Health / Immunity Passports - A Study of The Pros & Cons

This forum is to discuss general things concerning TSOI.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

Health / Immunity Passports - A Study of The Pros & Cons

I'm starting this study on the pros and cons of health / immunity passports , and related information. The articles posted will not be in chronological order . I'm going to be posting several different opinions from others on this topic, so be aware that some of the following articles posted might lean toward one direction , or the other sometimes .



Ten reasons why immunity passports are a bad idea

Restricting movement on the basis of biology threatens freedom, fairness and public health.


5/21/20

https://www.nature.com/articles/d41586-020-01451-0


Natalie Kofler &
Françoise Baylis


Imagine a world where your ability to get a job, housing or a loan depends on passing a blood test. You are confined to your home and locked out of society if you lack certain antibodies.

It has happened before. For most of the nineteenth century, immunity to yellow fever divided people in New Orleans, Louisiana, between the ‘acclimated’ who had survived yellow fever and the ‘unacclimated’, who had not had the disease1. Lack of immunity dictated whom people could marry, where they could work, and, for those forced into slavery, how much they were worth. Presumed immunity concentrated political and economic power in the hands of the wealthy elite, and was weaponized to justify white supremacy.

Something similar could be our dystopian future if governments introduce ‘immunity passports’ in efforts to reverse the economic catastrophe of the COVID-19 pandemic. The idea is that such certificates would be issued to those who have recovered and tested positive for antibodies to SARS-CoV-2 — the coronavirus that causes the disease. Authorities would lift restrictions on those who are presumed to have immunity, allowing them to return to work, to socialize and to travel. This idea has so many flaws that it is hard to know where to begin.

On 24 April, the World Health Organization (WHO) cautioned against issuing immunity passports because their accuracy could not be guaranteed. It stated that: “There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection”(see go.nature.com/3cutjqz). Nonetheless, the idea is being floated in the United States, Germany, the United Kingdom and other nations.

China has already introduced virtual health checks, contact tracing and digital QR codes to limit the movement of people. Antibody test results could easily be integrated into this system. And Chile, in a game of semantics, says that it intends to issue ‘medical release certificates’ with three months’ validity to people who have recovered from the disease2.

In our view, any documentation that limits individual freedoms on the basis of biology risks becoming a platform for restricting human rights, increasing discrimination and threatening — rather than protecting — public health. Here we present ten reasons why immunity passports won’t, can’t and shouldn’t be allowed to work.

Ten points

Four huge practical problems and six ethical objections add up to one very bad idea.


COVID-19 immunity is a mystery. Recent data3 suggest that a majority of recovered patients produce some antibodies against SARS-CoV-2. But scientists don’t know whether everyone produces enough antibodies to guarantee future protection, what a safe level might be or how long immunity might last. Current estimates, based on immune responses to closely related viruses such as those that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), suggest that recovered individuals could be protected from re-infection for one to two years. But if SARS-CoV-2 immunity instead mimics that seen with the common cold, the protection period could be shorter.

Serological tests are unreliable. Tests to measure SARS-CoV-2 antibodies in the blood can be a valuable tool to assess the prevalence and spread of the virus. But they vary widely in quality and efficacy. This has led the WHO and former US Food and Drug Administration commissioner Scott Gottlieb to caution against their use in assessing individual health or immune status. Several available tests are sufficiently accurate, meaning they are validated to have at least 99% specificity and sensitivity. But preliminary data suggest that the vast majority aren’t reliable4. Low specificity means the test measures antibodies other than those that are specific to SARS-CoV-2. This causes false positives, leading people to think they are immune when they aren’t. Low sensitivity means that the test requires a person to have a high concentration of SARS-CoV-2 antibodies for them to be measured effectively. This causes false negatives in people who have few antibodies, leading to potentially immune individuals being incorrectly labelled as not immune.

The volume of testing needed is unfeasible. Tens to hundreds of millions of serological tests would be needed for a national immunity certification programme. For example, Germany has a population of nearly 84 million people, so would require at least 168 million serological tests to validate every resident’s COVID-19 immune status at least twice. Two tests per person are the minimum, because anyone who tested negative might later become infected and would need to be retested to be immune certified. Repeat testing, on no less than an annual basis, would be necessary to ensure ongoing immunity. From June, the German government will receive 5 million serological tests a month from the Swiss firm Roche Pharmaceuticals — a leading supplier of one SARS-CoV-2 serological test that has been approved by regulators. This will allow only 6% of the German population to be tested each month.

Even if immunity passports were limited to health-care workers, the number of tests required could still be unfeasible. The United States, for example, would need more than 16 million such tests. At the time of writing, the US Centers for Disease Control and Prevention and US public-health laboratories have performed more than 12 million diagnostic tests for SARS-CoV-2 (3% of the total US population; see go.nature.com/2wemdd2). Even South Korea, a country with high testing rates, had managed to test only 1.5% of its population by 20 May (see go.nature.com/2aztfvp).

Too few survivors to boost the economy. The proportion of individuals known to have recovered from COVID-19 varies widely in different populations. Reports from hot spots in Germany and the United States suggest some locations could have recovery rates between 14% and 30%. In New York state, for example, where 3,000 people were tested at random in grocery shops and other public locations, 14.9% had antibodies against COVID-19 (see go.nature.com/2waaku9). But these seem to be the exception. In an April press conference, the WHO estimated that only 2–3% of the global population had recovered from the virus.

Low disease prevalence combined with limited testing capacity, not to mention highly unreliable tests, means that only a small fraction of any population would be certified as free to work. Based on current numbers of confirmed US cases, for example, only 0.43% of the population would be certified. Such percentages are inconsequential for the economy and for safety. A cafe can’t open and serve customers without risk if only a fraction of its staff are certified as immune. A shop can’t turn a profit if only a minuscule proportion of customers are allowed to enter.

Monitoring erodes privacy. The whole point of immunity passports is to control movement. Thus, any strategy for immunity certification must include a system for identification and monitoring. Paper documentation could be vulnerable to forgery. Electronic documentation integrated into a smartphone app would be more resistant to fraud and more effective for contact tracing, retesting and updates of immune status.

But electronic documents present a more serious risk to privacy5. In some Chinese provinces, QR codes on smartphones control entrance into public places on the basis of the individual’s COVID-19 health status. However, these apps report more than COVID-19 information — including people’s locations, travel history, who they’ve come into contact with and other health information, ranging from their body temperature to whether they’ve recently had a cold. Taiwan is also using smartphone apps with alert systems that are directly linked to police departments. The United Kingdom, United States and many other countries are testing various app options. Yet there’s no guarantee that the apps will recede when COVID-19 does. China has announced that elements of its QR-code tracking system are likely to remain in place after the pandemic ends.

Marginalized groups will face more scrutiny.
With increased monitoring comes increased policing, and with it higher risks of profiling and potential harms to racial, sexual, religious or other minority groups. During the pandemic, China has been accused of racially profiling residents by forcing all African nationals to be tested for the virus. In other parts of the world, people from Asia have faced spikes in racialized prejudice.

Before this pandemic, stop-and-frisk laws in the United States already disproportionately affected people of colour. In 2019, 88% of people who were stopped and searched in New York City were African American or Latin American (go.nature.com/2jntjym). And during the pandemic, policing continues to target people from minority groups. Between mid-March and the start of May in Brooklyn, New York, 35 of the 40 people arrested for violating physical distancing laws were black6.

These numbers are deeply concerning, but would be even more so if monitoring and policing for COVID-19 immunity were to be used for ulterior motives. For example, ‘digital incarceration’ has already increased in countries such as the United States, Brazil and Iran, where individuals have been released from prison to minimize the spread of COVID-19 and then monitored using digital ankle bracelets. In the United States, where people of colour are racially segregated by neighbourhood and disproportionately incarcerated, digital incarceration could be used to monitor large segments of certain communities. The risk would be even higher if digital monitoring were to be linked to immigration status .

