Comment: Adversity can bring hygiene opportunities

Professor Rodney Cartwright and Dr Esteban Delgado look at how holidays might be safer after Covid-19


The coronavirus pandemic has firmly put consideration of health and safety at the top of the tourism industry’s agenda.  While its importance has long been recognised, there have often been differing points of view between marketing and health and safety departments of tour operators and owners and managers of hotels.  Necessary health and safety precautions and guidance have been regarded by some as infringing personal liberty and detrimental to tourists’ enjoyment.  A balance has always to be struck.


The importance of good health and safety has been recognised by the Abta “Tourism Accommodation, Health and Safety Technical Guide”.  First conceived in the 1980s, this guide was developed in response to unacceptable incidences of stomach upsets experienced by tourists in many destinations.  It now covers multiple aspects of hotel operations and is continually subject to revision with expert input.


The coronavirus outbreak has seen tourism come almost to a halt with the industry struggling to make plans for the future.  There are many unknowns in the understanding of the virus, how it spreads and the means for effective control that will allow tourism to open up again.  When will a vaccine be developed, produced in large amount and administered to the population?  Will potential tourists be prepared to travel and, if so, will they follow sensible advice?  Will hoteliers need to implement extra health and safety procedures?

The list could go on.


History tells us travel and the spread of many infections is closely linked.  The Black Death in the 14th century wiped out more than half of Europe’s population. It was caused by a bacterium, manifesting as plague and was spread by fleas on infected rodents travelling on ships around the world. It again appeared in Great Britain in April 1665, resulting in the death of 15% of London’s population. In 1918, influenza swept the world in what was known as the ‘Spanish Flu’, and more rapidly than the plague as modes of transport were more rapid and the number of travellers much greater. The causative influenza virus was responsible for more deaths than the First World War that had just finished. In contrast to Covid-19, there was a predominance of deaths in otherwise fit young adults than future pandemics of influenza in 1957 and of swine flu in 2009.  In between these major pandemics, smaller pandemics associated with travel have occurred due to a range of viruses including smallpox, AIDS, Ebola, Zika and polio.


Little has apparently been learned by governments to be prepared for what history tells us will happen at undetermined intervals.


Increasing globalisation and easy travelling is now well-recognised as a factor in the rapid spread of illnesses worldwide. The present pandemic provides a good opportunity to learn from the current experience and to develop changes in our social and economic models, but also very importantly to develop plans to be prepared in how to deal with new pandemics or local outbreaks.


There is, fortunately, a recognition that the tourist industry will recover at some time and a recognition that now is the time to develop and apply new health and safety protocols in hotels to ensure that when tourists return they can be confident that their wellbeing has been protected.  But the testing of new protocols and, importantly, the training of staff needs to begin now.


Although some parts of the tourist industry have recognised the importance of high standards of health and hygiene in resorts and accommodation units for many years this has not been universal.  The implementation of health and safety programmes has usually been in response to litigation and implementation has been fraught with difficulties and often opposed by those unwilling to spend resources on what they do not recognise as a real problem.

Programmes that have been developed, as illustrated by the Abta guidelines, have expanded from food safety to covering areas including fire safety, pools hygiene, general safety, waterparks and the prevention of legionnaires disease.

The recognition of outbreaks of norovirus led to the development of the prevention of the spread of infection (POSI) guidance which together with much of the other guidance has been a valuable building block in the development of coronavirus programmes for hotels.


Preverisk, already has well established health and safety programmes that are used across the industry, and has actively taken on the challenges posed by Covid-19.  The first stage of its response was to take a step back and take a holistic view of the situation and the present health and safety programmes. Many protocols and guidelines have been produced and training programmes developed but it was recognised that, in reality, they were only part of what should be a comprehensive risk management approach, which required a radical and proactive rethink.


A risk-based approach for identifying hazards and risk factors related to the spread of Covid-19 has been adopted.  Risk assessment is a process to identify potential hazards and analyse what could happen if a hazard occurs.  It is a systematic process for identifying workplace hazards and assessing the risks involved from those hazards.  As such it is a crucial step in protecting people in the workplace and those affected by its activities.

