International Tourism and Global Public Health Crisis

 

Adamantia V. Roussou, Vasiliki Papanikolaou & Eleni Kornarou

Department of Public Health Policies, University of West Attica, 196, Leof. Alexandras, Athens GR 1152, Greece, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..

 

 

ABSTRACT

This paper discusses the close relationship between tourism and public health regarding the role of travelling in the spread of infectious diseases. It examines the diversity of the tourism industry and the special characteristics that compose the tourist product, the way tourist destinations are chosen and how the travel experience is shaped through the provided tourist services. Other aspects also explored are the contribution of globalization to the transmission of contagious diseases and their impact on global tourist destinations, the way disease is recorded and monitored by the WHO and the ECDC, the effect of the Covid-19 epidemic on the tourism sector and the catalytic role of the hospitality industry in ensuring public health through the health protocols it implements.

This is a PRISMA review that synthesizes findings from existing Greek and international studies of quantitative, qualitative and mixed methods, published in academic journals mainly after 2000, in the Greek or English language.  The relationship between tourism and public health is analyzed in three main areas: a) tourism, b) the spread of diseases and c) public health.

According to the findings, tourist motivation is associated with rules, cultural views and perceptions that revolve around the individual while the image of destinations consists the main pull factor for tourists. The search for "enhanced" experiences in emerging new destinations as well as the ever-increasing public health risks are leading a shift in interest towards safety and protection. Disease recording and surveillance, as well as early warning, play an important role for the implementation of effective measures to prevent epidemics from escalating into pandemics. Finally, multinational hotel companies are currently focusing on the strengthening their existing health protocols.

This paper concludes that the Covid-19 pandemic further reinforces the view that health security will be a key factor in attracting travelers and that tourism and public health are more closely linked than ever before. The restart of the tourism industry is likely to primarily depend on a marketing strategy that will strengthen both the image of protection and security of destinations and the support of new tourism products for the viability of the industry.

Keywords:  travel experience, risk perception, infectious disease, health protocols.

 

 

1 INTRODUCTION

               The emergence of new markets has led to a significant increase in the volume and size of global tourism since the 1950s. The evolution of the means of transport, but also the emergence of new popular tourist destinations in developing countries (mainly tropical / subtropical) have made travel patterns more complex, allowing the transport of pathogenic microorganisms to distant destinations (Chen & Wilson, 2008). Conversely, travelers also face an increasing likelihood of exposure to local infections and diseases when getting in contact with host populations during their journey (Wilson, 2003). Travel has reduced geographical barriers but has increased the spread of infectious diseases. Especially in the case of the hospitality industry, Coppola (2010) argues that it is one of the most vulnerable to emergency situations, which are now more frequent and complex than before, and affect all related industries at the same time.

               Infectious diseases remain a critical issue for Public Health due to the constant change of their epidemiological profile (e.g. antibiotic resistance, mutations etc.) but also due to the burden they cause on humanity. In recent years, the incidence of Infectious Disease Threat Events (IDTES) has increased. Globalization and the environment and more specifically, travel and tourism, food and water quality, the natural environment, global trade and climate change are the top five drivers of IDTES while early prevention is more desirable than tackling (Semenza et al., 2016). The existing epidemiological surveillance networks, both globally and at European level, facilitate the surveillance of diseases, especially infectious diseases, which are important for Public Health. These networks are highly effective in detecting epidemics early and provide data with accuracy and speed, thus facilitating the monitoring of disease trends and are an important tool for designing disease prevention and control programs. Tourism is a highly vulnerable and volatile product influenced by factors that are sometimes beyond the control of tourism businesses and destinations. Health crisis affecting tourism, such as the SARS pandemic in 2003, have been on the rise in recent decades, while the current Covid-19 pandemic unfortunately proves that proper and timely preparation plays a role of crucial importance in mitigating the effects but also in minimizing the damage. 

               Tourism is an economic activity that will continue to attract international interest due to its global impact on the social, cultural and economic system of various countries. Creating direct and indirect employment opportunities and significantly contributing to capital inflows and national incomes, it is one of the key components of economic growth. As a result of international political instability, terrorist attacks, the emergency of natural disasters but also epidemics, tourists’ interest in their safety and protection is constantly growing. Infectious diseases affecting public health and consequently tourism are not a new phenomenon but have followed the trend of global travel both in terms of rapid growth and spread. As diseases know no borders, they are not limited to their nations of origin and therefore, their restraint requires a global approach and effort.

