As the White House and state officials quarrel over authority to lift social distancing restrictions in the U.S., European countries already past their peak of COVID-19 cases are mulling strategies to reopen.
Italy’s special commissioner for the virus emergency Domenico Arcuri said exit from the lockdown will include increased virus testing, the deployment of a voluntary contact-tracing app and mandatory antibody blood tests as the country seeks to set up a system of “immunity passports.”
German researchers also are floating ideas for “immunity certificates” based on an antibody blood test study at the Helmholtz Centre for Infection Research in Braunschweig, study author and epidemiologist Gerard Krause told German magazine Der Spiegel.
Even America’s leading coronavirus expert Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CNN’s “New Day” last week that immunity certificates are being discussed.
“It’s one of those things that we talk about when we want to make sure who the vulnerable people are and not,” he said. “I think it might actually have some merit.”
Some experts argue immunity certificates – documentation verifying a person is immune to the coronavirus that causes COVID-19 – could help reopen the economy by allowing some people to safely return to work, eat at restaurants and partake in activities prohibited by social distancing restrictions.
Dr. Jeffrey Kahn, director of Johns Hopkins Berman Institute of Bioethics, said enacting such a policy isn’t so easy.
Categorization beyond immune and not immune would be required, Kahn said, such as by age or residence. Younger people more resilient to the virus likely would be favored to receive certification.
And if an entire household wasn’t immune, the person with the immunity certificate could bring the virus back home and infect the family.
“It would be super complicated to institute, we haven’t gotten a clear answer on how it would work because of all these complications,” Kahn said.
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There also are concerns about stigmatizing immune or not immune people, he added.
“Anytime you publicly brand people whether it’s for them to be able to do this or not, it could have this stigmatizing effect,” he said. “All of that would have to be managed somehow.”
Harald Schmidt, assistant professor at the University of Pennsylvania, compared immunity documents to crosses that marked the homes of those infected with plague in Europe in centuries past. An immunity certificate would be a “badge of honor,” he said, and those without one would be marginalized.
Schmidt also worries about the political consequences on undocumented immigrants. If certification requires proof of residency, he said, they would be less likely to test for immunity. And there could be other long-term impacts.
“It’s not helpful if we give them immunity from deportation while assessing virological immunity but then two years do the line, knock on their door and throw them out of the country,” he said.
While state officials are considering options to reopen their economies, experts say immunity certificates are far from implementation as antibody testing can be unreliable and is not yet widely available. They say a certificate of immunity only makes sense if researchers have high confidence in test results.
Elitza Theel, director for the Infectious Disease Serology Laboratory at the Mayo Clinic, said more than 50 commercial manufacturers are seeking FDA approval for antibody tests and few of those tests have been vetted for clinical accuracy. Companies marketing 90 antibody tests have notified the federal agency of plans to offer tests.
“We can only introduce those measures that have risks of negative consequences if we can be sure to reliably assess immunity,” Schmidt said.
Kahn said with reliable, widespread testing it’s possible to reopen the country without immunity certificates.
“We are grasping for any way to help ease the situation,” he said. “It’s among the things people are thinking and talking about because they need to think and talk about everything.”
Contributing: Associated Press. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.