COVID-19 antibody testing and 'immunity certification': a discussion paper

This paper was prepared as background to inform the Nuffield Council on Bioethics policy briefing on COVID-19 antibody testing and immunity certification. The paper is intended to provide a more detailed overview of key ethical, social and policy issues, and is published to further promote and stimulate discussion of the issues that it identifies. The paper draws on discussion of testing, immunity and solidarity at an online meeting of experts, hosted by the Nuffield Council on Bioethics on 24 April 2020’.

Introduction

In the absence of an effective treatment or vaccine, the response to the current COVID-19 pandemic has focussed on non-pharmaceutical interventions (NPIs) to minimise transmission of the SARS-CoV-2 virus among the general population. In many countries, including those of the UK, this has included general restrictions on movement and association (‘lockdown’). Alongside the direct impact of COVID-19, these restrictions are having a substantial impact on people’s physical and mental health, social wellbeing, and economic activity. Many advanced economies are expected to enter recession in 2020.

Governments are therefore exploring options for controlled relaxation of emergency restrictions to enable businesses and services to resume some activities while continuing to protect public health. An effective approach will involve a combination of adjusted measures that responds to the changing situation rather than a single solution. This background paper describes the legal, social, and biomedical context of measures that would selectively modify restrictions on individuals who have a low risk of infection and transmission of SARS-CoV-2 (‘immunity certification’).

This briefing draws on discussion of testing, immunity, and solidarity at an online meeting of experts, hosted by the Nuffield Council on Bioethics on 24 April 2020. It also draws on earlier in-depth inquiries conducted by the Council, and reports published by the Council.

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