As your partner in health and safety, we are continuously monitoring regulatory updates that may affect your operations. See the ECDC's latest COVID-19 updates and resources below.
Guidance for Discharge and Ending of Isolation of People with COVID-19
In the context of ongoing community transmission of SARS-CoV-2, increasing testing capacity across EU/EEA countries and the UK, and accumulating evidence on the viral shedding and infectiousness, there is a need to update the guidance for discharge and ending of isolation of people with COVID-19.
The current document reflects the information available at the time of publication and may change if more information on the incubation period of SARS-CoV-2 infection and viral shedding becomes available.
Download Data on Country Response Measures to COVID-19
Disclaimer: The data on non-pharmaceutical interventions (or response measures) are based on information available from official public sources as of July 1, 2020 and may not capture measures being taken by countries that are not reported on publicly available websites. The situation is evolving rapidly, and this represents a snapshot of the measures that countries in the EU/EEA and the UK have reported to date. The response measures displayed are national measures, reported on official public websites.
ECDC Launches New COVID-19 Situation Dashboard
The ECDC COVID-19 situation dashboard, first launched in March 2020, has been improved with a simplified design and enhanced functionality enabling users to easily monitor the COVID-19 pandemic at the European and global level.
Through interactive maps, graphs and tables, users are able to easily view, compare and export data on COVID-19 cases and deaths by region or country, and within a specified timeframe.
The dashboard also allows users to view and export data on subnational levels of transmission in the EU/EEA and the UK, as well as enhanced data on subsets of cases, including age, gender, hospitalization and admission to intensive care.
Since the beginning of the pandemic, ECDC’s Epidemic Intelligence team has been collecting data on COVID-19 at the European and global level on a daily basis. The COVID-19 situation dashboard is updated every day to visualize and disseminate this data.
Guidelines for the Implementation of Non-Pharmaceutical Interventions Against COVID-19
Non-pharmaceutical interventions (NPI) are public health measures that aim to prevent and/or control SARS-CoV-2 transmission in the community. As long as there is no effective and safe vaccine to protect those at risk of severe COVID-19, NPI are the most effective public health interventions against COVID-19. These ECDC guidelines detail available options for NPI in various epidemiologic scenarios, assess the evidence for their effectiveness and address implementation issues, including potential barriers and facilitators.
Rapid Risk Assessment: Increased Transmission of COVID-19 in the EU/EEA and the UK – Twelfth Update
In this update, the ECDC analyzes the risk posed to the general population, vulnerable individuals, and healthcare provision by the current increase in COVID-19 case notification rates observed in the EU/EEA and the UK.
Reinfection with SARS-CoV-2: Considerations for Public Health Response
Cases with suspected or possible reinfection with SARS-CoV-2 have been recently reported in different countries. In many of these cases, it is uncertain if the individual’s Polymerase Chain Reaction (PCR) test remained positive for a long period of time following the first episode of infection or whether it represents a true reinfection.
The aim of this Threat Assessment Brief is to elucidate the characteristics and frequency of confirmed SARS-CoV-2 reinfection in the literature, to summarize the findings about SARS-CoV-2 infection and antibody development, and to consider the following questions:
- How can a SARS-CoV-2 reinfection be identified?
- How common are SARS-CoV-2 reinfections?
- What is known about the role of reinfection in onward transmission?
- What do these observations mean for acquired immunity?
Finally, options for public health response are proposed.
COVID-19 Testing Strategies and Objectives
ECDC provided this document that outlines strategies and objectives for sustainable SARS-CoV-2 testing of populations to achieve specific public health objectives in various epidemiological situations. General population-wide testing, as well as targeted testing of individuals, or specific populations related to particular settings, are presented on the basis of country experiences and information collected from scientific literature.
COVID-19: Cases Increasing Across Europe
According to the latest COVID-19 data, the 14-day case notification rate for the EU/EEA and the UK has been increasing for more than 50 days, with over half of all EU countries currently experiencing an increase in cases.
While increased testing contributes to better awareness of all ongoing transmission, it is not the only reason for the increase of COVID-19 cases, which is also linked to the relaxation of physical distancing and other preventive measures.
As schools reopen and more indoor activities are held, the increase of cases comes as a reminder that the pandemic is not over.
