{"id":3904,"date":"2020-07-01T11:35:41","date_gmt":"2020-07-01T10:35:41","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=3904"},"modified":"2020-07-01T11:35:41","modified_gmt":"2020-07-01T10:35:41","slug":"immunity-passports-reopening-the-economy-and-repackaging-racism","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/07\/01\/immunity-passports-reopening-the-economy-and-repackaging-racism\/","title":{"rendered":"Immunity passports &#8211; reopening the economy and repackaging racism"},"content":{"rendered":"<p>By Natalie Kofler and Fran\u00e7oise Baylis<\/p>\n<p>In the midst of worldwide protests against anti-Black racism and violent policing, private companies and governments are developing a novel platform for discrimination that would effectively increase the reach of law enforcement into public society \u2013 so called, digital \u201cimmunity passports\u201d.<\/p>\n<p>It all starts with a seemingly innocuous plan to restrict the workplace to those who have recovered from COVID-19, tested positive for antibodies to the virus, and are presumed to have immunity. The stated goal is to have people return to work in the belief that (at least for a time) they are not at risk of being infected with coronavirus, or of infecting others. Then, like the virus, immunity certification spreads to schools, airports, concerts, museums, religious services, and so on.<\/p>\n<p>In the UK, <a href=\"https:\/\/www.prnewswire.com\/news-releases\/press-launch-of-hvivo-covid-clear-test-the-most-accurate-antibody-test-available-to-uk-employers-to-help-get-people-back-to-work-301070331.html\">hVIVO<\/a> has begun to administer antibody tests and hopes to sell these directly to private businesses to monitor employees at a cost of around \u00a3100 per test. In the U.S., some Silicon Valley <a href=\"https:\/\/www.forbes.com\/sites\/thomasbrewster\/2020\/05\/20\/facial-recognition-firms-pitch-covid-19-immunity-passports-for-america-and-britain\/#4c6d1de45914\">facial recognition startups<\/a> have been pitching immunity passport apps to the UK and US government, despite documented <a href=\"http:\/\/news.mit.edu\/2018\/study-finds-gender-skin-type-bias-artificial-intelligence-systems-0212\">racial bias<\/a> of facial recognition products in law enforcement. <a href=\"https:\/\/www.newyorker.com\/tech\/annals-of-technology\/immunity-passports-and-the-perils-of-conferring-coronavirus-status\">Hotel reservation and sporting event app developers<\/a> have also rushed to introduce immunity certification platforms for employees and patrons and some <a href=\"https:\/\/www.theguardian.com\/business\/2020\/may\/17\/heathrow-boss-urges-plan-to-restart-flights-between-low-risk-countries\">transport officials<\/a> have proposed immunity passports as one way to restart the struggling airline industry.<\/p>\n<p>All of these initiatives are <a href=\"https:\/\/www.nature.com\/articles\/d41586-020-01451-0\">deeply problematic for scientific, practical, and ethical reasons<\/a>. Most significant is the risk of increased discrimination against racial and ethnic minorities in North America and Europe. In a world where immunity passports are the norm and systemic racism abounds, only those lucky enough to have survived COVID-19, privileged enough to have access to immunity testing, white enough to avoid police scrutiny, and rich enough to own a smartphone to display their status on demand would be able to return to work, social activities, and travel. The rest would not.<\/p>\n<p><strong>Racial and ethnic disparities<\/strong><\/p>\n<p>In many <a href=\"https:\/\/www.cbc.ca\/news\/politics\/trudeau-elliott-covid-19-race-based-data-1.5600824\">countries<\/a> and <a href=\"https:\/\/www.politico.com\/news\/2020\/06\/14\/missing-data-veils-coronavirus-damage-to-minority-communities-316198\">counties<\/a>, data on racial and ethnic disparities in COVID-19 infection and mortality are not collected. Where data are available, the disparities are all too evident; people of colour are more likely to fall ill with COVID-19 and to die of this disease. In the U.S., a study of <a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2020.05.07.20094250v1.full.pdf\">28 states and New York City<\/a> confirmed an increased risk of death for Black and Latinx people. <a href=\"https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/892085\/disparities_review.pdf\">Public Health England<\/a> has confirmed higher COVID-19 mortality rates among Brits of Bangladeshi, Chinese, Indian, Pakistani, Other Asian, Caribbean and Other Black ethnicity as compared with people of white British ethnicity.