This method has been applied to guests, staff and other visitors to the entire operations in hotels.  Protocols and control procedures have been developed that will be applied according to risk levels.  Many of these protocols and procedures have required only minor modifications to those already existing but the risk assessment step ensures that their application is more fully understood and relevant.


The work undertaken by Preverisk has involved the in-house team, external consultants and industry partners. In particular, a joint working group with a team from the international chain RIU Hotels and Resorts was established and has developed new risk-based protocols.   The involvement of a hotel group with wide experience was regarded as essential as it is too easy for “experts” to develop programmes that are fine in theory but do not work in practice and thus become not only useless but potentially misleadingly dangerous.  The new protocols were thoroughly tested in a hotel environment and where necessary modified.  A detailed programme is now complete for use by hoteliers as the basis for applying a risk management programme in their hotels together with recommendations on appropriate staff training that will be necessary.  The manual “Covid-19. Hygiene Response for Hospitality” is made up of 17 protocols and addresses the new situation globally, going into the detail of daily operation and customer service, as well as cleaning and disinfection.  The main objective of this guide is to guarantee the safety of the guests and employees. In addition, the manual will be shared with the entire industry through an alliance called Post Covid19 Hospitality Tourism Alliance, because – as Preverisk has stressed – “the most important thing now is the recovery of destinations and all they offer together”.  There is much yet unknown about the disease and the effective methods of control, Preverisk says. Its programme is “live”, recognising that fine tuning, adaptations and enhancements to the programme will be necessary. In addition, constant assessments will be necessary and it will be subject to an ongoing auditing programme. The next stage will be comprehensive training for all grades of staff.


The government of Cape Verde is working with Preverisk on a pilot application of the programme for tourism on the island of Sal.  A holistic approach is being taken for the whole island applying the programme to the entire traveller circuit – airports, ports, transfers, taxis, hotels and other accommodations, bars, restaurants, shops, excursions, activities and nightclubs.  The experience gained should provide a valuable working model for other destinations.  In Egypt, the Ministry of Tourism has launched a health and hygiene programme, managed by the Egyptian Hotel Association, where Preverisk is accredited to validate the compliance of the hotels. Similar discussions are underway with the Ministry of Tourism in Morocco.


This new approach has raised many questions and required previous recommendations to be re-examined. The deeper understanding of the rationale and differing levels of risk has already shown the value of having a full risk management programme, not just producing protocols and guidelines. This approach will be applicable not only to Covid-19 but also other infections and all operations within a hotel or destination. Everyone associated with tourism will need to recognise that Covid-19 is highly unlikely to be soon a thing of the past.  Dr Michael Ryan, executive director of the World Health Organization’s Health Emergencies programme, recently said: ‘There is a long way to go, this virus may never go away’.


An effective vaccine may not be developed soon, or manufactured and administered in sufficient numbers to enable tourism to return to the previous normal.  Will the industry have learnt anything? Or, like governments in the past, will it assume another pandemic is unlikely to occur or can be rapidly controlled? Will programmes such as the one developed by Preverisk be short term and given less attention as the infection is controlled?  If so, further words from Dr Ryan should be heeded: “There is a vicious cycle of public health disaster followed by economic disaster followed by public health disaster followed by economic disaster.“  Prevention may not be possible, and indeed it would be foolish to believe that man is mightier than the microbe, but with careful preplanning the repercussions can be ameliorated.


The coronavirus outbreak has certainly caused many problems but has also provided the opportunity to develop a more thorough approach to health and safety in the tourist industry with the result of safer holidays for now and the future.


Let us be optimistic but realistic, alert and prepared.


Professor Rodney Cartwright is a medically qualified microbiologist and a senior consultant in the British Public Health Laboratory Service.  He is a medical adviser to the British Federation of Tour Operators (FTO) and Abta.

Dr Esteban Delgado, is a practising member of The Academy of Experts of London, a fellow of the Royal Society of Public Health (UK), and International Fellow of the Royal Society of Medicine (UK) and an International Member of the Worshipful Company of Plumbers, City of London. Since April 2008 he has been giving public health advice to the FTO and Abta.

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