Saturday , September 25 2021

Hungary and Iceland adopt “immunity passports”. Why is not the rest of the world?



(CNN) – Hungarian borders are not always the friendliest place for foreigners with miles of barbed wire and electric fences along the border and open government hostility towards migrants.

It is during normal times. In the midst of the pandemic, Hungary has closed its doors to almost everyone, including its European neighbors.

If they have not had Covid-19.

This is not the place you can expect to find such a new exemption from otherwise strict entry rules.

The policy, which came into force in early September, opens the door for visitors who can prove that they have recovered from Covid-19 – evidence of both a positive and negative test over the past six months.

Iceland has plans for a similar policy starting next week – and it already gives citizens who have previously been infected permission to ignore the nationwide worm mandate.

Experts call this type of policy a kind of “immunity pass”. But does beating the virus give you immunity? The evidence so far suggests that for most people it does.

“It is indeed theoretically possible that some people who do not have antibodies may not be protected,” Dr. Ania Wajnberg told CNN outside her lab at Mount Sinai Hospital’s Icahn School of Medicine in New York.

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

Reopens society

Hungary has not revealed any results of its Covid border strategy.

Hungary has not revealed any results of its Covid border strategy.

Orsi Ajpek / Getty Images

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

So the risk that someone who enters Hungary according to this policy can become infected or infect others is low, she says. Although science has not fully determined the duration of immunity, there have been only a handful of documented cases of re-infection.

“This can be a reasonable way to start resuming society and enabling travel and business,” she says.

Iceland’s foremost epidemiologist Thorolfur Gudnason has reached the same conclusion based on the country’s own data and studies abroad.

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

Testing and quarantine exemption at the border will begin on 10 December. The North Atlantic Tourist Magnet accepts documented evidence of a positive polymerase chain reaction (PCR) test that is 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.

Thorolfur says that Icelanders who have contracted the virus are also exempt from the nationwide worm mandate with a letter from their doctor – although he says that most people still carry them due to social stigma. He has never heard of anyone being deliberately 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 contracted the infection. Why should they not be allowed to travel freely?” he said. “I think it’s a matter of justice, basically. If you have the medical condition that you do not spread or have the virus, you are not a risk to the environment, then you should be recognized for it.”

Covid spikrisk

Iceland allows quarantine-free entry for people who can prove that they have had Covid.

Iceland allows quarantine-free entry for people who can prove that they have had Covid.

Shutterstock

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

Thorolfur did not know about Hungary’s policy.

The Central European country has, in principle, nothing to say about success or failure with its unique exception, what science it is based on and how it weighed the pros and cons.

The Hungarian government rejected interview requests and sent only a statement describing the policy itself. Many of the experts contacted by CNN were not aware that it was in place. It has not been widely discussed in Hungary either.

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

On Thursday, the WHO confirmed that it has not changed its position, but regional adviser Dr Siddhartha Sankar Datta said it wanted to help countries implement electronic vaccination certificates. Other experts have also raised concerns about immunity passes.

“I think the worst case scenario is that you see an increase in cases that happen because people are encouraged to try to get Covid to show immunity,” said Carmel Shachar, a Harvard University bioethics and health law expert, CNN.

“Suddenly you would see people not wearing masks, not respecting social distancing, because they want Covid. Especially if more and more countries adopt a similar system.”

Experts in several leading medical journals have also warned that immunity passes can stimulate otherwise healthy people to consciously search for infection.

It is unclear if anyone was actually intentionally infected to enter Hungary, but University of Oxford label Rebecca Brown has a hard time believing.

“It would be an extreme thing to do. And I think most people would not,” she says, explaining that Covid-19 can have long-lasting effects even in some young, healthy people. people.

‘A bad idea’

Hungary has closed its borders to most of Europe.

Hungary has closed its borders to most of Europe.

Orsi Ajpek / Getty Images

Shachar also claims that “immunity passes” could potentially reward careless people who become infected after ignoring the Covid rules or weakening medical integrity.

“The more information you need to post there, the more normalized it is to intrude on people’s privacy,” she argues.

Harvard bioethicist Natalie Kofler is blunt in her opposition to immunity passes. “It’s a bad idea,” she says.

Kofler says they can exacerbate existing inequalities.

“If you’ve had [the virus] previously it was not like a vaccine from an ethical point of view. This is because you must be healthy enough, privileged enough to get the health care you may have needed and rich enough to get the tests you may have needed to survive the virus, she says.

Oxford’s Brown wrote an essay examining the pros and cons of immunity passes, which ultimately argue that the potential benefits outweigh the disadvantages.

“Many people who are worried about immunity passes have not really put forward many suggestions on how we can solve the difficulties and they do not look insurmountable. It seems that there are ways to deal with the problems that may arise,” she says.

‘Positive advantage’

The IATA aviation body wants to introduce vaccination passports to open borders.

The IATA aviation body wants to introduce vaccination passports to open borders.

STR / AFP via Getty Images

Immunity passes can come back into vogue when there is a vaccine. The International Air Transport Association, which represents hundreds of airlines, strives for a secure, digital “travel card” for passengers to show that they have been vaccinated when a shot is available.

The CEO of the Australian airline Qantas, Alan Joyce, has already suggested that passengers in the future must prove that they have been vaccinated in order to board.

Brown believes that those who have recovered from the virus should be treated in the same way as those who have received the vaccine. Even skeptical Shachar is cautiously open to the idea.

“There is actually a positive benefit to treating them the same way. We do not want to waste vaccine doses, it will be a while before we have enough vaccines for absolutely all the people on the planet,” she says.

Asked whether those who have recovered from the virus should be placed on the back of the vaccine line, Wajnberg says that in theory it is a good idea. In practice, she says that it would require the same exact high-quality ELISA tests that she uses in her laboratory to be rolled out on a large scale.

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

Neil Bennett, Christian Streib, Oscar Featherstone Bálint Bárdi, David Allbritton and Adrian Divirgilio contributed to this report


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