WHO public health checklist for controlling the spread of COVID-19 in aviation

WHO public health checklist for controlling the spread of COVID-19 in aviation ABSTRACT This checklist helps to identify the necessary measures to be implemented to mitigate infection transmission among travellers and aviation staff in the context of the COVID-19 pandemic. It features key questions and considerations for gauging the capacity of responding to COVID-19 transmission risks and informing on reducing them at airports and in aircrafts. It does so in the form of a structured questionnaire. The guidance will have particular relevance for National International Health Regulations Focal Points and competent authorities at the point of entry, including relevant representatives of aviation authority/ies of the country such as public health authorities, and representatives from other sectors, including law enforcement, customs and migration. Keywords: COVID-19; PUBLIC HEALTH EMERGENCIES; COMMUNICABLE DISEASES, EMERGING; DISEASE TRANSMISSION, INFECTIOUS; PANDEMICS; PUBLIC HEALTH, EPIDEMICS WHO/EURO:2021-3467-43226-60581 © World Health Organization 2021 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. 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In no event shall WHO be liable for damages arising from its use. ii CONTENTS Page Acknowledgements........................................................................................................................iii Introduction ................................................................................................................................1 Objective .................................................................................................................................1 Target audience .......................................................................................................................1 Background, and scope and purpose ........................................................................................1 Checklist .....................................................................................................................................2 Checklist index........................................................................................................................2 Checklist questions..................................................................................................................3 References ................................................................................................................................ 17 Annex ....................................................................................................................................... 19 iii Acknowledgments This document was developed by the Country Capacity Monitoring and Evaluation (CME) unit of the Country Health Emergency Preparedness (CPI) Department, WHO Regional Office for Europe in consultation with WHO headquarters Ute Enderlein, Ihor Perehinets, Tanja Schmidt, Sara Barragan Montes, Vasily Esenamanov, Jennifer Addo and Emma Honkala. Special thanks go to colleagues at WHO headquarters for their technical contributions: Ninglan Wang and David Bennitz. Sincere appreciation also goes to Christos Hadjichristodoulou and Barbara Mouchtouri from the European Union (EU) Joint Action Healthy Gateways and David Waller from European Union Aviation Safety Agency (EASA). 1 Introduction Objective This checklist aims to operationalize WHO guidance on international air travel and transport in the context of COVID-19, by featuring key questions and considerations for gauging the capacity of responding to COVID-19 transmission risks and informing on measures that should be in place to reduce them, targeting the Point of Entry (PoE) entity: airport(s) and air travel. It does so in the form of a structured questionnaire. Target audience The target audience is National International Health Regulations Focal Points (IHR NFPs) and competent authorities at the PoE, including relevant representatives of airport authority/-ies (to complete sections 1 and 3–5 of the questionnaire), and airline operators (to complete section 2). Background, and scope and purpose In response to the pandemic Member States requested WHO to develop operational tools tailored to their needs to mitigate infection transmission among travellers, crews and airport ground staff and to determine their level of readiness in the context of the COVID-19. PoE authorities, jointly with IHR NFPs, should analyse the results of the checklist to develop action plans to overcome weaknesses and challenges related to the COVID-19 preparedness and response with the ultimate goal to get more PoEs in the country designated under IHR (2005) or to maintain/renew the status of a designated PoE. The checklist will further support Member States in responding to the Strategic Preparedness