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Coronavirus: How 'immunity passports' could create an antibody elite | Coronavirus: How 'immunity passports' could create an antibody elite |
(3 days later) | |
Governments around the world are testing citizens for coronavirus antibodies, to work out whether people have had the deadly Covid-19 disease. | Governments around the world are testing citizens for coronavirus antibodies, to work out whether people have had the deadly Covid-19 disease. |
Some countries are setting up so-called "immunity passports" and others may follow suit. | Some countries are setting up so-called "immunity passports" and others may follow suit. |
The idea is that a passport would certify that you have had coronavirus and will not carry or contract the disease again, opening up a way out of lockdown restrictions for the holder. | The idea is that a passport would certify that you have had coronavirus and will not carry or contract the disease again, opening up a way out of lockdown restrictions for the holder. |
But is this theory correct? And will it create a group of antibody-carrying elite who can date, travel and work as they wish, while others are still limited by health precautions? | But is this theory correct? And will it create a group of antibody-carrying elite who can date, travel and work as they wish, while others are still limited by health precautions? |
'I know I'm clear, we should meet!' | 'I know I'm clear, we should meet!' |
Pam Evans, from Aberdeen, has just had a rude awakening to the new reality of internet dating. She says that a man who was interested in meeting her took a novel approach. | Pam Evans, from Aberdeen, has just had a rude awakening to the new reality of internet dating. She says that a man who was interested in meeting her took a novel approach. |
"I had one guy at the weekend: 'I've just been tested last week for Covid so I know I'm clear, we should meet up' And I said: 'Oh no, absolutely not'... he became just absolutely abusive straight away." | "I had one guy at the weekend: 'I've just been tested last week for Covid so I know I'm clear, we should meet up' And I said: 'Oh no, absolutely not'... he became just absolutely abusive straight away." |
Pam's hopeful date was trying to take advantage of his apparent negative coronavirus test result as a reason to break lockdown rules to visit her. | Pam's hopeful date was trying to take advantage of his apparent negative coronavirus test result as a reason to break lockdown rules to visit her. |
Is this a sign of how those who get a certificate stating they've already had coronavirus might use their privileged position in society? | Is this a sign of how those who get a certificate stating they've already had coronavirus might use their privileged position in society? |
In New York, people are using antibody tests - showing that they have been exposed to the virus and have recovered - as a way of suggesting they are safe to date. | In New York, people are using antibody tests - showing that they have been exposed to the virus and have recovered - as a way of suggesting they are safe to date. |
They are photographing positive test results to use as a kind of improvised "Covid-immunity passport". | They are photographing positive test results to use as a kind of improvised "Covid-immunity passport". |
If you have antibodies, the theory goes, you will not get the disease again. | If you have antibodies, the theory goes, you will not get the disease again. |
Dating aside, what if we could decide who is safe to return to work or get on an aircraft? For those people. the Covid-19 lockdown could be over. | Dating aside, what if we could decide who is safe to return to work or get on an aircraft? For those people. the Covid-19 lockdown could be over. |
'Immunity passports' | 'Immunity passports' |
The idea behind immunity passports, is that of a certificate confirming that you have had Covid-19. It could be used to enter places that those people without one are barred from. | The idea behind immunity passports, is that of a certificate confirming that you have had Covid-19. It could be used to enter places that those people without one are barred from. |
To get one, you'd have to test positive for antibodies created after exposure to the virus. | To get one, you'd have to test positive for antibodies created after exposure to the virus. |
Estonia is building an "immunity passport" system, and Chile is also planning what it calls a "release certificate", following such principles. | Estonia is building an "immunity passport" system, and Chile is also planning what it calls a "release certificate", following such principles. |
Tavvet Hinrikus, co-founder of the money exchange firm TransferWise, helped in the development of Estonia's phone app-based system. | Tavvet Hinrikus, co-founder of the money exchange firm TransferWise, helped in the development of Estonia's phone app-based system. |
"There are areas where I think it's a no-brainer we should use this, like… who takes care of our elders; can I go and see my parents? | "There are areas where I think it's a no-brainer we should use this, like… who takes care of our elders; can I go and see my parents? |
