Table 1.
Elements to address in pre-travel consultation, incorporating assessment for risk for COVID-19
| Components | Main elements | Description of risk factors and characteristics to assess | Pre-travel checklist |
|---|---|---|---|
| Component 1: Traveller’s personal risk stratification | Risk for severe disease | Age | |
| Underlying diseases including cardiac, diabetes mellitus, obesity, hypertension, renal failure and respiratory conditions | |||
| Threshold for risk | How much risk is individual willing to accept for this trip | ||
| How important is this trip (e.g. wedding, graduation, professional meeting, job interview, vacation) | |||
| Immunity | Confirmed history of COVID-19 | ||
| If and when appropriate scientific evidence and adequate tests become available to substantiate the premise that prior infection (or antibody presence) can confer immunity for this trip’s timeframe | |||
| Component 2: Trip-based determinants | Ship/cruise travel | Exceptional vulnerability evident, confined space, passenger density, co-mingling onboard and sampling of multiple ports with different disease patterns (requires additional detailed and specific advice) | |
| Ground transport | Size, seating configuration and density of seats, commitment of airline to cleaning, use of high frequency particulate air filters, frequency of filter change and air exchanges/hour | ||
| Airports | Origin and destination airports or more, size, volume of traffic, time spent in airports, potential to have to stay in ‘in-transit’ destination/country for prolonged period | ||
| Airplane/airline | Size, seating configuration and density of seats, commitment of airline to cleaning, use of high frequency particulate air filters, frequency of filter change and air exchanges/hour | ||
| Destination country | Socioeconomic status, healthcare facilities, public health infrastructure, surveillance for infections and current level of circulation of coronavirus | ||
| Hotel or other accommodations | Hotel, home, city, rural and standards for disinfecting/reduce density/physical distancing | ||
| Planned activities | Outdoor, indoor; presence of large crowds/nature of crowds e.g. local vs international from high-transmission countries, and numbers involved, proximity and duration of close contact; season of year | ||
| Healthcare facilities | Adequacy of services, capacity and service for foreigners | ||
| Public health infrastructure at destination (overlaps with destination country element) | Testing ability and appropriate detection of local cases/quarantine/isolation | ||
| Component 3: Policies including health insurance, employer mandate and government regulations (origin and destination) | Traveller’s health insurance | Coverage for travel-related healthcare needs | |
| Travel-related insurance (including medical, evacuation) | Coverage for delays, cancellations and healthcare need abroad | ||
| Employer policy | Travel restrictions | ||
| Requirement/recommendation for quarantine upon return | |||
| Requirement/recommendation for testing upon return | |||
| Destination (and in-transit) country government policy | Travel restrictions | ||
| Requirement for mandatory quarantine on arrival | |||
| Requirement for testing on-arrival | |||
| Requirement for mask wearing or face covering | |||
| Origin country government policy | Travel restrictions | ||
| Requirement for mandatory quarantine upon return | |||
| Requirement for testing upon return |