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COVID-19: Where was it born: China, the United States or Ukania? (At the school of Doctor Rasputin: part 7)

Continued from: COVID-19: Where was it born: China, the United States or Ukania? (At the school of Doctor Rasputin: part 6)

By Outsider

Bill Gates is not known as a great thinker or speaker, but he has the advantage of money – and loads-o-fit! – and of frequent, uninhibited access to television. The viewer has no opportunity to ask him about his past, his parents, his Foundation, his connection with the so-called international elite and – above – all his qualifications  to speak on medical matters.

Because of his wealth, his rank amongst American celebrities, his contacts with the World Economic Forum at Davos-Kloster, his ability promptly to call on Kissinger as his consigliere, hence his feeling of moving in the wake of a Rockefeller, Bill Gates may regard himself as particularly qualified on all subjects under the sun. After all, in today’s world and at today’s ‘values’ “he’s got the money.” He is a modern billionaire. He also has the cunning of appearing as “one of us”, with those pastel sweaters, that ‘ordinary’ grin, that voice sounding more like Kermit the Frog – a straight man, for goodness sake! (D. Broze, Bill Gates’ Web of Dark Money and Influence – Parts 1, 2 and 3 …, 30.05.2020). He might need some improvement there but, hey !, he may appear as an improvement on that other, real, bottomless zillionaire, who lives in that huge big house in London, appears occasionally with her be-medalled once-Teutonic or paleo-Nazi and the coterie of surrounding  parasites to reward the prole with her presence, made more solemn by the customary feudal practices and incantations and occasional rare address – to maintain the glamour, gramarye actually – for the ‘subjects’. They, the ‘subjects’, are very occasionally to be addressed. In her fourth ‘statement’ – one of the four she has given in her 68 year reign – the Monarch who holds the PirBright Institute Golden Share directed herself to people of “the Commonwealth and around the world”, once again strangling the English language in joining “with all nations across the globe in a common endeavour, using the great advances of science and our instinctive compassion to heal.” (Channel 4 News – Queen Elizabeth II tells UK “We will succeed” against corona virus in rare address to the nation, 05.04.2020).

Image from axios.com

Not many of Gates’ viewers would have a chance to have a clarification  on his once-notorious statement that the ideal global population is “the golden billion,” a goal which would require – at present figures – the disappearance of some six to seven  billion people. And: how?

Toward the end of March 2020 Bill Gates called for vaccine certificates as requirement for travel during a conversation with reporter Chris Anderson. Now, Anderson is no ordinary run-of-the-mill journalist. He is a a British-American businessman who is the head of TED, a non-profit organisation which provides idea-based talks and hosts an annual conference in Vancouver, British Columbia, Canada. Previously he founded Future Publishing. An Oxford educated – philosophy, politics and economics – he moved the United States in 1994, where he became a very successful publisher. In 2001, as Curator of TED Talks, he began the activity of the TED Conference, an annual meeting of luminaries in the fields of technology, entertainment and design, held in Monterey, California.

He expanded the conference to cover all topics, including science, culture, academia, and business and key global issues. He added a fellows programme, which now has some 400 alumni. He also established the TED Prize, which grants recipients $1 million to support their “one wish to change the world.” Just Gates’ cup of tea.

At that March Conference Gates said that: “Eventually what we’ll have to have is certificates of who’s a recovered person and who’s a vaccinated person because you don’t want people moving around the world…[without their certificates].”

Gates did not specify who the ‘we’ are, and one is entitled to think that he meant people who moved and move in the grand steps of Kissinger and Rockefeller, who had similar ideas for people ‘outside the circle’, as it were. After all, the Bill & Melinda Gates Foundation, through its funding to the United Nations through G.A.V.I., is one of the world’s largest funders of vaccine programmes in ‘low-income nations’. (B. Shilhavy, Bill Gates Calls for Vaccine Certificates as Requirement for Travel, 28.03.2020). Some in the ‘alternative media’ are beginning to use the term ‘plandemic’ instead of ‘pandemic’ as there is clear evidence that the events now unfolding over COVID-19 have been planned for some time, even before the breakout in Wuhan China late in 2019.

