What is an Immunity Passport? A 101 Guide for Beginners

immunity passport

Immunity Passport Beginner’s Guide

The coronavirus disaster is still rapidly spreading to every corner of the world. Our healthcare system and economy have proven desperately ill-prepared.

“Stay home” is the new trendy hashtag on social media, and some seem to enjoy a break from the world. However, without people going back to work, the world is set for its sternest economic challenge yet.

With no vaccine and treatment, lifting the lockdown seems out of question for still months ahead. But we may have another way out: immunity passports.

You may be wondering:

  • What is an immunity passport?
  • How does immunity work?
  • What else do I need to know about immunity passports?

We’ll break it all down in this article.

What Is An Immunity Passport?

An immunity passport is a certificate for people who have recovered from COVID-19.

The rationale is that they would have developed resistance to the deadly enemy and can therefore return to work. 

This way, we can potentially identify healthcare workers who are safe to work on the frontline. It also helps to free people who can help out from being trapped at home.

Britain’s health secretary Matt Hancock suggested that certificates may be issued to people who got antibodies and therefore immunity in the form of wristbands. In Germany, a study is underway to determine if people can develop immunity to the virus and re-enter the workforce with an immunity passport.

Can We Actually Develop Immunity to COVID-19?

Despite a scientifically sound rationale behind immunity passports, the nature of immunity against coronavirus is still nowhere near understood. 

Normally, when your body meets a virus, the immune system quickly rings the alarm bell and sends off immune soldiers like the white blood cells to get rid of the invader.

From the initial infection, the immune system may “remember” how to protect against the same virus in a future infection. 

The immune system uses an “antibody” to recognize a specific invader, or “antigen”. We exploit this natural response in vaccination to stimulate the body to produce antibodies, and therefore, protective memory.

    HOW CAN WE TELL IF THERE IS IMMUNITY?

    Usually higher levels of antibody in the blood means a higher immunity. However, a high level of antibodies doesn’t always mean full protection. Someone may develop partial immunity that would not prevent them from another infection, but could protect them from severe symptoms.

In addition, it is possible that someone with COVID-19 antibody can still carry the virus and pass it onto others, despite being immune themselves. If COVID-19 mutates at a fast rate like the seasonal influenza virus, being immune to the first wave of COVID-19 also doesn’t protect people against the second or third wave.

Every virus is different, and we are learning more about this new enemy at the same time as our immune system. A small preliminary study from China just found that some of the recovered patients developed antibodies, whereas others did not. 

While this is a good start, researchers will still need to figure out answers to questions like:

  • If we do develop immunity to COVID-19, how long is it going to last?
  • To what extent can high levels of antibody protect someone from re-infection?
  • Will the virus mutate to a new form that evades the immune system’s protective memory?
  • Can people who are “immune” to COVID-19 still pick up the virus and transmit to others?
  • What determines if someone develops high, low or undetectable antibody levels?

The best scenario is a lifetime immunity, similar to the case of polio. The worst case scenario? A short, partial immunity.

This immunity could last a month, a year or ten years — we just don’t know.

For more on coronavirus testing ➡️ Read this article

Are Immunity Certificates the Future?

Many countries are racing to get an antibody test that can serve the basis of immunity certificates. The UK has ordered millions of antibody tests, but so far none of them has proven sufficient

The hope was that a valid antibody test could become the “game changer” amid a global shortage of COVID-19 testing kits and medical stuff. This is because antibody tests should be cheaper to mass produce and easy to be completed at home with a finger prick

But before we roll out any home testing kits, scientists have to make sure that the kits have high accuracy and low error rates. The reason is obvious – we don’t want to send anyone out in the danger with a false negative result! So far, we haven’t found one that is reliable enough.

In addition, socialists have raised concerns that immunity passports could create a divided  society, where those who have them can live a “normal” life, whilst others are locked down on the dark side. 

Questions have already been raised regarding certificates and how they could be used to find jobs or have other privileges in society. Some have even raised concerns that young people who are desperately in need of income may deliberately get the virus in order to get an immune passport.

Scenarios like these make some experts more cautious on the idea of immunity passports.

Expert Opinions on Immunity Passports

Just like many other discussions around COVID-19, experts also can’t agree on the immunity passports yet. Even experts who are closely involved in studying COVID-19 and immunity have largely different opinions. They generally fall into two categories:

  1. Those who are optimistic
  2. Those who are cautious

a) The Optimistic

Professor John Newton, a professor at Public Health England has said that “I think we have to be optimistic that it will give some immunity, but we’re just not quite sure how much at the moment.”

Professor Tim Spector, head of the twin research and genetic epidemiology at King’s College London, thinks that even a test that’s only 50% accurate may be useful if combined with other data about people’s symptoms. By pooling data, an algorithm may ramp up the accuracy rate to 90%.

b) The Cautious

Prof Marion Koopmans, head of virology at the Erasmus University Medical Centre, whose lab is evaluating more than 100 home antibody tests in the Netherlands, said: “Based on what I’ve seen so far I’d be hesitant to give you an immunity passport based on a rapid test result.” 

Dr David Ho, a leading infectious disease specialist at Columbia University in New York, said that:“The problem is after a couple of weeks, the detection rate remains at about 50%-60%. But this may not be a fault of the tests, because even using more sensitive methods in the lab we can see the antibody levels are quite low.”

Frequently Asked Questions Related to Immunity Certificates

  • Can you be refinfected with coronavirus? There have been a few early reports that claimed people could develop COVID-19 twice. However, it is likely that those people had the resurgence of symptoms linked to the initial infection as most testings were performed within two weeks of apparent recovery. Preliminary research in monkeys has shown that they could not contract COVID-19 twice. A study from China also reported that COVID-19 virus could persist in the body for two weeks after patients are considered “recovered”. 
  • What is the incubation period of the coronavirus disease? According to the World Health Organization (WHO), the incubation period for COVID-19 can range from 1-14 days, but most commonly around 5 days. These estimates may be updated with more data in the future.
  • What are coronavirus test kits? The current coronavirus test kits look for the virus’s genetic material (RNA) in a patient’s cells. This involves a swab at the back of the throat that will be sent to labs for a procedure known as polymerase chain reaction (PCR). PCR amplifies the genetic material collected to a level high enough to determine if someone is infected with COVID-19 or not. The test generally takes 24-72 hours and is very accurate.
  • Will antibody tests replace current coronavirus test kits? No. Even when the antibody tests are validated, they will not replace the swab tests. Both are important and the two will work together. The antibody is ideally done 28 days after an infection in someone who is already recovered. However, we still need the current test kits to identify patients who may get critically ill in the first place and start treating them.

Bottom Line on the Immunity Passport Concept

It seems that with all doors shut, immunity certificates may give us a way out that would allow some people out of the strict lockdown.

However, it is still too early to tell if this strategy is going to work as well as many hope. At the end of the day, officials will need to strike a balance between moving forward and coping with the potential risks associated with this exit strategy.

Currently, too many uncertainties remain:

  • Are recovered patients immune to COVID-19? If so, for how long?
  • What level of antibodies in the blood means that the person has developed immunity?
  • Can people immune to reinfection themselves still spread the virus to others?
  • How accurate and reliable are antibody test results?
  • If the antibody test is done at how, what reliable authority can issue the passport? Will there be fraudulence?

What are your thoughts on immunity certificates? Let us know in the comments.

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