"If immunity as a concept exists, then I think people who have immunity should be cleared to work with elders, or the same for frontline workers," he says. | "If immunity as a concept exists, then I think people who have immunity should be cleared to work with elders, or the same for frontline workers," he says. |
Other apps are being developed to display antibody - and potentially immunity - status. One example is Onfido. Its co-founder, Husayn Kasai, says some US hotel chains are now accepting immunity passports via an app. | Other apps are being developed to display antibody - and potentially immunity - status. One example is Onfido. Its co-founder, Husayn Kasai, says some US hotel chains are now accepting immunity passports via an app. |
"It's predominately for guests who want to access some of the services, be it the spa or the gym, where social distancing isn't an option." | "It's predominately for guests who want to access some of the services, be it the spa or the gym, where social distancing isn't an option." |
Antibody elite | Antibody elite |
But could there be a sinister aspect: the potential for a supposedly Covid-immune elite to develop? | But could there be a sinister aspect: the potential for a supposedly Covid-immune elite to develop? |
Robert West, professor of health, psychology and behavioural science at University College London (UCL), fears a "divisive society". | Robert West, professor of health, psychology and behavioural science at University College London (UCL), fears a "divisive society". |
"You can imagine a situation where if you can get hold of some sort of certification, it will open up doors for you that wouldn't be open to people who can't have that certification. | "You can imagine a situation where if you can get hold of some sort of certification, it will open up doors for you that wouldn't be open to people who can't have that certification. |
"It could create a multi-tier society and increase levels of discrimination and inequity." Prof West also warns that the entire premise of immunity might be on shaky ground. | "It could create a multi-tier society and increase levels of discrimination and inequity." Prof West also warns that the entire premise of immunity might be on shaky ground. |
"It wouldn't be based on solid scientific foundation. It would be based on a probability that you may or may not be susceptible [to coronavirus] yourself or may or may not be in a position to pass the virus onto other people. | "It wouldn't be based on solid scientific foundation. It would be based on a probability that you may or may not be susceptible [to coronavirus] yourself or may or may not be in a position to pass the virus onto other people. |
"It would be to the detriment of sectors of society, really being driven by commercial pressures." | "It would be to the detriment of sectors of society, really being driven by commercial pressures." |
Prof West envisages a point where people with recent antibody certificates would be able to work with vulnerable patients in healthcare roles, or that firms might use their workers' immunity passports as a way of competing with other companies. | Prof West envisages a point where people with recent antibody certificates would be able to work with vulnerable patients in healthcare roles, or that firms might use their workers' immunity passports as a way of competing with other companies. |
But he believes there's not enough evidence to show that having antibodies is a reliable way to tell how likely you are to catch or pass on the virus. | But he believes there's not enough evidence to show that having antibodies is a reliable way to tell how likely you are to catch or pass on the virus. |
'She's OK, she has antibodies' | 'She's OK, she has antibodies' |
The air travel sector has been hit particularly hit hard by the pandemic and John Holland-Kaye, chief executive of Europe's busiest airport, London Heathrow, wants all countries to recognise antibody certificates. | The air travel sector has been hit particularly hit hard by the pandemic and John Holland-Kaye, chief executive of Europe's busiest airport, London Heathrow, wants all countries to recognise antibody certificates. |
"What you really need [is to know that] your health passport... is going to be accepted in the country you are going to, and you'll be allowed to return home safely without having any kind of quarantine." | "What you really need [is to know that] your health passport... is going to be accepted in the country you are going to, and you'll be allowed to return home safely without having any kind of quarantine." |
Carmel Shachar, of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School in the US, fears that people may actually try to catch Covid-19. | Carmel Shachar, of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School in the US, fears that people may actually try to catch Covid-19. |
A scenario she worries about is: "If you want to go back to work, you're going to have to contract a deadly disease, one that we don't actually want you to have, from a public health point of view or from an individual point of view." | A scenario she worries about is: "If you want to go back to work, you're going to have to contract a deadly disease, one that we don't actually want you to have, from a public health point of view or from an individual point of view." |
