Immunity Passport – Burning Issues – Free PDF Download

Looking for an Exit strategy

• Covid-19 has overwhelmed healthcare systems, destroyed economies and caused several countries to close their borders and go into ‘Lockdown’.
• Going back to work and getting the economy moving again may take a long time in many countries.
• A few countries have started considering issuing “immunity passports” or some kind of certificates indicating a person has immunity to COVID-19.

China’s strategy

• To tackle ‘silent’ (or asymptomatic) carriers of the Covid-19 China introduced a system to regulate citizens’ lives that require them to use a software on their smartphones that dictates in real-time whether they should be quarantined or allowed into subways, malls, and other public spaces.
• QR codes on people’s cellphones to signal their freedom of movement.

What is an Immunity passport?

• The idea for the “immunity passport” or a “back to work” pass is that if you have been infected with SARS-CoV-2 and recover, then you have immunity that will protect you from getting the disease again for some amount of time.
• Immunity passport = a certificate for those who have recovered from COVID-19 and have been declared immune to the virus.

Immune Response

• When people get sick with SARS-CoV-2, they recover from the illness because their body produces antibodies specifically to fight that ‘ANTIGEN’
• Patients who have recovered from Covid-19 will contain antibodies that their immune systems have produced in fighting the virus
• Even if you weren’t tested for SARS-CoV-2, if you are tested for the antibodies, that could tell you that you at some point had the virus. If you are healthy, then that could mean that you can go back to your normal activities.

How would you get an “immunity passport”?

• To be able to show that you have immunity to issue an immunity passport, one would need reliable antibody testing, which tells if your body has the antibodies specific to SARS-CoV-2

Major issue – Low ‘Test Sensitivity’

• Many tests available now are not accurate enough at identifying people who have had the disease, a property called test sensitivity, and those who haven’t been infected, known as test specificity.
• A high-quality test should achieve 99% or more sensitivity and specificity. That means that testing should turn up only about 1 false positive and 1 false negative for every 100 true positive and true negative results.

• But some commercial antibody tests have recorded specificities as low as 40%. Many are in the region of 60-70%.
• The UK government ordered 3.5 million tests from several companies in late March, only to later discover that none of these tests performed well enough.
• At present, based on current evidence, WHO recommends the use of these new point-of-care immunodiagnostic tests only in research settings.
• They should not be used in any other setting, including for clinical decision-making, until evidence supporting use for specific indications is available.

Timing is critical

• One unknown that affects both kinds of test is the interplay between timing and accuracy.
• If a test is done too soon after a person is infected and the body hasn’t had time to develop the antibodies the test is designed to detect, it could miss an infection.
• But scientists don’t yet know enough about the timing of the body’s immune responses to SARS-CoV-2 to say exactly when specific antibodies develop.

For How Long will the passport be valid ?

• What we don’t know for certain with COVID-19 is whether people do have immunity once they’ve recovered and how long that immunity would last.

• Another complicating factor for immunity passports is that antibody tests can’t rule out that a person is no longer infectious.
• A study published in Naturethis month found that viral RNA declines slowly after antibodies are detected in the blood.
• The presence of viral RNA could mean that the person is still shedding infectious virus.

Implementation

• There will be increasing pressure to grant immunity passports more widely, in an effort to restore the workforce and the economy.

Ethical issues

• Employers could look down on employees who don’t qualify for an immunity passport and give their jobs away to those who have them.
• People will deliberately seek to become infected with COVID-19 in order to get a passport and return to work
• Any time a group of people is marked as different, we create the conditions for stigmatization and discrimination. 

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