There are several reasons whereby immunity passports are not such a commendable idea. From a broadly philosophical point of view, with reference to human rights, restricting movement on the basis of biology threatens freedom, fairness and public health.

The more elaborate point was made by Natalie Kofler, a trained molecular biologist who lectures in bioethics at Yale University and Harvard Medical School, and is an adviser for the Scientific Citizenship Initiative, at Harvard, Boston, MA and Françoise Elvina Baylis, a professor of philosophy with a specialisation in bioethics at Dalhousie University, Halifax, Nova Scotia, Canada. The illustrious scholars sounded the alarm in an article appearing in Nature: “Ten reasons why immunity passports are a bad idea.”. (Ten reasons why immunity passports are a bad idea, 21.05.2020).

The point is complex and demand a lengthy, technical  explanation.

Here is what they wrote: “Imagine a world where your ability to get a job, housing or a loan depends on passing a blood test. You are confined to your home and locked out of society if you lack certain antibodies.

It has happened before. For most of the nineteenth century, immunity to yellow fever divided people in New Orleans, Louisiana, between the ‘acclimated’ who had survived yellow fever and the ‘unacclimated’, who had not had the disease. (Olivarius, K. Am. Hist. Rev. 124, 425–455 (2019).

Lack of immunity dictated whom people could marry, where they could work, and, for those forced into slavery, how much they were worth. Presumed immunity concentrated political and economic power in the hands of the wealthy elite, and was weaponized to justify white supremacy. [Emphasis added]

Something similar could be our dystopian future if governments introduce ‘immunity passports’ in efforts to reverse the economic catastrophe of the COVID-19 pandemic. The idea is that such certificates would be issued to those who have recovered and tested positive for antibodies to SARS-CoV-2 – the coronavirus that causes the disease. Authorities would lift restrictions on those who are presumed to have immunity, allowing them to return to work, to socialize and to travel. This idea has so many flaws that it is hard to know where to begin.

Show evidence that apps for COVID-19 contact-tracing are secure and effective. On 24 April the World Health Organization cautioned against issuing immunity passports because their accuracy could not be guaranteed. It stated that: “There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection”(see: W.H.O., “Immunity passports” in the context of COVID-19, Scientific Brief, 24 April 2020). Nonetheless, the idea is being floated in the United States, Germany, the United Kingdom and other nations.

China has already introduced virtual health checks, contact tracing and digital QR codes to limit the movement of people. Antibody test results could easily be integrated into this system. And Chile, in a game of semantics, says that it intends to issue ‘medical release certificates’ with three months’ validity to people who have recovered from the disease. (Fraser, B. Lancet 395, 1473 (2020, Chile plans controversial COVID-19 certificates, The Lancet, PDF file, 09.05.2020).

In our view, any documentation that limits individual freedoms on the basis of biology risks becoming a platform for restricting human rights, increasing discrimination and threatening – rather than protecting – public health. [Emphasis added]

Here we present ten reasons why immunity passports won’t, can’t and shouldn’t be allowed to work.

Ten points

Four huge practical problems and six ethical objections add up to one very bad idea.

COVID-19 immunity is a mystery. Recent data (Wajnberg, A. et al. Preprint at medRxiv, Humoral immune response and prolonged PCR positivity in a cohort of 1343 SARS-CoV 2 patients in the New York City region (2020), suggest that a majority of recovered patients produce some antibodies against SARS-CoV-2. But scientists don’t know whether everyone produces enough antibodies to guarantee future protection, what a safe level might be or how long immunity might last. Current estimates, based on immune responses to closely related viruses such as those that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), suggest that recovered individuals could be protected from re-infection for one to two years. But if SARS-CoV-2 immunity instead mimics that seen with the common cold, the protection period could be shorter.

