Special Briefing: What Happens If Having COVID-19 Doesn’t Give You Immunity?
WHY YOU SHOULD CARE
Even as some countries prepare “immunity passports,” it’s not clear post-infection protection is all it’s cracked up to be.
By Fiona Zublin
This is an OZY Special Briefing, an extension of the Presidential Daily Brief. The Special Briefing tells you what you need to know about an important issue, individual or story that is making news. Each one serves up an interesting selection of facts, opinions, images and videos in order to catch you up and vault you ahead.
WHAT TO KNOW
What’s happening? Everyone wants some protection from COVID-19 and a way to reopen economies, and at first glance, the idea of immunity to the disease seems to offer both. Resistance — which people develop to many diseases after having them — would mean a relatively invulnerable population being armed with documents dubbed “immunity passports.” Those with them could start working and buying in a fairly normal way long before a vaccine arrives. But it’s not at all clear that such immunity follows a coronavirus infection, and rushing to that conclusion could be dangerous.
Why does it matter? These immunity documents could end up spawning a fresh health crisis, while deepening inequality. Scientific authorities like the WHO say there’s no evidence that you’re immune to the coronavirus once you’ve been infected. Given the inaccuracy of some antibody tests, false promises of immunity could prompt people with certification to take risks they shouldn’t. And if they pick up the virus again, they could rapidly spread it to others who mistakenly feel safe in the presence of those who’ve been cleared. At the same time, immunity passports, proposed by the U.K. and Chile, threaten to create a new set of haves and have-nots — from those able to work and provide for their families through to those who find themselves untouchable. That might create an incentive for people to deliberately get infected, or fake documents.
HOW TO THINK ABOUT IT
The power of knowledge. While the idea of immunity is appealing — Dr. Anthony Fauci, U.S. infectious diseases guru, cautiously said last month that such tests “might have merit” — even governments that were initially most gung-ho about its promise have since pulled back. Chilean officials now say that the medical discharge certificates they plan to issue to COVID-19 survivors won’t necessarily prove holders are immune to the virus. The U.K., meanwhile, had to pull back on its immunity certificate plan when the tests it bought proved unreliable. But better antibody tests — like the Roche screenings recently approved by the FDA — could put governments in a bind: Is getting people back to work worth the risk of trusting potentially unreliable immunity claims?
Ain’t no party. In late March, the Federalist published an editorial exhorting young, healthy people to deliberately infect themselves with the virus to create what it called herd immunity. That’s a bad idea for a lot of reasons, not least because young, healthy people are being killed by COVID-19 too, and public health experts called it out at the time. But concerns linger that immunity certificates could encourage new-age “pox parties” — where people have deliberately exposed themselves to viruses in the hope of building immunity against measles, chicken pox and other diseases. Washington state officials scolded people this week for what they said were such gatherings created for people to catch the coronavirus, though they later walked back that characterization.
How many COVIDs? While a recent viral study found that there’s at least one significant new strain of COVID-19, scientists say it’s not at all clear that’s the case — and that while like all viruses, this one mutates, that doesn’t mean it’s creating whole different strains that will require new vaccines like the flu does. Still, some see a future where instead of developing immunity to this coronavirus, we fight a new version of this battle every year (again, as we do with the flu).
Anti-vax boost. Science still hasn’t determined how long COVID-19 immunity lasts or if it’s strong enough to make a difference. It may turn out that a vaccine (still months or even years away) is the only definitive answer. But by giving an official stamp of approval to past infections as an alternative route to immunity — which is what immunity certificates would do — governments risk playing into the narrative of anti-vaccine movements that insist inoculations aren’t necessary to protect yourself against a disease. That could set the stage for a public health nightmare even once a vaccine is available.
WHAT TO READ
What COVID-19 Antibody Tests Can and Cannot Tell Us, by Stacey McKenna in Scientific American
“Overestimates of COVID-19’s spread could lead to underestimates of fatality and hospitalization rates — or excessive confidence about herd immunity.”
Should People Without Coronavirus Antibodies Be Second-Class Citizens? by Kenneth Roth and Annie Sparrow in the New York Times
“It’s too easy to imagine antibody tests becoming a new form of discrimination: Employers might insist on antibody certificates simply to minimize absenteeism or medical costs among their workers; employees might find it easier to work with colleagues who have antibody certificates rather than to continue with face masks and social distancing.”
WHAT TO WATCH
An Update on COVID-19 Immunity with Arturo Casadevall
“The coronavirus is … capable of relatively rapid mutation, but it is not in the same league as HIV or influenza.”
Watch on the Johns Hopkins Bloomberg School of Public Health YouTube channel:
Understanding Immunity’s Role in the Coronavirus Pandemic
“Our big concern is: Can we get this viral infection again? And the answer is we simply don’t know.”
Watch on CBS News on YouTube:
WHAT TO SAY AT THE WATERCOOLER
Who was that masked man? Kentucky Sen. Rand Paul is the only member of the upper house so far to have tested positive for COVID-19. He is also a doctor and refuses to wear a mask, telling reporters, “I have immunity” — but unless he has access to data the rest of the world is still lacking, he can’t know that.