and Response Plan (SPRP) 2021 questions related to Points of Entry (i.e., the checklists will identify gaps to align with the action points of the SPRP), and thus will help identify shortcomings to appropriately develop or update contingency plans. It is not intended to replace WHO’s technical guidance, but rather to operationalize it by providing a set of questions that can guide authorities in assessing the extent to which recommended public health measures and capacities are in place at PoE. WHO advises that confirmed, probable and suspected cases and their contacts should not travel. The questions and considerations are based on WHO’s interim technical guidance issued in the context of COVID-19 (1-7), and technical guidance released by the International Civil Aviation Organization (ICAO) for the COVID-19 pandemic (8). They are also aligned with the requirements of the IHR core capacities for airports (9). WHO public health checklist for controlling the spread of COVID-19 in aviation page 2 Checklist Instructions on completing the questionnaire When answering the questions in the checklist, the option “partly” refers to actions that are not yet fully implemented or are not covered by the response categories “yes” or “no.” Please provide further explanations in the “comments” section when you tick “partly,” or when additional explanations will help in assessing your capacity. The colour coding for the answers in the columns (green for yes, yellow for partly and red for no) will simplify the final analysis and enable easy visualization of areas that might need further improvement. National authorities may choose to use the entire checklist or only those sections that need to be assessed. Checklist index 1. Questions and considerations for airports 1.1 General considerations 1.2 Considerations for travellers before travel 1.3 Training of all airport staff on COVID-19 1.4 At the terminal 1.5 Before boarding 2. On board of the aircraft 2.1 Infection control and prevention (ICP) and other measures on board 2.2 If a suspected COVID-19 case is detected on board 3. Upon arrival at destination/transit 4. Disinfection of aircraft 5. Handling of cargo 3 Checklist questions - Airport name: - Address: - Country: - Coordinates of the airport: - Name and contact details of the responsible officer of the airport: - Passenger capacity: - Number and names of airlines accommodated: - Number of airport ground staff: - Number of take-off/landings per week: - List of airports/countries with direct flights to your airport: - List of airports/countries with direct flights from your airport: Yes Partly No Comments 1. Questions and considerations for airports 1.1 General considerations (1,9,19) Responsible authorities: airport and public health authorities, IHR NFPs EXAMPLE: has the airport been designated under International Health regulations (IHR) (9)? Done in 2015 1.1.1 Has this airport been designated under the IHR (9)? 1.1.2 Does the airport have a multisectoral emergency committee activated for COVID-19? 1.1.3 Does the airport have an emergency contingency plan activated for COVID-19? WHO public health checklist for controlling the spread of COVID-19 in aviation page 4 Yes Partly No Comments 1.1.4 If your answer to the previous question was ‘yes,’ is it integrated within the national emergency contingency plan for COVID-19? 1.1.5 Was the emergency contingency plan updated during the last two years? 1.1.6 Was an airport risk assessment done during the last 1–2 years that includes a health emergency component? 1.1.7 Have public health emergency simulation exercises been conducted at the airport during the last two years? 1.1.8 Have the lessons learnt following these exercise(s) been implemented? (Please describe the response in the “comments” column.) 1.1.9 Are health services regularly available at the airport? 1.1.10 Does the airport have access to adequate quarantine and isolation facilities? 1.1.11 Does the airport have access to ambulance services for timely transfer of ill travellers? 1.1.12 Does the airport have access to health-care facilities to provide assessment and care of COVID-19 cases? 1.1.13 Is COVID-19 risk communication material available and well placed at the airport for travellers and staff to see and hear? 1.1.14 If your answer to the previous question was “yes,” is it available in multiple languages? 1.1.15 Are aircraft operators/airlines complying with public health measures within the airport (i.e., physical distancing, use of masks, hand disinfection) recommended by WHO and national authorities? (19) 1.1.16 Is alignment of public health measures (physical distancing, use of masks) with other local modes of transport (such as airport buses and subways) and other infrastructures ensured? (1) 5 Yes Partly No Comments 1.1.17 If your answer to the previous question was “yes,” how is the alignment ensured? (Please enter your response in the “comments” column.) 