The “COVID-19: Updates from Singapore” weekly webinar series is a forum for leading clinicians, scientists, public health officials and policy makers to share insights from their fields of study. The 18th webinar session was held on Thursday 6 August at 7pm.
Dr Voo Teck Chuan, Assistant Professor at the Centre for Biomedical Ethics of the NUS Yong Loo Lin School of Medicine, was this session’s guest speaker. Dr Voo is a member of the steering committee for the Global Forum on Bioethics in Research, focusing on research ethics work conducted in low and middle-income countries. As a member of the World Health Organisation (WHO) Working Group on Ethics and COVID-19, Dr Voo is involved in developing WHO ethics guidance in the area of outbreak emergencies.
Titled The Ethics of Immunity Passports During COVID-19, Dr Voo discussed the concept of immunity passports, the ethical debate around immunity passports and the approaches for their ethical implementation and deployment moving forward. The concept of an immunity passport is inextricably linked to the question of returning to the life we once enjoyed before the pandemic happened, which would revert if a safe and effective vaccine were to be developed. Yet, obtaining a vaccine comes with its own challenges, in addition to the vague possibility of a cure.
The immunity passport serves as a health documentation, certifying individuals as immune or at low-risk of infections so that they can be exempted from restrictive measures. Citing Estonia as an example, Dr Voo mentioned that the Northern European country has already implemented its own digital immunity passport, in the form of an app, where users can download their antibody results to prove that they have reduced risk of spreading the coronavirus. Nonetheless, there are many indeterminate scientific questions from implementing an immunity passport such as the period of protected immunity an individual actually possesses. Ultimately, a successful implementation of immunity passport depends on the accepted threshold of evidence and error in serological testing, and in choosing the option that least infringes on individual liberties. Crucially, liberty restoration, pandemic response and psychological assurance need to be maintained for the well-being of individual and society.
Dr Voo outlined potential problems which may arise when ethical considerations of implementing an immunity passport programme are not properly considered. Firstly, an incentivised immunity passport programme might encourage people to deliberately expose themselves to infection to obtain the passport. There is also the risk for fake immunity passport certification being circulated in the black market. Such a programme could potentially bring about invidious discrimination against racial and ethnic groups and stigma against an uninfected individual. Most importantly, there is a fear that an immunity passport programme might fracture the solidarity of societies and sense of togetherness among people during this pandemic because of the stratification of people into different tiers of privileges and liberties. In addition, he stressed that possession of immunity passports should not be a factor for consideration when it comes to gaining employment, accessing healthcare or voting eligibility.
Dr Voo concluded that prioritising serological testing and immunity certification for essential workers is a practical necessity, which can benefit society as a whole since more manpower and resources can be deployed to provide more social support for the marginalised communities.
WATCH: COVID-19 Updates from Singapore: Webinar 18 | Dr Voo Teck Chuan
Join us next on 13 August 2020 as guest speaker Professor Peter Horby from the University of Oxford will be speaking on “COVID-19 Clinical Trials: From Concept to Results”. Register now at https://medicine.nus.edu.sg/cet/webinar/.
