{"id":635,"date":"2020-04-13T17:07:00","date_gmt":"2020-04-13T17:07:00","guid":{"rendered":"https:\/\/covidqanda.org\/?p=635"},"modified":"2020-11-09T17:09:30","modified_gmt":"2020-11-09T17:09:30","slug":"im-hearing-a-lot-of-chatter-about-immunology-certificates-being-a-ticket-to-economic-recovery-whats-the-thinking-on-this-front","status":"publish","type":"post","link":"https:\/\/covidqanda.org\/?p=635","title":{"rendered":"I\u2019m hearing a lot of chatter about \u201cimmunology certificates\u201d being a ticket to economic recovery. What\u2019s the thinking on this front?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\" id=\"b323\"><strong>Question:&nbsp;<\/strong>I\u2019m&nbsp;<a href=\"https:\/\/www.statnews.com\/2020\/04\/06\/the-certified-recovered-from-covid-19-could-lead-the-economic-recovery\/\">hearing a lot<\/a>&nbsp;of chatter about \u201cimmunology certificates\u201d being a ticket to economic recovery. What\u2019s the thinking on this front?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"f049\"><strong>Answer:<\/strong>&nbsp;I\u2019ve been hearing more about this too lately. The basic idea is \u2014 folks who have developed antibodies to SARS-CoV-2 are presumably immune to the virus. These immune folks are ideally suited for helping to care for the sick, for taking on essential positions that are at increased risk of exposure, and for helping to get our economy revving again. On first blush, it sounds pretty good. Dig a bit deeper and it becomes a worrisome and troubling road. There are societal, scientific, and ethical reasons to worry. Here are a few examples of each challenge, but this is not an exhaustive list:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"4fcd\">On the&nbsp;<strong>societal front<\/strong>, creating a new \u201cin\u201d and \u201cout\u201d group is exceptionally problematic given human nature and existing inequities.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>For example, just yesterday, The New York Times published this fascinating opinion, \u201c<a href=\"https:\/\/www.nytimes.com\/2020\/04\/12\/opinion\/coronavirus-immunity-passports.html\">The Dangerous History of Immunoprivilege<\/a>,\u201d from scholar, Ms. Kathryn Olivarius, describing the history of Yellow Fever in New Orleans where \u201cimmunocapital\u201dwidened the economic divide. \u201cBlack people, with limited access to health care, were of course as scared of yellow fever as anyone else. But those enslaved people who\u2019d acquired immunity increased their monetary value to their owners by up to 50 percent. In essence, black people\u2019s immunity became white people\u2019s capital.\u201d<\/li><li>Meanwhile, behavioral scientists have noted that social cohesion will suffer. Robert West, a professor of health psychology at University College London,<a href=\"https:\/\/www.wired.co.uk\/article\/coronavirus-immunity-passports\">&nbsp;told&nbsp;<em>Wired<\/em><\/a>, \u201cThere\u2019s so much evidence on \u2018in group\u2019 and \u2018out group\u2019 work that, even when you set up arbitrary \u2018in groups\u2019 and \u2018out groups\u2019, people become quite tribal.\u201d And Adam Oliver, a behavioral economist at the London School noted, \u201cThe whole approach might also undermine the message that we are all in this together, which is crucial if we are going to get through this relatively quickly.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"65e8\">On the&nbsp;<strong>science front<\/strong>, this<a href=\"https:\/\/www.statnews.com\/2020\/04\/10\/immunity-certificates-covid-19-practical-ethical-conundrums\/\">&nbsp;article in STAT News<\/a>&nbsp;lays out a number of the issues. Even if we decided the societal risks were worth it, we still have so much to learn before we know whether this proposed approach would even work!<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Does antibody presence confer COVID-19 immunity? Does immunity require a given level of antibody presence? How long does protection last? Is it protective even in high concentrations of SARS-CoV-2?<\/li><li>How well do antibody tests perform at detecting COVID-19 antibodies? What is the sensitivity and specificity of the tests? How comfortable are we with people being told they are immune and they actually aren\u2019t?<\/li><li>How will we differentiate people with active infections who exhibit antibodies from those who are recovered and have antibodies? What do we make of recovery in light of reports of virus reactivation? (per&nbsp;<a href=\"https:\/\/medium.com\/@madeleinefabic\/covid-19-questions-and-answers-ee65d2f749e7\">Q&amp;A of 4\/11<\/a>)<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"5316\">On the&nbsp;<strong>ethical front:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>How can testing be rolled out in an equitable way without further straining the health system? If we rely on folks who tested positive and recovered, then we are privileging those who were able to get tested. If we rely on antibody tests, will that focus take away resources from the existing testing, tracking, quarantine approach epidemiology recommends? Just today,&nbsp;<a href=\"https:\/\/khn.org\/news\/a-colorado-ski-community-planned-to-test-everyone-for-covid-19-heres-what-happened\/\">Kaiser News reported<\/a>&nbsp;that the town in Colorado that was experimenting with population-based antibody testing (mentioned in<a href=\"https:\/\/medium.com\/@madeleinefabic\/covid-19-questions-and-answers-ee65d2f749e7\">&nbsp;Q&amp;A of 3\/30<\/a>) had to stop because the resource pull on existing laboratories in terms of PPE and supplies was just too much.<\/li><li>What are the perverse incentives for tying economic engagement\/activity to immune status? How many people will aim to infect themselves for a chance to work?<\/li><li>What are the ramifications \u2014 moral, legal, etc. \u2014 of document falsification? Of falsely believing you are immune?<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Question:&nbsp;I\u2019m&nbsp;hearing a lot&nbsp;of chatter about \u201cimmunology certificates\u201d being a ticket to economic recovery. What\u2019s the thinking on this front? Answer:&nbsp;I\u2019ve been hearing more about this too lately. The basic idea is \u2014 folks who have developed antibodies to SARS-CoV-2 are presumably immune to the virus. These immune folks are ideally suited for helping to care [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":636,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[38,6],"tags":[99,98,129],"class_list":["post-635","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-immunity","category-testing","tag-antibodies","tag-antibody-tests","tag-inequality","fallback-thumbnail"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/i0.wp.com\/covidqanda.org\/wp-content\/uploads\/2020\/11\/pexels-photo-2292837.jpeg?fit=1880%2C1245&ssl=1","_links":{"self":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/635","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=635"}],"version-history":[{"count":1,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/635\/revisions"}],"predecessor-version":[{"id":637,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/635\/revisions\/637"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/media\/636"}],"wp:attachment":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=635"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=635"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=635"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}