               The present study presents a detailed synthetic picture of the public health risks associated with tourism and traveling. It is a PRISMA review (Moher et al., 2009) that synthesizes findings from existing Greek and international studies of quantitative, qualitative and mixed methods, published in academic journals mainly after 2000, in the Greek or English language. The relevant bibliography was searched in a series of databases (Cochrane, CINAHL, MEDLINE, PUBMED, Google Scholar) and was conducted using keywords related to the research object. The evaluation of the studies was carried out with the help of the QATSDD questionnaire (Sirriyeh et al., 2012) while the analysis of the data was conducted in accordance to the instructions of the narrative composition (Popay et al., 2006). The relationship between tourism and public health is analyzed in three main areas: a) tourism, b) the spread of diseases and c) public health.  This paper not only stresses the importance of early and timely reporting of public health threatening events, but also the need of redesigning crises management plans and reinforcing health protocols in tourism, so as to ensure the prevention and containment of future outbreaks.

 

2 CONSUMER BEHAVIOUR IN TOURISM

 

2.1 Tourism: a human activity & a market of economic goods

According to the definition put forth by the World Tourism Organization (UNTWO) “tourism is a social, cultural and economic phenomenon which entails the movement of people to countries or places outside their usual environment for personal or business/professional purposes. These people are called visitors (which may be either tourists or excursionists; residents or non-residents) and tourism has to do with their activities, some of which involve tourism expenditure”. In this framework, tourism is primarily defined as a human activity, composed by the journey and the individual activities visitors engage into during the trip and secondarily as a market of economic goods, whereby it should not be studied only in terms of tourism demand but also in terms of the tourist offer and their spatial interconnection (Kandampully et al., 2001, Lagos 2005, Koutoulas, 2015).

               As a significant form of human activity, tourism can have major impacts which cannot easily be categorised as solely social, environmental or economic, but tend to have several inter-related dimensions. Depending on the value position of the observer, those impacts can be positive or beneficial (for example contribution to local economy, job creation, willingness to support measures to protect the environment) (Loizidou, 2008), but also negative or detrimental (for example: disturbance to habitats and damage to landscape features due to overcrowding, pollution, loss of cultural identity. As a market of economic goods, tourism is a complex concept as, while it constitutes a single activity, it consists of a mixture of products and services which are promoted and provided to tourists by its various sub-sectors. As an industry, it requires products and services from all sectors of the economy (primary, secondary and tertiary) and employs, directly or indirectly, millions of workers worldwide (Edgell, 1990; Lagos, 2005). The biggest challenge for all the parties involved in the creation of the final product is to ensure the delivery of the desired quality services with coherence and reliability, whenever requested, with appropriate procedures and coordination. (Kandampully et al., 2001). 

               Although the tourism product reflects the overall travel experience that the visitor experiences, tourism impacts are largely spatially concentrated in the tourism destination since production and consumption take place in the same location (Menges, 1973; Burkart & Medlik, 1981). In recent years, a number of international economic, social and environmental developments, notably the international financial crisis and financial instability, the increase in the debts of countries, companies and citizens, political instability, natural disasters, the emergence of new destinations in developing countries among others, have a catalytic effect on the tourism phenomenon, resulting in changes both outside the operating environments of tourist destinations and tourism businesses (Tsartas et al., 2014). Additionally, the significant development of informatics and new technologies, the economic development of third world countries and the changes in the policy of many countries, are just some of the factors that shall accelerate the growth of the global tourism market. The tourism industry continues to grow in an ever-changing business environment.

2.2 Tourist motivation

               The investigation of tourist motivations, in an effort to understand the tourists’ behaviour and their decision making process, has become an important area of tourism research (Ryan, 1997). Initially based on Maslow’s motivational theory, many researchers have attempted to provide an understanding of tourists’ motives and their decision making process. Dann (1977) suggested that tourism consumption may be stimulated by ‘pull’ factors, which influence the individual’s desire to leave its current context so as to escape daily routine and discover new places and cultures while ‘push’ factors are directly associated with the image of the destination itself (Laloumis, 2015). Iso-Ahola’s (1980) psychological model summarized the motives into ‘seeking & escaping’ and suggested that individuals seek personal and interpersonal rewards while at the same time, they wish to escape personal and interpersonal environments (Mannel & Iso-Ahola, 1987, Pearce, 1993). Sociological theories focused more on tourists’ typology and their interaction with host communities. Cohen (1972) sub-divided tourists into four types (the organized mass tourist, the individual mass tourist, the explorer and the drifters) while Plog (1974) classified them into ‘psycho-centric’ (inhibited, non adventurous) and ‘allo-centric’ (confident, naturally inquisitive), based on their willingness to seek more familiarity in their holiday surrounding versus seeking out the unfamiliar when travelling and seizing each new experience as a unique opportunity to discover new places and completely immerse into the culture of the host countries. 

