Sunday , July 25 2021

Hungary and Iceland accept “immunity passports”. Why isn’t the rest of the world?

(CNN) – With miles of barbed wire and electric fencing along the border and the government’s open hostility to migrants, Hungary’s borders are not always the most friendly place for foreigners.

It is in normal periods. Amid the pandemic, Hungary has closed its doors to almost everyone, even its European neighbors.

Except, they had Covid-19.

This is not where you would expect to find such a Romanian exception to the otherwise difficult entry rules.

The policy, which went into effect in early September, opens the door to visitors who can provide evidence that they have recovered from Covid-19 – evidence of a positive and negative test over the past six months.

Iceland has plans for a similar policy starting next week – and it already gives previously infected citizens permission to ignore the mask mandate across the country.

Experts call these types of policies a kind of “passport to immunity.” But does beating the virus really give you immunity? Evidence so far suggests that for most people, it does.

“It’s certainly theoretically possible that some people, even those with antibodies, can’t be protected,” Dr. Ania Weinberg told CNN in front of her lab at Ican Medical School at Mount Sinai Hospital in New York.

“But I think the majority of people who test positive for antibodies will be protected for a while.”

Reopening of society

Hungary does not disclose any results of its Covid border strategy.

Hungary does not disclose any results of its Covid border strategy.

Orsay Apek / Getty Images

Weinberg is conducting a mass study of more than 30,000 people who have had mild to moderate cases of Covid-19. Her latest study, published in October, found that more than 90% of people have enough antibodies to kill the virus many months after infection, perhaps longer.

So the risk of someone entering Hungary under this policy being re-infected or infecting others is small, she said. Although science has not completely resolved how long immunity lasts, there are only a few documented cases of reinfection.

“This can be a reasonable way to start reopening society and allowing travel and business,” she said.

Icelandic chief epidemiologist Torolfur Gudnason has come to the same conclusion based on data from his country and foreign studies.

“I think it’s pretty safe. I mean, everything we do has uncertainty with it. Nothing is 100%,” he told CNN.

Testing and quarantine at the border begin on December 10. The North Atlantic Tourism Magnet will accept documented evidence of a positive polymerase chain reaction (PCR) test at least 14 days old, or an enzyme-linked immunosorbent assay (ELISA) test that measures antibody levels – provided it is issued by an approved European laboratory.

Torolfur says Icelanders who have beaten the virus have also been exempted from the nationwide mask mandate in a letter from their doctor – although he says most people wear them anyway because of social stigma. He has never heard of anyone intentionally becoming infected, especially with a vaccine coming soon.

“It is possible. But on the other hand, I think it is also unfair for people who have had an infection. Why should they not be allowed to travel freely?” he said. “I think it’s about justice, basically. If you have a health condition not to spread or you have a virus, you are not a risk to the environment, then you need to be somehow recognized for that.”

Risk of caviar jump

Iceland allows quarantine entry to people who can prove they had Covid.

Iceland allows quarantine entry to people who can prove they had Covid.


Iceland is also talking to other Nordic countries – Sweden, Denmark, Finland and Norway – so that people with that freedom can travel freely without restrictions. Although Torolfur says the talks have not gone far – he does not expect other countries to follow Iceland’s lead.

Torolfur was unaware of Hungary’s policy.

The country of Central Europe had virtually nothing to say about the success or failure of its unique exemption, on what science it is based, and how it measures its pros and cons.

The Hungarian government rejected the interview requests and sent only a statement describing the policy itself. Many of the experts who arrived at CNN were unaware that this was the case. It was not widely discussed in Hungary either.

The World Health Organization (WHO) advised against passports for immunity in April. “There is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection,” his scientific brief said.

On Thursday, the WHO confirmed that it had not changed its position, but regional adviser Dr Siddhartha Sankar Data said he wanted to help countries implement electronic vaccination certificates. Other experts have also expressed concern about passports for immunity.

“I think the worst-case scenario is to see a jump in cases that happen because people are stimulated to try to get Covid to demonstrate immunity,” Carmel Sachar, a bioethics and health law expert at Harvard University, told CNN. .

“So, suddenly, you will see people who do not wear masks, do not respect social distance, because they want to get Covid. “Especially if more and more countries are adopting a similar scheme.”

Experts in several leading medical journals also warn that immunity passports can encourage otherwise healthy people to deliberately seek infection.

It is not clear if anyone really got infected intentionally to enter Hungary, but Oxford University ethicist Rebecca Brown is hard to believe.

“It would be an extreme thing to do. “And I think the vast majority of people probably wouldn’t do that,” she said, explaining that Covid-19 can have long-term effects even on some young, healthy people.

“Bad idea”

Hungary has closed its borders to most of Europe.

Hungary has closed its borders to most of Europe.

Orsay Apek / Getty Images

Sachar also argues that “immunity passports” could potentially reward reckless people who become infected after ignoring Covid’s rules or violating private medical care.

“The more information you need to publish, the more normal it is to invade people’s privacy,” she said.

Harvard bioethicist Natalie Kofler has been outspoken in her opposition to passports for immunity. “It’s a bad idea,” she said.

Kofler says they can exacerbate existing inequalities.

“If you had [the virus] rather, it is not like a vaccine from an ethical point of view. “It’s because you had to be healthy enough, privileged enough to get the health care you might need and rich enough to get the testing you might need to survive the virus.”

Brown from Oxford wrote a paper examining the pros and cons of immune passports, which ultimately argues that the potential benefits outweigh the disadvantages.

“Many people who are concerned about passports for immunity have not really made many suggestions on how we can solve the difficulties and they do not seem insurmountable. “There seem to be ways we can deal with the kinds of problems that can arise,” she said.

“Positive benefit”

The IATA airline wants to introduce vaccination passports to open the borders.

The IATA airline wants to introduce vaccination passports to open the borders.

STR / AFP via Getty Images

Immunity passports can be returned to fashion once the vaccine is available. The International Air Transport Association, which represents hundreds of airlines, is pushing for a secure, digital “road map” for passengers to show proof of vaccination once a shot is available.

The CEO of the Australian airline “Cantas”, Alan Ooys, has already suggested that in the future, passengers will have to prove that they were vaccinated in order to board.

Brown argues that those who have recovered from the virus should be treated the same as those who developed the vaccine. Even the skeptical Shahar is cautiously open to the idea.

“In fact, there are positive benefits to treating them. We do not want to waste doses of vaccines, it will be some time before we have enough vaccines for absolutely every person on the planet,” she said.

Asked if those who have recovered from the virus should be placed on the back of the vaccine line, Weinberg said it was a good idea in theory. In practice, she says, the same accurate, high-quality ELISA tests she uses in her lab will be needed to make them widely available.

“It may make sense … not to vaccinate people with very high levels of antibodies anymore, but I think it will be very challenging operationally.”

Neil Bennett, Christian Streib, Oscar Federston Balint Bardi, David Albrighton and Adrian Divirgilio

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