Dr Sarah Jarvis, MBE
Author: Dr Sarah Jarvis, MBE, General Practitioner (GP)

Sarah is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and is the resident doctor for BBC Radio 2.

Originally posted: 30th Jun 2021

The pandemic has dragged on for well over a year and not surprisingly, everyone has had challenges. After multiple lockdowns and restrictions, there is still uncertainty about travel courtesy of the English 'traffic light' system.

Nobody should be travelling to red list countries other than in exceptional, non-leisure related circumstances. It's not illegal to travel to an amber list country, but the government is advising people that they shouldn't travel to them for leisure – they recommend that it should only be for major emergencies such as family illness. Anyone can travel to a green list country (if they're allowed by that country to enter).

But with so many people desperate for a break, many are keeping everything crossed that foreign holidays will become a reality sooner rather than later.

From 17th May 2021, international leisure travel from England is no longer illegal. However, there are strict rules about steps you need to take when you do return.

COVID-19 swab tests – what's in a name?

Many of us have become used to taking regular 'lateral flow' COVID-19 swab tests at home in the last few months. These tests give a result within about 15 minutes, and are pretty accurate in terms of telling you whether you're highly infectious. However, they're less accurate than PCR swab tests, which need to be sent to a lab for analysis, at spotting if you're in the early stages of infection. That's why all the tests referred to below are PCR tests.

The traffic lights

Red list countries

Nobody except British or Irish Nationals, or people with residence rights in the UK, is allowed to enter England if they have been in or through a red list country in the previous 10 days. Anyone who does enter from a red-list country has to:

  • Self-isolate for 10 days at their own expense at a quarantine hotel.
  • Take a COVID-19 test on or before 2 days after arrival, and on or after 8 days of entering quarantine.
  • In addition, follow all other UK COVID-19 restrictions.

Amber list countries

If you're entering England from an amber list country:

  • Before you travel, you need to take a COVID-19 test as well as booking and paying for COVID-19 tests on day 2 and day 8 after you return (not needed for children under 4 years) and completing a passenger locator form.
  • Once you arrive, you need to quarantine for 10 days and take the tests you've booked.
  • Under the Test to Release scheme, you can book a COVID-19 test before you travel back to England, to be taken at least 5 full days after you arrive. If it's negative, you can leave quarantine at this point.

Green list countries

Sadly, green list countries are currently few and far between, and most of them aren't accepting visitors from the UK anyway. However, there's hope that this may change and the list is reviewed every 3 weeks. If you are entering England from a green list country, you need to book and pay for a COVID-19 test on or before day two after you get back, but don’t have to quarantine unless it's positive.

Traffic Light Crossing

What about restrictions imposed by the country I'm visiting?

In addition to the regulations above on entering England, all countries have their own regulations for arriving travellers. The EU is set to make a COVID-19 vaccine passport available for all EU citizens and residents, as well as for specific categories of travellers from third countries, by July 1. However, they haven't yet specified what those categories are.

Many countries are desperate for UK tourists and are planning to waive quarantine requirements on entry for people with proof of vaccination. The UK government has said it plans to develop the NHS App to provide a COVID-19 vaccination passport that can be used for travellers from the UK. While users of the app can now download and share their COVID-19 vaccination details, there is as yet no update on when or whether it will be possible simply to scan your NHSA app at the airport as proof of vaccination.

Do quarantine rules still apply if I've been vaccinated?

For now, you're still required to self-isolate and carry out pre- and post-arrival tests when you get back to the UK from an amber list country, whether you've been vaccinated or not.

However, that may change. There's currently a study going on to see whether it's safe for people who have had two vaccines to take daily lateral flow COVID-19 tests to avoid having to self-isolate after being identified as a close contact of someone with COVID-19. The idea is that people identified as close contacts through the NHS Covid-19app could take a test each morning for a week. Each negative result would give them 24 hours of freedom from the legal requirement to self-isolate.

The study involves 40,000 people and is due to report by the end of summer 2021. If it proves successful, the next step may well be the option for fully vaccinated people to carry out lateral flow tests daily on return from amber list countries, instead of self-isolating.

The advice that stays the same

Although the rules are currently the same whether you've been vaccinated or not, there's no question that being fully vaccinated against COVID-19 dramatically reduces your risk of infection – and, if you do get infected, hugely reduces your chance of becoming severely unwell.

But none of the vaccines offer 100% protection, and the vaccine is slightly less effective against some of the new variants of the virus. So whether you've been vaccinated or not, you should still take steps to minimise your risks on holiday, whether it be within the UK or to sunnier climes.

Regardless of what other precautions you’re taking, the most effective ways to reduce your risk are the same precautions doctors have been advising for months. COVID-19 is caught in three ways:

  • By aerosol spray from some who’s infected but who doesn’t have symptoms (the virus is breathed out into the air and sits in a cloud around that person, building up in concentration the longer they stay in the same place).
  • By droplets spread by coughs and sneezes from someone who’s infectious.
  • By touching contaminated surfaces with your hands, then transferring the virus to your eyes, nose or mouth.

That means there are several precautions – some more useful than others.

  • Keeping a distance of at least 2 metres from other people at all times where possible is your single best protection.
  • Fresh air. In the last year we've learnt a lot about how the virus spreads, and we now know that aerosol spread – miniscule particles breathed out by someone who's infected – is one of the major routes of transmission. These particles are so light that they don't fall to the ground, instead building up in a cloud around you. But because they're so light, any air current disperses them really effectively. That means being outside carries significantly lower risks than inside and keeping windows open if you are inside also cuts your chance of becoming infected.
  • Coronavirus can’t get into your body through your skin, but it’s essential to wash your hands regularly – that includes before your touch your face, before you eat and of course, after you visit the toilet.
  • Carry hand sanitiser containing at least 60% alcohol with you at all times - alcohol destroys the virus. Don’t assume that ‘antibacterial’ sanitiser will protect you against viruses, and don’t rely on understanding the instructions on foreign sanitisers. Take enough supplies with you to last for your trip.
  • Self-isolate if you have symptoms. If you develop a new cough, fever or a loss of sense or smell, it’s essential to self-isolate for at least 10 days (this was revised from 7 days by the UK Government). Other people you live with or have close contact with also need to self-isolate for 10 days.
  • Face coverings. These are no substitute for handwashing and social distancing. But in enclosed spaces where you can’t socially distance, they do reduce spread.
  • Gloves. It’s important to remember that if you wear gloves, you can still transfer the virus onto your face if you touch it. Gloves are of little extra value if you’re washing your hands, sanitising when you can’t wash and avoiding touching your face. Don’t be lulled into a false sense of security.

Plan your insurance

Millions of people have had first-hand experience of the importance of holiday insurance since the COVID-19 pandemic. But it has never been more important to remember that other medical conditions can affect your insurance.

If you have any long term medical condition, you may be required to declare it – if you don’t, your travel insurance could be invalid. Medical Travel Compared offers a wide range of insurance providers who can ensure that regardless of your medical history, you won’t come home from your long-awaited holiday with any nasty surprises.

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