Covid passport: a useful tool that still poses great challenges

After much passionate debate, the European Union (EU) finally gave the green light to a Covid certificate or passport, which will facilitate travel around Europe from July 1. Since the advent of the pandemic, and with the aim of containing the spread of the virus, all kinds of restrictions on fundamental rights have been imposed on a global scale, such as the suspension of freedom of movement. These measures have led to an economic contraction that is still difficult to gauge.

Today, more than a year after the arrival of Covid and with a global vaccination campaign underway, several options have been considered to leave these exceptional measures behind and reactivate mobility and the economy. One of these options is Covid passports or certificates, such as the one approved by the EU.

Officially called the EU's Covid Digital Certificate, it’s a free of charge digital accreditation system that uses a QR code or paper which allows people to easily prove they have been vaccinated against Covid, they have antibodies because of having had the virus, or have tested negative recently. The certificate, which will be valid for 12 months, will go into effect on July 1 (although in countries such as Spain it has been on trial since June 7) with the aim of facilitating the safe mobility of citizens.

The certificate will have a common format, meaning each EU member state will be able to issue them and they will be valid in the rest of the countries. Not having a certificate will not mean not being able to travel, but people who do not have one may have to comply with the additional measures that each state imposes on travellers, such as quarantines.

It includes the vaccines approved by the European Medicines Agency (EMA), which are currently four: Astrazeneca, Moderna, Pfizer and Jansen. In Catalonia, the certificate can be ordered through Lamevasalut or on the website of the Ministry of Health.

Diversity of certificates and little global cooperation

The EU’s is not the only such certificate that has been developed in the world. Other countries such as China, Israel and Greece have developed or are currently developing their own document, and some private sector initiatives are doing likewise. This variety, which can lead to disorder and confusion, also shows the lack of global cooperation that has taken place, in line with the fierce nationalism that has marked the production, purchase and distribution of vaccines.

At the same time, experts point out, this lack of harmonisation of vaccination passports can be a problem in achieving the goal that has been set: the reopening of global mobility.

“The problem is not so much scientific as diplomatic, but if countries recognize the certificates of others, there should be no problems in recovering global mobility,” says Clara Marín, a resident physician in Preventive Medicine and Public Health at the Hospital Clínic de Barcelona and collaborator of the Analysis Department of the Barcelona Institute of Global Health (ISGlobal), a centre promoted by the Fundació “La Caixa” (La Caixa Foundation).

In this sense, Marín believes a good solution would be to adopt a common and logical criterion: validating all certificates that include vaccines accepted by the World Health Organization (WHO).

Something that the resident doctor of the Hospital Clínic sees as less likely is to agree on a global standardisation that makes possible the creation of a single certificate: “Technically it’s not impossible, but in the context marked by fierce nationalisms that we have seen on the subject of vaccines, it seems very difficult for all countries to agree.”

An interesting tool that poses challenges

The introduction of these certificates or passports has not been easy and has generated a whole series of doubts and ethical, scientific and legal debates that should not be overlooked. It’s clear that a reopening is urgent, but are these certificates a hasty measure that seeks to encourage economic recovery at any cost?

"With regard to the EU certificate, the challenges of every kind posed by an initiative like this have been taken into account. It’s clear that its main objective is to start an economic recovery, and if it doesn’t put the population at risk and takes into account health objectives, it’s a very interesting tool," says Marín, who emphasises that the certificate will not be mandatory to travel, it’s accessible and free of charge and, in principle, it will guarantee privacy.

On the other hand, one of the questions raised by these certificates is whether they make sense at a time when knowledge about the virus and its vaccines is still limited, especially with regard to the duration of the immunity provided by the vaccines and antibodies, or whether vaccinated people, despite not developing the pathology, can transmit the virus.

Clara Marín believes that this system has been put in place given the evidence that vaccinated people reach very high rates of immunity and transmission is reduced. However, she points out that this system must not be static or immovable and must respond to changes in the epidemiological situation and to the new evidence that is generated, always prioritising safeguarding the health and protection of the population.

Facilitating mobility without discriminating

However, there is a fear that the certificates will deepen existing inequality and discrimination, favouring vaccinated people over those who are not, especially given the unequal access to vaccines that has been seen between high-income and middle- and low-income countries.

Marín believes that this is a “clear challenge” for Covid certificates, given that “this inequity exists, that’s a fact,” which is why she believes that “everything depends on the certificates not being mandatory to travel or to access any type of space or service,” while offering alternatives such as access to affordable diagnostic tests to do the same things that the certificate allows.

In this sense, the EU has already announced that it will mobilise 100 million euros to make massive testing available to the population. "This financial aid to access diagnostic tests in an affordable way must be implemented if we don’t want to generate inequities, including for people who can’t be vaccinated because of some pathology or simply freely decide that they don’t want to do so," Marín points out.

And what if once these certificates are consolidated, it’s decided to demand them to grant freedom of access to services, facilities or equipment such as theatres, cinemas, or even for a job interview? In Israel, for instance, concerts and theatre performances have already been held where access was only granted to people in possession of the certificate, the so-called ‘green passport’.

"We’re talking about the same thing: there must be an affordable alternative for unvaccinated people to prevent any kind of discrimination, especially when it comes to work," says the collaborator of ISGlobal, who also points out that in a job interview the employer should never be able to access this data.

The challenge of privacy

Another major challenge the Covid certificates present has to do with the handling of data, identity and privacy. Marín admits that this is a "real concern", as it has always been the idea to link these certificates to the identity records of each country. However, the problem, she emphasises, is that not all countries keep the same records and today many people in the world don’t have access to basic identity documents.

"The global solution to this problem is not clear," she acknowledges, because although in the EU almost the entire population has access to identity documents and this is not a problem because there are centralised and digitised records, "it’s true that we must look for a solution adapted to the context of other places”.

As far as the management of the data, Marín believes that privacy is absolutely essential. "This data must not be used for purposes that the person has not authorised, nor should it be accessible to third parties, so a prepared strategy is needed and the privacy of individuals must be protected," she concludes.