The total economic loss of covid-19 in terms of GDP and health costs is estimated to be around 16 trillion dollars, according to a study by two Harvard University professors. To put that in perspective, that is 90 percent of the total GDP. Clearly, we need to focus on reopening the economy as soon as possible. And I’m hearing there’s talk about a vaccine passport. What is that?
Yes, this is this kind of futuristic idea where we actually have a requirement to get a certificate of vaccination before we can do things. It’s pretty clear that vaccination certificates are moving forward. And given that, you know, how do we do it Right? What if we were to be required to prove to employers, airlines or sporting venues that we’re immune to the virus?
I think it’s a little premature to be thinking and to be talking about how we get people these immunization certificates. Last thing you want to do is create further inequalities and make people feel like they really can’t access the same things. We have to be ready for this to happen in the future. And if we missed the window a little bit and don’t make money off that or whatever, that the financial goal is some way, shape or form, we’ve all realized that this has got to be in place.
So what are vaccine verifications exactly? And can they speed up a return to normal?
DIGITAL IMMUNIZATION VERIFICATION
For herd immunity, between 58 percent and 94 percent of the population need to be immune, that means anywhere from one hundred and ninety two to three hundred eleven million Americans. As of mid-January 2021, nearly 10 million Americans have received at least their first dose of a covid-19 vaccine, while the vast majority of Americans believe that the vaccine is important to facilitate a return to normal life.
Nearly half plan to defer vaccination for three months or up to a year. And so this, I think, combined with the inherent challenge of manufacturing and distributing vaccines, really threatens to slow progress towards herd immunity and ultimately to economic recovery. That’s where immunization verification, passports or certificates could come in. Remember the yellow card immunization forms?
In the age of the global pandemic, that could be a smartphone application or a QR code on paper. If we can make it work with travel, I think it allows us to study the technology as well as the validation, as well as to keep the confidence and privacy that will then allow us to think about how we use this for other things. I don’t think it’s going to make and I don’t believe it’s going to make social distancing and masking go away until we hit herd immunity. But I think it’s again, it’s this process of maybe we can reopen up things a little bit faster.
For nearly five years, the Kutta Gruder has been advocating for digital IDs as a basic human need, especially in developing countries. She’s currently on a WHO sponsored working group for smart vaccination certificates over the course of six months.
The group is hoping to establish global standards for these types of solutions. This is a very complex multi stakeholder effort. Obviously, they’re trying to do this at an international level. But the idea is to do something I think quite similar to what we’ve done with ID 2020 certification, which is what are the specifications of a good digital ID solution or in this case, a smart vaccination certificate. And how do we get to the point where there’s almost a list of WHO recognized solutions, but we don’t pretend that in the interim some of these solutions are moving forward independently.
Dozens of start-ups, as well as major companies like Microsoft, Ticketmaster, Apple and Google have shown interest or are currently working on creating their version of an immunization certificate for covid-19. I think where we’re at, at least on the technical side, is a bit of a Wild West. You know, it’s pretty clear that vaccination certificates are moving forward. And given that, you know, how do we do it? Right. And how do we ensure that that investment is made in the in the sort of greatest possible way? This is not the time to move fast and break things.
Onfido is one of the start-ups who jumped on the idea early as an identity verification company with two hundred million dollars in funding. A vaccination app was a no brainer. So the first thing where we fit in is making sure that it is Kevin Trilli or Tala that is the person signing up for this service. And then there’s a second step that says use the core service, book your travel in the case, decide how or whatever. Then the third is being able to add a new piece that says embed your health status as part of that application so it can be shared with the person that you’re booking travel with.
And then in the case of the other one, with employment, you sign up for the service, you declare your employment status, and then you’d have some health testing status that you would update and maintain so you can come to the office on a regular basis. The life cycle of a pandemic looks something like this.
Right now. We’re in the pandemic phase, meaning there’s widespread human infection. Even with a vaccine, there’s a lot we don’t know, for example, the duration of immunity or if asymptomatic transmission can happen despite vaccination. And more importantly, only about three percent of the U.S. population has been immunized so far.
Our focus should be on getting people vaccinated. Once we get enough people vaccinated that we can actually then we can leverage that vaccinated pool as a as something that we can use. That’s when I think that immunization certificates become, something we can talk about. That should happen around a time 40 to 50 percent of the population have been vaccinated, according to L.G..
Even then, it’s an interim solution. If the pandemic turns endemic, meaning seasonally circulating in society, or we simply reach herd immunity, the use of verification solutions becomes pointless. It could be a year, right, depending on how slowly we got there. And we remember as if more people take vaccination, if we stay, we’re staying below that seventy five percent threshold that say, let’s use that as a threshold and that could change the below that it takes that much longer to get up there. Right.
Because we’ve we. Infection enough such that left people are going to get sick, which is wonderful, but it also means that we’re going to if people don’t get vaccinated, we’re going to be creeping to that level. So thank goodness we have that vaccine. The reason we’re having this conversation is because we have a vaccine. Vaccination records in the US are tracked by 61 independently run immunization information systems, according to the American Immunization Registry Association.
They help public health authorities ensure that patients are administered a second dose and to monitor the safety and efficacy of the vaccines. Sharing data between state lines requires approval from the governor or a health officer, and very few have embraced vaccine apps So far. The data in these systems are validated by the state health department, by the provider who vaccinated, so on and so forth. How do we connect that data with some form of digital I.D. that the patient can now carry with them?
Is it worthwhile to try and stretch our already stretched super thin public health resources? I’m not sure this is the right time and place to do that. Collaboration between governments, private providers and international stakeholders will be key in the success of immunization verifications.
Onfido is based in the UK and submitted the product to the British government in the spring of 2020. Kevin says they’re not focused on scale at the moment. This has to come out in stages. There’s a lot we have to figure out, though, about a system like this. So in a way we’re sort of innovating. And if we if we can impact twenty five percent of the population, the cycle, it’s great.
That’s a huge impact of people that could go further into their worlds. You know, in this really restrictive world that we’re in today. While much of the app can be customized, privacy cannot. A poorly designed digital ID solution could become a surveillance tool. Privacy is not a concern until it is a concern. So it must be architected into the system at the beginning. And the example I would say is you don’t need to tell me your first name, last name, your address, everything about yourself and all of your testing data and give that to everybody.
You should just say I’m good. And the way you know it’s me is because I use my face to unlock my phone, to access that credential, to then send it to you. And then what’s sent to you is just the status.
If you can do it in that way, then privacy is protected. As with anything that entails digitization and access, there are some equity concerns. For one, requiring that individuals are vaccinated to be able to participate is risky, especially for communities of color who are more skeptical of the vaccine. The last thing those communities want is for Big Brother to be watching.
The other thing is the intention may be to enable some people to go back to work. But is it seen as well If I don’t get the vaccine or if I hesitate to the vaccine, will that cut my opportunities? Another equity concern is regarding access to technology and high speed Internet. Some providers are working on making ID verifications on paper, a QR code embedded with information that can’t be falsified. What we design and build today is going to have longevity past this. This may have utility in routine immunization.
This may have utility in a whole host of use cases outside of health care. We should be leading the world on this problem. So I think we have a second opportunity here to come with technology and other systems where we can get back to maybe the next one. We’re actually going to lead the world in the way that we handle this.