10 problems with 'immune passport'



In each country, the idea of an ' immunity passport ' is being lifted, in which people who have been infected with the new coronavirus (SARS-CoV-2) and have been immunized will lift restrictions such as going out and moving. However, experts point out that there are a total of 10 practical and ethical problems with this idea.

Ten reasons why immunity passports are a bad idea

https://doi.org/10.1038/d41586-020-01451-0



The problem was pointed out by Natalia Koffler, an advisor to the Scientific Citizenship Initiative at Harvard Medical School, and Francoise Bayliss, a professor of philosophy (bioethics) at the University of Dalhousie, Canada.

01: There are still many mysteries about immunity to SARS-CoV-2
It is not yet known whether immunity to SARS-CoV-2 will produce enough antibodies for future protection, how safe it is, or how long it will last. Immune response to SARS coronavirus, the cause of SARS (severe acute respiratory syndrome) that has been prevalent between 2002 and 2003, and MERS coronavirus, which has been confirmed since 2012, causing MERS (Middle East respiratory syndrome) From this, it is estimated that the protection period is 1 to 2 years, but if it is close to a cold, the protection period may be shorter.

02: Low reliability of inspection
Test that measures the SARS-CoV-2 antibodies in the blood, the virus

prevalence , but it can become a valuable tool for evaluating and spread, there is a large variation in the quality and effectiveness. For some tests, the 'sensitivity', which is the probability that an infected person is correctly positive, is 99%, and the 'specificity', which is the probability that an uninfected person is correctly negative, is 99%. However, preliminary data suggest that most are unreliable.

03: The number of tests required is not realistic
A national immune certification program requires tens of millions to hundreds of millions of tests. For example, Germany has a population of about 84 million, but more than one immunological test for all citizens requires a minimum of 168 million tests. The reason that at least two tests are required per person is that a person with a negative result may be infected at a later date, and it is necessary to obtain proof of immunity by another test. From June 2020, Germany will have 5 million monthly inspections by Roche Pharmaceuticals of Switzerland, covering 6% of the population.

Even if the examination is limited to medical personnel, we cannot secure a sufficient number of examinations. In the case of the United States, the required number of inspections is estimated to be more than 16 million, but the number of inspections that have been performed in the United States is 12 million. Even in Korea, which is said to have a high inspection rate, only 1.5% of the population is inspected.



04: There are few recoverers and economic effect is weak
The number of people recovering from a novel coronavirus infection (COVID-19) varies greatly depending on the location, with 14% to 30% reported in the United States and Germany, but according to WHO 2 to 3% of the population. Also, due to problems with the number of tests and the low prevalence, it is expected that the number of people who are certified as 'workable' will be very small. In the case of the United States, based on the reported number of cases, only 0.43% of the population are 'workable and OK'.

05: Privacy violation due to surveillance
The point of 'immunity passport' is that movement is managed. In other words, the 'immune passport' will also include an identification and surveillance system. In addition, since a paper passport is weak against forgery, it is better to use an electronic document integrated in a smartphone application that is resistant to fraud and convenient for updating tracking, retesting, and immune status. However, there is an increased risk of privacy infringement.

In China, access to public facilities is restricted using QR codes displayed on smartphones, but it is also reported that location information, travel history, contacts, body temperature, health information including recent medical history, etc. are all reported. That. This mechanism is likely to continue even after the pandemic has converged.

06: Socially marginalized groups are snooped
Increased social oversight means increased police enforcement, increased profiling, and increased risk of potential harm to race, gender, religion, and other minorities. Already worldwide, increased racism against Asians has been reported.

In the first place, there was a prejudice against colored races in the United States even before the pandemic, and 88% of the people who received a police question in New York in 2019 were African or Latino. Also, of the 40 people arrested for 'physical distance' violations between March and May 2020, 35 were black.

It is worrisome that the 'immune passport' can be a source of surveillance and police activity. In the United States, Brazil, and Iran, prisoners in prison wear digital bracelets and release them to stop the spread of infection, but they also carry out “digital imprisonment”, but this “digital imprisonment” is also used to monitor specific communities. available. If this surveillance is tied to immigrants, there are additional risks of concern.



07: Unfairness of inspection
Due to the limited number of people that can be tested, many people cannot get tested for antibodies, but it has been suggested that wealthy people and those in power are more likely to get tested. In early March 2020, many states in the United States had less than 20 tests a day, but athletes, tech executives, and movie celebrities were able to get tested.

08: Social stratification
Classifying people by the state of COVID-19 will lead to the birth of new 'things that have' and 'things that do not have'. If the vaccine is free and easy to obtain, people can choose whether to strike the vaccine themselves or not, but if the vaccine is difficult to obtain, whether immunity can be acquired is `` It is influenced by 'money' and 'personal circumstances', and social and economic inequalities are amplified. For example, a manager who thinks 'I don't want to hire people at risk for COVID-19' might preferentially hire immune people.

In addition, people from countries that do not / are not willing to carry out immunity passports may be banned from traveling to countries where they have immunity passports, which may promote national conflicts. In countries with laws that infringe the rights of sexual minorities, such as Russia, Egypt, and Singapore, there are examples of HIV entry restrictions on living, working, and working.

09: New forms of discrimination
The immune authentication platform could be expanded to record additional personal information such as mental health and genetic test results. What is initially operated as an 'immune passport' may become a 'comprehensive biological passport' in the future. If people, such as business owners, insurance companies, and police officers, can access this information for their own benefit, the platform is a risk of new discrimination.

10: Threats to public health
When some kind of social and economic freedom is given to people with immunity, it is possible that people who are 'not immune but healthy' dare to get an incentive by 'being infected with the virus' There is a possibility. It is highly probable that 'a person who is financially difficult to be infected will be infected,' and there are concerns about cases of illegally obtaining immune passports.

For this reason, Mr. Kofler and Mr. Baylis were anonymized including health status and location information to promote 'testing / tracking / quarantine' which is already known to be more effective than 'immune passport'. We recommend that you invest time and money in deploying safe apps and developing, producing and globally distributing vaccines.

in Science, Posted by logc_nt