               Although mainly criticized for their lack of empirical evidence, these theories continue to be relevant regarding consumer motivations in tourism. Push and pull factors can further help planners to augment and enhance destinations’ offers, and provide marketers with a clearer grasp of which factors within their destination play an important role in destination choosing. In addition, the identification and understanding of travellers’ individual motivations may facilitate and provide a more accurate segmentation of tourism markets, helping marketing managers and/or destination planners to strategise their offers and facilitate channel marketers’ approaches in more productive directions. 

               Tourist behaviour can be influenced by a number of factors including cultural conditioning, social influences, perception and education while travel motivations are not static but change over time in terms of quantity, quality, variety and past experiences (Pearce, 1993). As the image of the traditional tourist evolves, the shift towards the search for "enhanced experiences", the search for the quality of the services provided and the search for self-improvement is particularly noticeable. As Dwyer et al. (2008) point out tourists become more critical and less loyal, seeking ‘value for money’ and not necessarily lower prices. In the same way, holidays become more specialized and take the form of an educational and cultural experience. Travel experiences will increasingly take into account the values ​​and lifestyles of the growing middle class worldwide, as tourists seek to discover, experience, participate and become better acquainted with the daily life of the destinations they visit.

2.3 Risk perception and travel behaviour

               Tourism and risk are two concepts inherently linked as the very decision to travel contains the concept of risk (the insecurity of being in a foreign country, the chances of something happening, etc.). The perception of risk concerns a cognitive but subjective assessment of the possibility of an unpleasant event occurring, which may differ from the real probability (statistical risk). Quintal et al. (2010) argue that tourists are more concerned about the risks that directly affect them or at least the risks they are able to perceive. In tourism, the dimensions of perceived risk are related to physical hazards, type of holiday and destination and include crime, disease, personal injury, equipment damage, weather conditions, cultural barriers and political crises (Pennington-Gray & Schroeder, 2013). Other factors that affect the perception of risk are the typology of the tourist, personal characteristics, age, gender, personality, nationality and level of education, previous travel experiences as well as sources of information and the information itself (Lepp & Gibson, 2003; Pizam et al., 2004; Kozak et al., 2007).

               In the field of psychology, the first attempt to provide an understanding of risk perception and decision-making was put forward by a psychometric model, which revealed that people tend to use heuristic cognitive methods[1] in order to classify and simplify the information they receive, which often lead to preconceptions or biases which are influenced by several factors such as fear, risk unfamiliarity and stigma, among others. (Sapountzaki & Dandoulaki, 2016). Therefore, though it should ideally also take into consideration the existing empirical evidence, a number of additional factors contribute to their formation, including personal experiences, affective factors and salience of available examples, making the risk seem higher when a potential threat is seen as uncontrollable or dreaded (Sapountzaki & Dandoulaki, 2016). 

               Tourism is a highly vulnerable and unstable product that is influenced by factors that sometimes are beyond the control of tourism businesses and destinations. Even if the voluntary decision to choose a destination that is considered dangerous can make a positive contribution in the enrichment of the travel experience (Cohen, 1972; Plog, 1974), tourists' interest in their safety and protection is constantly growing, mainly as a result of international political instability, terrorist attacks, natural hazards, but also epidemics and many researchers argue that tourists tend to avoid destinations with higher potential risk (Law, 2006; Batra, 2008). Incidents that may threaten the health, safety or environment of tourism businesses or destinations can significantly damage their reputation and credibility, and negatively affect travelers' perceptions. The vulnerability of the tourism product increases the need for the existence and implementation of effective crisis management strategies, especially at the destination level.

