatibility tests. For other products, the label of the manufacturer should mention that the disinfectant is effective against emerging viruses or against coronaviruses or that have sporicidal effect.
Detailed guidance for Aircraft preventive disinfection and for aircraft disinfection after an event can be found at the EASA Interim guidance on Aircraft Cleaning and Disinfection in relation to the SARS-CoV-2 pandemics at:
15. European Centre for Disease Prevention and Control, ECDC TECHNICAL REPORT. Infection prevention and control in the household management of people with suspected or confirmed coronavirus disease(COVID-19). 2020, ECDC: Stockholm
Affected areas are defined by WHO in the website https://www.who.int/
In the latest travel advice published by WHO on 29 February 2020, the following are defined as affected areas:
“Affected areas” are considered those countries, provinces, territories or cities experiencing ongoing transmission of COVID-19, in contrast to areas reporting only imported cases. As of 27 February 2020, although China, particularly the Province of Hubei, has experienced sustained local transmission and has reported by far the largest number of confirmed cases since the beginning of the outbreak, lately the situation in China showed a significant decrease in cases. At the same time, an increasing number of countries, other than China, have reported cases, including through local transmission of COVID-19. As the epidemic evolves, it will be expected that many areas may detect imported cases and local transmission of COVID-19. WHO is publishing daily situation reports on the evolution of the outbreak (available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/). The outbreaks reported so far have occurred primarily within clusters of cases exposed through close-contacts, within families or special gathering events. COVID-19 is primarily transmitted through droplets from, and close contact with, infected individuals. Control measures that focus on prevention, particularly through regular hand washing and cough hygiene, and on active surveillance for the early detection and isolation of cases, the rapid identification and close monitoring of persons in contact with cases, and the rapid access to clinical care, particularly for severe cases, are effective to contain most outbreaks of COVID-19 .
Specimen collection and laboratory testing will be conducted at the health care facility where the suspect case has been transferred.
Please see answer to question 1 above.
Although currently there is no evidence of airborne transmission, a precautionary approach is recommended due to uncertainties surrounding the potential for aerosol-mediated transmission of the virus. Transmission through inhalation of aerosols during aerosol-generating procedures, may have occurred in some cases  .
Whenever possible, ships isolation rooms with mechanical ventilation should have negative pressure with minimum of 12 air changes per hour, while isolation rooms with natural ventilation, should provide a ventilation rate of at least 160 litres/second . All air handling units on board the ship should be adjusted to supply 100% outside air and no air recirculation should take place.
This will depend on the policy of each country and authority. Exchange of questions, opinion, and experiences could be done between points of entry or through the central level.
This will be judged by the physician and occupational health specialist for the specific persons and workplace.
This could be applied as a precautionary measure.
Scenario 1: A suspect case is detected on board while a ship is in port and as many travellers are on tours, others walking in the city and others are on board.
Since according to the scenario the symptomatic person is currently on board, the procedures for managing the symptomatic suspect traveller will start immediately on board. The procedures for identifying the close contacts will start immediately with the persons who are currently on board. The procedures for identifying the close contacts who are currently ashore will start once they are back to the ship. If it is feasible, their return back could be arranged earlier than scheduled. All other steps will be followed according to the EU HEALTHY GATEWAYS advice for ship operators: https://www.healthygateways.eu/Novel-coronavirus.
Scenario 2: A suspect case is detected in one of the buses that are transferring passengers to the organized tours (there could be other buses doing the same stops and visiting the same places at the same time of the bus where a suspect case was detected).
The suspect case on board the bus should be transferred with an ambulance to the hospital immediately, if this is feasible. Further advice about management of a suspect case on the bus can be found in the EU HEALTHY GATEWAYS advice for bus operators: https://www.healthygateways.eu/Novel-coronavirus
The identification and management of close contacts on board the ship will take place according to the procedures described in the EU HEALTHY GATEWAYS advice for ship operators: https://www.healthygateways.eu/Novel-coronavirus.
Scenario 3: One of the drivers or guides becomes a suspect case and has performed tours for cruise lines in the past 14 days or is at that moment working with cruise line passengers.