1.1.18 Airports fall under the IHR regulations. Are all IHR core capacities for points of entry (PoE) implemented (9)? 1.1.19 Do some IHR capacities still need to be implemented to prevent the spread of COVID-19? 1.1.20 If your answer to the previous question was “yes,” please list them in the “comments” column. 1.2 Considerations for travellers before travel (2,10,11,12,13,14,19,20) Responsible authorities: airline operators, travel agencies, public health and airport authorities, travellers themselves 1.2.1 Are travellers encouraged to use online booking of tickets, and printing of boarding passes and baggage tags at home? 1.2.2 Before booking, are travellers made aware of public health requirements, such as quarantine, self-monitoring of symptoms or testing, at destinations where they are required by national authorities? 1.2.3 Before travelling, are travellers made aware that compliance with the health measures at the airport and on the aircraft may be mandatory through rules and regulations from relevant authorities? 1.2.4 Is the airport closed for accompanying persons, except for persons accompanying individuals with special needs? 1.2.5 If your answer to the previous question was “no,” is the number of accompanying persons limited? 1.2.6 If your answer to the previous question was “yes,” are travellers made aware of the limitation during online booking, at travel agencies and at the airport? 1.2.7 Are meet-and-greet areas set away from the main passenger flow? WHO public health checklist for controlling the spread of COVID-19 in aviation page 6 Yes Partly No Comments 1.2.8 Are passengers encouraged to travel as lightly as possible with check-in of all luggage except small hand luggage that fits under the seat to reduce embarkation and disembarkation time and human contact? 1.2.9 Is the wearing of masks obligatory for travellers at the airport and in the aircraft when requirements on physical distance cannot adequately be met (10,19)? 1.2.10 Can travellers purchase masks at the airport? 1.2.11 Do airlines comply with current IHR Emergency Committee 3 and 4 recommendations not to request vaccination certificates from travellers? (20) 1.2.12 Do airlines comply with WHO recommendation not to request immunity certificates (clinically or laboratory based) from travellers Note: The use of “immunity certificates” for international travel in the context of COVID- 19 is currently not supported by scientific evidence and not recommended by WHO (11). 1.2.13 Are passenger locator forms mandatorily required to be filled in by travellers before they get boarding passes issued or before landing (12)? 1.2.14 Is testing undertaken at the airport based on a risk assessment? Note: If testing upon arrival is conducted, it should be done based on a thorough risk assessment, taking into account an understanding of the epidemiological situations and health system capacities in the countries of origin and destination of the traveller; surveillance and case management for COVID-19 and arrangements for follow-up and observation of incoming travellers, including self-monitoring for the development of symptoms after arrival for up to 14 days (2), (13) 1.2.15 Is travel with accompanying animals/pets allowed? Note: The World Organization for Animal Health currently does not recommend restrictions (14). 1.3 Training of all airport staff on COVID-19 7 Yes Partly No Comments (3.4,8,19) Responsible authorities: airport and public health authorities 1.3.1 Are all airport staff trained on the following elements of COVID-19: symptoms and signs, when and how to do self-monitoring, self-quarantine and self-isolation, and when to seek medical advice in case symptoms are detected? (3,4) 1.3.2 Are airport personnel trained about transmission prevention of COVID- 19, including physical distancing, hand hygiene, respiratory etiquette, environmental cleaning, waste disposal, and the adequate use of personal protective equipment (PPE), including masks? (19) 1.3.3 Are airport staff trained on managing suspected COVID-19 cases (in line with ICAO Annex 9 (Facilities required for implementation of public health measures) (8). 1.3.4 Is COVID-19 refresher training available for airport staff and crews (such as cleaners, catering staff, service staff, baggage handlers, customs officials and security staff)? 1.3.5 If your answer to the previous question was “yes,” how often is refresher training undertaken? (Please use the “comment” column). 1.3.6 Are any simulation exercises undertaken to reinforce the above refresher training? 1.4 At the terminal (2, 5. 