There will be increasing pressure to grant ‘immunity passports,’ in an effort to restore the workforce and the economy. And when that happens, there is every reason to believe people will deliberately seek to become infected
In the rush to get the economy off life support, a deceptively simple idea has emerged: test citizens for antibodies to the coronavirus and issue them so-called “immunity passports,” so they can return to their daily lives. Yet this may create more problems than it solves.
Governments around the world are waiting for the results of research from bodies like Germany’s Robert Koch Institute, which aims to determine who in the population has immunity to the disease by developing a reliable blood test. Such a test would confirm whether a person has antibodies to COVID-19 in their blood, which is the biological basis for certifying a person’s immunity. The sooner we can do that, the sooner people can get back to work. And, so the story goes, the sooner the economy will recover.
Seductive as this idea sounds, immunity passports have the potential to derail public health efforts to get the outbreak under control. And that will be bad for the economy in the long run. Worse, it threatens the newfound solidarity within and between communities as they unite to overcome the ravages of this novel and destructive virus.
To be sure, health-care providers and other people deemed essential to the pandemic response and the continued functioning of society should be first in line for these passports. It is important that we get them back to work quickly.
But, similar to China, where the government has been using QR codes on people’s cellphones to signal their freedom of movement, there will be increasing pressure to grant immunity passports more widely, in an effort to restore the workforce and the economy.
And when that happens, there is every reason to believe that people will deliberately seek to become infected with COVID-19 in order to get a passport and return to work. Instead of chickenpox parties, we will see coronavirus parties, where poor people trade economic suffering for the pain of COVID-19. That would be a terrible idea, but many people who are are staring down the barrel of destitution may conclude that the benefits of such a reckless action outweigh the risks — even if one of the risks is spreading the infection to others.
Some politicians, like U.K. Health Secretary Matt Hancock, have been quick to downplay the ethical problems, even though immunity passports raise serious concerns about who has access to this personal medical information, and how it will be used. Will it affect your insurance coverage, and how much you pay for it? How far, and where, will you be able to travel without an immunity passport? And then there are the regulatory challenges related to preventing fakes and fraud.
But there is more that should concern us. Any time a group of people is marked as different, we create the conditions for stigmatization and discrimination. Those with the coveted passports may sometimes be given the side-eye for having had COVID-19. But, unlike with other outbreaks, it will be those without COVID-19 who will likely suffer most.
Employers could look down on employees who don’t qualify for an immunity passport and give their jobs away to those who have them. Or those without a passport might be payed less, or passed over for a promotion, because they’re working from home and are less productive. Such probable penalties raise the risk of nullifying public health measures designed to keep people healthy. And for those who are desperate to go back to work, they amount to an incentive to become infected.
Solutions that create whole classes of people who are marked as “other” could take us back to some grim times in human history when two-tiered citizenship was justified on biological grounds. If this technology becomes available globally, it is naive to think that governments and private companies will not use it in unethical ways.
The health of the economy depends on the health of our bodies, and vice versa. That relationship is, of course, what makes the idea of an immunity passport so appealing. But let’s take a moment to think about where immunity passports might take us as a society and talk about whether we want to go there — together.
Alison Thompson is a professor of public health ethics at the University of Toronto’s Leslie Dan Faculty of Pharmacy and Dalla Lana School of Public Health. She is an expert in pandemic ethics, has published widely on the topic and has consulted with governments in Canada, the U.S. and Germany on their pandemic plans, as well as worked with the WHO on outbreak communications.