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