8, 10.,11,12,19) Responsible authorities: airport and public health authorities, support services 1.4.1 Is crowd control – physical distancing at the airport entrance, in the check-in hall, at security, customs and passport control, in transit areas, and in boarding and baggage areas – implemented and respected (a distance of at least 1 m from person to person)? WHO public health checklist for controlling the spread of COVID-19 in aviation page 8 Yes Partly No Comments 1.4.2 Are sufficient security personnel available to enforce/supervise the physical distancing and other public health measures required? 1.4.3 Are areas of potential crowding within the airport mapped to implement rigorous physical distancing measures (i.e., normative signage, crowd control and staggering of passenger flow)? 1.4.4 Have duty-free shops, restaurants and other shops implemented physical distancing measures, crowd control and hand hygiene measures? 1.4.5 Are smoking areas closed (8)? 1.4.6 Are travellers repeatedly reminded through audio-visual messages of COVID-19 symptoms and the need to adhere to public health measures? 1.4.7 If your answer to the previous question was “yes,” are these reminders provided in multiple languages? 1.4.8 Are measures and legal support in place if travellers refuse to adhere to public health measures, including not being allowed to access the airport building or aircraft cabin (12)? 1.4.9 Are staff deployed to check and control physical distancing and ensure wearing of masks is done correctly? (19) 1.4.10 Are arrival times of conveyances staggered to manage multiple arrivals with, for instance, separate pathways and terminals? 1.4.11 Is the whole terminal well equipped with hand sanitizers for travellers and staff? 1.4.12 Are health declaration forms regularly collected from arriving travellers? 1.4.13 Is entry screening done via temperature screening or visual screening for signs and symptoms? Information about WHO recommendation for entry screening in the context of COVID-19 is available in WHO guidance (2) 9 Yes Partly No Comments 1.4.14 If your answer to the question above was “yes,” which measures are used for entry screening? (Please comment/describe in the “comment” column.) 1.4.15 If thermal screening is required before embarkation, is it done at the entrance to the airport to reduce interaction between travellers and gain time (12)? 1.4.16 Are travellers with a skin temperature equal to or higher than 38 °C referred for second screening by a health worker in a separate screening area? 1.4.17 Is exit screening after disembarkation done via temperature screening, visual screening for signs and symptoms? Information about WHO recommendation for exit screening in the context of COVID-19 is available in WHO guidance (2). 1.4.18 If your answer to the question above was “yes,” which measures are used for exit screening? (Please comment/describe in the “comment” column.) 1.4.19 Do staff wear face masks and respect physical distance during work? Note: full PPE is recommended only when in direct contact with a suspected COVID-19 case (10,5). 1.4.20 Are physical separators (plexiglass shields) used between selected staff and passengers in areas of repeat exchanges and transactions? 1.4.21 Are sufficient printing machines (for boarding passes and baggage tags) available and regularly cleaned for printing at the airport? 1.4.22 Are COVID-19 health promotion posters and information leaflets for physical distancing, respiratory and hand hygiene and for accessing local health care well distributed in the terminal? 1.4.23 If your answer to the previous question was “yes,” in what languages are these available? 1.4.24 Are support services (aircraft cleaners, cargo and baggage handlers, water handling services and waste removers) informed about a COVID-19 WHO public health checklist for controlling the spread of COVID-19 in aviation page 10 Yes Partly No Comments event on board a plane and the associated health risk so they can implement safe handling procedures and reduce the risk of transmission? 1.4.25 Are hand hygiene sanitizers sufficiently available and refilled regularly in all public and working areas? 1.4.26 Are toilets, all handrails, floors and desks cleaned and disinfected several times a day with alcohol-based disinfectant or bleach, as per WHO guidance (8)? 1.4.27 Is the airport COVID-19 cleaning/disinfection control sheet (Public Health Corridor (PHC) Form) or similar used where appropriate (8)? 1.4.28 Are sufficient disposal bins available? 1.4.29 If your answer to the previous question was “yes,” are they emptied regularly (around seats prior to security screening and in boarding/check- in areas, as well as on buses)? 1.4.30 Are contact-free handovers conducted for staff and teams working shifts (via telephone, videoconference, electronic logs or, at a minimum, through physical distancing)? 1.5 Before boarding (19) Responsible authorities: airport authorities, airlines 1.5.1 Are travellers requested to use face masks where appropriate physical distancing cannot be achieved (close contact), as on transportation (for example, buses, planes and trains)? (19) 1.5.2 Is boarding undertaken in small groups to avoid crowding? 