Unfair access.
With a shortage of testing, many will not have access. Experience so far suggests that the wealthy and powerful are more likely to obtain a test than the poor and vulnerable. In tiered health-care systems, these inequities are felt even more acutely. In early March, for example, when professional sports teams, technology executives and film celebrities were getting tested, dozens of US states were conducting fewer than 20 tests per day (see https://covidtracking.com/data). The very people who need to get back to work most urgently — workers who need to keep a roof over their head and food on the table — are likely to struggle to get an antibody test. Testing children before they return to school could be a low priority, as would testing retired older people and those who face physical, mental-health or cognitive challenges.

Societal stratification. Labeling people on the basis of their COVID-19 status would create a new measure by which to divide the ‘haves’ and the ‘have-nots’ — the immunoprivileged and the immunodeprived. Such labelling is particularly concerning in the absence of a free, universally available vaccine. If a vaccine becomes available, then people could choose to opt in and gain immune certification. Without one, stratification would depend on luck, money and personal circumstances. Restricting work, concerts, museums, religious services, restaurants, political polling sites and even health-care centres to COVID-19 survivors would harm and disenfranchise a majority of the population.

Social and financial inequities would be amplified.[For example, employers wanting to avoid workers who are at risk of becoming unwell might privilege current employees who have had the disease, and preferentially hire those with ‘confirmed’ immunity.

Immunity passports could also fuel divisions between nations. Individuals from countries that are unable or unwilling to implement immunity passport programmes could be barred from travelling to countries that stipulate them. Already people with HIV are subjected to restrictions on entering, living and working in countries with laws that impinge on the rights of those from sexual and gender minorities — such as Russia, Egypt and Singapore.

New forms of discrimination.
Platforms for SARS-CoV-2 immune certification could easily be expanded to include other forms of personal health data, such as mental-health records and genetic-test results. The immunity passports of today could become the all-encompassing biological passports of tomorrow. These would introduce a new risk for discrimination if employers, insurance companies, law-enforcement officers and others could access private health information for their own benefit. Such concerns have been catalogued over the past few years in debates about who should have access to genetic information, as demand rises from clinicians, researchers, insurers, employers and law enforcers, for example7.

Threats to public health. Immunity passports could create perverse incentives. If access to certain social and economic liberties is given only to people who have recovered from COVID-19, then immunity passports could incentivize healthy, non-immune individuals to wilfully seek out infection — putting themselves and others at risk8. Economic hardship could amplify the incentive if an immunity passport is the only way to a pay cheque. Individuals might obtain documents illicitly, through bribery, transfer between individuals or forgery. These could create further health threats, because people claiming immunity could continue to spread the virus. Crises tend to foster nefarious trade, as happened during the Second World War when food rations in Britain caused the emergence of a robust underground exchange system.

Next steps

Strategies that focus on the individual — using conceptions of ethics rooted in libertarianism — contradict the mission of public health9. They distract attention from actions that benefit all, such as funding international collaborations, practising effective public-health measures and redressing income inequity. In North America (and elsewhere), because of structural inequities, people of colour are dying from COVID-19 at much higher rates than are white people, and the virus is disproportionately affecting those who live in First Nations territories. Success depends on solidarity, a genuine appreciation that we are all in this together. An ethic premised on individual autonomy is grossly inappropriate during a public-health crisis; the overarching aim must be to promote the common good.

Instead of immunity passports, we contend that governments and businesses should invest available time, talent and money in two things.

First is the tried and true formula of pandemic damage limitation — test, trace and isolate — that has worked well from Singapore and New Zealand to Guernsey and Hanoi. Health status, personal data and location must be anonymized. Apps that empower individuals to make safe choices about their own movements should be prioritized.

Second is the development, production and global distribution of a vaccine for SARS-CoV-2. If universal, timely, free access to a vaccination becomes possible, then it could be ethically permissible to require vaccine certification for participation in certain activities. But if access to a vaccine is limited in any way, then some of the inequities we highlight could still apply, as the literature on uptake of other vaccines attests10.

Threats to freedom, fairness and public health are inherent to any platform that is designed to segregate society on the basis of biological data. All policies and practices must be guided by a commitment to social justice.

Nature 581, 379-381 (2020)
doi: https://doi.org/10.1038/d41586-020-01451-0
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

An Immunity Passport After COVID-19 And How Digital Health Can Support It

30 April 2020


https://medicalfuturist.com/an-immunity ... upport-it/#


If you’re reading this from home due to the COVID-19 pandemic, then you’re likely not the only one. Even at The Medical Futurist, we are working from home to bring you the latest digital health news in a timely manner. One of the latest trends of interest to governments is the immunity passport, or some certified methods to ensure someone has antibodies against SARS-CoV-2 in order to move around.

We have already discussed scenarios about how and when the pandemic will end, but we’ve also analyzed the ways that life will drastically change. One of the major changes we could experience is the introduction of an immunity passport. This new health document is gaining attention as a means to slowly and safely get things back to “normal”; or what we will consider normal post-COVID-19.

However, despite being attractive, experts dispute its efficacy. Others are pointing out that such a document will only highlight inequality issues. Some are even evoking similarities from horrendous historical events.

So what to make out of this so-called immunity passport? Let’s see where the potential next travel document stands as of now, how effective it can be and its digital health aspects.

What is an immunity passport?

This document will certify that someone is immune to SARS-CoV-2, by performing an antibody test and a virus test. The former will check whether the person has had a previous encounter with the virus and their immune system responded accordingly by producing antibodies. The latter will check if there’s any active infection going on, with the virus still present in the person. The person will get an immunity pass if the antibody test is positive (competent immune response) and a negative virus test (no longer carrying the virus).

Once issued, this document could be a requirement to allow the holder to go back to work, travel or, like a recent Quartz article puts it, “participate in society”. Given that the person is proven immune to the disease, they cannot get infected again and won’t pose a public health risk; hence it could become a requirement by companies or even airlines.


A version of this concept is already in place. Emirates Airline had conducted the first rapid Covid-19 blood tests on airline passengers in mid-April before they flew to Tunisia. “We are working on plans to scale up testing capabilities in the future and extend it to other flights,” reads a statement from the company. “This will enable us to conduct on-site tests and provide immediate confirmation for Emirates passengers traveling to countries that require COVID-19 test certificates.”

Tech-savvy passports

With all the talks about reducing contact with others, checking such a passport will benefit from the help of technology; there’s already an app for that. UK-based Bizagi released CoronaPass, an app that stores the user’s immune status data obtained from a healthcare authority. It presents a QR code that an official can then scan to check the user’s immunity status. This can limit contact with other forms of an immunity certificate like a hard copy.

Of course, privacy issues come to mind with apps dealing with such sensitive data. According to Gustavo Gómez, Bizagi ’s CEO, the company is HIPAA-compliant. They only store the immune status of patients in an encrypted database. This data will only be accessible to governments or companies with access to the “requesting” side of the app. But what about other competitors which will sprout if demand arises? Will they also securely store patients’ data?


Another option would be to add blockchain in the mix. This is the approach of Vottun, a company specializing in the certification and traceability of data on the blockchain. The company’s CEO, Rohan Hall, explained that their immunity passport “can be verified at any time using cryptography by any mobile phone that can read a QR code”. They have already started to roll out their solution at the PwC firm in Spain. In the U.S., they’ve had ”early conversations” with the CDC and Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, according to Cointelegraph.

Nonetheless, this concept raises further questions. Residents in China are questioning about leaks and how else such data might be used. Others are drawing comparisons with the need of an immunity pass to German soldiers demanding papers.

Is immunity passport the solution?


However, there are several issues pertaining to the validity of an immunity passport. First off, COVID-19 is caused by a new virus; new virus, new problems, as you can probably attest yourself. The outbreak has been ongoing for a couple of months and we don’t have a definite answer about how long immunity against the virus lasts.

