As the COVID-19 outbreak started to spread from the initial epicentre in Wuhan, China to other continents and regional hot-spots, countries began to assemble a battery of measures aimed at disrupting the transmission of the virus.
Globally, restrictions aimed at limiting the number of people from entering a country were adopted fairly early on, starting with the United States (12 March) and followed by dozens of other countries. Italy was the first country in Europe to impose restrictive containment and lock-down measures, and also banned non-essential travel into the country on 28 March.
This snapshot provides a comparative analysis of 48 countries in the World Health Organization (WHO) European Region which have implemented entry restrictions and conditions for both their own nationals and other travellers. As the situation is rapidly evolving, the information presented here is a cross-section based on evidence available in the COVID-19 Health Systems Response Monitor (HSRM) (up to 28 May 2020) as well as other sources documented under the Figure.
While the examples given here are not exhaustive, this policy snapshot focuses on what kinds of entry restrictions are in place, namely who is allowed to enter; what documentary proofs are being requested; and whether a period of quarantine is a mandatory requirement for entry. (It does not cover countries’ rules on people exiting for business, leisure or other purposes, nor does it look at internal movement restrictions within their territories).
Practically all countries are restricting entry but with exceptions for certain groups
Most of the countries surveyed have imposed entry bans on tourists and others engaging in non-essential travel (Albania, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia & Herzegovina, Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Georgia, Greece, Hungary, Iceland, Israel, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Luxembourg, Malta, Moldova, Montenegro, the Netherlands, North Macedonia, Norway, Poland, Portugal, Romania, Russian Federation, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine, Uzbekistan). The two exceptions are Ireland and the United Kingdom whose external borders are still open, although those entering Ireland must self-isolate for 14 days as well as submit a mandatory Public Health Locator Form upon entry, and the United Kingdom will require similar controls from 8 June.
Almost universally, countries are allowing entry to their own citizens and their immediate family members, as well as legal residents. Within the European Union (EU), countries are setting their own rules for their internal borders but in a move to coordinate measures for the block’s external borders, Member States, except for Ireland, plus the Schengen Associated Countries (Iceland, Lichtenstein, Norway and Switzerland), agreed in mid-March to apply temporary travel restrictions on all non-essential travel from third countries; these are currently in place until 15 June 2020.
There is a common list of exceptions to these EU-wide restrictions which means that in practice, people who carry out essential functions, such as health care workers, health researchers and long-term care professionals can enter their host country and continue to work. Similarly, cross-border workers, lorry drivers and others involved in the transportation of goods are also allowed entry, along with diplomats, staff of international organisations and humanitarian aid workers. Other valid reasons for permitting entry are compelling family reasons, those requiring international protection or humanitarian assistance (essentially refugees and asylum seekers), and those transiting to reach their home country.
As individual countries start to ease their restrictions, they have added their own exemptions. For example, the Czech Republic allows people to enter the country for a short period (less than 72 hours) to conduct business, Spain and Hungary allow entry to seasonal agricultural workers and the Baltic countries (Estonia, Latvia and Lithuania) now permit their citizens to move between the three countries without restrictions or quarantine.
Countries are asking for a range of documentation, with a growing number requiring COVID-negative medical certification
Given the large number of countries in this snapshot, it is not feasible to list in detail the documentation that each requires of people entering through airports or land borders. However, it is possible to highlight some broad categories. The most basic (administrative) documentation is proof of citizenship or residency (passports, ID, residency permits) to demonstrate the right to entry. Similarly, where the travel is for permitted work or business-related purposes, a letter from the employer, an employment contract or a cross-border worker (ID) card is required (e.g. Belgium, Germany, Latvia, Norway). France and Italy require people to fill in a certificate formally stating the reasons for travel.
As part of monitoring and surveillance efforts, some countries, such as Iceland, Ireland, Italy and Poland, require all entrants to provide contact details, including an address, to let officials know where they will spend their mandatory quarantine period (see below). Health declaration forms or medical questionnaires are also being used to screen entrants (Armenia, Bulgaria, France, Hungary, the Netherlands, Poland and Turkey).