<\/p>\n<p>Despite the increased risk of death, people of colour are less likely to be tested for the disease. \u00a0In Texas, for example, <a href=\"https:\/\/www.npr.org\/sections\/health-shots\/2020\/05\/27\/862215848\/across-texas-black-and-hispanic-neighborhoods-have-fewer-coronavirus-testing-sit\">public testing sites<\/a> (to test for active SARS-CoV2 infection, not antibodies against the virus) are disproportionately located in predominantly white neighborhoods.<\/p>\n<p>Just as racial and ethnic groups have not had equal access to viral testing, they likely would not have equal access to antibody testing for immunity certification. And those who managed to obtain immunity certification might struggle to hold on to it. <a href=\"https:\/\/www.latimes.com\/local\/california\/la-me-license-suspensions-bias-20160411-story.html\">Latinx and black drivers<\/a> are more likely to have their licenses suspended because of an inability to pay traffic violations. Racialized and low-income groups could face similar hurdles if fees for immunity certification and renewal were required, and even more so if tickets for \u201cimmunity infractions\u201d were instated.<\/p>\n<p>The <a href=\"https:\/\/www.scientificamerican.com\/article\/why-racism-not-race-is-a-risk-factor-for-dying-of-covid-191\/\">systems of racism<\/a> causing these health disparities would also play out in immunity passport programs, putting every person of colour at risk of discrimination at work, in policing, and at the border &#8211; whether they have immunity certification or not.<\/p>\n<p><strong>In the workplace: <\/strong><\/p>\n<p>Systemic racism is manifest in the overrepresentation of people of colour in minimum wage, front-line jobs as grocery store clerks, healthcare aids and orderlies, cleaning staff, meat processors, bus drivers, and delivery people. With the pandemic, these workers have been classified as \u201cessential\u201d, but from their perspective they have been treated as <a href=\"https:\/\/www.thestar.com\/news\/world\/2020\/04\/14\/in-the-us-covid-19-puts-low-income-workers-in-the-line-of-fire.html\">sacrificial<\/a> \u2013 <a href=\"http:\/\/bostonreview.net\/class-inequality-race-politics\/shaun-ossei-owusu-coronavirus-and-politics-disposability\">disposable, expendable<\/a>. They have continued to go to work and risk infection, and possibly death, while <a href=\"https:\/\/www.washingtonpost.com\/business\/2020\/03\/22\/working-home-reveals-another-fault-line-americas-racial-educational-divide\/\">salaried workers<\/a> with computer-focused jobs have been working safely from home. \u00a0The most recent data from the <a href=\"https:\/\/www.bls.gov\/news.release\/flex2.t01.htm\">US Bureau of Labor Statistics<\/a> confirm that 30% of white people are able to work from home, whereas only 20% of Black and 16% of Latinx workers are able to do so. The inability to work from home during the pandemic has contributed to <a href=\"https:\/\/www.urban.org\/urban-wire\/latinx-unemployment-highest-all-racial-and-ethnic-groups-first-time-record\">higher unemployment rates<\/a> for people of colour, as well as <a href=\"https:\/\/www.theguardian.com\/world\/2020\/may\/25\/covid-19-lockdowns-african-americans-essential-workers\">higher COVID-19 prevalence in communities of colour<\/a>.<\/p>\n<p>In light of these facts, it has been suggested that since people of colour have experienced disproportionately high unemployment rates and COVID-19 infection rates, it stands to reason that they would benefit from immunity passports. This presumption of benefit rests on the presumption that people of colour will be able to access immunity testing. But if such testing is a personal expense, it may be cost-prohibitive for some (likely many) prospective workers; especially for those who are unemployed, underemployed or for those who work in the gig economy (and even more so if repeat testing is required).