Life after coronavirus some countries are considering issuing immunity passports for those whove recovered from the illness the aim is to allow them to go back to a normal life but would that work and is it certain their immunity would last this is inside story. Hello and welcome back to the program. We are all a climate sizing to a new world of the coronavirus pandemic people staying at home businesses shuttered economies walking towards a cliff edge and role wondering when will we return to something approaching the old normal for some people immunity to cope at 19 could be a future gate pass a passport back to work writing public transport flying on a plane going out shaking hands remember those days experts are studying Antibody Tests to see whether people whove already had coronavirus are no longer at risk any risk of contracting it again if so they could have certificates that grant them freedom when the rest of us stay locked it sounds like a godsend solution but its not clear how reliable such a scheme would actually be and scientists are uncertain about if and for how long reinfection would simply not become an issue the u. K. s Health Secretary saying his government is looking into issuing socalled passports immunity passports to allow people to get back to work. Now blood tests are designed to tell whether people have had the virus and are now immune these tests are done by taking a blood sample and looking for the presence of the right coded 19 antibodies these could be potentially be done at home with a finger prick and deliver results in as little as 20 minutes were currently working with 9 companies whove offered these tests and evaluating their effectiveness these Antibody Test blood tests offer the hope that people who think theyve had the disease will know theyre immune and can get back to life as much as possible as normal but theyve got to work. There we are here we go lets bring in our guest today here on inside story from oxford we have dominic will concern hes the director of medical ethics at the university of oxford or hero center for practical ethics in a branch in germany we have Gerard Krauss hes an epidemiologist at the helms hold center for Infection Research and in lancaster we have derek gatherer hes overall a just at the university of lancaster gentlemen welcome to you all Dominic Wilkinson coming to you 1st there listening to mr hancock it sounds very simple you do a test at home you pick the end of your finger you are good to go will it work that well well i think we dont know yet where there is going to be as simple as that it does seem like an attractive way of of stepping out of these great restrictions because a course at this point in time it seems that some people might not need to be restricted because theyve had the virus already in and no longer at risk of becoming unwell or spreading it to others and if we could know who was in that category and then that might represent a way forward there are some interesting scientific and ethical challenges. Gerard krauss in germany it sounds on the face of it like a good idea because at least in theory a percentage of people would be able to go back to work if only with a certificate that doesnt necessarily last for that long well its not necessarily the question whether they are now to go back to work or not its also a part a question and then what conditions theyre allowed to go back to work we know nowadays that many many times in hospitals at least in germany medical offices need to provide p. C. R. Nasal swabs to a test as a positive or not and in case that would be human you could as you mean that this procedure would not be necessary for them so its not only all or nothing its also about what conditions you can go back to work. There i gather in lancaster is the political desire getting ahead of the science here. I think that politics and science are very intertwined moment has great pressure on on governments to perform and opposition groups are just waiting for them to make stick so that we can capitalize on that there are very few countries in europe that have any signs of much difference to the other so the epidemic trajectory and across all of europe and north america seems to be fairly somewhat which indicates that the policy that we see between some countries that are in heavy walked and such as spain and italy in particular and countries that are in somewhat later walked down to the most obvious example of sweden and that doesnt seem to be very much difference yet in the way that the epidemic is going in those countries in asia think poor answer korea hasnt had have had a bit of success in controlling number spot there may be special circumstances there that we dont fully understand exactly why its going back to those countries and indeed in singapore it seems to be slightly on the up again and. Yes theres no doubt that this is a big Political MovementTony Wilkinson and also coming back to you correct me if im wrong here at the tester antibodies they find that people have got immunity but its not the Gold Standard of immunity they cant say 100 percent yes you are immune you can go back to a normal life. Well i think what we do know about this in fiction because its new but it by its nature is with and with it the in fiction could come back again with or it might come back and be as severe or even more severe on a 2nd time or whether indeed you could have a mild infection because youve got immunity we had that the other viruses and but then be able to pass on the virus to other people who are not immune and make them serious deal so those that questions that we dont have answers to yet jared krauss in braunschweig in your country in germany you are testing tens of thousands of people is that prohibitively expensive and what does Angela Merkel intend to do with the people who come back testing displaying