- Click to share on Facebook (Opens in a new window)
- Click to share on Twitter (Opens in a new window)
- Click to share on LinkedIn (Opens in a new window)
- Click to email a friend (Opens in a new window)
Editor's Note: Dr. Saju Mathew is a CNN Medical Analyst, Primary Care Physician, and Public Health Specialist. Follow him on Facebook, Instagram and Twitter, @drsajumathew. The opinions expressed in this comment belong to the author. See more opinion at CNNe.com/opinion
(CNN) - Given the economic devastation of the covid-19 pandemic, we need to start developing a plan to get people out of the lockdown. With so many people out of work and businesses temporarily closed, many aspects of life have stopped. The sooner people can safely return to normal life, the sooner we can begin economic recovery. To do so, we must be able to continue to know that those who are allowed to leave are no longer at risk of catching or spreading covid-19.
While the WHO said Friday that "there is still no evidence that people who have had covid-19 do not get a second infection," based on what we know about immunology, there are reasons to assume that recovery from the virus will provide a certain amount of immunity.
- MIRA: WHO warns that there is no evidence that people who had coronaviruses are immune to a second infection
The key is to further develop our antibody tests to better understand who is immune to the virus and to conduct research to determine how long this immunity can last. Then, we must provide credentials to those who are immune, through a covid-19 immunity passport, so that those people can resume their lives.
In China, for example, QR codes have been used to loosen restrictions in Wuhan, where the pandemic originated. People evaluated as healthy have been given a green QR code, which indicates that they can travel within the province. (A yellow code indicates that a person may have come into contact with an infected person, while red is for those who have been diagnosed with or suspected of having the virus.)
Since the start of the pandemic outbreak, we have assumed that the public health distancing strategy, or what I prefer to call "physical distancing," would be effective in reducing the spread of contagion. However, to work and produce the best results, distancing must be carried out by populations, preferably worldwide, but at least nationally, consistently, with widespread participation.
Some nations are taking a more aggressive approach. India, with a population of more than 1.3 billion, is currently in the midst of a blockade that will last until at least May 3, although limited employees have been allowed to return to work with strict hygiene guidelines.
South Africa has also chosen this country-wide draconian blocking method, as practiced in Wuhan, although this week it plans to lift some restrictions and implement a curfew.
Most states in the United States have also implemented confinement orders.
When large numbers of people are out of work due to lockout, personal finance comes at an inevitable cost, not to mention the global economy. Since March 14, about 26.5 million Americans, about 16.2% of the workforce, have applied for unemployment.
But with a covid-19 passport, those without the risk of spreading or contracting the virus can move freely, return to work, and help boost the economy.
We have long known from other diseases, such as hepatitis and even the common cold, that your body can protect you from contracting a disease you have already had by making antibodies. These are proteins made by the immune system in response to an alien or an unwanted visitor like covid-19. The body tries to attack and fight the infection. Once these antibodies are produced, they remain in the body even after the virus disappears, and the theory is that it can create a state of immunity, which can hopefully prevent the same infection if it comes along again on the road.
With certain pathogens, only one exposure will cause the body's immune system to flush it out forever, as in the case of chickenpox and polio. However, for the coronavirus family that can cause a variety of colds, our bodies can form an immunity that can last only a couple of months, up to a few years. That is why we can have colds frequently.
We still don't fully understand the reason behind the different immunities, and since covid-19 is new to us, we're not sure how long the immunity could last. At this point, we can assume that once infected and recovered, our bodies will likely have immunity for a period of time. The whole concept of vaccines is based on this theory. We expose our bodies to a small portion of the pathogen, or a molecule that is similar to the pathogen, and we stimulate our immune system to form antibodies.
There is some data that cast doubt on this assumption, however. Some patients in South Korea who got the infection tested positive again after recovery. As the Wall Street Journal reported, South Korean doctors believe that these cases were not a reinfection, but a reactivation of the initial virus. But clearly, more research is needed to understand covid-19 immunity before we can confidently begin to open up society.
There is also a popular concern that new strains of the virus may emerge in the community. But this is little cause for concern, since mutations are natural, common, and in many cases pose no additional danger to humans. A mutation could, for example, pose a greater threat to the survival of the virus itself.
Tests that verify viral immunity, if created with precision and accuracy, can identify what kind of protection people will have recovered. This can be done by looking at "immunoglobulins" or specific antibodies called IgM and IgG. IgM tends to indicate short-term protection, while IgG suggests longer-term protection.
There are currently many companies working on antibody tests, but the results so far have not been promising.
Its precision leaves much to be desired; some have falsely identified antibodies to covid-19 cousins of the same coronavirus family, such as the virus that causes common colds and SARS. And as covid-19 tests have become more accessible, some health officials have complained about its poor quality. However, if the US it can develop adequate tests, and if covid-19 behaves like other viruses in the same family, we should be able to confirm that we are immune, once infected and recovered. How long remains to be determined, and the expiration date of the immunity passport should be evaluated once we have more information about the longevity of the antibodies.
With these tests, we would be armed with the knowledge that could allow us to protect those who are sick or vulnerable to the coronavirus more pragmatically and at the same time allow those who are now immune to the disease to return to normal life. Testing could be a critical resource for determining whether healthcare workers and loved ones are immune and therefore safe to treat and care for covid-19 patients without the risk of contracting the disease. Travel could also start safely around the world, which would be great for both the nation and the world.
We are still far from the vaccine, which will probably be the answer to this pandemic once and for all. However, an accurate covid-19 immunity test could also be a game changer, below the vaccine. Hopefully a reliable antibody test will be developed soon and can send people to work and go out into the world safely.
coronavirus immunity