Most leaders share a priority to reduce risk and harm to the general population, in any context, and certainly during a crisis, including a health crisis.  

A. Many doctors report that they do not believe that it is clinically indicated to limit or discontinue #travel, not to or from any country, not due to morbidity or mortality statistics, and not due to variants, mutations, related medical practices or vaccines.  

It is however clinically indicated to prevent travel for those with an increased temperature, symptoms, a confirmed diagnoses or recent confirmed contact, which makes sense from a clinical point of view and is based on clinical evidence. 

Many medical doctors agree that it is negligent to not facilitate social distancing on #flights and #airports (which many countries have consistently illustrated is possible), consistently ask about recent confirmed contact, #symptoms and check #temperature before and after flights.

B. Most medical doctors recommend that those at high risk for severe COVID-19 only travel when necessary (20% of the global population and 4% of those under age 20). 

C. Many doctors agree that flight cancellations increase risk, especially direct flights, as individuals are now asked to take numerous flights to reach one destination, which increases risk for the general public. 

It is also relevant to add that most countries in #Asia, as well as #France and the #USA (#Hawaii and #California) ensured that travellers had sufficient and good quality #food, drinks and facilities available such as ablutions, hotels, taxis and rental cars, this reduces risk for individuals who travel.  

Some leaders have stated their intention to cause “discomfort” for travellers and it must be noted that many individuals now travel for work, including to provide medical and mental health care, to provide relief and to reach hospitals for medical procedures.  Many agree that it is not #ethical or #legal, certainly not clinically indicated, quite the contrary, to intentionally cause discomfort, and increase risk of harm, to any individual, especially to individuals who are vulnerable, unwell or assisting those who are not well or vulnerable. 

It is of note that we were offered a warm welcome, friendly service and the usual range of food and drinks within #Asia and the #USA in airplanes during the pandemic, however in #Europe we were often offered no or little choice regarding food or drink (sometimes only water available), and no food or no good quality food; we were informed that this was due to the pandemic, which made little clinical sense. 

D. Social distancing was successfully facilitated in most airports and #airplanes in Asia, as well as in Hawaii, Los Angeles and Cape Town, however this was not observed in most European cities, and most European airlines did not prioritise or facilitate social distancing; eg 1 individual was placed next to 3 open seats, whilst 2 strangers were asked to sit immediately next to each other in rows of 2 for a 12h flight.  Social distancing could have been facilitated, but was not facilitated.

E.  Some individuals or doctors with no symptoms and no raised temperature are now asked to engage in 5 PCR tests (some 2 days apart) and 17d quarantine (despite negative tests) within a 20 day period during travel and transit due to different countries’ policies and protocols making no allowance for clinical context, clinical indications or evidence.  

These concerns now exist for individuals who have had the #vaccine, which makes no clinical sense if risks and benefits are weighed for individual patients, especially individuals at low risk for severe COVID-19 (80% of the general population). 

A global health plan is essential to facilitate #communication and clinical #coordination to protect the general public; reduce risk, rather than increase risk from a bio-psycho-social point of view.

F. Many #medical colleagues agree that #variants, new variants or #mutations should not be a determining factor in the context of travel or quarantine.

Based on current #evidence and trends relating to new cases, #morbidity and #mortality statistics, as well as variants (such as the #SouthAfrican variant, with the same #mutation now having occurred independently in UK #variants, ie not being in the UK due to travel from South Africa), many doctors agree that it is not clinically indicated to quarantine individuals from ‘variant of concern’ or ‘high incidence’ countries.  

It is however clinically indicated to consider #quarantine or self-isolation at home for individuals with a raised #temperature, relevant #symptoms or confirmed diagnoses or recent contacts, which is an evidence-based approach observed in much of Asia.