We could get insights by analyzing other members of the coronavirus family, of which SARS-CoV-2 is a member. A study showed that immunity against SARS lasts an average of two years. But there have been reports of some recovered patients already testing positive again for COVID-19; although some could be attributed to testing errors. So for this specific virus, immunity could last for months or years; but we have no definite answer as of now.


Additionally, the timing of an immunity test is important. If someone is infected with the virus but their body hasn’t yet developed the antibodies the test checks, then the person will miss their immunity passport chance. Moreover, having antibodies can avert sickness but might not protect from an infection altogether. Again due to the novelty of the contagion, scientists don’t have enough data on the body’s immune responses for conclusive answers.

On a purely managerial perspective, an app with one’s immune status will prove to be a herculean task to control. To get a considerable chunk of society to use this software will be challenging. Only big tech companies like Facebook or Google have the resources and established user base to effectively implement it on such short notice.

When tests need testing

The issue with testing for immunity might very well be the tests themselves. Their accuracy needs to be verified via trials but given the speed of COVID-19’s spread, this has not been possible. This has resulted in unusable tests, like the 3.5 million ones that the U.K. government ordered.

Additionally, even if highly accurate tests are developed and tested, we are bound to see cases of false positives (people incorrectly identified as immune) and false negatives (people incorrectly identified as not immune). All it needs for a second outbreak is one infected individual. “Imagine the psychological state of a person who thought they were in the all clear and has gone back to work in a care home and ended up killing several people,” said Susan Michie, a professor of health psychology at University College London, who is also a member of the scientific group advising the U.K. government’s response to Covid-19. Such a prospect undermines the very purpose of an immunity pass.


Things further complicate with testing for a new virus part of a larger family of viruses. “There may be cross-reactivity between the antibodies for SARS-CoV-2 [Covid-19] and other circulating coronaviruses – including those that cause common colds – meaning a positive result might not indicate past exposure to SARS-CoV-2 but maybe another coronavirus instead.” said Claire Standley, an assistant professor at Georgetown University’s Center for Global Health Science and Security.

It will take time, and a lot of trial and error before we can get a reliable test. “It took several years to develop antibody tests for HIV with more than 99% specificity,” says Peter Collignon, a physician and laboratory microbiologist at Australian National University in Canberra.

Yet another story of the haves and the have-nots?

The fact that such an initiative will highlight inequality issues cannot be ignored. A WHO report in late April showed that only a small fraction of the population, as few as 2% or 3%, have the antibodies to show a past infection with SARS-CoV-2. Only those privileged few will be allowed to go out? What about those who cannot afford to get tested?

“In an effort to return to work, or allow their children back to school, will the promise of an immunity passport make people behave less responsibly, and risk infection, in order to end up with a positive antibody test?” questioned Claire Standley.

While people are struggling to make the ends meet during a lockdown, if the only way to earn a living is with a pass, some might want to expose themselves to the virus so as to gain immunity. It could even sprout the need for forged immunity passports and a thriving black market. These will further put the population at risk, or lead to a second outbreak.


In early April, Kathy Hall, the director of the testing strategy for COVID-19 in the U.K., said that “no country appeared to have a validated antibody test that can accurately determine whether an individual has had COVID-19”. This will mean travelling to other countries under an immunity passport requirement might require other tests or apps validated by that country. This further complicates matters by adding another layer of financial and possibly legal issues with the immunity passport.

Another option?


Debates around the efficacy and need for an immunity passport will continue for months, if not years to come. In the short term, an immunity passport could help those immune to go back to work and get things running in a country.

But there are still lots of uncertainties and unanswered questions around immunity passports. These will likely remain until we get more information about this disease. Given these issues, we should hope for an effective vaccine to hit the market sooner; this will provide a safer solution.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

"Immunity passports" in the context of COVID-19

Scientific Brief
24 April 2020


https://www.who.int/news-room/commentar ... f-covid-19


WHO has published guidance on adjusting public health and social measures for the next phase of the COVID-19 response.1 Some governments have suggested that the detection of antibodies to the SARS-CoV-2, the virus that causes COVID-19, could serve as the basis for an “immunity passport” or “risk-free certificate” that would enable individuals to travel or to return to work assuming that they are protected against re-infection. There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.

The measurement of antibodies specific to COVID-19

The development of immunity to a pathogen through natural infection is a multi-step process that typically takes place over 1-2 weeks. The body responds to a viral infection immediately with a non-specific innate response in which macrophages, neutrophils, and dendritic cells slow the progress of virus and may even prevent it from causing symptoms. This non-specific response is followed by an adaptive response where the body makes antibodies that specifically bind to the virus. These antibodies are proteins called immunoglobulins. The body also makes T-cells that recognize and eliminate other cells infected with the virus. This is called cellular immunity. This combined adaptive response may clear the virus from the body, and if the response is strong enough, may prevent progression to severe illness or re-infection by the same virus. This process is often measured by the presence of antibodies in blood.

WHO continues to review the evidence on antibody responses to SARS-CoV-2 infection.2-17 Most of these studies show that people who have recovered from infection have antibodies to the virus. However, some of these people have very low levels of neutralizing antibodies in their blood,4 suggesting that cellular immunity may also be critical for recovery. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans.

Laboratory tests that detect antibodies to SARS-CoV-2 in people, including rapid immunodiagnostic tests, need further validation to determine their accuracy and reliability. Inaccurate immunodiagnostic tests may falsely categorize people in two ways. The first is that they may falsely label people who have been infected as negative, and the second is that people who have not been infected are falsely labelled as positive. Both errors have serious consequences and will affect control efforts. These tests also need to accurately distinguish between past infections from SARS-CoV-2 and those caused by the known set of six human coronaviruses. Four of these viruses cause the common cold and circulate widely. The remaining two are the viruses that cause Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome. People infected by any one of these viruses may produce antibodies that cross-react with antibodies produced in response to infection with SARS-CoV-2.

Many countries are now testing for SARS-CoV-2 antibodies at the population level or in specific groups, such as health workers, close contacts of known cases, or within households.21 WHO supports these studies, as they are critical for understanding the extent of – and risk factors associated with – infection. These studies will provide data on the percentage of people with detectable COVID-19 antibodies, but most are not designed to determine whether those people are immune to secondary infections.

Other considerations


At this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an “immunity passport” or “risk-free certificate.” People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission. As new evidence becomes available, WHO will update this scientific brief.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

Health passports and distancing tools among COVID-19 tech climbing Gartner Hype Cycle

Those pandemic-era technologies will reach the fabled Plateau of Productivity sooner than other emerging innovations approaching the peak of the curve, such as digital twins, data fabric and SASE network architecture, researchers say.


August 21, 2020

https://www.healthcareitnews.com/news/h ... hype-cycle


Gartner research's famous hype curve looks like a steep roller coaster leading to a launch pad. Beginning with the necessity-is-the-mother-of-innovation "Innovation Trigger," it predictively tracks new technologies as they might evolve over the next years and decades: a long, slow climb up the Peak of Inflated Expectations, then falling with a reality check into the Trough of Disillusionment, before slowly, with tweaks and refinements, clawing back up the Slope of Enlightenment toward, eventually, the Plateau of Productivity.

WHY IT MATTERS


With most technologies it can take five years or more to trace that bumpy path, from shiny-object to indispensable tool (or, in many cases, obsolete fad).

And, indeed, plenty of the innovations on the most recent Hype Cycle for Emerging Technologies, published this week, will take plenty of time to evolve and either prove their worth or lose steam, whether two-way brain-machine interface, generative adversarial networks or responsible AI.

But at least a couple species of emerging tech are charting their course on the hype curve much faster than usual, and it probably won't be a surprise that they emerged in response to the COVID-19 public health crisis.

So-called health passports and new social distancing technologies "are taking the fast track through the Hype Cycle and have high impact," according to Gartner.

"Technologies rarely enter the Hype Cycle at the point where social distancing technologies have entered it, but this technology has received extraordinary attention in the media, mainly because of privacy concerns."

