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Are you travelling to and from SA during the novel Coronavirus outbreak?

Should you travel to areas affected by the COVID-19 outbreak? What should you do if you develop symptoms of respiratory illness while travelling? And, considering the risk of contracting COVID-19, should you travel at all?

Are you concerned about local or international travel in the wake of the novel Coronavirus (COVID-19) outbreak? If you’re deciding on global or local travel to any destination at all, and in particular to a region affected by COVID-19, read on. Here’s what you need to know about travelling abroad from, and returning to, South Africa.

All around the world, hundreds of businesses have cancelled travel to countries with cases of novel Coronavirus and some have gone so far as to cancel international travel outright, in the short-term. The list of corporate, sporting, scientific and other global events and attractions facing cancellation as a result of travel restrictions is growing. Airlines have also reduced flights to areas hardest hit by the illness.

The novel Coronavirus has the potential to cause severe disease and death. The virus that causes COVID-19 disease the is highly transmissible and its swift spread has meant new hotspots presenting almost daily across the world, forcing a rethink of travel plans.

Advice: Outbound travel

  • All individuals should avoid non-essential travel to:
    • Italy
    • South Korea
    • Iran
    • The people’s Republic of China (this does not include Hong Kong, Macau, or the island of Taiwan).

Non-essential travel to these countries must be avoided as there continues to be a widespread, ongoing outbreak of respiratory illness (COVID-19) in these areas, that can spread from person to person. This advice includes layovers at airports in these countries. If a layover is unavoidable, it is recommended that travellers not leave the airport. It is also important to note that there may be limited access to adequate medical care in some of the affected areas. It’s important to note that older adults and travellers with chronic medical conditions may be at risk for more severe disease and should particularly avoid travel to these countries.

If travel cannot be avoided, the following precautionary measures should be adhered to during travel:

  • Avoid contact with sick people.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Clean your hands often by washing them with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains 60 to 95% alcohol. Soap and water should be used if hands are visibly dirty.
  • It is especially important to clean your hands after going to the bathroom, before eating, and after coughing, sneezing, or blowing your nose.
  • Supplies of hand sanitizer, tissues, and other hygiene products may be limited, so consider bringing them with you.
  • Pay attention to your health during travel and for 14 days after you leave.
  • Ensure that you comply with instructions from local authorities on any local restrictions on travel, movement or large gatherings.

For the 4 countries above, it is strongly recommended that on return from each of these countries, travellers self-quarantine for a period of two weeks, even if the traveller feels well and does not have any symptoms of illness.

  • Travel to Japan

Older adults and those with chronic medical conditions should avoid non-essential travel to Japan.  These individuals may be at increased risk for severe disease as Japan is experiencing sustained community transmission of respiratory illness, COVID-19. Anyone else travelling to  Japan should practice the precautionary measures listed above.

  • Travel to any other country

Adherence to the everyday prevention measures is advised while travelling to other countries not listed above. These include:

  • Avoiding close contact with people who are sick.
  • Avoiding touching your eyes, nose, and mouth with unwashed hands.
  • Staying home when you are sick.
  • Covering your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Cleaning and disinfecting frequently touched objects and surfaces using a regular household cleaning product.
  • Washing your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • If soap and water are not readily available, using an alcohol-based hand sanitizer that contains 60%–95% alcohol.

Should you travel if you have symptoms of possible COVID-19?

Everyone with a dry cough, fever and respiratory symptoms – the primary symptoms of COVID-19 – should avoid travelling via shared transport, and particularly not at all if possible. People who have a fever and symptoms of respiratory illness and choose to travel by aeroplane, train, bus cruise liner or other shared transport, should wear a face mask. If the symptoms of COVID-19 develop while a person is travelling, it’s important to inform the transport staff/crew and seek medical care as soon as possible.

Remember that people who contract the novel Coronavirus may take anywhere from one to 14 days to develop symptoms. There is no medication available to combat the virus during the asymptomatic phase. Doctors can only treat the symptoms of COVID-19 as they present. No specific therapy has been shown to be effective against the virus itself. In close quarters, such as on a cruise ship or in an aeroplane cabin, the virus could spread more easily.

Should you use a medical mask while travelling if you are not sick?

It is not recommended that travellers wear face masks to protect themselves from COVID-19. Travellers may still choose to wear a mask, but it is more important that the precautionary measures listed above be adhered to. Masks should be used appropriately when someone is ill and is coughing, to prevent the spread of disease-carrying droplets, or by those caring for an ill person to protect themselves from contracting an illness.