The advice for bus operators should be followed in regard to the suspect driver or guide while on the bus. All persons who had been in close contact with the suspect driver or guide the previous 14 days should be informed about their exposure. Close contacts who are still on board should be managed according to the EU HEALTHY GATEWAYS advice. All other persons who participated in previous cruises and have disembarked should be managed according to the ECDC advice for management of close contacts: https://www.ecdc.europa.eu/en/publications-data/public-health-management-persons-including-health-care-workers-having-had-contact
The items 3.4.6 to 3.4.9 of European Manual for Hygiene Standards and Communicable Disease Surveillance on Passenger Ships are relevant to receiving food provisions on board cruise ships. In addition, items 3.4.10 through 3.4.21 relate to storage of food. The European Manual for Hygiene Standards and Communicable Disease Surveillance on Passenger Ships is available here: http://www.shipsan.eu/Home/EuropeanManual.aspx
There is no special requirement for receiving food due to potential contamination with COVID-19. WHO advises that “It is highly unlikely that people can contract COVID-19 from food or food packaging”. When receiving food, the ship should follow the standard hygiene practises as defined on the HACCP Plan of the ship, as well as follow some general infection control practices. These include reporting of symptoms, frequent hand washing with warm water and soap (the use of gloves does not replace the need for frequent handwashing), physical distancing (by maintain more than 1 meter distance from other crew members, good respiratory hygiene (cover mouth and nose when coughing or sneezing; dispose of tissues and wash hands), frequent cleaning and disinfection of work surfaces and frequently touched surfaces such as door handles. Food workers should avoid touching their nose, mouth and eyes when wearing gloves and without washing their hands first. Moreover, while working with food, hands should be washed after touching nose, mouth and eyes.
Additional information regarding food safety and COVID-19 is available in the WHO Interim Guidance on COVID-19 and Food Safety: Guidance for Food Businesses: interim guidance available here: https://www.who.int/publications-detail/covid-19-and-food-safety-guidance-for-food-businesses
1. van Doremalen, N., et al., Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med, 2020.
2. Moriarty, L.F., et al., Public Health Responses to COVID-19 Outbreaks on Cruise Ships - Worldwide, February-March 2020. MMWR Morb Mortal Wkly Rep, 2020. 69(12): p. 347-352.
3. Ling, Y., et al., Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients. Chin Med J (Engl), 2020.
4. Ren, L.L., et al., Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl), 2020.
5. Holshue, M.L., et al., First Case of 2019 Novel Coronavirus in the United States. N Engl J Med, 2020. 382(10): p. 929-936.
6. Ong, S.W.X., et al., Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient. JAMA, 2020.
7. European Centre for Disease Prevention and Control, ECDC TECHNICAL REPORT. Disinfection of environments in healthcare and nonhealthcare settings potentially contaminated with SARS-CoV-2. 2020, ECDC: Stockholm
8. World Health Organization. Scientific brief - Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations. 29 March 2020 [cited 30/03/20; Available from: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations.
9. European Centre for Disease Prevention and Control, ECDC TECHNICAL REPORT - Guidelines for the use of non-pharmaceutical measures to delay and mitigate the impact of 2019-nCoV February 2020 2020: Stockholm.
10. Klaus, J., et al., Disinfection of aircraft : Appropriate disinfectants and standard operating procedures for highly infectious diseases. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2016. 59(12): p. 1544-1548.
11. European Aviation Safety Agency. Interim guidance on Aircraft Cleaning and Disinfectionin relation to the SARS-CoV-2 pandemics. Issue: 01 –Date: 20/03/2020. 2020 20/03/2020 [cited 27/03/2020; Available from: https://www.easa.europa.eu/sites/default/files/dfu/Interim-guidance-on-Aircraft-Cleaning-and-Disinfection.pdf.
12. World Health Organization, Interim Guidance - Laboratory testing for coronavirus disease (COVID-19) in suspected human cases. 2020.
13. World Health Organization. Summary of SARS and air travel. 2003 23 May 2003 21/1/2020]; Available from: https://www.who.int/csr/sars/travel/airtravel/en/.
14. World Health Organization, Handbook for the Management of Public Health Events in Air Transport. Updated with information on Ebola virus disease and Middle East respiratory syndrome coronavirus. 2015: World Health Organization.
15. World Health Organization. International travel and health Updated WHO recommendations for international traffic in relation to COVID-19 outbreak 29 February 2020. 2020; Available from: https://www.who.int/ith/2019-nCoV_advice_for_international_traffic-rev/en/
16. EU HEALTHY GATEWAYS JOINT ACTION PREPAREDNESS AND ACTION AT POINTS OF ENTRY (PORTS, A., GROUND CROSSINGS),. INTERIM ADVICE FOR PREPAREDNESS AND RES PONSE TO CASES OF COVID-19 AT POINTS OF ENTRY IN THE EUROPEAN UNION(EU)/EUROPEAN ECONOMIC AREA MEMBER STATES (MS) - Public health measures at points of entry. 2020 20/02/2020; 3rd:[Available from: https://www.healthygateways.eu/Novel-coronavirus.
17. Rothe, C., et al., Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. The New England journal of medicine, 2020: p. 10.1056/NEJMc2001468.
18. World Health Organization. Interim guidance - Clinical management of severe acute respiratory infection (SARI) when COVID-19 is suspected. 2020 13 March 2020; Available from: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected.
