Exit Framework

EXIT FRAMEWORK

Updated Version 2 - April 2021 GD 2021/0024

Isle of Man Government Strategy: Transition Phase www.gov.im/coronavirus Updated Exit Framework 2 - April 2021

The first version of the Isle of Man Government Exit Framework approach to living with COVID-19 was published in March, and outlined three key phases - Preparation, Transition and Release, that the Council of Ministers expected to move through as the Island's vaccination programme rolls out, and the UK threat profile decreases.

The Preparation phase (March to April 2021) was primarily concerned with research and planning, building up our defence, and allowing the UK position to materially improve. It also importantly allowed for real world information to develop on the likes of the individual vaccines’ effectiveness and the UK’s progress.

As we now approach the end of the Preparation period, and are also emerging from the most recent outbreak on our Island, we are moving into the phase of ‘Transition’.

The Exit Framework remains a living document, and the intention is to revise it as required as we progress in both our experience and our understanding of the virus. This second version represents an accelerated timeframe than was first expected back in February / March based on improved progress here in the Island and in the UK. There may be further opportunities for us to accelerate our ‘exit’ going forward, although conversely, whilst clearly we hope it is not the case, there may be unexpected events that slow down our progress.

Version two provides a simplified plan between now and the end of June as we move through the Transition Phase based on three strategic objectives:

Strategic Objectives for Mitigation:

Learning to live in a world with COVID-19

Moving from legislation to education and personal choice Working together to foster healthy habits

Returning unrestricted British Isles travel

Begin to adjust border restrictions based on our progress and that of the UK

Develop a long term sustainable position

Find a new balance for society, economy and the health of our Island Develop and maintain a long term sustainable infrastructure and services that support living in a world with COVID-19

1 During the ‘Transition’ phase, we expect to make a significant amount of change, particularly around the border position to begin to allow family and friends to visit our Island, and to move toward welcoming other visitors to our shores.

The Exit Framework should be seen as a reasonable proposal as we move into a permanent 'Mitigation' strategy. Of course, we cannot rule out major developments, such as new variants of concern developing and taking hold, but it does provide a blueprint for restoring unrestricted British Isles travel, and proposed dates for us to move forward as an Island.

Recent progress, as well as wider health, economic and social considerations, support a move to a Mitigation strategy as we learn to live in a world with COVID-19.

Recent Progress: Substantial progress in Isle of Man vaccination programme - over 50,000 first doses delivered

Substantial progress in the UK vaccination programme - around 32 million first doses delivered

Increasing evidence regarding vaccine effectiveness[1] on infection and transmission rates for first dose

Significant improvement in UK position

The third Isle of Man lockdown built up further understanding of local outbreak management and impact of vaccine

The end of April, May and June represent important milestones in vaccination programme

Pursuing a strategy of 'Elimination' meant setting the objective of eradicating the virus from our community, ideally in its entirety. While elimination was an attractive goal, it is increasingly no longer possible for us to completely eradicate the virus in the long term, and we must move forward.

A strategy of Mitigation does inherently carry a higher acceptance of imported risk, but it acknowledges that as a community we increasingly have the systems and mitigations in place to better manage this risk.

We have many tools at our disposal, such as our contact tracing, testing and isolation capabilities, border controls, professional and experienced health systems and capacity as well as collective habits and behaviours that will ensure we are able to manage future cases.

We must assume that the virus will come back, but must also assume that we are - collectively and individually - increasingly prepared to mitigate against it.

[1] Public Health England - https://www.gov.uk/government/publications/phe-monitoring-of-the-effectiveness-of-covid- 2 19-vaccination As we adopt a collective position of Mitigation, we need to adopt a collective responsibility to take small but effective intervention steps, such as maintaining good standards of personal hygiene and adopting healthy habits that make a big difference.

Personal measures such as respiratory etiquette, hand hygiene and staying at home if unwell, will need to become every day habits to protect our Island.

