The opening up of Europe should have come as a relief for inbound and outbound medical tourism. But an array of bans and new rules imposed by individual EU countries, often with little notice, for all or just non-vaccinated travellers, has left prospective medical travellers confused. Ian Youngman looks at what is happening on European travel and the future of the region’s medical tourism.
The only thing that is certain about European travel is that this feature will be overtaken by events by the time it is published. While most progress is good news and forward, instant bans or changes within or about certain countries can and does change, overnight.
Even the EU politicians who make the rules admit they are confused, so it is no surprise that most potential medical and health tourists are uncertain how to plan.
And yet there is significant, pent up demand for medical treatment.
Few countries have figures on how many people await hospital treatment. In England, the number has exceeded 5 million for the first time, highlighting the growing problem of long waits for NHS care.
This would normally encourage potential medical travellers to seek ways to go to Europe or elsewhere for treatment.
Countering this, however, is that many people are still scared of leaving their country, or even their home. In many countries there is demand for healthcare, but both public and private healthcare are still at capacity just dealing with the pandemic.
Add in complex and ever changing traffic light systems of who can go where; whether or not they have to quarantine at home on return and/or in the destination country; and how many expensive tests they have to take in each country, means everyone is confused.
Quarantine and testing can add thousands to a travel bill, which could stop potential medical travellers looking for lower cost treatments abroad.
The future of European medical tourism
Although those involved in the medical travel sector in Europe would like to see a recovery this year, the real timing may depend on country vaccination rates, Covid figures, spare capacity in hospitals, whether any major new variants appear, what happens to travel rules and when, and travel costs.
It is also likely health tourism may recover more quickly, while medical travel in Europe may take until 2023.
EU Vaccine Passport
The European Union’s vaccine passport scheme launched on 1 July, with a phasing-in period of six weeks for the issuance of certificates for those countries that need additional time.
All 26 EU countries have already started issuing the certificates, as have Iceland, Liechtenstein, Norway, and Switzerland.
The EU and Switzerland have agreed to recognise each other’s COVID-19 digital certificates to allow travel for Swiss citizens within the EU, and between the EU and Switzerland. Switzerland is the first country outside the EU and the EEA to take part in the EU certificate system. Certificates issued by Switzerland will be considered equivalent to the EU COVID certificate. Switzerland will accept the EU Digital COVID Certificate for travel to Switzerland.
Non-EU states San Marino and Vatican City are also getting ready to launch.
The EU is negotiating with Andorra, Australia, Canada, Malaysia, Moldova, Monaco, Morocco, New Zealand, Singapore, Ukraine, UK and the USA.
Certificate holders should be exempt from any additional travel restrictions. The regulation will apply for 12 months as of 1 July 2021.
European countries are setting restrictions
European lawmakers have criticised the way some countries have implemented the digital vaccination certificate. They argue is not a question of having or not having restrictions, but of having the same rules for each country, following a common agreement.
But the rules are not being applied consistently within Europe. After launch, for example, France advised citizens not to travel to Spain or Portugal; while Portugal now requires all arrivals who are not vaccinated to quarantine. Germany demanded a two week quarantine on travellers form Portugal.
The agreed implantation rules for all EU countries are that holders of vaccination certificates issued in line with the EU digital COVID certificate regulation should not be subject to testing or quarantine/self isolation if they are fully vaccinated with an EMA approved vaccine and at least 14 days have passed since full vaccination. Member states can also lift such restrictions after the first dose of a two-dose series.
Recovered persons holding a certificate indicating that less than 180 days have passed since the date of a positive test result should not be subject to testing or quarantine/self isolation.
The problem is that countries can use various ‘get out’ clauses in the EU agreement, including one on new variants. Where the epidemiological situation in a region deteriorates rapidly, in particular due to a high prevalence of variants of concern or interest, member states can trigger an emergency brake. On that basis, member states should also require vaccinated and recovered persons to undergo testing and/or quarantine/self-isolate.
Who can travel into the EU and associated countries?
Following a review under the recommendation on the gradual lifting of the temporary restrictions on non-essential travel into the EU, the Council updated the list of countries, special administrative regions and other entities and territorial authorities for which travel restrictions should be lifted. The list was updated on 15 July and will continue to be reviewed every two weeks.
England will from 19 July allow travel to many EU countries without the need for quarantine on return. Wales, Scotland and Northern Ireland have their own rules.
Only adults that have had both vaccinations will no longer need to quarantine on return home to England from amber list countries. Travel is dependent on countries on the amber list allowing them in at all or with rules on testing and quarantine at the destination. There is no guarantee that amber list countries will not become red ones during the trip. On return, those coming from amber list countries will still need to take two PCR tests each – one before they fly back, and one on Day 2 of their return.
There is no change to the rules for travellers from those amber list countries.
Vaccinated travellers
Many European countries are open to fully vaccinated travellers but each one has its own rules for those not covered by the EU Covid passport scheme.
Entry regulations depend on the country from which you are travelling. Some countries allow all vaccinated travellers while others have lists of banned countries while others have stricter rules apply to those arriving from high-risk or very high-risk areas that may include quarantine.
As of 12 July, European countries open to many vaccinated travellers without quarantine include:
- Austria
- Bulgaria
- Croatia
- Cyprus
- Czech Republic
- Denmark
- Estonia
- Finland
- France
- Germany
- Greece
- Hungary
- Ireland
- Italy
- Latvia
- Lithuania
- Malta
- Netherlands
- Poland
- Portugal
- Romania
- Slovakia
- Slovenia
- Spain
- Sweden
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