Disclaimer: This document arises from the EU HEALTHY GATEWAYS Joint Action that was funded by the European Union’s Health Programme (2014-2020).The content of this document represents the views of the authors only and is their sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.
Guidance for COVID-19 from WHO, ECDC, US CDC, EASA, ICAO, IATA, ACI, IFALPA, IFATCA, UIC, IMO, ICS, IOM
World Health Organization
Interim guidance - Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19 29 July 2020 https://www.who.int/publications/i/item/water-sanitation-hygiene-and-waste-management-for-the-covid-19-virus-interim-guidance
Interim guidance - Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected or confirmed. 29 June 2020 https://apps.who.int/iris/bitstream/handle/10665/332879/WHO-2019-nCoV-IPC-2020.4-eng.pdf?sequence=1&isAllowed=y
Interim guidance - Advice on the use of masks in the context of COVID-19. 5June 2020 https://apps.who.int/iris/bitstream/handle/10665/332293/WHO-2019-nCov-IPC_Masks-2020.4-eng.pdf?sequence=1&isAllowed=y
Controlling the spread of COVID-19 at ground crossings: interim guidance, 29 May 2020 – https://www.who.int/publications-detail/controlling-the-spread-of-covid-19-at-ground-crossings
Considerations for mass gatherings in the context of COVID-19: annex: considerations in adjusting public health and social measures in the context of COVID-19, 14 May 2020 https://apps.who.int/iris/handle/10665/332079
Statement on the third meeting of the IHR (2005) Emergency Committee regarding the outbreak of coronavirus disease (COVID-19) https://www.who.int/news-room/detail/01-05-2020-statement-on-the-third-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-coronavirus-disease-(covid-19)
Contact tracing in the context of COVID-19 – 10/05/2020 https://www.who.int/publications-detail/contact-tracing-in-the-context-of-covid-19
Surveillance strategies – 10/05/2020 https://www.who.int/publications-detail/surveillance-strategies-for-covid-19-human-infection
A Joint Statement on medical certificates of seafarers, ship sanitation certificates and medical care of seafarers in the context of the COVID-19 pandemic 22 April 2020 https://www.who.int/docs/default-source/coronaviruse/2020-04-22-ilo-who-imo-joint-statement-on-medical-certificates-of-seafarers-ship-sanitation-certificates-22-april-sg-(003).pdf?sfvrsn=6afdd464_2
Interim guidance. Considerations in adjusting public health and social measures in the context of COVID-19 16 April 2020 https://apps.who.int/iris/bitstream/handle/10665/331773/WHO-2019-nCoV-Adjusting_PH_measures-2020.1-eng.pdf?sequence=1&isAllowed=y
Interim Guidance. COVID-19 and Food Safety: Guidance for Food Businesses: interim guidance. 7 April 2020. https://www.who.int/publications-detail/covid-19-and-food-safety-guidance-for-food-businesses
Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations during severe shortages 06 April 2020 https://www.who.int/publications-detail/rational-use-of-personal-protective-equipment-for-coronavirus-disease-(covid-19)-and-considerations-during-severe-shortages
- Interim recommendations on obligatory hand hygiene against transmission of COVID-19. 1st April 2020 https://www.who.int/who-documents-detail/interim-recommendations-on-obligatory-hand-hygiene-against-transmission-of-covid-19
- Severe Acute Respiratory Infections Treatment Centre 28 March 2020 https://www.who.int/publications-detail/severe-acute-respiratory-infections-treatment-centre
- Modes of transmission of virus causing COVID-19:implications for IPC precaution recommendations. 27 March 2020 https://www.who.int/publications-detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
- Interim guidance Operational considerations for COVID-19 surveillance using GISRS. 26 March 2020. https://apps.who.int/iris/bitstream/handle/10665/331589/WHO-2019-nCoV-Leveraging_GISRS-2020.1-eng.pdf
- Interim Guidance - Management of ill travellers at Points of Entry – international airports, seaports and ground crossings – in the context of COVID -19 outbreak 19 March 2020 https://apps.who.int/iris/bitstream/handle/10665/331512/WHO-2019-nCoV-POEmgmt-2020.2-eng.pdf
- Interim guidance- Global Surveillance for human infection with coronavirus disease (COVID-19). 20 March 2020 https://apps.who.int/iris/bitstream/handle/10665/331506/WHO-2019-nCoV-SurveillanceGuidance-2020.6-eng.pdf
- Interim Guidance - Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19) 19 March 2020 https://www.who.int/publications-detail/considerations-for-quarantine-of-individuals-in-the-context-of-containment-for-coronavirus-disease-(covid-19)