THE LARGER TREND

Health passports, also called immunity passports or immunity certificates, offer digital proof – via a QR code, for instances – that a person is free of COVID-19 and allowed. They're controversial, given the privacy implications, and their accuracy and efficiency may be questionable, considering how little is still known about lasting post-infection immunity. But they're already in use in places like China and India, and some say they'll be key to a safe reopening.

Social distancing technologies – contact tracing apps and other tools to indicate where and with whom a person has been – have similar privacy concerns, of course, but also similar promise to enable a faster lifting of quarantine rules.

Given those potential society-wide benefits, it's perhaps unsurprising that, even with relatively modest uptake so far, both of these technologies are already outpacing others on the hype curve.

"Health passports are also unusual as technologies with market penetration of 5-20% are rarely introduced, but this technology, required for access to public spaces and transportation in China (Health Code) and India (Aarogya Setu), is being used by hundreds of millions of people in those countries," according to Gartner. "Both technologies are expected to reach the plateau of productivity in less than two years."

Other leading-edge technologies on the new Hype Cycle include AI-assisted design, biodegradable sensors and private 5G – all of which could take five to 10 years or more to become commonplace.

Another, that could prove especially useful for healthcare, is the concept of Digital Twins – which, as Healthcare IT News explained earlier this year, use data from wearable sensors, such as Apple Watch or Fitbit to collect baseline health information – essentially creating a backup of a patient’s physical state so providers and patients can detect deviations from the norm and know what to work toward for better health.

ON THE RECORD


"Emerging technologies are disruptive by nature, but the competitive advantage they provide is not yet well known or proven in the market. Most will take more than five years, and some more than 10 years, to reach the Plateau of Productivity. But some technologies on the Hype Cycle will mature in the near term and technology innovation leaders must understand the opportunities for these technologies, particularly those with transformational or high impact,” said Brian Burke, research vice president at Gartner, in a statement.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

Digital health passport CommonPass begins testing to help travel and trade resume

CommonPass allows travelers to document their COVID-19 status electronically and present it when they board a plane or cross a border.

By Mallory Hackett October 07, 2020


https://www.mobihealthnews.com/news/dig ... ade-resume


A new digital health pass for travelers, CommonPass, will begin testing internationally today, the Commons Project Foundation and the World Economic Forum announced.

The purpose of CommonPass is to allow travelers to document their COVID-19 status electronically and present it when they board a plane or cross a border, giving both the traveler and the country assurance that safe traveling is taking place.

CommonPass was developed by the Commons Project Foundation, a nonprofit public trust that's building global digital services and platforms, and the World Economic Forum, an international organization for public-private cooperation.

To use it, travelers take a COVID-19 test at a verified lab and share their results with CommonPass. From there, they complete any additional screening measures set up by the destination country.

Once their health information has been confirmed to be in compliance with the country’s entry requirements, CommonPass generates a QR code that can be viewed on mobile phones or printed. Airline staff, border officials and any other health personnel can then scan the code to ensure all safety measures were taken.

The CommonPass platform is adaptable. It allows governments to update their entry requirements as the pandemic progresses. It also promotes user privacy by complying with privacy policies like the general data protection regulation (GDPR).

Two of the trials that are underway partner with Cathay Pacific Airways and United Airlines. They attempt to mimic the full traveler experience of taking a COVID-19 test prior to departure, uploading the results, and following entry requirements at their departure and destination airports.

The trials will take place for a flights between Hong Kong International Airport to Singapore Changi International Airport and London Heathrow Airport to Newark Liberty International Airport.

Following these trials, CommonPass will expand to additional airlines and routes across Asia, Africa, the Americas, Europe and the Middle East.

WHY IT MATTERS

During the pandemic, many countries took measures to decrease cross-border travel with the hopes of stopping the spread of COVID-19. In early April, 194 countries implemented visa restrictions and 143 closed their borders, according to the World Health Organization.

These protective measures have been found to be counterproductive at times because they can discourage people from disclosing relevant information during screenings and could hinder the movement of health workers and essential supplies, according to an article published in the Lancet.

They have also had significant economic impacts on countries. For example, European exports of services dropped by 10.6% and imports of services dropped by 3.3% in March 2020 compared to the previous year, according to the European Central Bank.

"Individual national responses will not be sufficient to address this global crisis,” said Christoph Wolff, head of mobility at the World Economic Forum, in a statement. "Bans, bubbles and quarantines may provide short-term protection, but developed and developing nations alike need a long-term, flexible and risk-based approach like CommonPass."

Through its framework, CommonPass is working to get travel and trade back to pre-pandemic levels by supplying a secure and verifiable way to document travelers’ health status as they cross borders, it says on its website.

“Partners across the globe are looking for sustainable solutions to keep travel healthy, responsible and safe,” said Dr. Martin Cetron, the director of the Division of Global Migration and Quarantine at CDC, in a statement. “CDC is eager to learn from the CommonPass pilot, as it could be one of the many potential tools that may one day contribute to a safe, responsible and healthy global air travel experience.”

THE LARGER TREND

Around the world, countries still have varying degrees of travel restrictions, according to the U.S. Department of State.

Over the course of the pandemic, several other platforms with similar functions have sprouted up to help get travel back to normal.

IBM created its own version that is currently under limited availability. Users of the IBM version can download the digital health pass, upload relevant health data and receive a QR code that can be reviewed when they travel or attend an event.

London-based Tento Health also created a similar product, originally called COVI-PASS. The company has since pivoted to include a suite of products used to securely store and share health information.

Although these systems present a path to get travel and trade back on track, others worry they could deteriorate the public’s personal privacy. The fear is that these health-tracking platforms could be a slippery slope towards a system comparable to China’s social credit rating, which rewards or punishes people based on their behaviors.

Other efforts to help create safe travel during the pandemic include Etihad Airways’ COVID-19 risk assessment tool that assesses the users’ probability of having contracted coronavirus. Google Maps also updated its system to show users the prevalence of COVID-19 cases in an area by creating a color-coded overlay that illustrates the seven-day averages of new cases per 100,000 in that area.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

The scientific and ethical feasibility of immunity passports

Rebecca C H Brown, PhD
Dominic Kelly, PhD
Prof Dominic Wilkinson, DPhil
Prof Julian Savulescu, PhD

Published:October 16, 2020


https://www.thelancet.com/journals/lani ... 0/fulltext

Summary

There is much debate about the use of immunity passports in the response to the COVID-19 pandemic. Some have argued that immunity passports are unethical and impractical, pointing to uncertainties relating to COVID-19 immunity, issues with testing, perverse incentives, doubtful economic benefits, privacy concerns, and the risk of discriminatory effects. We first review the scientific feasibility of immunity passports. Considerable hurdles remain, but increasing understanding of the neutralising antibody response to COVID-19 might make identifying members of the community at low risk of contracting and transmitting COVID-19 possible. We respond to the ethical arguments against immunity passports and give the positive ethical arguments. First, a strong presumption should be in favour of preserving people's free movement if at all feasible. Second, failing to recognise the reduced infection threat immune individuals pose risks punishing people for low-risk behaviour. Finally, further individual and social benefits are likely to accrue from allowing people to engage in free movement. Challenges relating to the implementation of immunity passports ought to be met with targeted solutions so as to maximise their benefit.

Context of the debate

At this point in the COVID-19 pandemic, how or when our lives might return to normality is unclear. One strategy proposed to help this resumption is the identification and documentation of immunity: so-called immunity passports. These passports are a potential tool for recording and sharing the immune status of an individual. The introduction of immunity passports is being considered by several countries, including the UK, Estonia, Italy, and Chile; although as yet, there is no information on the effects of their use.1,2,3

Health certification for public health purposes is already used in other contexts—eg, in the management of yellow fever.4
Passports could take different forms, such as a wristband, smartphone application, or certificate, and be used to confirm to others that a particular individual is at a low risk of acquiring or transmitting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). During periods of lockdown, immunity passports could allow immune individuals to follow less stringent requirements around physical distancing and travel, perhaps permitting them to return to work, care for those at risk, visit friends and relatives, or undertake other activities that expose them to the virus. Whether this strategy should be pursued depends on both scientific evidence and ethical reasoning.