Serological tests are unreliable. [Emphasis added] Tests to measure SARS-CoV-2 antibodies in the blood can be a valuable tool to assess the prevalence and spread of the virus. But they vary widely in quality and efficacy. This has led the WHO and former US Food and Drug Administration commissioner Scott Gottlieb to caution against their use in assessing individual health or immune status. Several available tests are sufficiently accurate, meaning they are validated to have at least 99% specificity and sensitivity. But preliminary data suggest that the vast majority aren’t reliable. (Whitman, J. D. et al. Preprint at medRxiv, Test performance evaluation of SARS-CoV-2 serological assays, (2020). Low specificity means the test measures antibodies other than those that are specific to SARS-CoV-2. This causes false positives, leading people to think they are immune when they aren’t. Low sensitivity means that the test requires a person to have a high concentration of SARS-CoV-2 antibodies for them to be measured effectively. This causes false negatives in people who have few antibodies, leading to potentially immune individuals being incorrectly labelled as not immune.

The volume of testing needed is unfeasible. Tens to hundreds of millions of serological tests would be needed for a national immunity certification programme. [Emphasis added] For example, Germany has a population of nearly 84 million people, so would require at least 168 million serological tests to validate every resident’s COVID-19 immune status at least twice. Two tests per person are the minimum, because anyone who tested negative might later become infected and would need to be retested to be immune certified. Repeat testing, on no less than an annual basis, would be necessary to ensure ongoing immunity. From June, the German government will receive 5 million serological tests a month from the Swiss firm Roche Pharmaceuticals – leading supplier of one SARS-CoV-2 serological test that has been approved by regulators. This will allow only 6% of the German population to be tested each month.

Even if immunity passports were limited to health-care workers, the number of tests required could still be unfeasible. The United States, for example, would need more than 16 million such tests. At the time of writing, the US Centers for Disease Control and Prevention and US public-health laboratories have performed more than 12 million diagnostic tests for SARS-CoV-2. (3 per cent of the total U.S. population; see Testing Data in the U.S., Updated May 29, 2020. Total tests reported: 16,794,182; positive tests reported: 2,012,929; per cent positive: 12 per cent).

Even South Korea, a country with high testing rates, had managed to test only 1.5 per cent of its population by 20 May. (Coronavirus Disease-19, Republic of Korea, Cases in Korea, Confirmed cases: 11,468; released from quarantine: 10,405; quarantined: 793; deceased: 270, see go.nature.com/2aztfvp).

Too few survivors to boost the economy. The proportion of individuals known to have recovered from COVID-19 varies widely in different populations. Reports from hot spots in Germany and the United States suggest some locations could have recovery rates between 14% and 30%. In New York state, for example, where 3,000 people were tested at random in grocery shops and other public locations, 14.9% had antibodies against COVID-19. (see Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces Phase II Results of Antibody Testing Study Show 14.9% of Population Has COVID-19 Antibodies, 27.04.2020).  But these seem to be the exception. In an April press conference, the WHO estimated that only 2–3% of the global population had recovered from the virus.

Low disease prevalence combined with limited testing capacity, not to mention highly unreliable tests, means that only a small fraction of any population would be certified as free to work. [Emphasis added] Based on current numbers of confirmed US cases, for example, only 0.43% of the population would be certified. Such percentages are inconsequential for the economy and for safety. A cafe can’t open and serve customers without risk if only a fraction of its staff are certified as immune. A shop can’t turn a profit if only a minuscule proportion of customers are allowed to enter.

Monitoring erodes privacy. [Emphasis added] The whole point of immunity passports is to control movement. Thus, any strategy for immunity certification must include a system for identification and monitoring. Paper documentation could be vulnerable to forgery. Electronic documentation integrated into a smartphone app would be more resistant to fraud and more effective for contact tracing, retesting and updates of immune status.