Everybody has a role to play in preventing the further spread of the disease by observing simple preventive measures, including:
- Increased hand hygiene;
- Proper cough and respiratory etiquette;
- Appropriate use of face masks;
- Staying home when even mildly ill;
- Physical distancing.
Recent evidence confirms the importance of physical distancing for the prevention of person-to-person transmission. Physical distancing of one meter or more has been proven to ensure a five-fold reduction in the transmission risk, and every extra meter of distance gives twice the protective effect.
ECDC recommends that testing efforts are maximized, with the aim of offering timely testing to all symptomatic cases, including mild ones. Along with rapid contact tracing, large-scale testing is the key to controlling transmission within a population, followed by the isolation and treatment of identified cases and the quarantining of contacts.
Furthermore, with the influenza season approaching, the preparedness of healthcare systems across Europe is vital. This includes essential services, primary care facilities and hospitals ensuring appropriate surge capacity plans in case of a high demand for the care of patients with respiratory distress.
Population-Wide Testing of SARS-CoV-2: Country Experiences and Potential Approaches in the EU/EEA and the United Kingdom
This document summarizes country experiences and perspectives relating to the objective and application of different population-wide testing approaches and discusses the options in the context of the EU/EEA and the UK. The testing of all individuals in a specific setting as part of an outbreak investigation (e.g. related to an occupational setting) or a research study are not considered to be population-wide testing in the context of this document. Details on the screening of particular targeted populations (e.g. testing of pregnant women on labor and delivery wards, testing of residents and staff in long-term care facilities, testing of all patients prior to surgery, etc.) are also not included in this document.
- Different population-wide testing approaches have already been used in various countries, including household testing, individual testing and the testing of incoming travelers, irrespective of whether or not they are displaying symptoms.
- Factors that need to be considered prior to implementation of any population-wide testing strategy which is to include all individuals are the epidemiological situation, costs, logistics, technical feasibility, resource availability, contract tracing capabilities, barriers to testing, potential false positivity and timely notification.
- Population-wide testing strategies can complement other public health measures and are more effective when paired with case isolation and contact tracing.
COVID-19 Clusters and Outbreaks in Occupational Settings in the EU/EEA and the UK
ECDC released this document to describe COVID-19 clusters and outbreaks in the EU/EEA and the UK linked to occupational settings, including healthcare and non-healthcare settings, and to identify possible factors contributing to transmission in these settings.
Rapid Risk Assessment: COVID-19 in the EU/EEA and the UK – Resurgence of Cases
ECDC reported that the COVID-19 pandemic continues to pose a major public health threat to EU/EEA countries and the UK and to countries worldwide. As cases increased, peaking in early April 2020 in the EU/EEA, many countries implemented a range of response measures which led to a reduction in incidence. As countries regained control of transmission and alleviated the burden on healthcare, many measures were relaxed or removed to allow for a more viable way of life with the virus in circulation. Subsequently, a recent increase in COVID-19 cases has been reported in many EU/EEA countries. While many countries are now testing mild and asymptomatic cases, which has resulted in increased case reports, there is a true resurgence in cases in several countries as a result of physical distancing measures being relaxed.
What is new in this update?
- Updated epidemiological situation and response measures implemented in the EU/EEA countries and the UK
- Updated testing strategies, contact tracing, and general and targeted measures to minimize the risk of COVID-19 resurgence
- Various risk profiles, based on the changes countries are observing in their reported cases, hospitalizations, testing methodologies, and test positivity rates in response to the relaxing or removing of measures
Objectives for COVID-19 Testing in School Settings
The aim of this document is to provide an overview of major aspects of testing, contact tracing, contact identification and contact follow-up in school settings within the EU/EEA countries and the UK. Objectives for testing in school settings:
- To ensure early identification of cases among students and staff in order to conduct contact tracing and initiate prevention and control measures, thereby reducing further transmission
- To identify infection in students and staff at high risk of developing severe disease due to underlying conditions
- To support investigations and studies concerning the role of children in the transmission of COVID-19
COVID-19 Rail Protocol
ECDC released recommendations and an infographic for safe resumption of railway services in Europe. This protocol reflects the current status of knowledge about the COVID-19 disease and its pandemic effect. In addition, it summarizes preventive measures considered effective at the date of publication (July 21, 2020), and complements measures taken by the European Commission to support Member States in re-launching mobility and tourism across Europe.