What is the risk of getting COVID-19 on an aeroplane?

The way in which air circulates and is filtered on aeroplanes means that most viruses and other germs do not spread easily on aeroplanes. Although the risk of infection on an aeroplane is therefore low, travellers should to avoid close contact with sick passengers or people who are coughing, and wash their hands often with soap and water for at least 20 seconds – or use hand sanitizer that contains 60 to 95% alcohol.

Advice: Inbound travel

Travellers returning back from countries currently experiencing the COVID-19 outbreak should:

  • Self-monitor for symptoms for 14 days and take their temperature twice a day.
  • Follow national protocols of receiving countries. Some countries may require returning travellers to enter quarantine.

If you were in a country with a COVID-19 outbreak and feel sick with fever, cough, or difficulty breathing, within 14 days after leaving, you should:

  • Seek medical advice: Call ahead before you go to a doctor’s office or emergency room. Tell them about your recent travel history and your symptoms.
  • Avoid close contact with others
  • Not travel on public transportation while sick
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing
  • Wash your hands often with soap and water for at least 20 seconds to avoid spreading the virus to others
  • Wash your hands with soap and water immediately after coughing, sneezing or blowing your nose
  • If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains 60 to 95% alcohol. Always wash hands with soap and water if hands are visibly dirty.

After returning from China, when can employees return to work?

Travellers from Hubei Province will be quarantined and actively monitored in a location to be determined by public health authorities for up to 14 days (21 days in South Africa). Travellers from other parts of China who do not have any symptoms are being asked to monitor their health and practice social distancing for 14 days.

Social distancing means remaining out of:

  • Public places where close contact with others may occur (such as shopping centres, movie theatres, stadiums).
  • Workplaces (unless the person works in an office space that allows distancing from others).
  • Schools and other classroom settings.
  • Local public transportation (such as on a bus, subway, taxi, rideshare, plane, ship)
  • These restrictions are to be in effect for 14 days from the time the person was possibly exposed.

When do you need to be tested for COVID-19?

You need to be tested for COVID-19 if you have

  • a severe acute respiratory illness, with fever or history of fever and cough with pneumonia
  • or Acute Respiratory Distress Syndrome (based on clinical/X-ray findings) that requires you to be admitted to hospital
  • and any of the following:
    • Have a documented travel history to Wuhan, Hubei Province China within 14 days before symptom onset; or
    • Have had close physical contact with a person confirmed to have COVID-19 while he/she is symptomatic
    • Are a healthcare worker who was exposed to patients with severe acute respiratory infections (in the absence of any other reason for your symptoms)

What measures have been put in place in South Africa to minimise the risk of transmission should cases be imported?

On arrival to South Africa, travellers from affected countries undergo health screening, including having their temperature taken and being asked to fill out a symptom questionnaire. Travellers with signs and symptoms of illness (fever, cough, or difficulty breathing) will have an additional health assessment.

Fever screening is in place at international airports. If there is a suspected case, procedures are in place for case isolation and management as well as rapid specimen collection and transport so that the diagnosis can quickly be made. Suspected cases will be managed at designated hospitals with isolation facilities. Protocols are in place for follow up of case contacts to ensure that the virus does not spread.

Should you cancel your travel plans?

At the end of the day, the decision rests with you as to whether to cancel or postpone travel plans and also to assess your level of risk of illness. While governments work to curb the spread of the disease the World Health Organization has advised against the application of travel or trade restrictions. Asked whether people should cancel their travel plans in the wake of novel Coronavirus, Dr Carmen Dolea – Head of the WHO’s International Health Regulations Secretariat – answered: “No. The WHO has said there should not be travel or trade restrictions during this outbreak, including to most places in China. The risk of infection is low in many countries and the epicentre remains the Hubei Province in China. Travellers should not cancel their plans but take into account the various restriction that airlines have put in place when planning for travel.”

For more information

Visit the NICD website at www.nicd.ac.za for further information. For medical/clinical related queries by health care professionals only, contact the NICD Hotline +27 (0) 82 883 9920 (for use by healthcare professionals only). For laboratory-related queries call the Centre for Respiratory Diseases and Meningitis (011-555- 0315/7/8 or 011-555-0488).

Guidelines and case definitions are available on the NICD website

Visit the CDC Coronavirus Disease 2019 Information for Travel for regular updates.

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