But electronic documents present a more serious risk to privacy. (On the responsible use of digital data to tackle the COVID-19 pandemic, Nature Medicine, 27.03.2020, Ienca, M. & Vayena, E. Nature Med. 26, 463–464, 2020). In some Chinese provinces, QR codes on smartphones control entrance into public places on the basis of the individual’s COVID-19 health status. However, these apps report more than COVID-19 information – including people’s locations, travel history, who they’ve come into contact with and other health information, ranging from their body temperature to whether they’ve recently had a cold. Taiwan is also using smartphone apps with alert systems that are directly linked to police departments. The United Kingdom, United States and many other countries are testing various app options. Yet there’s no guarantee that the apps will recede when COVID-19 does. China has announced that elements of its QR-code tracking system are likely to remain in place after the pandemic ends.

Marginalized groups will face more scrutiny. With increased monitoring comes increased policing, and with it higher risks of profiling and potential harms to racial, sexual, religious or other minority groups. Emphasis added] During the pandemic, China has been accused of racially profiling residents by forcing all African nationals to be tested for the virus. In other parts of the world, people from Asia have faced spikes in racialized prejudice.

Before this pandemic, stop-and-frisk laws in the United States already disproportionately affected people of colour. [Emphasis added]  In 2019, 88% of people who were stopped and searched in New York City were African American or Latin American (N.Y.C.L.U., Stop-and-frisk-data, Annual stop-and-frisk numbers. S According to the New York Police Department’s Annual Report for 2019: 13,459 stops were recorded. 8,867 were innocent (66 per cent); 7,981 were Black (59 per cent); 3,869 were Latinx (29 per cent); 1,215 were white (9 per cent) ). And during the pandemic, policing continues to target people from minority groups. Between mid-March and the start of May in Brooklyn, New York, 35 of the 40 people arrested for violating physical distancing laws were black. (A. Southall, Scrutiny of Social-Distance Policing as 35 of 40 Arrested Are Black, The New York Times, 7 May 2020).

Will antibody tests for the coronavirus really change everything? [Emphasis added]

These numbers are deeply concerning, but would be even more so if monitoring and policing for COVID-19 immunity were to be used for ulterior motives. For example, ‘digital incarceration’ has already increased in countries such as the United States, Brazil and Iran, where individuals have been released from prison to minimize the spread of COVID-19 and then monitored using digital ankle bracelets. In the United States, where people of colour are racially segregated by neighbourhood and disproportionately incarcerated, digital incarceration could be used to monitor large segments of certain communities. The risk would be even higher if digital monitoring were to be linked to immigration status.

Unfair access. With a shortage of testing, many will not have access. [Emphasis added] Experience so far suggests that the wealthy and powerful are more likely to obtain a test than the poor and vulnerable. In tiered health-care systems, these inequities are felt even more acutely. In early March, for example, when professional sports teams, technology executives and film celebrities were getting tested, dozens of US states were conducting fewer than 20 tests per day (see The Covid tracking project, Our most up-to-date data and annotations). The very people who need to get back to work most urgently – workers who need to keep a roof over their head and food on the table – are likely to struggle to get an antibody test. Testing children before they return to school could be a low priority, as would testing retired older people and those who face physical, mental-health or cognitive challenges.

Societal stratification. Labelling people on the basis of their COVID-19 status would create a new measure by which to divide the ‘haves’ and the ‘have-nots’ – the immunoprivileged and the immunodeprived. [Emphasis added] Such labelling is particularly concerning in the absence of a free, universally available vaccine. If a vaccine becomes available, then people could choose to opt in and gain immune certification. Without one, stratification would depend on luck, money and personal circumstances. Restricting work, concerts, museums, religious services, restaurants, political polling sites and even health-care centres to COVID-19 survivors would harm and disenfranchise a majority of the population. [Emphasis added]

How do children spread the coronavirus? The science still isn’t clear.