Use of Gloves in Healthcare and Non-Healthcare Settings in the Context Of COVID-19
ECDC released a document to provide scientific evidence and guidance document (attached) and infographic (attached) for healthcare settings and the public on using gloves as a preventive measure during the COVID-19 pandemic. Key messages include:
In the Community
- There is currently insufficient evidence to recommend the regular use of gloves as a preventive measure in the context of COVID-19 to the public and to people in most occupations.
- Use of gloves in the community may lead to the misconception that hand hygiene practices can be neglected.
- Regular use of gloves may confer the risk of dermatological side effects.
- The generation of waste from unnecessary glove use causes environmental damage.
In Healthcare Settings
- The use of medical gloves is recommended as part of standard precautions to reduce the risk of contamination of healthcare workers’ hands with blood and other body fluids including contact with non-intact skin and mucous membranes.
- When indicated, use of medical gloves is recommended as part of contact precautions, to reduce the risk of pathogen dissemination to the patient’s environment, to other patients and for the protection of healthcare workers.
- Taking into consideration the currently available types of gloves for use in healthcare settings, extended use, decontamination and reuse of single-use medical gloves is discouraged.
- In the event of shortages, single-use medical gloves should be prioritized for use in healthcare settings.
Provision of Support for Medically and Socially Vulnerable Populations
ECDC released a document to provide guidance for civil society and non-governmental organizations (NGOs) as well as for national and regional authorities in the European Union and European Economic Area (EU/EEA) and the United Kingdom (UK), who are providing support for people who have medical and social vulnerabilities during the coronavirus disease (COVID-19) pandemic. Specifically, it aims to identify some of the major cross-cutting challenges, successes and lessons learned by these organizations during the period of stay-at-home and other measures from March-May 2020. It is hoped that the findings presented may be applicable to support service providers across the EU/EEA and the UK as the pandemic evolves, and in particular in the event of an upsurge in cases over the coming months that necessitates a subsequent return to stay-at-home measures or other restrictions in movement.
Aviation Health Safety Protocol, 2nd update
ECDC and EASA issued an update to Aviation Health Safety Protocol and operational guidelines for the management of air passengers and aviation personnel in relation to the COVID-19 pandemic (attached). The purpose is to serve as an aviation health safety protocol and to provide a source of best practice on how airport operators, airplane operators conducting commercial and non-commercial passenger transport operations and national aviation authorities can ensure the health and safety of passengers, as well as the staff and crew who serve them, by maintaining safe and secure operations whilst minimizing the risk of virus transmission. This should complement the advice of public health authorities and help employers in their duties under the relevant legislation on protection of workers’ health and safety.
Heating, Ventilation and Air Conditioning (HVAC) Systems in the Context of COVID-19
ECDC released a guidance document describing current evidence of coronavirus transmission and HVAC systems. The role of ventilation in preventing COVID-19 transmission is not well-defined (i.e. by preventing dispersal of infectious particles to minimize the risk of transmission or preventing transfer of an infectious dose to susceptible individuals). COVID-19 is thought to be primarily transmitted via large respiratory droplets, however, an increasing number of outbreak reports implicate the role of aerosols in COVID-19 outbreaks. Aerosols consist of small droplets and droplet nuclei which remain in the air for longer than large droplets. In addition to preventative measures of physical distancing, hand hygiene, face coverings and cleaning/disinfecting routines, the following infection prevention measures are suggested:
- Direct air flow should be diverted away from groups of individuals to avoid pathogen dispersion.
- Avoid recirculating air as much as possible (refer to HVAC system manufacturer or technicians to assist).
- Maintain the minimum number of air exchanges per hour in accordance with applicable building regulations. Increasing the number of air exchanges per hour will reduce risk of transmission in closed spaces.
- As a general principle, mechanical ventilation should be arranged to minimize the direction of sustained air flow for stationary persons.
Monitoring and Evaluation Framework for COVID-19 Response Activities
ECDC released a monitoring and evaluation framework to support EU and EEA countries and the UK in their efforts to monitor the implementation and effects of COVID-19 response activities. The framework presents indicators for a variety of key pillars of COVID-19 preparedness, prevention and control activities and provides guidance to countries on how to collect and analyze data for the suggested indicators. The strategic information provided by the indicators can assist decision makers at subnational, national and EU level to support preparedness and response planning, and in-action and after-action reviews. The framework will need to be adapted to local circumstances; the relevance of indicators depends on the specificities of the setting.