A relatively more recent development is the growing number of countries which require authorised arrivals to present a medical certificate confirming a negative COVID-19 test (e.g. molecular biological test for SARS-CoV-2) issued no more than 3-4 days prior to travel (Austria, Cyprus, the Czech Republic, Finland, France, the Netherlands, Slovakia, Slovenia, Russian Federation; see Figure). Denmark recommends such testing both before and after an allowed trip. The absence of a test result does not automatically mean that entry is denied; for example, in Austria and the Czech Republic, having this medical certificate allows the entrant to avoid a 14-day period of mandatory quarantine that they otherwise would have to complete. While the aim is to detect and minimise the number of infected or asymptomatic individuals from entering the country, the cost and efficacy of using COVID-negative medical certificates as a border entry screening tool may be questionable, given the debates over the reliability of tests or what they can actually tell us about a person’s immunity status even if they are negative at entry (Phelan, 2020) (also see the forthcoming post on this topic).
Mandatory quarantine is being used extensively, either for all entrants or more selectively
The vast majority of countries in the WHO European Region enforce a period of mandatory quarantine or self-isolation, usually of 14 days’ duration, for people entering the country (see Figure). In the majority of cases, this is a blanket requirement for all entrants, regardless of their point of departure but for 10 of the countries surveyed, it is necessary only for those arriving from specific countries considered to be of higher risk due to their large numbers of confirmed COVID-19 cases.
Conversely, Cyprus, Estonia, France, Latvia, Lithuania, Poland and Slovenia provide exemptions from their quarantine requirements for entrants from a specific list of (mainly neighbouring) countries. Other common exemptions across countries apply to authorised people entering for business purposes or for very short periods of time (under 72 hours), and to those transiting.
Only five of the countries in the European Region – Denmark, Luxembourg, Portugal, Sweden and Switzerland – currently dispense with quarantine requirements for arrivals altogether. Instead, they urge entrants to self-isolate if they believe they are at risk, to observe the transmission containment rules in the country, and if they develop symptoms to seek medical advice and care through the established procedures.
Self-isolation at home is the most prevalent method of quarantining people arriving from abroad but some countries mandate quarantining in designated state facilities, depending on the circumstances. For example, following medical screening at entry points, those displaying symptoms and/or subsequently testing COVID positive, need to isolate in government quarantine centres in Cyprus, Hungary and Turkey. In other cases, such as in Armenia, Azerbaijan and Uzbekistan, those coming from high-risk coronavirus outbreak countries are transferred to medical facilities for quarantining. Pursuing a slightly different policy, Kazakhstan and Slovakia require people to self-isolate in state-designated facilities for the time it takes to conduct a test and if it comes out negative a person can continue the required 14-day quarantine period at home.
Policy reflections and looking ahead
Efforts to stem the spread of the coronavirus have included countries closing their borders to all but citizens, legal residents and essential travellers who need to enter for specific purposes. In most cases, national entry restrictions have been adopted as logical complements to lockdowns or other internal containment measures in coordinated efforts to stop the spread of the virus.
In the same way that the easing of internal restrictions must be considered in a cautious and phased way, led by robust data on infection trends and continuing hot-spots within countries, the prospect of lifting entry bans also involves balancing public safety concerns with efforts to re-open social and economic activity, particularly for countries that rely on tourism. Avoiding a second wave of infections is a very real challenge and no doubt is a paramount consideration among those countries, Greece and Spain among them, which are already considering options for resuming tourism for the upcoming summer season through lifting entry bans for foreign travellers or creating more limited tourist corridors. Needless to say, any quarantining requirements that will still be in place when people re-enter their home country will also impact on their willingness to travel abroad for work or leisure even if entry restrictions are temporarily lifted in the destination country. Tackling this will require reciprocal coordination efforts between countries.
IATA (2020) Travel documents. https://www.iatatravelcentre.com/international-travel-document-news/1580226297.htm
Phelan, AL. (2020) COVID-19 immunity passports and vaccination certificates: scientific, equitable and legal challenges. The Lancet, 395(10237): 1595-98. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)31034-5.pdf
UN World Food Programme Travel Restrictions tracker (2020). https://unwfp.maps.arcgis.com/apps/opsdashboard/index.html#/db5b5df309ac4f10bfd36145a6f8880e;