- Interim guidance - Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts. 17 March 2020 https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts
- Coronavirus disease (COVID-19) outbreak: rights,roles and responsibilities of health workers, including key considerations for occupational safety and health 18 March 2020 https://www.who.int/publications-detail/coronavirus-disease-(covid-19)-outbreak-rights-roles-and-responsibilities-of-health-workers-including-key-considerations-for-occupational-safety-and-health
- Interim guidance - Operational considerations for managing COVID-19 cases or outbreak in aviation. 18 March 2020 - https://apps.who.int/iris/bitstream/handle/10665/331488/WHO-2019-nCoV-Aviation-2020.1-eng.pdf
- Interim guidance - Critical preparedness, readiness and response actions for COVID-19. 24 June 2020
- Risk Communication and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response. 16 March 2020. https://www.who.int/publications-detail/risk-communication-and-community-engagement-(rcce)-action-plan-guidance
- Interim guidance - Considerations in the investigation of cases and clusters of COVID-19. 13 March 2020. https://www.who.int/internal-publications-detail/considerations-in-the-investigation-of-cases-and-clusters-of-covid-19
- Q&A on Mass Gatherings and COVID-19. 11 March 2020 https://www.who.int/news-room/q-a-detail/q-a-on-mass-gatherings-and-covid-19
- Interim guidance - Responding to community spread of COVID-19. 7 March 2020 https://www.who.int/docs/default-source/coronaviruse/20200307-responding-to-covid-19-communitytransmission-final.pdf?sfvrsn=ec5fa30a_5
- The COVID-19 risk communication package for healthcare facilities. 2 March 2020 https://iris.wpro.who.int/handle/10665.1/14482
- Q&A on infection prevention and control for health care workers caring for patients with suspected or confirmed 2019-nCoV. 1 March 2020 | Q&A https://www.who.int/news-room/q-a-detail/q-a-on-infection-prevention-and-control-for-health-care-workers-caring-for-patients-with-suspected-or-confirmed-2019-ncov
- Updated WHO recommendations for international traffic in relation to COVID-19 outbreak. 29 February 2020. https://www.who.int/ith/2019-nCoV_advice_for_international_traffic-rev/en/
- Interim Guidance - Operational considerations for managing COVID-19 cases/outbreak on board ships
- Interim Guidance - Key planning recommendations for Mass Gatherings in the context of the current COVID-19 outbreak
- Operational Readiness Checklist for COVID-19. 12 February 2020
- Key considerations for repatriation and quarantine of travellers in relation to the outbreak of novel coronavirus 2019-nCoV. 11 February 2020
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European Centre for Disease Prevention and Control
COVID-19 Rail Protocol: Recommendations for safe resumption of railway services in Europe https://www.ecdc.europa.eu/en/publications-data/covid-19-rail-protocol
COVID-19: EU guidance for cruise ship operations https://www.ecdc.europa.eu/en/publications-data/COVID-19-cruise-ship-guidance
ECDC EASA: COVID-19 Aviation Health Safety Protocol: Guidance for the management of airline passengers in relation to the COVID-19 pandemic https://www.ecdc.europa.eu/en/publications-data/covid-19-aviation-health-safety-protocol
Use of gloves in healthcare and non-healthcare settings in the context of the COVID 19 pandemic https://www.ecdc.europa.eu/en/publications-data/gloves-healthcare-and-non-healthcare-settings-covid-19
Heating, ventilation and air-conditioning systems in the context of COVID-19 https://www.ecdc.europa.eu/sites/default/files/documents/Ventilation-in-the-context-of-COVID-19.pdf
Considerations relating to passenger locator data, entry and exit screening and health declarations in the context of COVID-19 in the EU/EEA and the UK https://www.ecdc.europa.eu/sites/default/files/documents/ECDC-one-page_EntryScreening_Passenger-Locator-and-Health-Declarations.pdf
Options for the decontamination and reuse of respirators in the context of the COVID-19 pandemic https://www.ecdc.europa.eu/en/publications-data/options-decontamination-and-reuse-respirators-covid-19-pandemic
ECDC/EASA Poster: COVID-19 - Plan your journey https://www.ecdc.europa.eu/en/publications-data/poster-covid-19-plan-your-journey
COVID-19 Aviation Health Safety Protocol: Guidance for the management of airline passengers in relation to the COVID-19 pandemic https://www.ecdc.europa.eu/sites/default/files/documents/EASA-ECDC_COVID-19_Operational-guidelines-for-management-of-passengers.pdf
Contact tracing for COVID-19: current evidence, options for scale-up and an assessment of resources needed https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-Contract-tracing-scale-up.pdf