3 PUBLIC HEALTH AND TOURIM

3.1Globalization and transmission of infectious diseases

               Globalization has increased trade and strengthened international relations, but it also poses new challenges and risks. Infectious diseases have followed the trend of world travel in terms of their rapid growth and spread and, precisely because they are not limited to their countries of origin, they require a global approach. Today people cross the world in less time than many infectious agents need to incubate while many pathogens can be transmitted by asymptomatic or mildly symptomatic individuals, including travellers, who may not be aware they are carriers. The fact that some pathogens may carry resistance genes is even more alarming, as additionally to showing high infectivity, they also present high resistance to antibiotics and thus a higher rate of spread and prevalence. On average, one new infectious disease emerges every year (Woolhouse & Dye 2001). The risks of transmitting infectious diseases are not limited to human-to-human contact. About three-quarters of infectious diseases that have emerged or recurred in recent decades are zoonoses, or animal-borne diseases (US General Accounting Office, 2000). Unplanned urbanization, especially in developing countries, poses another set of risks for the transmission of infectious diseases especially due to inadequate sewerage, overcrowding, and the sharing of resources such as food and water (Moore et al., 2003). Among the main factors that may trigger an epidemic outbreaks are natural disasters, endemic diseases and bioterrorist attacks.

               Natural disasters do not usually lead to epidemic outbreaks but can, under certain circumstances, increase this possibility. Risk factors and transmission of infectious diseases are mainly associated with conditions such as heavy rainfall and floods, which favour the appearance  of animal and vector-borne diseases (e.g. malaria[2] and leptospirosis[3]), the degree of overcrowding and the immunological coverage of the population (measles[4] and tetanus[5]), the availability of clean water and sanitation facilities (cholera[6], typhoid and paratyphoid fever[7]), the population’s state of health and the availability of health services (PAHO, 2000).             

               Vector-borne diseases appear or reappear as a result of changes in public health policies, vectors’ resistance to insecticides and drugs, lack of prevention programs, demographic and social changes, and genetic changes in pathogens (Gubler, 1998). It is a fact that the existence of epidemics and endemic diseases that prevail in some areas play an important role in choosing a tourist destination. Malaria is one of the most severe public health problems worldwide and a leading cause of death and disease in many developing countries. In 2019, malaria caused an estimated 229 million clinical episodes, and 409,000 deaths[8]. Malaria is one of the most common pathogens among febrile patients returning from destinations where the disease is endemic, with the islands of Africa and the Indian Ocean being the main sources of the disease for European patients (Gautret et al., 2009).

        The September 11th, 2001, terrorist attacks on the World Trade Center and the Pentagon, accompanied by the sending of anthrax letters to the media and the Congress through the US postal service, have dramatically changed public opinion on issues of microbial bioterrorist attacks and the protection of citizens from future attacks (Kasper & Fauci, 2017). In terms of political trends, the effects of terrorist acts and the issue of travel security will continue to affect tourism as any threat to the safety of tourists causes a reduction or complete absence of activity in the affected destination and in turn has a negative impact on inbound tourism and neighbouring destinations (Cavlek, 2002). 

               The increased volume of global tourism activity combined with the attractiveness of high-risk exotic destinations exposes tourists to greater risk (Faulkner, 2001; Mistilis & Shelton, 2006). As the population ages, the most likely tourism profile of the future will be one that is less risk tolerant and less risk averse. As current trends indicate, as the number of tourism-related economies increases, the image of a "safe destination" becomes increasingly important (Dwyers et al, 2008).

 

3.2 The International Health Regulations and the role of the World Health Organization in the control of outbreaks

               In response to the exponential increase in international travel and trade, and emergence and re-emergence of international disease threats and other health risks, 194 countries across the globe have agreed to implement the International Health Regulations (2005). The stated purpose and scope of the IHR are "to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.". The IHR require States to strengthen core surveillance and response capacities at the primary, intermediate and national level, as well as at designated international ports, airports and ground crossings (WHO, 2008).

In light of its role as guardian of the 2005 International Health Regulations, the World Health Organization (WHO) bears special responsibility in the management of risks and emergency situations. Through dedicated epidemiological surveillance networks, including the  Global Outbreak Alarm and Response Network (GOARN), WHO works closely with Member States and partners in order to strengthen national, regional and global countermeasures and counter-terrorism efforts. (WHO, 2016). Responsible for monitoring the various events either until they end or until they cease to pose a significant risk to public health, WHO is also committed to providing the necessary adequate staff and core funding for incident detection and risk assessment and monitoring. The exchange of information, transparency and open communication between Member States is of the utmost importance as they are directly linked to the responsibilities of the organization and the legal framework provided by the IHR (WHO, 2017). The role of WHO is crucial for the timely detection and assessment of risk so that the incidence of infectious diseases does not escalate into large-scale outbreaks or pandemics.