1.5.3 Are additional means of protection, such as plastic curtains or plexiglass shields during the boarding process (to be removed once boarding is completed), available for crews? 2. On board of the aircraft (6, 15, 19) 11 Yes Partly No Comments 2.1 Infection prevention and control (IPC) and other measures on board Responsible authorities: airline operators, public health and airport authorities 2.1.1 Do all aircraft have universal precaution kits on board (as prescribed in the International Civil Aviation Organization (ICAO) standards and recommended practices (15). 2.1.2 Are aircraft crews trained in using PPE on board (safe donning (putting on) and doffing (taking off) of PPE)? 2.1.3 Are crews trained in managing a suspected COVID-19 case on board (i.e., separation of ill passengers by leaving two seats in all directions empty if possible; ill passengers to wear a medical mask and practice respiratory hygiene) (6)? 2.1.4 Do crew members in contact with suspected COVID-19 cases or their waste wear full PPE (medical mask, gowns, gloves and goggles)? 2.1.5 Have standard operating procedures been developed for managing suspected COVID-19 cases and their contacts on board the aircraft? 2.1.6 Do aircraft operators/airlines inform travellers of the health measures implemented by ground personnel and crews on board? 2.1.7 Do all travellers and crew wear face masks on board at all times (except during eating/drinking)? (19) 2.1.8 Do the seating arrangements for passengers assure 1 m physical distancing where possible? 2.1.9 Are travellers and crew reminded before take-off that the use of masks alone is insufficient to provide adequate levels of protection, and that this needs to be complemented by hand hygiene, physical distancing and other IPC measures? 2.1.10 Are crew and airport health authorities trained in safe disembarkation of suspected COVID-19 cases (6)? WHO public health checklist for controlling the spread of COVID-19 in aviation page 12 Yes Partly No Comments 2.1.11 Are measures implemented to reduce the likelihood of passengers passing in close proximity to each other when boarding and disembarking (by organizing small groups of passengers)? 2.1.12 Are seats in planes assigned for physical distancing? 2.1.13 Are travellers asked to limit their moves when on board? 2.1.14 Are newspapers and magazines removed? 2.1.15 Is the food and beverage service on short-haul flights limited or discontinued? 2.1.16 If your answer to the question above is “no,” is food sealed and distributed in pre-packaged containers? 2.1.17 Is one lavatory designated for crew use only, provided sufficient lavatories remain available for passenger use without fostering congregation by passengers? 2.1.18 Are crew members designated to provide service only to specific sections of the cabin? 2.1.19 Are airlines informed to operate fresh-air and recirculation systems to exchange the volume of cabin air before boarding? 2.1.20 Is the use of air conditioning and effective filtration systems (high- efficiency particulate air (HEPA)) to keep air clean applied at all times? Note: horizontal airflows should be limited. 2.2 If a suspected COVID-19 case is detected on board Responsible authorities: airline operators 2.2.1 Is the crew trained on detecting, reporting and managing a suspected case and his/her contacts? 2.2.2 Are pilots informed to report any illness indicative of a suspected COVID-19 case to airport control as early as possible before arrival at the airport of destination? 13 Yes Partly No Comments 2.2.3 Does the identification of contacts begin immediately after a suspected case has been identified on board? 2.2.4 Is physical distancing of a suspected case implemented at the aircraft, provided there are sufficient free seats? 2.2.5 Are crews familiar with local protocols for reporting and managing ill travellers and their possible contacts? 3. Upon arrival at destination/transit (2,3,6,8.9) Responsible authorities: airport and public health authorities, 3.1. Do airport health authorities or national authorities ask all passengers and/or crew to complete a Passenger Locator Form (PLF) and/or health declaration form before arrival? Note: use of the updated ICAO PLF is recommended (8). 3.2. Are sufficient PLFs in appropriate language(s) available at all aircrafts? 3.3. Is the completed PLF collected and delivered to the airport health authority upon arrival at the airport? 3.4. Is collected PLF information held by health authorities in accordance with applicable law, particularly with regards to the privacy of data? 3.5. If your answer to the previous question was “yes,” are they used only for authorized public health purposes? 3.6. Is testing of suspected passengers and contacts done upon arrival at the airport? 3.7. Is there a national surveillance system that includes the airport PoE health services? 