The World Health Organisations '3 C's' is a useful tool in considering how the risk of outbreak and infection rises in each of these settings and in particular when each of the "C's" overlap: Crowded Spaces Close-Contact Settings Confined and Enclosed Spaces

Key Messages: Mitigation Phase

Keep hands clean and cover coughs and sneezes If you are unwell, stay at home and contact 111 Wear a face covering if requested or based on personal choice Consider the 3 C's: Avoid confined spaces with poor ventilation Avoid crowded places with lots of people nearby Meet outdoors or in well ventilated areas where possible Consider maintaining distance and avoiding close-contact settings

3 Responding to Cases

Despite moving to Mitigation, COVID-19 still poses an unprecedented threat and we must continue to exercise caution and mitigate against the virus coming across our border and into our community.

In the short term as we increase the volume of border movements, we must maintain some level of border mitigations, such as testing and isolation, in order to keep the virus out for as long as possible. No level of defence is going to be fully 100% effective however and when further cases do develop outside these households, our primary response will need to continue to include robust contact tracing, testing and isolation so as to contain what would otherwise be an uncontrolled spread, only intervening with formal legal restrictions as a last resort when there is a clear and apparent threat to our health and care systems.

In parallel to contact tracing, testing and isolation, we will also respond by asking the public and businesses to exercise a heightened level of awareness and precaution to do everything possible to limit and contain the spread of the virus without the need to formally intervene with restrictions on society or the economy.

This “Level 0” will be our first level ahead of any formal circuit breaker and updates the original response as follows:

Response Level Normal Personal choice, education and awareness

Response Level 0 Enhanced awareness, advice and encouraged best practice

Response Level 1 Introduce mitigations in high risk settings

Response Level 2 Interventions in high risk settings and mitigations elsewhere

Response Level 3 Full 'Emergency' situation and range of interventions

Much of this will need to be refined based on the context of any cases, the level of assumed spread and containment through tracing, testing and isolation and Government will need to continually refine the assumptions used within Manx Care to ensure they are able to respond to any outbreak.

In parallel we will continue to seek external assessment and commentary on what an outbreak may look like, for example using the advice and modelling from the Warwick University team who are one expert team that provide input and models for SAGE in the UK.

4 UK Position and Indicators

Both of the Channel Islands intend to implement a Country Classification / 'Traffic Light' System, which for Guernsey will require 14 day testing for all arrivals and either a 14 day isolation or 7 day isolation with 7 days passive "follow on" (restricting some activities). Jersey's system requires 3 tests over 10 days with a minimum of 12 hours isolation, to be possibly at least 5 days in the short term.

The UK has indicated it will consider resuming non-essential international travel at the earliest on 17th May 2021 and has also followed a Country Classification / Traffic Light system. As a minimum it has suggested that all travellers will need to take pre- departure tests and potentially Day 8 test with 10 days isolation for Amber countries and 10 days managed quarantine for Red countries.

The UK's position has improved substantially since the beginning of the year, and indications are positive as they progress through their vaccination programme, and in parallel as they move through their phased exit from the current lockdown.

Council of Ministers will consider the position in the UK (based primarily on the 14 day rate for 7 consecutive days) at key milestones, and have set out broad indicators and what the border, testing and isolation response may be as we move from Border Level 4 to Border Level 1 (where restriction-free travel with the British Isles is restored for all).

14 day rate for 7 Restrictions/ Isolation Testing consecutive days Border Level Pathways

more than 100 Border 21 Days or Day 0 / 6 / 13 in 100,000 Level 4 14 days + testing

21 Days or Border 30 - 100 in 100,000 Day 0 / 6 7 day pathway Level 3 Shared Isolation Option

14 Days or fewer than 30 Border Day 0 / 6 1 day + testing in 100,000 Level 2 Shared Isolation Option

Border Equivalent to Level 1 / None required None required Isle of Man Airbridge

*These indicators are only guides and Council of Ministers will need to consider the whole position as we approach these milestones.

5 Revised Transition Plan

At present, the Isle of Man's border controls are: 1. Border Restrictions - controlling who can enter the Island 2. Border Controls - control measures upon entry to the Island

This position is not sustainable in the long term and there is a large proportion of the population who, after 12 months of restrictions, need more freedom of travel – whether for themselves, for family to visit or in the case of our visitor economy for tourists to once again enjoy what the Island has to offer. In the short term we will need to continue to maintain a level of border restrictions and mitigations, but are able to gradually reduce these as our defence builds and the threat continues to reduce further.