The scientific evidence: are immunity passports feasible?

Immunity passports could be implemented on the basis of either a laboratory test of immune response (a correlate of protection) or an immunising event (infection or vaccination), which would identify individuals less likely to get disease or transmit virus when exposed to SARS-CoV-2. Important immunological issues for such passports are: (1) the degree of immunity induced (an immune response might only attenuate disease severity, or might prevent any symptomatic disease and even pathogen carriage, which is necessary for herd immunity) and (2) the duration of immunity.
Critics of immunity passports point to persisting uncertainties about the immune response to COVID-19, claiming that “COVID-19 immunity is a mystery” and that this uncertainty makes immunity passports unfeasible.5
Whether SARS-CoV-2 will generate a short-lived immune response similar to those produced by seasonal coronaviruses, or one more similar to those from SARS and Middle East respiratory syndrome coronaviruses, in which antibody responses persist for 2–3 years, is unclear.6,7,8,9

Concerns also surround the sensitivity and specificity of the tests used to define immunity, especially in populations with a low incidence of previous infection, and the need for impractical numbers of tests to be done to ensure a population remains immune.5,10,11,12


Infection-related immunity

Symptomatic infection with SARS-CoV-2 generates various T-cell, B-cell, and antibody responses against components of the virus, including the spike glycoprotein and the nucleoprotein, which could be assessed as potential correlates of protection.13,14,15,16,17,18,19,20,21

For infections that have reliable correlates, these correlates have been based on antibody responses, which have the following advantages: these tests use serum or plasma that are easy to collect and store; the assays are more easily standardised and scaled for high throughput use than are cellular assays; and the assays provide a direct link to the protective immune response.

Current antibody assays for SARS-CoV-2 correlates already include sensitive and specific quantitative measurements of IgG against various viral proteins, and complex viral neutralisation assays.22,23,24

Following symptomatic infection, most patients develop antibody responses, with the majority of these individuals having neutralising antibodies.13,14,15,16,17,18,19,20,21,25,26

Although, like all antibody responses to viral infections, responses to SARS-CoV-2 wane in the weeks after infection, increasing evidence suggests that these responses remain higher than pre-infection levels for at least 4 months (the longest period that has been possible to study).14,15,19,25

As of September, 2020, there is not a recognised level of response for any assay that has been definitively shown to protect against disease or viral transmission. However, some progress has been made: monoclonal antibodies in animal models prevented SARS-CoV-2 infection in a dose-dependent manner;27,28,29

individuals with pre-existing neutralising antibodies were less likely to get infected during an outbreak on a fishing boat than were individuals with either no antibody response or antibody responses that were non-neutralising when tested pre-exposure;30
and higher antibody concentrations were associated with lower viral loads during illness in a study of hospitalised patients in the UK.31

In the absence of an immunological correlate of protection, confirmed infection itself could be used to certify immunity. In human challenge trials with seasonal coronaviruses and primate models of SARS-CoV-2 infection, disease severity was attenuated by previous infection.32
With widespread testing available and ongoing transmission occurring, there is likely to be rapid progress on quantifying the protective effect of previous infection and the duration of this effect. However, there are likely to be complexities to this approach because, for SARS-CoV-2 infection, antibody responses might be less marked in individuals with asymptomatic or mild disease than in those with severe disease.17
Furthermore, several individuals with evidence of reinfection within a short period of a first illness have been described, with at least one individual being more symptomatic with the second illness than with the first.33,34

Given the scale of the pandemic and the research into COVID-19, there is likely to be rapid progress in understanding the nature of infection and immunity such that clinical infection, with or without a measurement of antibody response, might form the basis of a time-limited immunity passport. Challenges for this approach include the heterologous nature of the initial infection, reflected in the variation in quality and duration of the subsequent immune response; the almost complete absence of information about an individual's ability to still transmit virus to others even if protected from disease; and the need to undergo the risk of infection to acquire immunity.

A recurrent criticism of immunity passports based on correlates of infection is the use of serosurveys of populations with a low incidence of infection. For instance, a Cochrane review suggested that the number of false positives produced in a setting with a 5% SARS-CoV-2 seroprevalence would be around 21%.35
However, an assessment of individual immunity is not likely to be derived from serosurveys of whole populations with a low incidence of infection. Such approaches are also unattractive given that asymptomatic infections might lead to less functional and less persistent antibody than might symptomatic infections. If a surveillance approach was considered in a group at high risk of infection, such as exposed health-care workers, a two-stage testing process could be implemented whereby individuals with a positive antibody test undergo second-line testing with neutralisation assays. At least one study has shown that individuals positive for antibodies against SARS-CoV-2 but negative for neutralising antibodies were susceptible to SARS-CoV-2 infection, reinforcing the need for a two-stage approach in some settings, especially where there is no infection documented as the origin of the antibodies.30

Vaccine-induced immunity

There has been rapid progress in vaccine development and emerging evidence that vaccines can provide protection from SARS-CoV-2 in animal models.32,36,37

Given the ongoing clinical efficacy trials that use widespread serological and cellular sampling, there will be more data emerging as to whether vaccination could form the basis of an immunity passport and, if so, whether there are any assays that provide correlates of protection. Basing immunity passports on a vaccine has advantages: the stimulus is uniform and is therefore likely to have a more predictable pattern and duration of immunity than is infection, and vaccination makes immunity potentially available to the whole population. The ethical issue then becomes one of timely access to vaccination for everyone. In the setting of routine immunisation in a population, the duration of immunity can be estimated from efficacy studies, together with serological surveys, and these data can support booster doses rather than continually reassessing immunity in individuals.

Transmission


A neglected issue in discussions of immunity passports is that of individual protection versus community protection. Perhaps the most important consideration for immunity passports is whether an individual can transmit the infection to others. Evidence from previous work with seasonal coronaviruses and studies of SARS-CoV-2 vaccines in macaques suggests that previous infection or vaccination might protect from severe disease but an individual might nevertheless carry the virus at similar levels, and for a similar duration, to those previously uninfected, with an unchanged potential for transmission.17,32,38,39

This fact provides the greatest challenge to the assurance that individuals who carry immunity passports would have a reduced risk to others. There are considerable challenges in measuring and inferring immunity to SARS-CoV-2. However, many of those challenges could potentially be overcome in the coming months. As information continues to accumulate, it is important to consider whether immunity passports should be used to reliably identify immune individuals, if this identification were possible.

Ethical arguments: are immunity passports ethical?

There are several key ethical advantages to immunity passports. First, the justification behind requiring people to remain in lockdown is the risk their free movement poses to themselves and others as they could acquire and pass on the virus. Individuals who are immune to SARS-CoV-2 are expected to be at a vastly reduced risk of getting and transmitting the virus, and so removing their civil liberties would be unjustified. It is unethical to require someone to avoid contact with others if they pose no or minimal risk of spreading the virus.
Second, people will know the reduced risks, and are likely to become less compliant with lockdown restrictions if they believe themselves to be immune anyway.40
Consider Neil Ferguson, who resigned from his role as an adviser to the UK Government after breaking lockdown guidelines, stating “I acted in the belief that I was immune”.41
By refusing to formalise the permissibility of such actions, inevitable low-risk behaviour is classified as rule breaking, and could even subject people to fines and punishments that do not correspond to the harm their behaviour causes.
Finally, there will be benefits for immune individuals and broader benefits to society from allowing people to return to work and care obligations. Lonely and isolated individuals could be visited by immune friends and relatives; small businesses can be reopened by staff who are immune and will not risk the health of colleagues and customers; immune health-care staff can care for patients with COVID-19; and immune care workers can protect vulnerable people in residential homes.