3.8. If your answer to the previous question was “yes,” are evaluated protocols for communication and response to results in place at all relevant levels? 3.9. Upon arrival, are suspected case(s) and their identified contacts kept under public health observation until they are safely assessed for risks and WHO public health checklist for controlling the spread of COVID-19 in aviation page 14 Yes Partly No Comments advised or transferred according to public health advice? Note: persons having interacted with a non-symptomatic person who meets the definition of a contact are not themselves contacts (3). 3.10. If the laboratory result of a suspected case is positive following a flight, are all contacts from the flight contacted and asked to quarantine (preferably in a dedicated facility or at home) or isolate, depending on national policy? (2) 3.11. Does the airport health authority rapidly inform the airline on the outcome of examinations? 3.12 If your answer to the previous question was “yes,” do airport health authorities instruct if further actions must be taken? 3.13 Does the airport health authority inform immediately its IHR National Focal Point (NFP) and local health authorities if a suspected COVID-19 case has been identified (following procedures for communication between competent authorities at PoE, local health authorities and the IHR NFP in the airport public health emergency plan)? 3.14 Are dedicated and accelerated routes for transiting passengers, including a unidirectional flow of movement, in place throughout the premises? 3.15 Is there a separate waiting area (with, for instance, physical distancing for seating, and separate toilets and water supplies) available for suspected COVID-19 cases and contacts (I.e., before interview and while waiting for transport to quarantine or hospital facilities)? 3.16 Is a separate room available to interview suspected COVID-19 cases and their contacts? 3.17 Is a separate room available for medical assessment? 3.18 Is there a written agreement with designated health facilities in the community to admit ill travellers (including suspected COVID-19 cases)? 3.19 Is there a written agreement for safe transport of ill travellers to designated hospitals (6)? 15 Yes Partly No Comments 3.20 Is safe transport arranged for ill travellers (COVID-19 or others) to a designated hospital? 3.21 Are there written agreements to transport contacts to quarantine facilities others than homes? 3. 22 Is a quarantine facility, staffed with health workers and catering staff and with Internet/telephone access, assigned to the airport? 3.23 Are passengers, who are required to quarantine/isolate upon arrival, not charged for related expenses? Note: Countries shall not charge travellers for measures required for the protection of health, including (a) examinations to ascertain their health status; (b) vaccination or prophylaxis on arrival (not published 10 days earlier); (c) appropriate isolation or quarantine; (d) certificates specifying the measures applied; or (e) applied to baggage accompanying them (9,2) 3.24 Is an environmental control system in place for safe waste removal and safe drinking water? 3.25 Are there disinfection protocols for all primary and secondary screening areas? 4. Disinfection of aircraft (8,17, 18) Responsible authorities: support services, airport authorities 4.1 Are cleaners and other ground staff informed that a suspected COVID-19 case was on board to take precautions when cleaning the aircraft? 4.2 Is a written plan for enhanced cleaning and disinfection agreed among the airport health authority, airport operators and service providers, according to standard operating procedures (17)? 4.3 If the answer to the previous question was “yes,” is application of these procedures routinely evaluated by local health authorities? 4.4 Are service staff who clean and disinfect the aircraft trained in using the appropriate PPE and cleaning detergence? (8, 18) WHO public health checklist for controlling the spread of COVID-19 in aviation page 16 Yes Partly No Comments 4.5 Are all cleaning and disinfection staff aware of the cleaning and disinfection plan, including areas that are touched frequently and are most likely to be contaminated (airport information desks, passengers with reduced mobility desks, check-in areas, immigration/customs areas, security screening areas, boarding areas, escalators and lifts, handrails, washrooms and baby- changing areas, luggage trolleys and collection points)? (8,18) 5. Handling of cargo (8) Responsible agency: airport authorities, transport agencies, airlines 5.1 Are cargo handlers and truck drivers informed about COVID-19 public health prevention measures? 5.2 If your answer to the previous question was “yes,” are they trained in using precautions? 