<\/p>\n<p>In the alternative, if immunity testing is an employer expense for \u201cessential\u201d low-wage frontline workers such as healthcare aids, orderlies and cleaning staff in hospitals, or facility and dining hall employees at universities, then it is conceivable that immunity passport programs would increase racial and ethnic disparities across socioeconomic classes. If people of colour are targeted for immunity testing to facilitate the \u201cessential\u201d workforce and if they are more likely to be deemed immune because their jobs have already put them at increased risk of SARS CoV2 exposure, then immunity passports could be used by employers to lock racial and ethnic minorities into those jobs. In this way, immunity passport programs could inhibit promotions and professional mobility, creating one more hurdle for people of colour trying to move up an economic ladder that is rigged against them.<\/p>\n<p><strong>On the streets<\/strong><\/p>\n<p><a href=\"https:\/\/www.nyclu.org\/en\/stop-and-frisk-data\">Stop-and frisk laws<\/a> and <a href=\"https:\/\/humanrights.novascotia.ca\/sites\/default\/files\/editor-uploads\/halifax_street_checks_report_march_2019_0.pdf\">police street checks<\/a> in many North American cities disproportionately target people of colour. During the pandemic, cities across the U.S. and Canada, Black individuals have been disproportionately <a href=\"https:\/\/www.propublica.org\/article\/in-some-of-ohios-most-populous-areas-black-people-were-at-least-4-times-as-likely-to-be-charged-with-stay-at-home-violations-as-whites\">ticketed<\/a> and <a href=\"https:\/\/www.nbcnews.com\/news\/nbcblk\/pattern-uneven-social-distancing-enforcement-coming-view-civil-rights-experts-n1216506\">arrested<\/a> for breaking stay-at-home orders.<\/p>\n<p>All proposed immunity passport programs include some level of surveillance and monitoring. If entering businesses, visiting public spaces, and traveling is limited to those with an immunity passport, then people\u2019s movements will need to be checked. Policing for immunity would provide just one more excuse for law enforcement to further violate the lives of Black people and threaten entire communities of colour.<\/p>\n<p>Indeed, there is reason to believe that if immunity passport apps are combined with racialized policing this could extend to state sanctioned <a href=\"https:\/\/theconversation.com\/high-tech-surveillance-amplifies-police-bias-and-overreach-140225\">digital surveillance<\/a>. In the U.S., many COVID-19 hotspots (areas with higher than average virus prevalence) <a href=\"https:\/\/www.statnews.com\/2020\/06\/30\/covid19-death-of-hospital-food-worker-a-microcosm-of-pandemic\/\">map onto neighbourhoods with residents who are predominantly people of color<\/a> and those who would be classified as \u201cessential\u201d workers. Neighborhoods such as these could therefore have a high number of residents enrolled in immunity passport programs. Given that immunity certification would likely be stored on cell phones, personal information beyond that of immune status could be made available for surveillance purposes including work hours, social habits, and political activism. If law enforcement gained access to this data, entire neighborhoods and racialized communities could be targeted.<\/p>\n<p><strong>At the borde<\/strong>r<\/p>\n<p>Many travelers of colour, with national passports in hand, are already subject to <a href=\"https:\/\/www.cbc.ca\/news\/canada\/toronto\/does-racial-profiling-exist-at-the-canada-u-s-border-1.2843758\">racial and ethnic profiling<\/a> at international border crossings and airport security checkpoints. In the U.S., for example, <a href=\"https:\/\/www.nytimes.com\/2014\/12\/06\/us\/politics\/obama-to-impose-racial-profiling-curbs-with-exceptions.html\">border patrol agents<\/a> are exempt from federal laws that prohibit racial and other discriminatory profiling. As regards immunity passports, agents would have the legal freedom to demand proof of immunity from select individuals. Because of high COVID-19 prevalence in certain nations, such as China, and certain racialized populations, such as Black Americans, checks for immunity could place racial and ethnic minorities under increased scrutiny, and thus risk of discrimination at border crossings and airport security checkpoints.