On 1 July 2020 the entry of tourists into Greece was permitted through 41 points of entry, with 27 airports, 7 ports and 7 ground crossings open to international arrivals. Reopening tourism via travel-related public health measures However, due to contradicting results from previous studies, further investigation is needed.ġ. This evidence supports the idea that tourism may not have affected the long term course of the COVID-19 pandemic in Greece. The island of Crete presented more than four times lower seroprevalence than the mainland of Greece, despite being a highly attractive tourist destination. Moreover, the monthly infection fatality rate (IFR) in Crete was calculated at 0.09%, compared with 0.21% in mainland Greece for December 2020. We identified 4.16 times lower seropositivity in Crete (2.58%) in comparison with the mainland of Greece (10.75%) during December 2020. In Crete, the seroprevalence ranged between 0% (June 2020) and 2.58% (December 2020), while the corresponding seroprevalence in Greece was 0.19% and 10.75%, respectively. A total of 55,938 samples were collected, 3,785 of which originated from Crete. These samples were tested for the presence of anti-SARS-CoV-2 IgG antibodies. Left-over serum samples were collected and obtained from public and private laboratories located in Greece, including the island of Crete. Crete welcomed nearly 2,000,000 travellers during the 2020 summer season. To achieve this, a cross-sectional serosurvey, repeated at monthly intervals, was conducted to compare the seroprevalence in Crete with seroprevalence in the mainland of Greece. The aim of this article is to examine the effect of tourism on the long term course of the Coronavirus Disease 2019 (COVID-19) pandemic during the pre-vaccination era (June to December 2020) on the popular Greek island of Crete. Greece opened its points of entry on July 1, 2020, with specific guidelines for travellers arriving by sea, air or land. 8Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece.7Internal Medicine Department, Infectious Diseases Unit, University Hospital of Heraklion, School of Medicine, University of Crete, Heraklion, Greece.6Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece.5Department of Microbiology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece.4Laboratory of Public Health, School of Medicine, University of Patras, Patras, Greece.3Microbiological Laboratory “Diagnosis Rethimnou”, Rethimno, Greece.2Biochemical Laboratory, Venizeleio Pananio General Hospital, Heraklion, Greece.1Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece. Kyritsi 1 Alexandros Vontas 1 Lemonia Anagnostopoulos 1 Paraskevi Mina 1 Alexia Matziri 1 Evangelia Vachtsioli 1 Alexandra Papagiannakis 2 Zacharias Archontakis 3 Michael Leotsinidis 4 Kalliopi Theodoridou 5 George Manios 6 Achilleas Gikas 7 Matthaios Speletas 8,† Christos Hadjichristodoulou 1* † Zacharoula Bogogiannidou 1 Michalis Koureas 1 Varvara A.
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