Considerations for infection, prevention and control measures on public transport in the context of COVID-19 https://www.ecdc.europa.eu/en/publications-data/covid-19-prevention-and-control-measures-public-transport
TECHNICAL REPORT - Contact tracing: Public health management of persons, including healthcare workers, having had contact with COVID-19 cases in the European Union - second update https://www.ecdc.europa.eu/en/covid-19-contact-tracing-public-health-management-second-update
TECHNICAL REPORT - Strategies for the surveillance of COVID-19. 9 April 2020 https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-surveillance-strategy-9-Apr-2020.pdf
Rapid risk assessment: Coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK – eighth update – 8 April 2020 https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-coronavirus-disease-2019-covid-19-pandemic-eighth-update
TECHNICAL REPORT - Guidance for discharge and ending isolation in the context of widespread community transmission of COVID-19 – first update. 8 April 2020 https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-guidance-discharge-and-ending-isolation-first%20update.pdf
Using face masks in the community - Reducing COVID-19 transmission from potentially asymptomatic or pre-symptomatic people through the use of face masks. 8 April 2020 https://www.ecdc.europa.eu/en/publications-data/using-face-masks-community-reducing-covid-19-transmission
TECHNICAL REPORT Infection prevention and control in the household management of people with suspected or confirmed coronavirus disease (COVID-19) https://www.ecdc.europa.eu/en/publications-data/infection-prevention-control-household-management-covid-19
- TECHNICAL REPORT Infection prevention and control for COVID-19 in healthcare settings–third update. 31 March 2020. https://www.ecdc.europa.eu/en/publications-data/infection-prevention-and-control-and-preparedness-covid-19-healthcare-settings
- Cloth masks and mask sterilisation as options in case of shortage of surgical masks and respirators. 26 March 2020 https://www.ecdc.europa.eu/sites/default/files/documents/Cloth-face-masks-in-case-shortage-surgical-masks-respirators2020-03-26.pdf
- Disinfection of environments in healthcare and non-healthcare settings potentially contaminated with SARS-CoV-2. March 2020 https://www.ecdc.europa.eu/sites/default/files/documents/Environmental-persistence-of-SARS_CoV_2-virus-Options-for-cleaning2020-03-26_0.pdf
- TECHNICAL REPORT - Considerations relating to social distancing measures in response to the COVID-19 epidemic. 23 March 2020 https://www.ecdc.europa.eu/en/publications-data/considerations-relating-social-distancing-measures-response-covid-19-epidemic
- Information leaflet template on COVID-19 Brochure 10 Mar 2020 https://www.ecdc.europa.eu/en/publications-data/information-leaflet-template-covid-19
- TECHNICAL REPORT - Resource estimation for contact tracing, quarantine and monitoring activities for COVID-19 cases in the EU/EEA. 2 March 2020 https://www.ecdc.europa.eu/en/publications-data/resource-estimation-contact-tracing-quarantine-and-monitoring-activities-covid-19
- Rapid risk assessment: Outbreak of novel coronavirus disease 2019 (COVID-19): increased transmission globally – fifth update. 2 Mar 2020 https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-outbreak-novel-coronavirus-disease-2019-covid-19-increased
- TECHNICAL REPORT - Guidance for wearing and removing personal protective equipment in healthcare settings for the care of patients with suspected or confirmed COVID-19. 28 Feb 2020 https://www.ecdc.europa.eu/en/publications-data/guidance-wearing-and-removing-personal-protective-equipment-healthcare-settings
- TECHNICAL REPORT - Interim guidance for environmental cleaning in non -healthcare facilities exposed to SARS -CoV-2 https://www.ecdc.europa.eu/en/publications-data/interim-guidance-environmental-cleaning-non-healthcare-facilities-exposed-2019
- Guidelines for the use of non-pharmaceutical measures to delay and mitigate the impact of 2019-nCoV February 2020 https://www.ecdc.europa.eu/en/publications-data/guidelines-use-non-pharmaceutical-measures-delay-and-mitigate-impact-2019-ncov
- Personal protective equipment (PPE) needs in healthcare settings for the care of patients with suspected or confirmed novel coronavirus (2019-nCoV) February 2020 https://www.ecdc.europa.eu/en/publications-data/personal-protective-equipment-ppe-needs-healthcare-settings-care-patients
- Current risk assessment on the novel coronavirus situation, 7 February 2020 https://www.ecdc.europa.eu/en/current-risk-assessment-novel-coronavirus-situation