immunity well 1st i must clarify the 10s of thousands that we are testing now for and their bodies is not for the sake of identifying those who have immunity or not on an individual basis so this for the sake of measuring the tool prevalence of of the disease or the incidence measuring the tool case fatality weight and measuring the dynamic of the epidemic because a case collins dont reflect a proper image of it so as i was at 2 Different Things nevertheless i do believe that if bennett and validate the tests of a double that the use case of yellow fever vaccination for example on the International Scale also the use case of hepatitis effects in asian or medical Health Workers might quite well be applicable for this situation also because even public scenes especially if i have a tight as b. We dont know of very much if on the individual basis an executed big scene really we need says protection so as to get in situations not so much different from what we are used to do for it seems. There again theyre coming back to you as well this is kind of counterintuitive i suspect as well does it almost incentivize people to get the virus therefore they go through the process therefore they get tested therefore they maybe get an immunity passport at the end of that instead of sitting at home either waiting to get it waiting for the blow to hit or just sitting at home and never getting it anyway. I think it would be very unwise for anybody to seek an infection in order to be tested positive theres still a lot that we dont know about the clinical face of this virus we know that it definitely does seem to be much worse in a lot of people and in an uncertain and certain high risk groups but we dont really know what the fatality rate is yet its that the base states that have comes probably from the diamond princess cruise ship where the case that everybody on board and of the 700 or so people who have tested positive about half of them have new symptoms at all and the remaining half there are. A range of symptoms from my own great right up to extremely serious and about 7 people died so far from that group so the fatality rate from that its it seems to me that one percent so certainly say that city needed to get infected in order to obtain an immunity certificate is it is a gamble that i dont think anybody really should seriously contemplate at all who also that there is the issue of potentially fake immunity certificates and if we are issuing response or some other kind of certification to be able to go back to an innocent enormous opportunity for organized crime to forge these things and stop selling them as the c. E. O. Of the documentation so again again theres not a lot of problems for governments on that score derek i guess that takes us to dominate rather i guess that takes us back to your earlier point about ethics so there is there is a chance here that people would abuse the system if and when its brought in but if you are issuing certification based on a home test whats the difference between discriminating against a Certain Group of people and protecting another group of people. Yes i mean one of the interesting things about this possibility of testing and then releasing people from isolation is that no longer is the restrictions of this virus imposed evenly on everybody from essential workers but now if some people get to get free of these these restrictions and interestingly and ironically those whove acquired the virus perhaps because they werent as good it staying isolated might certainly be rewarded by being allowed out of core into so theres some interesting. Paradoxes there and as its been pointed out that there might be incentives either to become immune or to have said to pick a sion of being immune that issues of forgeries in is in essence no different to forgeries of or any other that important documentation drivers license passports and an immunity passport would be no different jerod crouse in germany in italy theyre just about this week i think it is theyre about to Start Testing 100000 people in a very specific area because the gene pool in that area goes back generation upon generation upon generation and they think there might be something in there to do with either genome sequencing or the d. N. A. If you do that and you drill down into a very big in terms of numbers a very big group of people in a small geographical area you are creating or are you identifying a subspecies which should in theory surely can i suggest you should take us into a very uncomfortable conversation about people who can not be touched by the coronavirus really and lots of other people who can the old the young the people with Underlying Health issues. Im not quite sure which study youre talking about so i have difficulties to comment on this. Oh if were going to a situation in germany or else i know this is going on in italy within the next week or so ok so sorry for that i dont just dont know enough of the concept and difficult for me not to comment on it ok and i understand that totally respects your answer there it can move there on that one on to you if you start examining different groups of people and you find that because of their immediate local but quite longstanding history they maybe are able to push back against the coronavirus are you creating a subset of people who are stronger bigger better than the elderly the young the people who succumb to this. Well i think we have to be very careful about the statement izing people either because they agree to sit there with t 2 coronavirus theres been some speculation about the nation and intercept different providers thats the moment you get it binds to him belongs in the perhaps some populations are more susceptible than others it may well be conversely that study can identify some populations that are more resistant than others but that this this is