We are in new era with the affect of Covid 19 and we feel it all over the world. Incentives and aid packages offered in efforts to reduce the negative impact of the crisis on countrys’ economies during this period, many ideas are proposed to provide smooth return to normal life and revive the economy as soon as possible. Issuance of immunity certificates has been on the agenda of some countries to certify persons deemed safe to return to normal life.
In this respect, it is said that start-up companies have been competing with each other in developing Covid-19 immunity certificates/passports. According to the article published in the Financial Times[1], technology companies aim to develop digital identity systems that certify people who are immune to the virus so that these people could return to normal life. In Turkey, the Ministry of Health developed "HES" code system in Turkey in recent days and it consists of a code system that have to be used for travels in and from Turkey and is used as a kind of health certification system.
- Immunity Certificates in the World
There are discussions in some countries whether people who got a blood test and have Covid-19 antibody in their blood must be given immunity certificates so that they may return to work. It is also stated that people who have had Covid-19 will have a blood test only if they have explicit consent, but they will try to be persuaded to have a blood test.
German researchers first suggested that people can be tested, and as a result of this test, people who have Covid-19 antibodies in their blood (i.e., those who had Covid-19 and recovered) can get an “immunity certificate”. Thus, these people will be able to normalize economic life without being hindered by measures.[2] As of the end of April, it is declared that antibody tests have been carried out nationwide in Germany[3], but there has not been any news in the immune certificate yet.
It is considered in Great Britain, similar to that in Germany, to issue “immunity certificates” to people who have caught Covid-19 and recovered.[4] In Britain, antibody tests started to be performed to 20,000 people at the first stage.[5] Although there is no definitive scientific data yet, it is estimated that the recovered people are immune to Covid-19 for at least 2-3 months and at most 2-3 years.
Likewise, in Italy, it is planned to give a “Covid-pass” document to people with Covid-19 antibodies in their blood, and this will enable them to return to work life free from restrictions. Blood sampling and antibody testing from 100,000 people, primarily from healthcare workers and public officials, in the Veneto region of Italy, is planned. Guliano Martini, the governor of the Vo city in the Veneto region, said that those who do not want to participate in the blood test will be visited and persuaded.[6]In Italy, antibody tests have been started to cover 150,000 people, especially in the areas most affected by Covid-19.[7]
In the USA, similarly, it is discussed to ensure that those who are caught and recovered by Covid-19 are given a “certified recovered” certificate and that they return to work life. However, it is stated that no one can be forced to take a test and only those who test with their consent will receive this document. According to the "U.S. Equal Employment Opportunity Commission", giving priority to "certified recovered" people in recruitment is not a discrimination against uninfected people. On the other hand, New York Governor Andrew M. Cuomo said that they had developed a strategy allowing young people and people who had Covid-19 to return to their jobs.[8]
Chile, on the other hand, seems to be the first country to issue immunity certificates to people who have had Covid-19 and recovered. The Chilean government announced in its statement on April 20 that work on the issuance of immunity certificates was initiated, and those who had Covid-19 and recovered would return to economic life as soon as possible.[9]
On the other hand, many private organizations have begun to develop applications and software that are claimed to be safe in which immune certificates can be securely issued and that there will be no problems with data protection.[10]
- Possible Problems that Immunity Certificates May Create
First of all, the most important problem with immunity certificates is whether people recovered from Covid-19 and have antibodies in their blood really have immunity to Covid-19. Indeed, the World Health Organization said in a statement on April 24[11] that there is no scientific evidence that people who had recovered from Covid-19 and had antibodies in their blood had immunity to Covid-19.
Also, it is not known how long people who have had Covid-19, if any, have immunity against this disease. Although it is said that people won’t be reinfected for 2-3 years at best and 2-3 months at worst, new cases that have been reported in Italy, China and South Korea among people who had Covid-19 beforehand. For this reason, it is stated that starting such an application without proving whether someone who has had Covid-19 has immunity and how long they will have immunity may cause the second wave of the virus.
It is also foreseen that counterfeit tests and counterfeit certificates will begin to be sold on the black market and tests may be misused.
On the other hand, those who are caught with Covid-19 because they do not comply with the precautions taken will be able to get a certificate and return to their professional lives, while those who do not comply with the measures will remain in their homes and thus face discrimination. Employers may also tend to hire people with certificates, and this may also lead to legal disputes.
Where and how the health data of individuals who have taken antibody tests or certificates will be stored and how they are protected, how digital immunity certification programs can also comply with the rules of information security and protection of personal data, and how frame applications can be developed to use or store this data are the main issues to be taken into account to ensure compliance with laws.