5.3 Are cargo compartment touch surfaces cleaned and disinfected at an appropriate frequency to accommodate safe operations for ground staff (8)? 5.4 Does the operator periodically inspect equipment to ensure there are no long-term effects or damage over time through increased frequency of disinfection? 5.5 Do airlines review their operating procedures to minimize the number of personnel who need to make contact with frequently touched surfaces, such as access panels, door handles and switches? 5.6 Is physical distance kept (while not compromising operational safety) during physical loading of goods and document exchange, and when using ground support equipment? 17 References 1. Considerations in implementing and adjusting public health and social measures in the context of COVID-19. Interim guidance. 14 June 2021. Geneva: World Health Organization; 2021 ( https://apps.who.int/iris/handle/10665/341811) 2. Technical considerations for implementing a risk-based approach to international travel in the context of COVID-19: interim guidance : annex to: Policy considerations for implementing a risk-based approach to international travel in the context of COVID-19, 2 July 2021.( https://apps.who.int/iris/handle/10665/342212 ) 3. Public health surveillance for COVID 19. Interim guidance. 16 December 2020. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/handle/10665/337897). 4. Operational considerations for managing COVID-19 cases or outbreak in aviation. Interim guidance. 18 March 2020. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/handle/10665/331488) 5. Rational use of personal protective equipment (PPE) for COVID-19 and considerations during severe shortages. Interim guidance. 23 December 2020. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/handle/10665/338033) ). 6. Management of ill travellers at points of entry (international airports, seaports, and ground crossings) in the context of COVID-19. Interim guidance. 19 March 2020. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/10665-331512). 7. Contact tracing in the context of COVID 19. Interim guidance. 01 February 2021. World Health Organization (https://apps.who.int/iris/handle/10665/339128) ) 8. Guidance for air travel through the COVID-19 public health crisis. Montreal: International Civil Aviation Organization; 2020 (https://www.icao.int/covid/cart/Pages/CART-Take-off.aspx). 9. International Health Regulations (2005) third edition. 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(https://apps.who.int/iris/handle/10665/337832) 14. Questions and answers on COVID-19. In: World Organisation for Animal Health [website]. Paris: World Organisation for Animal Health; 2020 (https://www.oie.int/en/scientific-expertise/specific-information-and- recommendations/questions-and-answers-on-2019novel-coronavirus/). 15. SARPS – standards and recommended practices. In: International Civil Aviation Organization [website]. Montreal: International Civil Aviation Organization; 2020 (https://www.icao.int/safety/SafetyManagement/Pages/SARPs.aspx). 16. Annex 9 – facilitation. Appendix 13: public health passenger locator form (PLF). Guidelines on completing the PLF. In: International Civil Aviation Organization WHO public health checklist for controlling the spread of COVID-19 in aviation page 18 [website]. Montreal: International Civil Aviation Organization; 2020 (https://www.icao.int/safety/aviation- medicine/guidelines/Guidelines%20on%20Completeing%20the%20PLF.EN.pdf). 17. Guide to hygiene and sanitation in aviation. Geneva: World Health Organization; 2009 (https://apps.who.int/iris/handle/10665/44164). 18. Cleaning and disinfection of environmental surfaces in the context of COVID-19 (https://apps.who.int/iris/handle/10665/332096) ) 19. Masks use in the context of COVID-19: interim guidance. I December 2020. (https://apps.who.int/iris/handle/10665/337199)) 20. Interim position paper: considerations regarding proof of COVID-19 vaccination for international travellers Interim position paper: considerations regarding proof of COVID- 19 vaccination for international travellers (who.int) 19 Annex Action plan for improving COVID-19 response capacities at Point of Entries # Activity Colour code score Green for “yes,” Yellow for “partly ”Red for “no” Responsible officer/agency Planned action Further action needed if an activity is marked as “partly” or “no,” based on explanations in the comments section. Time frame for implementation Estimated costs for implementati on in national currency 1.1.5 EXAMPLE: Was the emergency preparedness (or contingency) plan updated during the last two years? red Airport operator, Mr/Mrs. XXX To update the airport contingency plan with all stakeholders 1st May 2021 300 WHO public health checklist for controlling the spread of COVID-19 in aviation page 20 The WHO Regional Office for Europe The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. 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