- Interim guidance for environmental cleaning in non-healthcare facilities exposed to 2019-nCoV. 7 February 2020 https://www.ecdc.europa.eu/en/publications-data/interim-guidance-environmental-cleaning-non-healthcare-facilities-exposed-2019
- Technican Report - Public health management of persons having had contact with novel coronavirus cases in the European Union. 29 January 2020.https://www.ecdc.europa.eu/en/publications-data/public-health-management-persons-having-had-contact-novel-coronavirus-cases
- Health emergency preparedness for imported cases of high-consequence infectious diseases - Operational checklist for country preparedness planning in the EU/EEA countries. Stockholm.https://www.ecdc.europa.eu/sites/default/files/documents/Health-emergency-preparedness-imported-cases-of-high-consequence-infectious-diseases.pdf
- Laboratory testing of suspect cases of 2019 nCoV using RT-PCR. 16 Jan 2020 https://www.ecdc.europa.eu/en/publications-data/laboratory-testing-suspect-cases-2019-ncov-using-rt-pcr
- RAPID RISK ASSESSMENT - Outbreak of acute respiratory syndrome associated with a novel coronavirus, China: first local transmission in the EU/EEA − third update. 31 January 2020 https://www.ecdc.europa.eu/sites/default/files/documents/novel-coronavirus-risk-assessment-china-31-january-2020_0.pdf
- Risk assessment guidelines for infectious diseases transmitted on aircraft (RAGIDA). Middle East Respiratory Syndrome Coronavirus (MERS-CoV). January 2020 Stockholm: ECDC.https://www.ecdc.europa.eu/en/publications-data/risk-assessment-guidelines-infectious-diseases-transmitted-aircraft-ragida-middle
- THREAT ASSESSMENT BRIEF - Pneumonia cases possibly associated with a novel coronavirus in Wuhan, China.https://www.ecdc.europa.eu/en/publications-data/pneumonia-cases-possibly-associated-novel-coronavirus-wuhan-china
- Algorithm for management of contacts of probable or confirmed 2019-nCoV cases 30/01/2020. https://www.ecdc.europa.eu/en/publications-data/algorithm-management-contacts-probable-or-confirmed-2019-ncov-cases
- LEAFLET - Advice for travellers: outbreak of a novel coronavirus 2019-nCoV. 30/01/2020.https://www.ecdc.europa.eu/en/publications-data/advice-travellers-outbreak-novel-coronavirus-2019-ncov
- LEAFLET - Advice to healthcare workers: management of patients with 2019-nCoV infection. 30/01/2020. https://www.ecdc.europa.eu/en/publications-data/advice-healthcare-workers-management-patients-2019-ncov-infection
US Centers for Disease Control and Prevention
Peer-reviewed scientific articles on COVID-19 and transportation
- Nikolaou, P. and L. Dimitriou, Identification of critical airports for controlling global infectious disease outbreaks: Stress-tests focusing in Europe. J Air Transp Manag, 2020. 85: p. 101819.
- Daon, Y., R.N. Thompson, and U. Obolski, Estimating COVID-19 outbreak risk through air travel. J Travel Med, 2020.
- Cadnum, J.L., et al., Evaluation of Ultraviolet-C Light for Rapid Decontamination of Airport Security Bins in the Era of SARS-CoV-2. Pathog Immun, 2020. 5(1): p. 133-142.
- Sriwijitalai, W. and V. Wiwanitkit, COVID-19 Outbreak in International Airport - Where the Incidence Case Occurs? Int J Prev Med, 2020. 11: p. 51.
- Zhang, Y., A. Zhang, and J. Wang, Exploring the roles of high-speed train, air and coach services in the spread of COVID-19 in China. Transp Policy (Oxf), 2020. 94: p. 34-42.
- Christidis, P. and A. Christodoulou, The Predictive Capacity of Air Travel Patterns during the Global Spread of the COVID-19 Pandemic: Risk, Uncertainty and Randomness. International Journal of Environmental Research and Public Health, 2020. 17(10): p. 3356.
- Clifford, S., et al., Effectiveness of interventions targeting air travellers for delaying local outbreaks of SARS-CoV-2. J Travel Med, 2020.
- Lau, H., et al., The association between international and domestic air traffic and the coronavirus (COVID-19) outbreak. J Microbiol Immunol Infect, 2020.
- Linka, K., et al., Outbreak dynamics of COVID-19 in Europe and the effect of travel restrictions. Comput Methods Biomech Biomed Engin, 2020: p. 1-8.
- Iacus, S.M., et al., Estimating and Projecting Air Passenger Traffic during the COVID-19 Coronavirus Outbreak and its Socio-Economic Impact. Saf Sci, 2020: p. 104791.
- Xu, J.W., et al., Deep thought of COVID-19 based on Diamond Princess's quarantine and home quarantine. Eur Rev Med Pharmacol Sci, 2020. 24(7): p. 4027-4029.
- Chen, C.M., et al., Containing COVID-19 among 627,386 Persons Contacting with Diamond Princess Cruise Ship Passengers Disembarked in Taiwan: Big Data Analytics. J Med Internet Res, 2020.