<\/p>\n<p>Immunity passports could also serve ulterior motives for discriminatory governments and travel companies. Under the guise of national safety and security, citizens of <a href=\"https:\/\/www.politico.com\/interactives\/2018\/trump-travel-ban-supreme-court-decision-countries-map\/\">several predominantly Muslim countries<\/a> already face U.S. travel restrictions. Verification of immune status could be a new tool to limit entry of certain foreign nationals. Chinese citizens, for example, could be forced to prove their immunity before entry into the U.S., Australians and Swedes may not be \u2013 all under the guise of public health. Airlines could attempt to enact similar discriminatory procedures on certain flight routes or even control where people can sit on planes based on their immune status.<\/p>\n<p><strong>Building a better future<\/strong><\/p>\n<p>There can be little doubt that the introduction of immunity passport programs would further entrench existing patterns of systemic social injustice among different racial and ethnic groups. History and current realities make it all too clear how policies and practices designed to privilege certain groups over others on the basis of biology, whether that\u2019s skin colour, gender, or <a href=\"https:\/\/www.nytimes.com\/2020\/04\/12\/opinion\/coronavirus-immunity-passports.html\">immune status<\/a>, result in societies with immense concentrations of power and wealth.<\/p>\n<p>Immunity passports would leave communities of colour at greater risk of economic disadvantage, policing, and discrimination during, and long after, this pandemic. For this reason alone, such programs must be rejected.\u00a0 What is sorely needed at this time are socially just policies and practices that disrupt patterns of systemic disadvantage in the workplace, in the streets and at the border.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Authors: <\/strong>Natalie Kofler and Fran\u00e7oise Baylis<\/p>\n<p><strong>Affiliations: <\/strong><\/p>\n<p>NK: Founder of <a href=\"http:\/\/www.editingnature.org\/\">Editing Nature<\/a> and an advisor for the <a href=\"https:\/\/sci.hms.harvard.edu\/\">Scientific Citizenship Initiative<\/a> at Harvard Medical School.<\/p>\n<p>FB: University Research Professor at Dalhousie University, Halifax.<\/p>\n<p><strong>Competing interests<\/strong>: None declared<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Natalie Kofler and Fran\u00e7oise Baylis In the midst of worldwide protests against anti-Black racism and violent policing, private companies and governments are developing a novel platform for discrimination that would effectively increase the reach of law enforcement into public society \u2013 so called, digital \u201cimmunity passports\u201d. It all starts with a seemingly innocuous plan [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/07\/01\/immunity-passports-reopening-the-economy-and-repackaging-racism\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":354,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8070,1],"tags":[],"class_list":["post-3904","post","type-post","status-publish","format-standard","hentry","category-pandemic","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Immunity passports - reopening the economy and repackaging racism - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/07\/01\/immunity-passports-reopening-the-economy-and-repackaging-racism\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Immunity passports - reopening the economy and repackaging racism - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Natalie Kofler and Fran\u00e7oise Baylis In the midst of worldwide protests against anti-Black racism and violent policing, private companies and governments are developing a novel platform for discrimination that would effectively increase the reach of law enforcement into public society \u2013 so called, digital \u201cimmunity passports\u201d. It all starts with a seemingly innocuous plan [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/07\/01\/immunity-passports-reopening-the-economy-and-repackaging-racism\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2020-07-01T10:35:41+00:00\" \/>\n<meta name=\"author\" content=\"Hazem Zohny\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Hazem Zohny\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2020\\\/07\\\/01\\\/immunity-passports-reopening-the-economy-and-repackaging-racism\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2020\\\/07\\\/01\\\/immunity-passports-reopening-the-economy-and-repackaging-racism\\\/\"},\"author\":{\"name\":\"Hazem Zohny\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/e73152f6aa4e164c7d625d77cf4fed35\"},\"headline\":\"Immunity passports &#8211; 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