Do Immune Passports Allow People to Travel Again?

Remember the hype about the so-called “exemption passport” that puts the world of travel back on track?

The government is investigating whether certificates, wristbands, or mobile apps can bring people who have recovered from Covid-19 back to work or travel.

However, it was a short-lived idea that a person with an immunity passport could travel around the world’s medical record brunch because he could fly around the empty museums and amusement parks without masks, without the risk of infection.

Immunity passports may look like proper planning in principle, but experts are currently alerting them.

Much turmoil arose when the airline Emirates began trying antibody finger prick tests on a small percentage of passengers in March. However, when the accuracy rate turned out to be around 30%, the Dubai Health Authority, which was managing the test, said forbidden The entire test.

Do you think 30% is low? becomes terrible. Report of more than 50 scientists out of 14 antibody tests on the market Only three It provided consistently reliable results (and even these three had problems).

The Foundation for Innovative New Diagnostics (FIND) is a global non-profit diagnostic organization, and it is estimated that more than 250 antibody tests have been commercialized and more than 30 antibodies are in development to date.

The US Food and Drug Administration has been criticized for allowing too many suspicious antibody tests to flood the market, Announced In early May, antibody test makers faced withdrawal from the market or provided accurate results within 10 days.

On May 21, the FDA removed 31 antibody tests from its official “notification list.” This is a decision by FDA member Stephen M. Hearn to be “a significant step taken to give the United States access to reliable testing.”

Using one reputable test kit may not be enough. The FDA states that a single antibody test may not be accurate enough to determine whether members of the general population have Covid-19 antibodies. Recommended Second test -Ideally for assessing antibodies to different viral proteins-To improve the accuracy of the results.

Of course, incorrect results can have serious consequences. Ah paper “False negatives can prevent an individual from returning to work,” said Johns Hopkins Bloomberg School of Public Health, April 22. “False positives can lead to a chain of epidemics.”

Focusing on these inaccuracies, the eight contributors to the article conclude that the immunity certificate is “not a legitimate step at this time.”

There is another major hurdle to surpassing the immunity passport, given the improved test accuracy. This is to understand what the results really mean.

Some antibodies confers decades of immunity to viruses, such as measles and chickenpox, but this is not true of coronaviruses.

The World Health Organization (WHO) published a summary in late April explaining that there is no evidence that people infected with Covid-19 are protected from a second infection. But two days later, in the tweet, it became clear that he expected the antibody to provide “some protection”.

The WHO also warned that antibody testing should be able to distinguish past infections from SARS-CoV-2, viruses that cause Covid-19, and other series of infections Six Human coronaviruses, two of which are MERS and SARS (these antibodies carry immunity on average for 1 and 2 years, respectively). The other four cause a common cold. People who recover from the milder coronavirus have little expectation of immunity to subsequent infections.

After all, the Covid-19 antibody may provide some protection against reinfection, but the extent and duration are still unknown. As a result, immunity passports are “less likely” to be widely used, said Dr. Sharona Hoffmann, Professor of Bioethics at the Case Western Reserve University School of Medicine.

“Immune passports may become a reality if tests become more reliable,” Hoffman said. “But you’re more likely to have to wait for the vaccine to be available.”

Dr. Peter Garrick, an infectious disease specialist at the Michigan State University School of Osteopathic Medicine, also agrees.

“At this point, we don’t know how long these antibodies last, months or a year,” he said. “Once you have a vaccine, you’ll need proof of vaccination and proof of protective antibodies, which makes it more meaningful and safe for travel.”

Medical research continues, but the travel industry is not on the sidelines. Aspiration to open air planes and hotels, travel industry is formulating A novel way To seduce travelers, walk the line between securing customers and making travel unnecessarily inconvenient.

Instead of favoring patients with positive antibody test results, some opted for a more accurate nasal swab molecule test (also called a PCR test) that detects active Covid-19 infection. Telegraph Reported last week The Maldives will be revisiting tourists again in July and will require Covid-19 molecular testing for all tourists. Sha Wellness Clinic, a medical clinic and hotel in southeastern Spain, needs every guest Provides two negative tests — I got one a few days before arrival and the other at check-in.

Most countries and companies Resume for summer trip We choose less invasive options such as health checkups, increased cleaning, and social distance guidelines. In particular, the trip is advanced and it seems that it is not held because there is no exemption passport Airlines, Return to the cruise company or hotel.

Immunity passports are attractive to everyone (that is, all of us) who want to reinstate their lives as usual, but that certain sectors of society are free to move, get together, travel and work. Consider the impact.

This was the subject of paper In the well-respected medical journal “The Lancet”. Vulnerable groups, such as those unable to spend a long time without work, may be motivated to look for infectious diseases that can exacerbate existing race and gender inequality, not to mention infection rates. May. Exemption evidence can be a condition of employment and can result in fraudulent disclaimer black market.

In addition to the concerns of discrimination, author Alexandra L. Ferrand distinguishes WHO’s Cartejoan or Yellow Card (which shows evidence of vaccination) and immune passports as follows: “The vaccination certificate is , In contrast, immune passports stimulate infection.”

A similar situation arose during the outbreak of yellow fever in the nineteenth-century United States, resulting in the denial of employment and housing for people who had not been exposed to the disease.

“Citizens of that era tried to prove they were exposed to yellow fever to get a job,” said Hoffman. “People sought exposure, through which they survived, adapted, and had the opportunity to work. Many of them died after the exposure.”

In the uk Control A passport program that uses tests and facial biometrics to identify people with Covid-19 antibodies (emphasis appears to focus on work, not travel), millions purchased by Germany We decided to seek advice from the national ethics committee before using the antibody test from the Swiss pharmaceutical company Roche.

If an immune passport is issued, some people may not be tested for antibodies or have no means of paying for them, Hoffman said.

“If possible, we’ll have a program that makes antibody testing very accessible. It’s probably free even for people without health insurance.”

For immunity passports to work, there must be sufficient people who have them to have a meaningful impact on the travel industry.

The countries with the highest prevalence of Covid-19, the United States, Brazil, Russia, Peru, India, and parts of Western Europe may be the best reason to create an immune passport. Countries may not be enough to make program development worthwhile.

This varies from region to region, 5% or less Of these populations, they have antibodies (in contrast, about 70% of the population need to have antibodies, either by a restored infection or vaccination to initiate a collective immunity. is there).

In countries with successful “curve flattening” such as Australia, New Zealand, Vietnam, Hong Kong and Taiwan, there are fewer cases and therefore less incentive to create an immunity passport program.

They may not be the golden ticket to travel around the world, but antibody testing is important for other reasons. You can track the extent of pandemics in a given area, improve modeling data, and identify front-line workers who can (eventually) work with infected people.

Singapore has effectively used antibody testing to track Covid-19 clusters. Those with antibodies donate plasma to help those currently struggling with the disease, and if they are already determined to have some immunity, later prioritized for vaccination. You can rank.

Digital “health passports”, not immune passports-positive antibody test results, recent Covid-19 test results negative, and may eventually include evidence of vaccination.

Health passports can mitigate some, if not all, of the issues specific to exemption passports, but privacy and international cooperation must be addressed in order for a health passport program to work.