- Yamahata, Y. and A. Shibata, Preparation for the Quarantine of The Diamond Princess Cruise Ship for COVID-19 in Japan: Study Design. JMIR Public Health Surveill, 2020.
- Wong, J., et al., High proportion of asymptomatic and presymptomatic COVID-19 infections in travelers and returning residents to Brunei. J Travel Med, 2020.
- Bruinen de Bruin, Y., et al., Initial impacts of global risk mitigation measures taken during the combatting of the COVID-19 pandemic. Saf Sci, 2020: p. 104773.
- Devi, S., Travel restrictions hampering COVID-19 response. Lancet, 2020. 395(10233): p. 1331-1332.
- Hirotsu, Y., et al., Environmental cleaning is effective for the eradication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in contaminated hospital rooms: A patient from the Diamond Princess cruise ship. Infect Control Hosp Epidemiol, 2020: p. 1-8.
- Lytras, T., et al., High prevalence of SARS-CoV-2 infection in repatriation flights to Greece from three European countries. J Travel Med, 2020.
- Arashiro, T., et al., SARS-CoV-2 and Legionella Co-infection in a Person Returning from a Nile Cruise. J Travel Med, 2020.
- Vaidya, R., et al., Travel restrictions and infectious disease outbreaks. J Travel Med, 2020.
- Petersen, E., et al., COVID-19 travel restrictions and the International Health Regulations - call for an open debate on easing of travel restrictions. Int J Infect Dis, 2020.
- Kraemer, M.U.G., et al., The effect of human mobility and control measures on the COVID-19 epidemic in China. Science, 2020.
- [Health protection guideline of passenger transport stations and transportation facilities during COVID-19 outbreak]. Zhonghua Yu Fang Yi Xue Za Zhi, 2020. 54(4): p. 359-361.
- Al Nsour, M., et al., The Role of the Global Health Development/Eastern Mediterranean Public Health Network and the Eastern Mediterranean Field Epidemiology Training Programs in Preparedness for COVID-19. JMIR Public Health Surveill, 2020. 6(1): p. e18503.
- Anzai, A., et al., Assessing the Impact of Reduced Travel on Exportation Dynamics of Novel Coronavirus Infection (COVID-19). J Clin Med, 2020. 9(2).
- Arab-Mazar, Z., et al., Mapping the incidence of the COVID-19 hotspot in Iran - Implications for Travellers. Travel Med Infect Dis, 2020: p. 101630.
- Arashiro, T., K. Furukawa, and A. Nakamura, COVID-19 in 2 Persons with Mild Upper Respiratory Symptoms on a Cruise Ship, Japan. Emerg Infect Dis, 2020. 26(6).
- Bogoch, II, et al., Potential for global spread of a novel coronavirus from China. J Travel Med, 2020. 27(2).
- Bwire, G.M. and L.S. Paulo, Coronavirus disease-2019: is fever an adequate screening for the returning travelers? Trop Med Health, 2020. 48: p. 14.
- Candido, D.D.S., et al., Routes for COVID-19 importation in Brazil. J Travel Med, 2020.
- Chinazzi, M., et al., The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science, 2020.
- Craig, A.T., A.E. Heywood, and J. Hall, Risk of COVID-19 importation to the Pacific islands through global air travel. Epidemiol Infect, 2020. 148: p. e71.
- Dahl, E., Coronavirus (Covid-19) outbreak on the cruise ship Diamond Princess. Int Marit Health, 2020. 71(1): p. 5-8.
- Elachola, H., S.H. Ebrahim, and E. Gozzer, COVID-19: Facemask use prevalence in international airports in Asia, Europe and the Americas, March 2020. Travel Med Infect Dis, 2020: p. 101637.
- Eldin, C., et al., Probable aircraft transmission of Covid-19 in-flight from the Central African Republic to France. Travel Med Infect Dis, 2020: p. 101643.
- Fernandes, E.G., J.D.S. Santos, and H.K. Sato, Outbreak investigation in cargo ship in times of COVID-19 crisis, Port of Santos, Brazil. Rev Saude Publica, 2020. 54: p. 34.
- Gherghel, I. and M. Bulai, Is Romania ready to face the novel coronavirus (COVID-19) outbreak? The role of incoming travelers and that of Romanian diaspora. Travel Med Infect Dis, 2020: p. 101628.
- Gostin, L.O. and L.F. Wiley, Governmental Public Health Powers During the COVID-19 Pandemic: Stay-at-home Orders, Business Closures, and Travel Restrictions. JAMA, 2020.
- Haider, N., et al., Passengers' destinations from China: low risk of Novel Coronavirus (2019-nCoV) transmission into Africa and South America. Epidemiol Infect, 2020. 148: p. e41.
