On the Nature website, bioethics experts opposed the division of people on the basis of the presence of antibodies to coronavirus.
Immune passports are documents that should indicate that a person has antibodies to the SARS-CoV-2 coronavirus. Since there is no vaccine against this infection, only people who have transferred COVID-19 could receive them now. It is understood that the bearers of such passports could receive a number of privileges, including the expansion of freedom of movement.
The introduction of immune passports will do more harm than good, the authors of the material published in the journal are convinced Nature. Bioethics experts Natalie Kofler from Harvard Medical School and Françoise Baylis from Dalhousie University expressed their views. They provide both scientific, practical and ethical reasons against immune certification.
1. We do not know whether the developed antibodies protect against re-infection of COVID-19. In addition, it is not known how long antibodies remain in the blood.
2. Antibody tests are unreliable. Both false positive and false negative results are possible.
3. An unreachable number of tests is required. Tens or hundreds of millions of tests must be done for a certification program in one country (at least two for one resident). The current pace of production does not meet this need. Tests will be missed even in the case of the introduction of immune passports only for health professionals.
4. People who have undergone COVID-19 are not enough to boost the economy. The low prevalence of the disease, multiplied by the lack of tests, will allow only a very small number of people to get permission for free work and movement. Scientists report that, according to estimates, only 0.43% of the total population would have received such certification in the United States.
5. Control violates confidentiality. Immune certification should be accompanied by an identification and monitoring system. Paper documents are inconvenient and vulnerable (including forgery), and information stored in electronic form is difficult to protect. Surveillance systems that are connected to smartphones collect a huge amount of personal information. At the same time, there is no certainty what will happen to these systems and this information when the pandemic is over.
6. Marginalized groups will be affected. Bioethics experts believe that with increased control carries potential risks for ethnic, sexual, religious and other minorities. They recall that during the pandemic, people from Asia were discriminated against all over the world, and Africans in China.
7. Due to the lack of tests, access to them will be unequal. Existing experience says that people who need the most testing will get them last.
8. Public stratification based on COVID-19 status. “Immuno-privileged” and “immunocompromised” people may appear. Privileged people will have much more rights. Stratification can be compounded by the fact that employers will seek to hire “immune” people. Residents of countries in which it will be difficult to get certified will not be able to travel.
9. New forms of discrimination. SARS-CoV-2 immunity certification may include other personal information, including mental health and genetic tests. Today's immune passport can turn into tomorrow's biological passport, which will open the door to abuse by insurance companies, employers and more.
10. Threat to public health. False stimuli may appear due to immune passports. Healthy people may start looking for an opportunity to get COVID-19, as this will give them more freedom in the future. Also, people can receive documents in dishonest ways, which will also create risks to the health of others.
Baileys and Kofler believe that immune passports are a strategy that is not associated with public, but individual interests, so it runs counter to the health mission. Such certification distracts from things that could be of real benefit. The authors include investments in the development and, subsequently, distribution of the vaccine against SARS-CoV-2, as well as the use of infection control measures, the effectiveness of which is known (testing, contact tracing, isolation).
“The threat to freedom, justice and public health is inherent in any system that is designed to divide society on the basis of biological data. Any policy and practice should be directed towards social justice, ”the authors conclude.