Guidance for Migrant and Refugee Reception and Detention Centers
ECDC issued a guidance document to provide scientific advice on public health principles and considerations for infection and prevention control of COVID-19 in migrant and refugee reception and detention centers in the European Union and European Economic Area (EU/EEA) and the United Kingdom (UK). Topics covered include:
- Whilst there is no evidence to suggest that SARS-CoV-2 transmission is higher amongst migrants and refugees, environmental factors such as overcrowding may increase their exposure to the disease.
- All principles of hand hygiene and physical distancing applied in the community should be applied in migrant reception and detention settings. If physical distancing and risk-containment measures cannot be safely implemented, measures to de-congest and evacuate residents should be.
- Providing free and equitable prevention, testing, treatment and care to migrants and refugees in settings of reception and detention is critical.
- There is no evidence that quarantining whole camps effectively limits transmission of SARS-CoV-2.
- Migrant and refugee reception and detention centers should be given priority for testing.
- Communicating about the risks and prevention requires strategies that are adapted to meet the different language, cultural and literacy needs of the different populations.
Rapid Risk Assessment: COVID-19 in the EU/EEA – Tenth Update
ECDC updated their risk assessment to include:
- Updated epidemiological and sero-epidemiological information;
- Overview of response measures implemented in the EU/EEA countries and the UK;
- Options for response to minimize the risk of resurgence of COVID-19.
Passenger Locator Data
The ECDC issued a position paper with guidance to transportation operators, particularly airlines, to improve contact tracing. The scope of the document is to provide ECDC’s views on the passenger locator data required and the appropriate use of entry and exit screening procedures at points of entry (PoE), including health declaration forms, in the context of COVID-19 in the EU/EEA and the United Kingdom (UK). In depth descriptions include these topics:
- In order for contact tracing to be successful and efficient, passenger locator data should become available to the public health authorities as soon as possible after the identification of a confirmed case among airline passengers.
- Current evidence indicates that entry and/or exit screening at ports of entry, such as airports, is ineffective in preventing the spread of SARS-CoV-2 virus.
- A health declaration form or health screening questionnaire is part of the exit or entry screening process targeting a specific disease and this needs to be assessed by a health professional with the objective of detecting cases in incoming passengers.
- ECDC advises against combining passenger locator data and health declarations or health screening questionnaires in the same form, as this will delay the transfer of data and the contact tracing procedures.
Mobile Applications for Contact Tracing in EU/EEA
ECDC released a document intended to facilitate the dialogue between public health authorities and app developers to ensure that the main epidemiological and operational considerations are taken into account, while also understanding the technological limitations.
Options for The Decontamination and Reuse of Respirators
Due to the COVID-19 pandemic induced worldwide shortage of respirators or filtering face pieces (FFP), ECDC has summarized the different procedures that have been tested for decontamination of respirators reuse decontamination methods and precautions for each method. FFPs should be prioritized for use in healthcare settings when aerosol-generating procedures (AGPs) are performed.
Guiding principles for reuse are:
- Respirators which have been visibly contaminated (e.g. during procedure at intubated patients, such as suction cleaning of airways, taking probes, extubation attempts, etc.) or are damaged or not fitting, should be discarded and cannot be taken for re-use or decontamination procedures.
- Respirators may be protected by a medical face mask in order to prevent soiling.
- Use of new ‘expired respirators’ (manufacturers expiry date) is possible if they were properly stored until use.
- One approach for reuse of respirators seems to be providing each healthcare worker with a set of minimum five respirators and rotate daily
- Irrespective of which method of decontamination is applied, a fit-check prior to re-use is necessary. If the fit check is not passed, the respirator should be discarded.
Infection Prevention and Control for Primary Care, Dental and Pharmacy
ECDC released a technical report to prevent spread of COVID-19. Specific guidance is called out for:
- General infection prevention and control training, measures, staffing and workplace considerations
- Primary care clinics and practices regarding staffing, actions prior to patient arrival, during patient visit, patient follow-up and information, after the patient leaves
- Dental offices and clinics before the patient arrives, during dental care, after the patient leaves
- Pharmacies at the counter, for the customers, and home deliveries
Conducting in-action and after-action reviews of the public health response to COVID-19
ECDC released a document aimed at supporting the implementation of after action reviews (AARs) focused on the public health response to COVID-19. Designed to strengthen preparedness and the current response, the document reviews the main phases of planning and conducting AARs and discusses specific considerations relevant to COVID-19.