for Research Purposes so that we can better develop treatments against the virus and different should be used for any nefarious sinister social purposes sometimes some very strange results can be turned out from this furnace and we know for instance that a buddhist receptor and which is the cholesterol transport protein know theres a mutation in a small Canadian Group in nova scotia. That renders them partially it due to a ball of viruses because this is never actually been tested on this canadian population its been its been tested on steroids that have been taken from and because they have this mutation thats a slight defect in the cholesterol transport protein you provide us cannot buy into that protein and therefore can into their sales presumably that would give them in a clinical context some some immunity but that thats something which is they now gates to talk origins who are working on drug treatments to prevent viruses into being sales that can be guided by this kind of stuff. Should we be approaching this from another point of view that says there is Something Better in the pipeline is this thing called digital Contact Tracing where if youve come out the other end and you become fit and well having had the corona virus you basically get a green light a green card something on your phone its an app and using Satellite Technology and g. P. S. Technology the relevant authorities can talk to your local supermarket and say yes your green you can go shopping you can go back to work or youre still read so youve basically got to stay away from everyone. Well personally i am very hesitant on those kind of approaches very kind of because i like of approach and i think we shouldnt follow or human wyatts and personal rights of ought because of this pandemic so im very hesitant in those kind of approaches i think there are ways it is tools that if it goes this way of the immunity pass we would probably not rely on home testing kits because you would need to have assurance of quality of pull and Quality Control and so selfmade home testing kit wouldnt be able to do that. Second the you would need some sort of set to figure out that its maybe a bit more modern and bit more of a put more and more secure against against changes and many other changes as the common use to paper based you know of you know if you like at the you know that everybody has been and he or she travels to south america or africa so that something between must be developed i would we think it is order of the bridge over to develop such a concept not to test the test is for the industry and for science to be developed and as to be validated but the concept is something that supernatural means ations such as w o w joe it typically should develop and that will wait and then provide procedures so that not every country has developed their own developing their own conflicting standards dont wilkinson how would you codify the shelf life of the certificate because for example anyone who lived through the sars epidemic got it but got well within a year some people were getting reinfected. Well i think these are these are questions that we will have to answer and we wont be able to answer except time theres a huge impatience because this is completely novel but has within the space of a couple of months shut down large parts of the world a large part of our economy and theres huge impatience to be able to return to normal life and thats of course the challenge is that we want to do that as soon as possible but we dont want to do it too soon and one of the interesting things is that Different Countries are going to take different approaches to this and so were going to learn to some extent from from the experiments that Different Countries are making so you mentioned sweden already compared with other parts of europe we are going to have a chance to learn if if the swedish approach is as effective as the approaches in other countries and some of these questions about immunity passports or using digital passports there may well be countries that use the east and that arent afraid of the Civil Liberties concerns that have been mentioned and we will see whether in fact thats an advantage where there is allows their economies to return at or whether there are risks associated with it including of prematurely breaking free of restrictions on the virus taking force again in the community its just not going to work properly derrick in lancaster because until it gets to or if it gets the state of say having like a yellow fever certificate in your passport because thats what its got to be thats a bill to embrace and exercise when it comes to not being able to get something. Well you know if you has an interesting example to use because it yellow fever vaccine is one of the most reliable vaccines that we have in a very i mean you gate quite good long term immunity with that so if you have a yellow fever bites its difficult your passport that probably see something rather different about your immune status against your fever on the other hand the Antibody Tests for coronavirus dont have that degree dont provide that degree of certainty that the f. D. A. The agency that proves all drugs and treatments in the u. S. Is just approved an Antibody Test which will start to be used in the usa and the manufacturers claim has 91 percent space city which means that 90 percent of the positives would be true posts of so 90 percent of the people that come up positive and would be issued with an amused certificate on that basis would actually know what to be positive and there are other examples of our no liability of of Antibody Tests for instance give you an example from a bowl of virus again and we know that theres been a bowl of ice outbreaks and mccomb go and neighboring countries and we had a big outbreak in west africa a few years ago but if you taste for a