Our objective is to return to unrestricted travel with the British Isles by the end of June, with the below dates providing an indicative timeline.

Transition Stage 1: 1st May Family, Partners and Property Owners Borders Level 3 Reintroduction of shared isolation option for all travellers Reintroduction of 7 day pathway option for all travellers Subject to UK position sustaining <100 in 100,000 for 7 days

Transition Stage 2: 29th May* Non-Resident Mitigated Travel

Borders Level 2 Supports business and society Pathways and Isolation to be reviewed and confirmed Subject to UK vaccination, infection and 'variants of concern' position

Transition Stage 3: June 28th* Unrestricted Travel

Borders Level 1 Traffic light system aligned to UK for international travel Border Force and systems in place to deal with scale Subject to UK vaccination, infection and 'variants of concern' position

* These dates are indicative dates and are set out to provide more clarity of what we hope to achieve. They are subject to change as the position continues to develop and regular updates will be provided as we progress through the Transition Phase.

6 Island Life During Transition

Through this period as we implement a Mitigation strategy and make changes, Island life will need to adapt, holding high standards, embracing new thinking and increasingly learning to live in a world with COVID-19. This will require personal responsibilities, business responsibilities and Government responsibilities with examples including those below:

Transition Period for Individuals

Stay at home if you feel unwell Make informed personal choices WHO’s 3C’s: consider Confined Spaces, Crowded Places and Close Contact personal consideration and assessment Recognise and support those still vulnerable, unprotected or anxious

Transition Period for Businesses

Encourage high standards of hygiene, ventilation, personal space Support personal choice for staff and customers, such as the ability to work from home or in isolation as a way of life Consider WHO's 3 C's model and develop response based on individual business circumstances Support Stay at Home if unwell Educate customers and staff, and be prepared 1st May (visiting family) and 28th June (broader visitor economy) are key dates for businesses within the Tourism and Travel sector Business travel enabled (with appropriate mitigations) 29th May

Government Response

Maintain Tracing, Testing and Isolation policies and processes Stabilise and Scale systems and approach Support 'Stay at Home if unwell' message Long term traffic light systems and plan Health, Borders, Public Health, Testing and Economic Response Ready to React: Understand variants of concern and develop rapid identification capabilities Improve public communications to educate and support businesses and individuals personal choices Publish ongoing dashboard to support informed personal choices

7 Conclusion

The past year has provided a great challenge for our Island. The measures that have been taken have defended our Island, and protected our National Health Service from being overwhelmed in the face of an invisible yet destructive virus.

We have made substantial progress in our vaccination programme, and our defences against the virus are increasing rapidly. We have now passed two weeks beyond the first milestone of Phase 1 priority groups, allowing for vaccine effectiveness. Looking further afield, there is growing scientific data to support the effectiveness of vaccinations and the outlook in the UK looks positive.

While effective to date, it is clear that we cannot continue to respond only with lockdown events, which bring with them their own threats to our social, health and economic wellbeing and are not sustainable in the long term.

We have listened to feedback from the public, our political members, our clinicians and our business leaders. It is the right time to adopt our approach, and accept that we must: Learn to live in a world with COVID-19 Return unrestricted British Isles travel Develop a long term sustainable position

The next step of our journey commences on 1st May and we will aim to gradually but quickly adjust our border position through to 28th June for travel between the Island and the British Isles. Government will continue to provide the response systems and infrastructure that will be needed to support this new approach, but there will be a higher emphasis on personal choice and collective responsibility. We must assume that at some point the virus will return, but we must also increasingly assume that we have the tools required to live with it.

The best way to protect our Island, protect our economy and protect our people longer term will increasingly be to learn to live in world with COVID-19 and increasingly return connectivity between the Island and the British Isles.

There is not one response that will fit all of our residents, and we must all take personal and collective responsibility to protect our residents, our businesses and our visitors, and balance our health, social and economic needs.

We will continue to provide regular updates as we progress forwards through this phase.

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h 9 I P R t L EXIT FRAMEWORK v2 Living in a world with COVID-19