There is a growing debate for a rethink on “immunity passport” to be handed out to those who have recovered from COVID-19 for the purpose of travel or work without restrictions of quarantine.

Try this question form mains:

Q.Discuss various ethical issues evolved during the outbreaks of pandemics (of the scale of COVID-19).

Immunity Passports

• They are the recovery or release certificate or a document attesting that its bearer is immune to a contagious disease.
• The concept has drawn much attention during the COVID-19 pandemic as a potential way to contain the pandemic and permit faster economic recovery.
• The can be used as a legal document granted by a testing authority following a serology test demonstrating that the bearer has antibodies making them immune to a disease.

What is the ongoing debate?

• Experts argue that if reinfections were a significant problem, by now, there would have been hundreds or at least thousands of cases of reinfections at the global level.
• Till such time effective vaccines become available people who have recovered from COVID-19 should be permitted to travel without restrictions.

A case for consideration

• Immune protection after infection/disease is always much more robust than most vaccines, and definitely than most COVID-19 vaccines in development.
• Some of the vaccines undergoing clinical trials are mostly directed at a single or a couple of proteins (spike) of the virus.
• But vaccines under trial that use the inactivated coronaviruses would expose the immune system to a whole range of viral proteins, much like natural infection and can produce immune responses.
• However, it is not known if people who have experienced asymptomatic infection would show robust immune responses like those who have recovered from moderate or severe disease.

Ethical issues involved

• Issuing ‘immunity certificates’ to people who have recovered can be an ethical minefield.
• Doctors do not generally prefer immunity to be induced by natural infection compared with vaccines. It seems logical, but there are multiple challenges.
• There might be long-term health complications in those who had COVID-19, whereas the vaccine will have minimal or no adverse health consequences.
• There is a danger that similar arguments will be made for other vaccine-preventable diseases for which we have a universal immunisation programme.

There is also a public health risk of issuing immunity certificates:

• People whose livelihood has have been affected would be encouraged to adopt risky behaviour so as to get infected rather than taking precautions to stay protected from the virus.
• This would lead to a sharp increase in cases across the country with huge numbers requiring hospitalization.
• Such a situation would lead to testing capabilities getting overwhelmed, crumbling of the health-care systems and increased deaths.

Threats over malpractices:

• Immunity certification will include a system for identification and monitoring, thus compromising privacy.
• Other contentious issues would be profiteering by private labs performing tests, and the menace of fake certificates which we have already seen in some Indian states.
• In the end, an immunity passport will further divide the society with different ‘haves’ and ‘have-nots’.

Way forward

• We need to look at COVID-19 with a sense of balance and not hysteria.
• Terms such as immunity passports may not have relevance as we do not know anything about specific kinds of immune responses and the duration of protection in people.
• There is currently not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an ‘immunity passport’ or ‘risk-free certificate’.
• The permission to travel or work should be decided on a case by case basis, according to the principles of ethics while dealing with a pandemic.

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