 The Severe Acute Respiratory Syndrome (SARS) outbreak of 2003 has shown how, in a closely interconnected and interdependent world, a new and poorly understood infectious disease can have an adverse affect not only on public health, but also on economic growth, trade, tourism, business and industrial performance, and political and social stability. More specifically, the disease was first identified on the 12^th March 2003 following the appearance of a severe respiratory illness of undetermined cause that was rapidly spreading among hospital staff in Hong Kong Special Administrative Region (China) and Vietnam (World Health Report, 2003). The world community became aware of the outbreak on March 15^th, 2003, when an infected doctor, who had treated the first cases of atypical pneumonia in Guanzhou (China) had reported having similar symptoms shortly before boarding an international flight returning to Singapore from New York. The doctor and his wife had spent the night at the Metropole Hotel in Hong Kong and through presumed contact, they transmitted the SARS virus to at least 16 other guests and visitors (all linked to the same hotel floor) who in turn carried the virus to their homeland as they entered local hospitals or travelled on to Singapore, Toronto and Vietnam. The doctor and his wife became the first two cases in Europe while an international outbreak eventually took place, spreading the virus to 30 countries.

SARS was successfully contained in less than 4 months, largely because of an unprecedented level of international collaboration and cooperation. The international response to SARS was coordinated by the World Health Organization (WHO) with the assistance of the Global Outbreak Alert and Response Network (GOARN) and its constituent partners made up of 115 national health services, academic institutions, technical institutions, and individuals. 

               The economic impact of the SARS outbreak has been considerable. Apart from the direct costs of intensive medical care and control interventions, SARS caused widespread social disruption and economic losses. Schools, hospitals, and some borders were closed and thousands of people were placed in quarantine. International travel to affected areas fell sharply by 50–70%. Hotel occupancy dropped by more than 60%. Businesses, particularly in tourism-related areas, failed, while some large production facilities were forced to suspend operations when cases appeared among workers (World Health Report, 2003).

 

3.3 The European disease and surveillance networks and COVID-19 pandemic

In an effort to improve communication between institutions and support the development of comparable surveillance methods in Europe, in recent years a number of international projects and networks have been developed. European surveillance networks include independent disease-specific networks[9] as well as the Early Warning and Response System (EWRS), which is a web-based, password-secured notification system used for the prompt alerting of EU Member States regarding potential public health threats. Launched in September 2004 in view of the threat of bioterrorism and the emergency of SARS, the European Centre for Disease Control and Prevention (ECDC) is the official body of the European Union for epidemiological surveillance, early detection of epidemics and immediate response to epidemic threats (Coker et al., 2018).

Managing the disease surveillance networks in Europe, the ECDC carries out a wide range of activities including the collection, classification, analysis and reporting of epidemiological data, the provision of scientific opinions, and the preparation and provision of technical assistance to Member States. It also reinforces the synergies between the existing national centres for disease control and is responsible for facilitating cooperation between national disease control agencies and other organizations and for coordinating European action (Coker et al., 2018). However, despite the creation of a transnational communication framework, disease control in Europe continuous to face many challenges, as the implementation of large-scale public health interventions at EU level remains difficult due to significant differences between each country's needs, resources, policy-making perspectives and the lack of adequate EU legal authority over health policies (Liverani & Coker, 2012).

