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The Joint Biosecurity Centre (JBC), part of the UK Health Security Agency, in partnership with devolved administrations, has developed a dynamic risk assessment methodology to inform ministerial decisions on red, amber and green list countries and territories, and the associated border measures. This methodology has been endorsed by the JBC technical board (4 UK Chief Medical Officers and their relevant specialists, such as Chief Scientific Advisers).
JBC reviews over 250 countries and territories. As a precautionary approach, countries and territories are assumed to be amber unless there is specific evidence to suggest they are:
- green – presenting (with confidence) a low public health risk to the UK from all COVID-19 strains
- red – presenting a high public health risk to the UK from known variants of concern (VOC), known high-risk variants under investigation (VUI) or as a result of very high in-country or territory prevalence of COVID-19
The methodology consists of 4 parts:
- variant assessment
- risk assessment
- outcomes that inform ministerial decisions
Regular monitoring and evaluation of new variants is undertaken by PHE to identify those which may be of concern (VOCs and VUIs) to the UK.
This assessment considers several factors including:
- severity of disease
- escape from natural immunity
- escape from vaccine-induced immunity
- effect on therapeutics
- zoonotic emergence (jumped from animal to human)
- current epidemiology
See further information on variants of concern and variants of interest.
Selects a list of countries and territories for further risk assessment (‘deep dives’). This stage considers a range of indicators, including:
- testing rates per 100,000 population
- weekly incidence rates per 100,000 population
- test positivity
- evidence of VOC/VUI cases in country and territory
- exported cases/VOCs/VUIs to the UK and elsewhere
- genomic sequencing capability
- strong travel links with countries and territories known to have community transmission of a VOC/VUI
Further risk assessment
All countries and territories that pass triage for green or red indicators undergo a more comprehensive risk assessment using additional quantitative and qualitative information (for example, from publicly available platforms such as GISAID and the World Health Organization, host government websites, UK mandatory testing data and travel data), taking into account data availability, limitations and biases.
Available and relevant sources of information for each country or territory are used to provide an overall assessment on:
- genomic surveillance capability
- COVID-19 transmission risk
- VOC/VUI transmission risk
Travel connections with the UK and details of the in-country and territory vaccination profile are included as contextual information.
Decisions on red, amber or green list assignment and associated borders measures are taken by ministers. Ministers will take the JBC risk assessments into account alongside wider public health factors to inform watchlists and make their decisions.
This methodology will evolve to reflect the changing pattern of the COVID-19 epidemic and as the JBC incorporates new scientific insights, new data sources, and new analyses that become available. The methodology is subject to quarterly review (as a minimum) by the JBC technical board.