Turkey’s Plan on the Subject
In Turkey, granting certificates to people who had Covid-19 and have antibodies in the blood has not yet come up. On the other hand, the Ministry of Culture and Tourism has announced the necessary conditions to give “Healthy Tourism Certificate” to the touristic facilities that fulfill the high-level health and hygiene conditions.[12]
The Healthy Tourism Certification program is gathered under 4 main headings: “Passenger health and safety”, “Employee health and safety”, “Measures taken in facilities” and “Measures taken in transportation vehicles”.[13] As of 01 June 2020, the Ministry of Culture and Tourism announces the facilities that have obtained this certification and the ones which are in the evaluation process on the Ministry's website.
The issuance of a certificate of this nature related to tourism facilities came to the agenda also in Spain, and hoteliers' associations announced that they would issue this certificate for free. The issuance of a certificate of this nature to tourist facilities is also on the agenda in countries such as Greece, Tunisia and Thailand.[14]
On the other hand, some foreign tourism companies plan to organize private tours to some countries, including Turkey. As part of these tour packages, it is stated that the guests will travel with the private plane of the tourism company, they will stay in the hotels chosen by the tourism company or the tourism company has the ownership, and Covid-19 tests will be carried out at all guests and crew airports.
The "HES" code, on the other hand, is defined as a code that allows you to securely share whether you carry any risks for Covid-19 disease for transportation purposes or interaction with institutions and other people within the scope of Controlled Social Life. Using the HES code has also became mandatory for all internal flights in Turkey and for international flights departing Turkey.
- Conclusion
Based on the above statements, the following conclusions have been reached:
- It is seen that the idea of giving immunity certificates to people who recovered from Covid-19 and have antibodies in their blood has been discussed in many countries of the world and antibody tests have started in some countries, and studies have been initiated to grant such certificates in some countries.
- However, many concerns have been raised about the immune certificate. Especially in the statement made by the World Health Organization; It is stated that there is no scientific evidence that people who had recovered from Covid-19 and who have antibodies in their blood will not be infected again.
- In Turkey, rather than issuing immunity certificates to people, granting Healthy Tourism Certificate to touristic facilities who meet certain criteria is on the agenda. However, the published rules seem to consist of detailed hygiene rules and do not contain any test / control condition. It may also come to the agenda that hotels take more precautions after they receive this certificate. These measures may include regular health check or test practices and checking the daily health of guests. In such cases, further attention must be paid to the principles of personal data protection.
- Turkey’s HES code system does not require people to take antibody test. This code only allows travel and transportation companies to question whether there is an up-to-date risk related to the person through the Ministry of Health services. If there is a risk reported by the Ministry of Health within the scope of the inquiry received, the travel will not be confirmed. Therefore, if the person has not applied to medical institutions with any complaints or if they have not been recorded by the healthcare institutions where he/she has previously had contact with a sick person, the person will not be prevented from traveling. Nevertheless, this code will be used to trace and inform those who have been in contact with a risky individual, who has been evaluated to be risk-free during and before the travel by the Ministry of Health.
[1] https://on.ft.com/2XzMbvV
[2] https://www.newsweek.com/germany-antibodies-tests-general-public-immunity-certificates-1494934
[3] https://www.businessinsider.com/germany-covid-19-antibody-testing-nationwide-2020-4?IR=T
[4] https://economictimes.indiatimes.com/news/politics-and-nation/immunity-certificates-the-passport-to-a-new-life-after-coronavirus/articleshow/74963050.cms
[5] https://www.gov.uk/government/news/government-begins-large-scale-virus-infection-and-antibody-test-study
[6] https://www.nytimes.com/2020/04/04/world/europe/italy-coronavirus-antibodies.html
[7] https://www.reuters.com/article/us-health-coronavirus-italy-testing/lombardy-becomes-latest-italian-region-to-start-own-coronavirus-tests-idUSKCN2251YH
[8] https://www.statnews.com/2020/04/06/the-certified-recovered-from-covid-19-could-lead-the-economic-recovery/
[9] https://www.washingtonpost.com/world/the_americas/chile-coronavirus-immunity-passport-antibody-testing-card/2020/04/20/8daef326-826d-11ea-81a3-9690c9881111_story.html
[10] https://www.coindesk.com/covid-19-immunity-passport-unites-60-firms-on-self-sovereign-id-project https://finance.yahoo.com/news/bizagi-launches-coronapass-support-covid-120010201.html https://medium.com/chiliz/chiliz-announce-socios-pass-a-covid-19-immunity-community-initiative-to-support-the-return-of-d797d48e4cb9
https://www.biospace.com/article/releases/centogene-and-ubirch-create-secure-blockchain-solution-for-the-successful-fight-against-covid-19/
https://www.inkworldmagazine.com/contents/view_Content-microsite/2020-04-20/sicpa-covid-19-secured-immunity-passport/
[11] https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19
[12] https://www.tga.gov.tr/sertifika-hakkinda-bilgi/
[13] https://www.tga.gov.tr/wp-content/uploads/2020/05/tesislerdeAlinanOnlemler.pdf
[14] http://www.turizmgazetesi.com/news.aspx?id=90264
First published by Dünya Gazetesi in Jun 15, 2020.