Air Travel Infographic Released
ECDC in conjunction with the EASA issued infographics (view here) to summarize air travel experience for passengers in the context of COVID-19.
COVID-19 Surveillance Tool: Methodology for Estimating Prevalence
ECDC released technical guidance tool for estimating the prevalence of SARS-CoV-2 infected cases, through a cross sectional study design based on pooled sampling for RT-PCR testing on a random population sample.
Projected Baselines of COVID-19 in the EU/EEA and UK
ECDC built mathematical models based on current knowledge to provide a short term 30 day forecast of expected number of COVID-19 cases, deaths and hospitalized cases (general hospital and intensive care).
Considerations for Travel in the EU/EEA
ECDC updated travel guidance for public health authorities and EU/EEA member states and the UK. The document outlines principles for developing more individualized guidance or operating procedures related to travel in European countries. Travels in the named areas are to check with local authorities of the destinations and locations traveling through.
Aviation Health Safety Protocol
Guidance for the management of air travel in relation to the COVID-19 pandemic was released. Aviation health safety protocol and to provide a source of best practice on how airport operators, airplane operators conducting commercial and non-commercial passenger transport operations and national aviation authorities can ensure the health and safety of passengers, as well as the staff and crew who serve them, by maintaining safe and secure operations whilst minimizing the risk of virus transmission. Topics covered include:
- Passenger Management including thermal screening, protective screens, check-in and boarding, onboard, disembarking
- Crew management
- Cleaning and disinfection
- Use of masks
COVID-19 in Care Homes and Long-Term Care Facilities
Released an infographic for COVID-19 in care homes and technical document for Surveillance of COVID-19 at long term care facilities in the EU/EAA. The document assists with planning, implementation, and monitory systems at long term care facilities.
Rapid Risk Assessment
A rare and severe condition in pediatric patients with COVID-19 has been identified and the ECDC characterized what is known to date and developed a questionnaire. While children appear to be less affected by COVID-19 overall, in total about 230 cases of Pediatric Inflammatory Multisystem Syndrome (PIMS). Cases present as a mix of symptoms similar to Kawasaki Disease and Toxic Shock Syndrome.
Update for Infection Prevention and Control Preparedness in Healthcare Settings
Changes to the current update have the following additions:
- The recommendation that all healthcare staff providing care to patients in areas with community transmission should consider wearing surgical masks or FFP2 respirators, if available, in addition to practicing meticulous hand hygiene.
- The clarification that the recommendation for long-term care facility (LTCF) staff not to come to work if they have symptoms compatible with COVID-19 also includes those with mild symptoms.
- The recommendation that in areas with community transmission all LTCF staff who provide care for residents or have contact with residents or communal areas of the LTCF should consider wearing surgical masks or FFP2 respirators, in addition to practicing meticulous hand hygiene.
- Additional references to current ECDC surveillance guidance for long-term care facilities recommending laboratory testing as soon as possible after the detection of a case, to guide infection prevention and control measures. If a suspected case is detected, samples should be tested from all suspected cases in residents and staff as a minimum, but preferably from all staff. If a laboratory-confirmed case is detected, all residents and staff should be tested, preferably with staff being tested weekly as a follow-up [1a].
ECDC Released Guidance Document for Contact Tracing
Document outlines the following:
- Typical methods for contact tracing (i.e. phone conversations) and alternative methods (text or pre-recorded calls)
- Repurposing of current infrastructure such as hotline and call center networks
- Use of tracing management software, Web based apps, mobile tracing
- Estimate of labor hours and staffing required based on number of cases reported, and best practices for that number of cases.
ECDC Released Guidance Document on Public Transportation Personal Protective Measures
Two main risk are transmission by crowding, risk of staff infection. The following measures are recommended:
- Discourage sick passengers from using public transit
- Ensure physical distancing for staff, ideally behind transparent barriers
- Educational infographics for physical distancing hand hygiene, face coverings
- Proper ventilation of the vehicle and avoid recirculating air
- Cleaning and disinfection to follow previously established protocols
ECDC Updated Their Guidance Document Regarding Supply of Products of Human Origin (Such as Blood, Plasma, Etc.)
Included new guidance regarding types of substances of human origin and risk assessment and management options for the safe and sustainable supply.