- Kakimoto, K., et al., Initial Investigation of Transmission of COVID-19 Among Crew Members During Quarantine of a Cruise Ship - Yokohama, Japan, February 2020. MMWR Morb Mortal Wkly Rep, 2020. 69(11): p. 312-313.
- Mallapaty, S., What the cruise-ship outbreaks reveal about COVID-19. Nature, 2020. 580(7801): p. 18.
- Meier, B.M., R. Habibi, and Y.T. Yang, Travel restrictions violate international law. Science, 2020. 367(6485): p. 1436.
- Mizumoto, K. and G. Chowell, Transmission potential of the novel coronavirus (COVID-19) onboard the diamond Princess Cruises Ship, 2020. Infect Dis Model, 2020. 5: p. 264-270.
- Mizumoto, K., et al., Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill, 2020. 25(10).
- Moriarty, L.F., et al., Public Health Responses to COVID-19 Outbreaks on Cruise Ships - Worldwide, February-March 2020. MMWR Morb Mortal Wkly Rep, 2020. 69(12): p. 347-352.
- Mouchtouri, V.A., M. Dirksen-Fischer, and C. Hadjichristodoulou, Health measures to travelers and cruise ships in response to COVID-19. J Travel Med, 2020.
- Nakazawa, E., H. Ino, and A. Akabayashi, Chronology of COVID-19 cases on the Diamond Princess cruise ship and ethical considerations: a report from Japan. Disaster Med Public Health Prep, 2020: p. 1-27.
- Nishiura, H., Backcalculating the Incidence of Infection with COVID-19 on the Diamond Princess. J Clin Med, 2020. 9(3).
- Olsen, S.J., et al., Early Introduction of Severe Acute Respiratory Syndrome Coronavirus 2 into Europe. Emerg Infect Dis, 2020. 26(7).
- Pullano, G., et al., Novel coronavirus (2019-nCoV) early-stage importation risk to Europe, January 2020. Euro Surveill, 2020. 25(4).
- Quilty, B.J., et al., Effectiveness of airport screening at detecting travellers infected with novel coronavirus (2019-nCoV). Euro Surveill, 2020. 25(5).
- Rocklov, J., H. Sjodin, and A. Wilder-Smith, COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures. J Travel Med, 2020.
- Russell, T.W., et al., Estimating the infection and case fatality ratio for coronavirus disease (COVID-19) using age-adjusted data from the outbreak on the Diamond Princess cruise ship, February 2020. Euro Surveill, 2020. 25(12).
- Sawano, T., et al., Limiting spread of COVID-19 from cruise ships - lessons to be learnt from Japan. QJM, 2020.
- Wells, C.R., et al., Impact of international travel and border control measures on the global spread of the novel 2019 coronavirus outbreak. Proc Natl Acad Sci U S A, 2020. 117(13): p. 7504-7509.
- Wilson, M.E., What goes on board aircraft? Passengers include Aedes, Anopheles, 2019-nCoV, dengue, Salmonella, Zika, et al. Travel Med Infect Dis, 2020. 33: p. 101572.
- Wilson, M.E. and L.H. Chen, Travellers give wings to novel coronavirus (2019-nCoV). J Travel Med, 2020. 27(2).
- Yasri, S. and V. Wiwanitkit, COVID-19, guests and crews of cruise: observation on Thai citizens. Int Marit Health, 2020. 71(1): p. 9.
- Zhang, M.X., et al., Quarantine Vehicle Scheduling for Transferring High-Risk Individuals in Epidemic Areas. Int J Environ Res Public Health, 2020. 17(7).
- Zhang, S., et al., Estimation of the reproductive number of novel coronavirus (COVID-19) and the probable outbreak size on the Diamond Princess cruise ship: A data-driven analysis. Int J Infect Dis, 2020. 93: p. 201-204.
- Zhang, X.A., et al., Importing coronavirus disease 2019 (COVID-19) into China after international air travel. Travel Med Infect Dis, 2020: p. 101620.
- Zhao, S., et al., The association between domestic train transportation and novel coronavirus (2019-nCoV) outbreak in China from 2019 to 2020: A data-driven correlational report. Travel Med Infect Dis, 2020. 33: p. 101568.
- Zheng, R., et al., Spatial transmission of COVID-19 via public and private transportation in China. Travel Med Infect Dis, 2020: p. 101626.
- Zhong, P., S. Guo, and T. Chen, Correlation between travellers departing from Wuhan before the Spring Festival and subsequent spread of COVID-19 to all provinces in China. J Travel Med, 2020.
- Zhuang, Z., et al., Preliminary estimation of the novel coronavirus disease (COVID-19) cases in Iran: A modelling analysis based on overseas cases and air travel data. Int J Infect Dis, 2020.
Last update: 05/08/2020