She also worries about privacy. "If my employer can demand medical information about me, have I had Covid, do I have antibodies - are they allowed to do so? If they have that information, are they allowed to share it?" | She also worries about privacy. "If my employer can demand medical information about me, have I had Covid, do I have antibodies - are they allowed to do so? If they have that information, are they allowed to share it?" |
The commercial benefits of publicising this information for certain industries are obvious, Ms Shachar believes. "If I work at a restaurant, can my employer tell every customer who walks in the door: 'Oh don't worry, she's OK because she has antibodies'?" | The commercial benefits of publicising this information for certain industries are obvious, Ms Shachar believes. "If I work at a restaurant, can my employer tell every customer who walks in the door: 'Oh don't worry, she's OK because she has antibodies'?" |
Ms Shachar thinks known immunity could be of significant benefit. "You might say, for healthcare workers working with Covid patients, or nursing facility workers... we do want to see immunity." | Ms Shachar thinks known immunity could be of significant benefit. "You might say, for healthcare workers working with Covid patients, or nursing facility workers... we do want to see immunity." |
She says that people really want to get back to how things were before the pandemic, or a "new normal" that is close to it, and are prepared to make compromises. | She says that people really want to get back to how things were before the pandemic, or a "new normal" that is close to it, and are prepared to make compromises. |
Testing questions | Testing questions |
Getting to that "new normal" as quickly as possible is the target for governments around the globe, Many find antibody-testing the entire population a tantalising idea where infection rates are high. | Getting to that "new normal" as quickly as possible is the target for governments around the globe, Many find antibody-testing the entire population a tantalising idea where infection rates are high. |
In Germany, the country's disease control and prevention agency, the Robert Koch Institute, is conducting large-scale random antibody testing. | In Germany, the country's disease control and prevention agency, the Robert Koch Institute, is conducting large-scale random antibody testing. |
But questions remain about the accuracy of some of these tests. Research published in May by the US-based Covid-19 Testing Project found that 12 antibody tests were accurate between 81-100% of the time. | But questions remain about the accuracy of some of these tests. Research published in May by the US-based Covid-19 Testing Project found that 12 antibody tests were accurate between 81-100% of the time. |
While the US Centers for Diseases Control and Prevention (CDC) has warned that some antibody tests could incorrectly state you had antibodies - up to half the time. Meaning those who'd never had Covid-19 could mistakenly think they had immunity, and might then act riskily because of this false sense of security. | While the US Centers for Diseases Control and Prevention (CDC) has warned that some antibody tests could incorrectly state you had antibodies - up to half the time. Meaning those who'd never had Covid-19 could mistakenly think they had immunity, and might then act riskily because of this false sense of security. |
And even if the test correctly identifies that you have antibodies, does that mean you are actually immune? The World Health Organization (WHO) has expressed its doubts. | And even if the test correctly identifies that you have antibodies, does that mean you are actually immune? The World Health Organization (WHO) has expressed its doubts. |
In the UK, for example, concerns were voiced by 14 senior academics in a letter published in the British Medical Journal at the end of June, saying that antibody tests for UK healthcare staff were being rolled out without "adequate assessment". | In the UK, for example, concerns were voiced by 14 senior academics in a letter published in the British Medical Journal at the end of June, saying that antibody tests for UK healthcare staff were being rolled out without "adequate assessment". |
Back in Aberdeen, Pam is similarly unconvinced by the antibody testing argument. | Back in Aberdeen, Pam is similarly unconvinced by the antibody testing argument. |
"We don't know how long this immunity could last for. We don't know if it is 100% right if you've had those symptoms. There's no harm in meeting somebody and sitting and having a coffee in a park," she says. | "We don't know how long this immunity could last for. We don't know if it is 100% right if you've had those symptoms. There's no harm in meeting somebody and sitting and having a coffee in a park," she says. |
"I'm not someone who'll kiss on the first date anyway. So to me, having that two metres apart means that a guy can't lunge on you for once!" | "I'm not someone who'll kiss on the first date anyway. So to me, having that two metres apart means that a guy can't lunge on you for once!" |
This article featured interviews broadcast on Business Daily, on the BBC World Service. | This article featured interviews broadcast on Business Daily, on the BBC World Service. |
Can 'immunity passports' help us get back to normal? | Can 'immunity passports' help us get back to normal? |
The business case for immunity passports | The business case for immunity passports |