The European Commission is currently coordinating a common European response to the coronavirus outbreak, taking decisive action to strengthen the public health sector and mitigate the socio-economic impact in Europe. The COVID-19 pandemic, also known as the Corona virus pandemic, is an ongoing global pandemic of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was first identified in December 2019 in Wuhan, China and was declared a pandemic by WHO on March 11^th, 2020. As of 9^th May 2021, more than 157 million cases have been confirmed, with more than 3.28 million deaths attributed to COVID-19, making it one of the deadliest pandemics in history (WHO, May 2020). From an economic aspect, the spreading of the virus across Europe plunged the continent into a deep economic crisis due to the widespread lockdown. EU institutions and organs financially contribute to the response to the Covid-19 crisis, and measures address direct support to public health and to humanitarian aid (through repatriation of European citizens, joint procurement of medical and protective equipment, the Fund for European Aid to the Most Deprived (FEAD) and more), support to scientific research and pandemic preparedness (through the Coronavirus Global Response action which facilitates universal and affordable access to Covid-19 treatments, tests and vaccines, the issuing of guidelines to curb the spread of the virus, the participation in the COVAX mechanism and more) and economic and social response (through the activation of the general escape clause of the Stability and Growth Pact, provision of fiscal stimulus and liquidity support measures to Member States, the NextGenerationEU recovery plan, the Support to mitigate Unemployment Risks in an Emergency (SURE) and many more) (Castellarin, 2020).

 

4 Tourism recovery measures and health protocols

 

4.1 The implications of the COVID-19 pandemic in tourism and the introduction of Health Protocols

As the pandemic continues to evolve, it is estimated that in tourism, revenue losses at European level have reached 85% for hotels and restaurants, 85% for tour operators and travel agencies, 85% for long-distance rail and 90% for cruises and airlines. EU travel and tourism industry reports a reduction of bookings in the range of 60% to 90%, compared to the corresponding periods in previous years (Niestadt, 2020).

EU tourism industry is under unparalleled pressure, with companies facing lack of liquidity and unemployment having devastating effects on the psychological, economic, and social well-being of individuals and communities (COM (2020) 550 FINAL)^[10]. EU has adopted measures so as to reinforce and complement the efforts of its State Members, including liquidity support, fiscal measures, easing of state aid rules (these include economic assistance packages such as  direct grants, selective tax advantages and advance payments, state guarantees for loans taken by companies from banks, subsidised public loans to companies, safeguards for banks that channel state aid to the real economy,  short-term export credit insurance)[11], new guidance on passenger rights and the application of the Package Travel Directive[12] (which provides guidance regarding issuing of vouchers as an alternative to cash refund). Furthermore, so as to maintain Europe’s position as a leading tourist destination, the European Commission continues to work on a number of initiatives to promote more sustainable models of tourism (coastal and maritime) and increase the visibility of Europe’s diversity of culture through platforms such as Europeana, European Capitals of Smart Tourism and the European Destinations of Excellence (EDEN).

               Finally, in order to ensure a safe and gradual resumption of tourism services and enable companies and public authorities to plan and prepare for de-confinement the Commission adopted the Communication “COVID-19: EU Guidance for the progressive resumption of tourism services and for health protocols in hospitality establishments”, which provides guidance on safety and health protocols for hospitality establishments. These guidelines are based on the ECDC recommendations and aim to protect tourists and tourism workers and propose a minimum set of principles which, on the one hand, meet strict health and safety requirements (rules of respiratory hygiene, hand hygiene, use of a protective mask, ventilation, cleanliness and disinfection), and, on the other hand, emphasize the importance of the availability of up-to-date and easily accessible information for travelers (access to digital media and real-time information on border controls, travel restrictions, travel advice, public health and safety measures, health points as well as available tourism services).

 

4.2 Health Protocols in Hospitality: the case of Group Accor

               Group Accor, the world's leader in the international industry of augmented hospitality, is present in 110 countries with more than 5,000 hotels and 39 brands. In recent years, and after the acquisition of Fairmont, Raffles and Swisshôtel in 2016, the group has been radically transformed, strengthening its presence in Europe and concentrating its development exclusively on two forms of management, hotel management and franchising. The group is now established in 28 European countries (out of the 39 in which it operates), tripling its portfolio from 2016 to 2023 with the addition of 300 new hotels and 50,000 rooms. Providing the hotel industry with over 50 years of know-how, the group currently employs more than 250.000 employees and continues to invest in the digital sector, further personalizing guests experience, optimizing its customers' loyalty program and providing more flexible payment solutions and information systems.

               AccorHotels risk management is supported by a structured system of risk identification, analysis and evaluation which is the basis for the implementation of appropriate action plans for the prevention and protection of both its employees and guests. This approach aims to ensure that any identified risk is properly taken into account and that all necessary measures are taken to eliminate it, with the use of, a standardized methodology whenever possible. Risk factors are related to business environment (legal and regulatory instability, acts of terrorism, political instability and epidemics), to changes in the competitive environment (arrival of new players, new products and new brands), to changes in the economic environment (lower economic growth in a given region or worldwide could expose the Group to a steep decline in business), to the natural environment (extreme natural events such as earthquakes, tsunamis and extreme weather conditions such as floods, hurricanes and cyclones) and to risks related to changes in the social environment (new consumer trends, ethics and CSR practices that could result in calls to boycott or unfounded or false accusation, impacting the reputation of the Group).