Ethical objections

Despite these advantages, some people have strongly opposed immunity passports. In numerous articles, ethicists Natalie Kofler and Françoise Baylis have claimed that immunity passports are “the height of folly” and should be fought against “tooth and nail”.42,43

Kofler and Baylis have highlighted how, in 19th century New Orleans, LA, USA, presumed immunity to yellow fever “was weaponised to justify white supremacy”,5
and have warned that immunity passports could cause similar effects in modern day. WHO have also expressed concerns about immunity passports,44
as has Alexandra Phelan writing in The Lancet,11
and numerous news outlets.45,46,47,48,49

A rapid policy briefing by the Nuffield Council on Bioethics emphasised the ethical risks of immunity passports, speculating that these passports could “create coercive and stigmatising work environments” and are “more likely to compound than redress…structural disadvantages and…social stigmatisation”.50
However, the strength of much of this opposition does not seem justified by the strength of the arguments opposing immunity passports.

Undermining solidarity and creating perverse incentives


Critics warn that immunity passports create a “perverse incentive for individuals to seek out infection” or choose to fraudulently acquire passports.11
How likely these scenarios would be is largely unknown. One survey suggested that people are very unlikely to intentionally seek infection, and Gilad Edelman, writing in Wired, has proposed that the reporting of so-called COVID parties might be overblown.51,52

This area is one for which additional evidence would greatly help to judge risk and how this risk can be traded off against the benefits of immunity passports.

Behavioural scientists have also highlighted research on the psychology of in-groups, social groups with which people identify, and out-groups, social groups with which people do not identify, suggesting that permitting immune individuals to exercise more freedoms than those who are not immune would undermine the message that we are “all in this together”.12
We are not aware of any published research that presents clear and compelling evidence supporting this assertion. There has been some exploration as to how various theories and findings from social and behavioural science can be applied to the pandemic response.53
At this stage, however, extrapolation from theories supported by evidence often based on laboratory experimentation or very different situational contexts is risky. Several behavioural scientists have raised concerns about the robustness and generalisability of claims from behavioural science and caution against the use of these claims to inform major policy decisions.54

Minimal economic benefits

The baseline prevalence of immunity varies from place to place. In some cities (ie, London [UK], New York [NY, USA], and Stockholm [Sweden]), the prevalence of immunity could be as high as a fifth;55,56,57,58,59

elsewhere, prevalence is likely to be much lower. Economic analyses are needed to find out how much economic benefit would be generated if some proportion of the population had fewer restrictions on their movement. We are not aware of any published work that informs this argument. However, it would be a mistake for ethicists, in the absence of such evidence or expertise, to dismiss immunity passports on the assumption that there will be “too few survivors to boost the economy”.5
In addition, immunity passports might deliver important non-economic benefits, such as regaining the ability to operate small buisnesses, to a small proportion of people.

Privacy

There is suspicion that immunity passports could provide a way in to more troublesome monitoring of people's movements and health statuses.60
Some have claimed that “the whole point of immunity passports is to control movement”.5
However, this claim is a gross mischaracterisation: the point of immunity passports is to facilitate movement when it is safe to do so. Of course, steps must be taken to avoid the production of fraudulent immunity passports, and careful attention must be given to privacy concerns and information governance. These problems are not unique to immunity passports (conventional passports and contact tracing measures also encounter such problems) and are not insurmountable.

Marginalised groups and discrimination

Immunity passports have been frequently objected to on the basis that their introduction would exacerbate existing inequalities.5,11,47,50

The main concerns are that, if immunity passports were introduced, marginalised groups would be subject to more scrutiny because of existing inequities and racism (eg, police checks for lockdown regulations) and would be less likely to access testing (and establish immunity) than non-marginalised groups would be. Furthermore, the advantages accruing to those with immunity (and immunity passports) would persist into the future. Although we recognise the deep existing inequalities in all countries, and the ways in which COVID-19 has increased the hardships for the worst off, we are surprised that the published responses42
of some prominent critics of immunity passports do not include suggestions of ways to mitigate resultant inequalities.

As frequently noted, such unequal experiences are not new. Factors, such as race and socioeconomic status, influence the health care that people access and the treatment they receive.61,62,63

Yet, this issue is rarely interpreted as a reason to remove health-care treatments or refuse to introduce new ones, assuming these therapies are considered cost-effective and net beneficial. Instead, such patterns point us to areas in which more effort must be made to improve the care of the most deprived, to look for solutions to the inequitable distribution of resources, and to tackle the upstream causes of inequality. This same reasoning should be applied to immunity passports. Furthermore, as some have highlighted, the advantages of COVID-19 immunity might not entrench existing inequalities in the way often assumed.40

Concluding remarks

Lockdown measures considerably curtail people's freedom. Immunity passports would potentially allow some proportion of the population to access more freedoms during lockdown periods. It is unethical to restrict freedom unless there is a real risk to other people. If we have the technology to decide who is not a risk, we should use it.
The specific scenarios in which immunity passports can be used will depend on the nature of the immunity generated. It might be desirable for immunity passports to record individuals, especially those who have pre-existing vulnerabilities, who have been identified as having a correlate of immunity that reliably indicates that they will not contract severe disease in the future. Alternatively, if immunity passports certify that individuals can move around freely and interact for business or leisure without increasing the risk of transmission, we might wish to certify only those who are unlikely to transmit the virus.

Although there remains considerable uncertainty regarding the nature, degree, and duration of immunity to SARS-CoV-2, the world's intense research focus on this infection will potentially yield useful answers in a practicable timeframe that could be translated into some form of immunity passport. Even after a correlate of protection is established, there will still be uncertainty around the duration of protection or whether the correlate can be applied across all ages and clinical scenarios, but complete certainty might not be necessary for policy in the medium term.64
Assuming that developing scientific evidence supports the use of immunity passports, safety nets must be put in place to protect individuals who remain in lockdown and are the most disadvantaged by lockdown (eg, those who are unable to work, socially isolated, or at risk from domestic violence). Similarly, we must take seriously the need to ensure fair access to testing and to address inequality that arises in the context of COVID-19 through targeted solutions.
We must be clear about what the alternatives are when evaluating the merits of different ways of tackling this pandemic. The choice is not between returning to a normal life versus issuing immunity passports. Instead, the choice is between periodic lockdowns, attempting to emerge from lockdowns with immunity passports, and attempting to emerge from lockdowns without immunity passports. Immunity passports are a potentially valuable and ethical tool. As further evidence relating to the immune response to COVID-19 accumulates, and the capacity to reliably identify immune individuals develops, immunity passports could be appropriately adopted. In such an event, the freedoms these passports confer must be subject to amendments and cancellations, and integrated with other measures, such as contact tracing and physical distancing, to keep people safe while maintaining quality of life.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

Opinion: The potential abuses of a coronavirus ‘health passport’ are downright frightening

Published: Aug. 3, 2020 at 2:32 p.m. ET
By Jurica Dujmovic

Western countries should resist tracking apps, even in the name of health and safety


https://www.marketwatch.com/story/the-p ... 2020-08-03


In 2017, Chinese martial artist Xu Xiaodong, aka “Mad Dog,” became well-known after exposing and defeating several martial-arts “masters” in the ring. His opponents claimed to have supernatural powers, and the fraudulence and hypocrisy were too much for Xu to take.

Afterward, he was accused of denigrating Chinese culture and, as a result, his social-credit rating (SCR) was slashed.

The SCR is an invention of the Chinese Communist Party to keep citizens in check. It rewards obedience and conformity. Xu’s rating was downgraded to a point where he couldn’t rent, own property, stay in certain hotels or travel by train or plane. After so much socio-economic pressure, Xu wound up apologizing to the fraudsters and agreed to pay a hefty fine. Soon enough, the government decided to lift the restrictions.

The Chinese government has made strides with modern technology to assert control — facial-recognition systems, analysis of big data and mandatory mobile apps all play roles in keeping citizens in line and erasing individuality.