bowl of antibodies right across tropical africa you find lots of communities where there are fairly high levels of cedar positivity as we see whats the state of being of having antibodies against the highest for a bullet so what does that imply does it imply that we havent refuted now used the bull outbreaks of occurred at some point in the past in africa or is it just that we have a problem with the accuracy of the tests and a sponsor book right of schools is still quite a controversial subject many people will argue that it was tastes arent really reliable and that we should rely only on places where we know. Greeks have occurred and that the race to the people arent really immune to the south theyre also with coronavirus it might be equally. Using and truly established and who isnt jerry cross who should be in the driving seat with this one should it be the doctors should it be the scientists or should it be the politicians i mean some canadian experts just in the past 24 hours theyre saying actually immunity passports pretty good idea theyre waiting for the politicians to say its a good idea and the politicians are waiting for the doctors to say its a good idea. No i think not what was just been said is absolutely white and i do believe that the current tests that we have available and that are in the pipeline do not have the necessary necessary position yet to use it for such a certificate so i agree on that point completely but i would hope that better test would become available in the next months they would have to be validated by scientists in the scientific institutions and by that i cannot tell institutions so that is clear who has that were it would have to be the politicians to decide whether they want to use that as a technical basis to implement that for certain measures and it would have to be as individuals to decide whether they would like to have this test to be done so i think that while words are quite separated and again i would think that w. H. O. Would be in the drivers seat to develop a concept so that those concepts are fairly similar similar to the International Health regulations really and thats what its there for so i think their words are quite clear was to take responsibility for heart and this very moment we do not have the tests available that have the necessary position i agree fully on that i would hope that it would become available in the next future even then also have Data Available that would tell us better for how long this immunity might be persisting because also a vaccine we have the problem that for some bio sense and bacteria as a vaccine is not very long lasting ok just think of it and try to put a couple of final thoughts 1st one to dominate wilkinson in oxford between one 3rd and one half of the global population is in effect locked down at the moment or theyre in some form of locked on were constantly being told we will probably have a vaccine by next january or february how long until we have certificate saying yes youre ok you can go back to normal. I dont know i dont i dont know that anybody knows when were going to have the Technology Available to do this this science that that informs us whether this is why hes. And a system in place thats going to be reliable enough to implement that so those things have all got to be got to be there and when thats going to be available i wouldnt like to hazard a guess very briefly derek in about 20 seconds can it work or will it have to be part of an overall arsenal. I think it will have to be part of an overall arsenal and i dont think that natural heard unity as well will play a big part in bringing this so true to a need in many countries in the world the simply cannot implement locked own populations limited to too crowded conditions and in parts of africa in other parts of the world the epidemic will simply just sweep across them and a population will acquire how did unity and eventually that will happen in europe as well we can manage it down and release it in the absence of treatment or a vaccine we will get hurt and unity as well gentlemen we must leave it there thank you so much for your contribution to this ongoing debate here on aljazeera and indeed of course around the world thank you very much they were i guess they were Dominic Wilkinson just across and derek gather and thank you too for your company you can see the program again anytime you want to the website aljazeera dot com and for further discussion go to our Facebook Page thats facebook dot com forward slash a. 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Im going with alan doha the top stories on aljazeera british Prime Minister barak johnson has been admitted to hospital 10 days after testing positive that 19 his office says it was a precautionary measure because he still has symptoms has more from rory challenge. One of course anything connected to coverage now and see him at a hospital admission is serious downing street is saying that this hospital admission is not because his condition has necessarily got any worse but its because it has been going on for so long its persistent we are being told that Boris Johnson is still consuming to leave the country but if things get much worse then it will be rob the foreign secretary will step in to take over. Also in the u. K. Britains Queen Elizabeth made a rare address to the nation the 93 year old monarch urged people to remain united and resolute to overcome the virus and a whole has story 2 weeks into the u. K. s lockdown and deserted city scenes are testament to a new way of life most people staying home for as long as science and the government decide they must also on lockdown in Windsor Castle her residence outside london the queen 93 years old reminded britains that this crisis to woodpiles we should take comfort that while we may have more still to endure better days were to