               In order to facilitate the process of decision-making, risks are translated into maps and classified according to their probability of occurrence and intensity of the impact. The risk mapping process is managed at corporate level. It provides a consolidated overview of major risks^[13] and is carried out based on a threat landscape that is common to the entire Group. The bodies which bare the responsibility for the implementation of the company’s Crisis Management strategy are the Risk Management & Insurance Department, responsible for defining, promoting and coordinating safety procedures, setting up insurance policies and identifying, analyzing and managing the data breach risks to which the Group is exposed, the Safety & Security Department, responsible for defining and rolling out group-wide safety and security policies, tracking the safety and security situation on a daily basis, reviewing the geopolitical context and public health and hygiene conditions, as well as risks relating to extreme weather events and social unrest, the Central Risk Management Coordination Committee, which monitors the rollout of the yearly map of major risks, helping priority risk owners with their risk mitigation processes, monitoring the implementation of the respective risk prevention and protection plans and ensuring that the risk mitigation measures taken by the regions and corporate functions are aligned, and the Audit, Compliance & Risks Committee, who oversees the annual major risks mapping and the development of priority risk action plans.[14] The Safety & Security Department and Risk Management Department operate a 24/7 crisis hotline.

               During the first quarter of 2020, the Group had opened 58 new hotels (8,000 rooms) while at the end of March 2020 its portfolio amounted to a total of 5,085 hotels (746,903 rooms), of which 1,202 in emerging markets[15]. As of April 22, 2020, more than 3,100 hotels of the Group were closed and most of them were used to support healthcare workers and non-profit organizations.. The company had been prioritizing the safety of its guest and employees for over 50 years, applying high standards of hygiene and cleanliness in all their brands around the world. Due to the Covid-19 pandemic and as hotels reopened, the company has elevated those norms even further by launching a unique cleanliness and prevention label: ALLSAFE. The ALLSAFE global cleanliness & prevention standards have been developed with and vetted by Bureau Veritas, a world leader in testing, inspections and certification, while the company also announced a strategic partnership with AXA insurance in order to provide medical support to guests across the 5,000 hotels worldwide[16].

               Last but not least, on April 2^nd, 2020, Accor announced its decision to allocate 25% of its €280m planned dividend to the creation of the ALL Heartist Fund, a €70m-fund devoted to help Group employees and individual partners affected by the Covid-19 crisis[17].

5 Conclusions

               Tourism is an economic activity that will continue to attract international interest due to its global impact on the social, cultural and economic system of various countries. It constitutes a main driver of economic development, contributing directly and indirectly to the generation of income, employment and foreign exchange earnings, while, given the complexity of tourism consumption, its impact is widely felt in other production sectors as well.

               Tourist motivation is associated with rules, cultural views and perceptions that revolve around the individual while the image of destinations constitutes the main pull factor for tourists.      

As the search for "enhanced" experiences in emerging new destinations as well as the ever-increasing public health risks are leading a shift in interest towards safety and protection, tourists will be seeking attractive destination that will, however, be able to ensure their safety while offering experiences that will align closely with their desires, expectations and interests.

               International travel is vast, rapid, on the rise, and a significant risk factor for the emergence and spread of infectious disease. Disease recording and surveillance, as well as early warning, play an important role for the implementation of effective measures to prevent epidemics from escalating into pandemics. The importance of prevention, preparedness and response strategies is justified by the high value tourists are placing on health safety and security at tourist destinations.  

                The COVID-19 pandemic has caused an unprecedented economic, social, health and humanitarian crisis and has hugely impacted the global travel industry. However, history has shown that the spread of infectious diseases and epidemics that afflict mankind will not end with COVID-19. Multinational companies, especially in the field of hospitality, are currently focusing on strengthening their existing health protocols and redesigning their crisis management plans so as to ensure the prevention and containment of future outbreaks. What remains yet to be studied is how effective those protocols will prove to be and how they shall impact the quality of the services provided and the overall tourist experience.

              

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