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  2. Coronavirus
15 September 2020

The rise and fall of the immunity passport

The government, with its £100bn “moonshot” testing programme, hopes Covid-19 certification can reopen society.

By Oscar Williams

In late March, Gérard Krause was preparing to launch one of the largest antibody surveys in Europe. The epidemiologist’s 100,000-person study was designed to assess how many Germans might have already developed a level of immunity to Covid-19.

The research attracted global attention, and Krause gave one of his first interviews to the news magazine Der Spiegel. A brief quote from the Brunswick-based scientist appeared at the end of a 300-word news story outlining his study. “[Those who have antibodies] could be issued with a kind of vaccination certificate that would allow them, for example, to be exempt from restrictions on their work,” said Krause, in remarks that have been translated from German.

Only a few days after the article was published, stories started appearing in English-language media that claimed Germany was planning to issue thousands of certificates that would allow people to escape lockdown restrictions. But the reports were based on a misinterpretation of what Krause had said, the epidemiologist told Spotlight earlier this month. Rather than revealing that Germany planned to push ahead with this particular idea, Krause was only describing what might be possible.

[see also: What does the rise in Covid-19 cases mean for the UK?]

Nevertheless, the concept of the coronavirus immunity passport had been released into the world, and, like the virus it was supposed to defend against, it spread fast.

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In the UK, less than a week after Krause’s remarks were published, the Health Secretary Matt Hancock announced at a daily press briefing that the British government was “looking at the possibility” of launching its own immunity passport scheme.

While the World Health Organisation (WHO) warned against the adoption of such schemes in April, noting that “there is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection”, the government continued to explore the idea.

In June, the Centre for Data Ethics and Innovation, a government advisory body, said immunity passports could “prove valuable” in the months ahead. In a blogpost, it admitted that scientists must first prove that the presence of antibodies guarantees immunity, while acknowledging that immunity passports could incentivise people to contract Covid-19.

But, despite these concerns, the CDEI concluded: “Although there are risks inherent to immunity certificates, there are few tangible alternatives, and any that do develop will likely hold similar trade-offs and concerns.” Commenting on the CDEI’s report at the time, Michael Veale, a lecturer in digital rights at University College London, said it “barely even touches upon the questions of what [the immunity passports] would be used for, who would be able to ask for them, what they should or should not have access to, [or] who would be able to challenge provision or non-provision of one.”

When pubs reopened in England on 4 July, the government had stopped talking publicly about immunity passports altogether. Although it had reportedly discussed with tech firms how such a scheme could be rolled out in Britain, Whitehall’s appetite for the certification had seemingly diminished.

It wasn’t just in London, however, that the momentum was slowing. In May the entrepreneurs behind the tech start-ups Bolt and Transferwise had unveiled plans for an immunity passport trial in Estonia, a famously pro-tech nation. But it failed to take off; one source with knowledge of the project told Spotlight that, as the level of Covid-19 cases plummeted in the Baltic state, so too did the number of trial participants.

[see also: The race for a Covid-19 vaccine]

Even in Germany, where the coalition government has expressed tentative support for the idea in recent weeks, there is still reticence about moving forward until more is known about Covid-19 immunity. A study from King’s College London in July revealed antibody counts in people who recover from the disease tend to fall sharply three months after infection. Plans for certification were further complicated by Swedish research indicating that roughly twice as many people who have antibodies may have a degree of immunity through T-cells, which are significantly harder and more expensive to detect.

In the UK, the government has signalled it is now moving in a different direction. Earlier this month, while detailing plans to make gatherings of more than six people illegal, Boris Johnson announced a new “moonshot” project that would enable people to secure rapid Covid-19 tests to prove they aren’t suffering from the virus. The Prime Minister said that “in the near future”, the testing would “identify people who are negative – who don’t have coronavirus and who are not infectious – so we can allow them to behave in a more normal way, in the knowledge they cannot infect anyone else… We believe that new types of test, which are simple, quick and scalable, will become available. They use swabs or saliva and can turn round results in 90 or even 20 minutes.”

But memos leaked to the British Medical Journal revealed that the plan, which would involve millions of daily tests, could cost £100bn: roughly as much as the government spends on education each year. Bottlenecks in the existing testing programme have also cast doubt on the credibility of the plans. But there is an even more fundamental issue: the technology underpinning the plan doesn’t yet exist.

“The Prime Minister’s suggestion that this will be as simple as ‘getting a pregnancy test’ that will give results within 15 minutes is unlikely, if not impossible, in the timescale he was suggesting to get the country back on track,” Dr David Strain, the chairman of the British Medical Association’s medical academic staff committee, told the BBC. If, as a number of scientists have predicted, the moonshot project fails, it’s not difficult to imagine a resurgence of support for immunity passports, which would provide the same kind of freedoms Johnson envisages for people who test negative under his latest scheme.

As “new ideas” to tackle Covid-19 have emerged over recent weeks, Gérard Krause acknowledges that support for his idea has ebbed. “But the concept is something that I, of course, stand behind.” While he admits there are “legitimate” concerns about encouraging infection, he reveals he is working with ethicists and biologists to “elaborate” on the proposals. “I’ve not yet decided whether or not we should promote the concept, but it’s too early to discard it.”

This article originally appeared in a Spotlight supplement on healthcare. Click here to download the report.

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