The advent of COVID-19 accelerated that trend. An official app assigns a color code to each citizen — red for supervised quarantine, yellow for self-quarantine and green for unrestricted movement. That enables the People’s Republic of China (PRC) to restrict the movement and financial activity of its citizens.

Tracking apps enter the West

Such tracking apps would never take hold in the West, right? Fifteen Western countries, including the U.S., are taking the first step. Where could it lead?

COVI-PASS is a “health passport” developed by a British cyber security company.

Let me know if any of this seems familiar:

“The COVI-PASS ... will work using a color system of green, amber, and red to indicate whether the individual has tested positive or negative for COVID-19 and relevant health information.”

The company says COVI-PASS offers “its own medical certificate” or “third-party medical certificates” issued by so-called authorized health entities.

The idea with these health passports is that the movement and access to services should, in the name of safety, be limited for those the app designates as positive. The app will be given authority to whitelist and blacklist individuals based on “its own medical certificate” data and “third-party medical certificates.”

It is likely that the app will inform bystanders if they’re in a vicinity of someone who is labeled “positive,” so they can avoid or report him or her to the authorities. Needless to say, this individual would be forbidden to leave their home until their status changed and be punished for breaking quarantine.

Medical treatment, other than the one prescribed by the app, could be denied as well (we can’t treat you until you’re “green”). All of this would be based on a promise that the certificate is valid and shows the true state of a person’s health.

Government authority

The next step could be using the same system to track other personal data — a person’s criminal record and social-media profile. And then all the information could be integrated into one online database that contains the entire personal history of every citizen — in the name of safety, of course. Then let’s give the government the authority to do what it wants with that data.

We all know security a loosely defined term. While I’m all for staying healthy and safe, we humans are more than capable of protecting ourselves with the help of existing health-care systems and without the absolute rule of external mechanisms — especially those that could lead to a loss of personal freedom, as is already evident in China.

This crucial first step must be met with resolute resistance, lest it becomes a gateway to something that we, as a society, will no longer be able to defend ourselves from.

If that happens, COVID-19 will be the least of our concerns.

Jurica Dujmovic is a MarketWatch columnist.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

Irish-based ROQU Group launches world-first 'Health Passport' digital platform to support increased global COVID-19 testing

Aug 28, 2020, 01:00 ET


https://www.prnewswire.com/news-release ... 20037.html


World-first technology developed by ROQU Group to protect society, economy, and jobs

- Irish trial commences with national partners in healthcare, agriculture, education, childcare, logistics, entertainment, and other sectors

- Irish-engineered digital platform, in partnership with advanced diagnostics, delivers test results within 15 minutes, allowing businesses to operate in a safely controlled environment

DUBLIN, Aug. 28, 2020 /PRNewswire/ -- The Irish-based ROQU Group has announced the pilot launch of Health Passport, a world-first digital platform designed to facilitate increased COVID-19 testing for businesses and the public.

Engineered in Ireland, the platform combines the latest digital technologies with highly accurate and validated COVID-19 testing solutions, delivering results in as little as 15 minutes. The platform will enable businesses and individuals to quickly minimise risks related to COVID-19 and ensure they can continue daily activities.

Health Passport is launching with a trial involving a select range of national participants representing a diverse range of industry sectors: healthcare (hospital, nursing home), logistics, agriculture, education, childcare, entertainment, and others.

Supporting businesses, protecting communities

The platform has been developed to help national economies by enabling businesses to remain open through continuous proactive testing of employees, identifying positive results at the earliest stage whilst simultaneously protecting communities by offering increased testing.

"Around the world, there is continued frustration and disappointment due to COVID-19 restrictions," said Robert Quirke, President and CEO of ROQU Group, at today's launch.

"Health Passport is designed to put a safety net in place where none currently exists, allowing economies to recover and thrive in a controlled environment," said Mr Quirke. "It is a world-first innovation, proudly engineered in Ireland to the highest standards, that will enable business and society to finally move forward. The game changer has finally arrived."

Works with all official COVID-19 tests

Health Passport has been developed specifically to work in harmony with all official COVID-19 tests, including laboratory swab and blood tests, and the very latest rapid testing solutions soon to be launched.

"Using our global visibility, we are helping local companies by making the best COVID-19 testing solutions readily available to all," said ROQU's Robert Quirke. "As testing and research continues to improve, we want to ensure that Irish society and economy can easily access testing solutions that offer the highest levels of clinical validation.

"The purpose of the pilot trial is to demonstrate how Health Passport works across a variety of real-life business and social scenarios," he added.

Amid calls for increased testing for the public, ROQU says that newly engineered rapid tests can provide the solution needed to stop the spread of the virus. Where no testing solution is already in place, Health Passport is providing the very latest rapid antibody blood tests and rapid antigen swab tests, which deliver a highly accurate diagnosis in less than 15 minutes. The testing solutions are engineered, manufactured, and clinically validated in Europe.

"Current situation not sustainable"

"We are all aware that the current situation regarding viral outbreaks in businesses and communities is simply not sustainable," said Robert Quirke. "There are too many gaps in the current testing system that are hindering our ability to get the economy and normal life back on track. It is time to immediately close those gaps.

"This platform provides the breakthrough we have been waiting for and can become the standard solution for business, travel, education, healthcare, events and all aspects of daily life," said Mr Quirke. "Every person on the Health Passport platform now represents one life and one job protected."

ROQU Group has announced that, in addition to Ireland, the Health Passport platform will be launched in the US, UK, Italy, Kenya and Germany, with other locations to follow. Health Passport has been developed as part of ROQU's international philanthropic and altruistic mission.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

Health Passports Fast Track Past the Hype

8/20/20


https://www.informationweek.com/strateg ... id/1338706?


With the COVID-19 pandemic triggering innovation, some emerging technologies are being implemented now, even as most emerging tech takes 5 to 10 years before hitting that plateau of productivity.

Every year brings a new set of hyped technologies. It often seems like everyone is talking about them, even if we don't all understand just what they are or what they do. For instance, in recent years everyone was talking about blockchain, even as there were very few in-production examples of what it did and how it worked. Yet it seemed that everyone needed to have a blockchain strategy.

The Gartner Hype Cycle for Emerging Technologies tries to categorize emerging technologies like this by where they are on the "hype cycle," a hero's journey for technologies, from the innovation trigger to the peak of inflated expectations, on through the trough of disillusionment to the slope of enlightenment and finally to the plateau of productivity.

In 2010, this Gartner report found that the 4G Standard and cloud computing were at the peak of inflated expectations. Now both of these are mainstream. Enterprises and consumers everywhere use them already and are looking ahead to what's next.

Just in time to answer that question of what's next, Gartner has released its Hype Cycle for Emerging Technologies, 2020, looking more closely at 30 of today's emerging technologies and the five trends they represent. This time around, a few technologies have been triggered and are taking a fast track through the hype cycle with high impact, which is pretty unusual. As you might guess, these technologies have been triggered by the COVID-19 pandemic. They include health passports and social distancing technologies.

Health passports are required for access to public space and public transit in China. Gartner research VP Brian Burke tells InformationWeek this bit of technology can sit on your mobile device and is powered by algorithms to determine your health risk and display it so that you can gain access to public places. That's particularly relevant during a pandemic outbreak. Depending on implementation, it may look at where you've traveled, whether you've been tested for the virus, or who you have come in contact with. China and India use the technology now, but more individualistic western cultures lag behind.

Nonetheless, this technology made its debut this year and is expected to hit that Plateau of Productivity within 2 years.

Social distancing technology, now at the Peak is also expected to reach the Plateau of Productivity within 2 years. This technology can include contact tracing on mobile devices. By providing information about who interacts with whom, such technology can make shutdowns and quarantines most efficient by only impacting the space and people who came in contact and not an entire facility and workforce.