Social and financial inequities would be amplified. For example, employers wanting to avoid workers who are at risk of becoming unwell might privilege current employees who have had the disease, and preferentially hire those with ‘confirmed’ immunity. Immunity passports could also fuel divisions between nations. [Emphasis added] Individuals from countries that are unable or unwilling to implement immunity passport programmes could be barred from travelling to countries that stipulate them. Already people with HIV are subjected to restrictions on entering, living and working in countries with laws that impinge on the rights of those from sexual and gender minorities – such as Russia, Egypt and Singapore.

New forms of discrimination. Platforms for SARS-CoV-2 immune certification could easily be expanded to include other forms of personal health data, such as mental-health records and genetic-test results. The immunity passports of today could become the all-encompassing biological passports of tomorrow. [Emphasis added] These would introduce a new risk for discrimination if employers, insurance companies, law-enforcement officers and others could access private health information for their own benefit. Such concerns have been catalogued over the past few years in debates about who should have access to genetic information, as demand rises from clinicians, researchers, insurers, employers and law enforcers, for example. (Clayton, E. W., Evans, B. J., Hazel, J. W. & Rothstein, M. A., The law of genetic privacy: applications, implications, and limitations J. Law Biosci. 6, 1–36 (2019).

Threats to public health. Immunity passports could create perverse incentives. [Emphasis added] If access to certain social and economic liberties is given only to people who have recovered from COVID-19, then immunity passports could incentivize healthy, non-immune individuals to wilfully seek out infection — putting themselves and others at risk. (Phelan, A. L., COVID-19 immunity passports and vaccination certificates: scientific, equitable, and legal challenges, The Lancet, 2020). Economic hardship could amplify the incentive if an immunity passport is the only way to a pay cheque. Individuals might obtain documents illicitly, through bribery, transfer between individuals or forgery. These could create further health threats, because people laiming immunity could continue to spread the virus. Crises tend to foster nefarious trade, as happened during the Second World War when food rations in Britain caused the emergence of a robust underground exchange system.

Next steps

Strategies that focus on the individual – using conceptions of ethics rooted in libertarianism – contradict the mission of public health. (Baylis, F., Kenny, N. P. & Sherwin, S., A Relational Account of Public Health Ethics, Public Health Ethics, Volume 1, Issue 3, November 2008, Pages 196–209 (2008), Relational Account of Public Health Ethics, 02.06.2008). They distract attention from actions that benefit all, such as funding international collaborations, practising effective public-health measures and redressing income inequity. In North America (and elsewhere), because of structural inequities, people of colour are dying from COVID-19 at much higher rates than are white people, and the virus is disproportionately affecting those who live in First Nations territories. Success depends on solidarity, a genuine appreciation that we are all in this together. An ethic premised on individual autonomy is grossly inappropriate during a public-health crisis; the overarching aim must be to promote the common good.

Instead of immunity passports, we contend that governments and businesses should invest available time, talent and money in two things.

First is the tried and true formula of pandemic damage limitation – test, trace and isolate – that has worked well from Singapore and New Zealand to Guernsey and Hanoi. Health status, personal data and location must be anonymized. Apps that empower individuals to make safe choices about their own movements should be prioritized.

Second is the development, production and global distribution of a vaccine for SARS-CoV-2. If universal, timely, free access to a vaccination becomes possible, then it could be ethically permissible to require vaccine certification for participation in certain activities. But if access to a vaccine is limited in any way, then some of the inequities we highlight could still apply, as the literature on uptake of other vaccines attests. (Bocquier, A., Ward, J., Raude, J., Peretti-Watel, P. & Verger, P. , Socioeconomic Differences in Childhood Vaccination in Developed Countries: A Systematic Review of Quantitative Studies, Expert Rev. Vaccines 16, 1107–1118, 21.09.2017).

Threats to freedom, fairness and public health are inherent to any platform that is designed to segregate society on the basis of biological data. All policies and practices must be guided by a commitment to social justice. [Emphasis added]” (N. Kofler and F. Baylis, Ten reasons why immunity passports are a bad idea, Restricting movement on the basis of biology threatens freedom, fairness and public health, 21.05.2020).

To be continued …

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