These two technologies, driven by the pandemic, are part of a larger trend of technologies that Gartner is calling Digital Me. This technology is creating digital representations or digital twins of people that can represent us in both digital and physical space. Gartner said other technologies to watch in this area include multi-experience and 2-way brain machine interface.
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Health / Immunity Passports - A Study of The Pros & Cons

Post by trader32176 »

How Digital Health Passports can help Restart the Air Transport Industry

Report by Marta Dimitrova, Editor, Future Travel Experience


https://www.coforgetech.com/resource-li ... t-industry


In recent weeks, the aviation industry has been discussing plans and strategies to ensure safe and secure air travel, once airports and borders open again. While it is still uncertain when restrictions to citizens’ movements will be lifted, the transition from the coronavirus lockdown will require careful management to stop, or at least minimise, the possibility of a further outbreak. One solution that has been widely discussed is the introduction of immunity passports.

During a webinar, hosted by Coforge and APPII last week, industry leaders looked into the efficacy of this technology to enable this swift transition from lockdown for companies in the travel, transportation and hospitality industries.

The right balance between containment and restarting the economy


Coforge has partnered with online verification platform APPII to develop and deploy a digital health passport solution that helps determine and verify the health status of an individual.

Simon Lamkin, Global Head of Travel Advisory at Coforge Limited, opened: “The focus of the lockdown strategy around the globe has been purely containment. As we start thinking about moving again, organisations are developing strategies to restart their operations. We have to get the balance right between containment and opening the doors to restart the economy, in order to get employees safely back to work and develop plans to enable us to get back to travel systems.”

In response to this need, Coforge has partnered with online verification platform APPII to develop and deploy a digital health passport solution that helps determine and verify the health status of an individual. According to Lamkin, the solution has a wide range of postlockdown use cases, from helping workers get back to their workplace to ensuring people can travel safely.

So, what is an immunity passport? The theory of health passports has, indeed, been around for some time. An example of this is the traditional paper-based processes already recognised as the International Certificate of Vaccination, also known as Yellow Fever card.

“The concept is here, and we are now looking into how we can digitise that and bring it to bear,” explains Lamkin. “It will all come down to trust – how individuals can verify that they are safe, and how companies can provide a safe environment for their employees.”

Individuals using APPII can biometrically verify themselves via the APPII mobile app

Gary McKay, Managing Director & Co-founder of online personal verification platform APPII, then provided more detail on how the platform will work. “In context of the coronavirus health status, we are trying to determine how we can verify people’s health status. One way to do that is through self-declaration such as uploading health certificate, or through authorised verification of health.”

Individuals using APPII can biometrically verify themselves via the APPII mobile app, have their coronavirus status catalogued through self-declaration or via an authorised verifier, and therefore prove their health status using their APPII profile to those that require to see it.

Employers will be seeking to manage the transition of employees from the position of working from home back to the workplace. In the context of the aviation industry, digital health passports can be applied to meet rigorous requirements to allow free movement of people.

The feasibility of the concept was then discussed by different participants during the webinar.

Secure and encrypted data

Of course, privacy issues spring to mind when it comes to apps dealing with such sensitive data. According to McKay, the data that is held in the platform is encrypted. “When it comes to the storage of data only the individual gains access to this information and they have full authority on the platform to allow access to this information. One of the key fundamentals for us is to put the control back in the hands of the consumer. We are looking to integrate with third party health care providers but not for putting the data into the platform, but to gain access to that data temporarily for the purposes of the context this individual wants to undertake, whether that’s to get back into employment or joining a workplace or whether it’s a passenger on an aircraft.”

Focusing on privacy issues and GDPR, Bill Buchanan, Professor of Cryptology, Edinburgh Napier University, added: “It’s unbelievable that we still live in a world of paper, so everything we have created since the start of the internet is still a paper-based approach. We really need to move into 21st century and have some digital credibility.

“The foundation of this world has already been created with the Public Key encryption. The true way to create our digital identity is to have what’s called a PKI – a private key that I keep and store on my phone, which carries my unique identity and then everyone in the world can prove my identity through my public key.”

Abhi Chacko, Head of Commercial & Innovation, Gatwick Airport, offered his personal opinion and also backed the viability of such digital solutions. However, he pointed out that in the UK there is already a capacity problem in testing both in public and private labs. “We will have to overcome this hurdle first, before testing becomes available for the travelling public. But I do see four to five months down the line that there should be enough testing capacity which then can be used for the travelling public. For things like health passports becoming viable, for instance, the government or the airlines can introduce a rule in which you should be tested 24 hours before travel, or you should have your immunity which is valid for six months or one year. And that information needs to be passed on to the airline and airport system before we can allow passengers to go through.”

He continued: “That’s where technologies like these will really help, otherwise we will have to go back to printed documents and in addition to the passport you will have to carry one or two additional immunity test results as well, and that would have to be physically checked by the airport or airline staff. So, the concept is good, and it is likely to become viable four to five months down the line when testing becomes available.”

Social distancing at airports is impractical

Joining the panel were Simon Lamkin, Global Head of Travel Advisory at Coforge Limited; Bill Buchanan, Professor of Cryptology, Edinburgh Napier University; Gary McKay, Managing Director & Co-founder, APPII; Abhi Chacko, Head of Commercial & Innovation, Gatwick Airport; and Shashank Nigam, CEO, Simplifying.

Chacko also took the opportunity to provide some examples of the solutions that the industry is exploring to ensure a safe airport experience. Among the technologies are temperature screening, however, he pointed out that in order to implement this, there has to be further legislation because of GDPR restrictions. Deploying robotics for cleaning, particularly floor cleaning for disinfection and using ultraviolet light technology to disinfect hand luggage trays, as well as the handrails of the travelators, are also options. At the high touch security area, antibacterial coating may be useful to kill the virus on surfaces.

In terms of social distancing, Chacko said: “Looking at this from an industry perspective, it is a bit impractical to have social distancing in the airport environment, so my preference is to see people wearing masks, so that they protect themselves as well as others. But in some places where we can all reduce queues and bring an orderly process, we would do that with the help of technology. For example, at Gatwick Airport for boarding we have come up with a concept called Bingo Boarding, which displays the boarding sequence by seat and people can walk to the jet bridge at the appropriate time as displayed on the screen. We provide the software platform, which can easily be integrated into an airline app, and it can also take the data from the airline in terms of passenger information and which groups can be boarded together.”

Consistency will build confidence


Shashank Nigam, CEO, Simplifying, spoke from an airline passenger perspective and agreed that health passports will give passengers an opportunity to skip the health checks that are likely to become mandatory at airports.

Having a health passport will allow passengers to skip all of those checks and get to board faster and arrive at the airport later.

However, Nigam pointed out that the real issue is inconsistencies between countries and this is what governments, airlines and regulators will have to address to build the confidence to bring the passengers back. Indeed, in his recent report, titled The Rise of Sanitised Travel, Nigam describes how he expects to see post-COVID-19 travel to be guided by a Transport Health Authority (THA), just like 9/11 led to the creation of the Transportation Security Administration (TSA) in the United States.

During the webinar he explained: “We need governments to work together to create a consistent standard. Let’s look back to 9/11 – two months after 9/11, the TSA was created with a budget of one billion dollars. The very next year its budget rose to $4.8 billion, and all of this was to ensure that people are safe. We have a similar need right now.”

He continued: “Everything from disinfection tunnels on the kerbside, to having bags being sanitised, to simplifying the boarding process with individual notifications as to when people are boarding – all of that will be critical. And of course, the standards are different from country to country, but we need these standards to be the same. Consistency will build confidence.”

Echoing Nigam’s comment, Chacko also said: “Personally, I feel like there could be more guidance coming from the likes of ICAO or IATA on travel. Different countries, airports and airlines are currently experimenting with different solutions. Now is the time to have some sort of common guidelines so that everyone can be aligned around aviation travel requirements.”

Discussions around the need for immunity passports will certainly continue to take place in the next few months. In the short-term, the solution could prove instrumental to getting employees back to work and bringing back passenger confidence when travelling. What is certain is that there needs to be more legislation and common guidelines put in place to create a consistent and smooth passenger experience.
Post Reply