“We need some leadership from the federal government,” said Marcus Plescia, medical director of the Association of State and Territorial Health Officers, noting that rapid and uncontrolled deployment can result in a number of systems that do not communicate.
The White House says the government should not issue credentials or store data. But they are discussing with technology companies how a passport system can work, asking for details on whether pharmacies and other establishments can provide the necessary data. The Department of Health and Human Services also sought information from 25 federal agencies about passports, including whether they would encourage their own employees to use them, say sources familiar with the talks. The national health technology office at HHS declined to comment.
“The right way is that it must be private, the data must be secure, access to it must be free, it must be available digitally and on paper and in several languages, and it must be open source,” White House Covid 19 adviser Andy Slavitt said on Monday.
Passports have been discussed since the beginning of the pandemic, when antibody tests and the applications that accompany them were presented as a tool to reopen the economy. But companies are reviving the field with rising vaccinations and accelerating travel: a coalition of aviation and travel groups this month called for a federal standard, saying passports would not only speed recovery, but would expand testing and vaccinations while limiting spread of diseases.
“There is a role for the US government to set standards”, especially to ensure that credentials are “interoperable” or to converse with other systems efficiently across borders, said Tori Barnes, executive vice president of public affairs and policy at US Travel Association.
However, there are legal and ethical questions about whether passports can increase inequalities that have already become a worrying feature of the pandemic.
Public health experts and bioethicists say that digital accreditation can discriminate against disadvantaged populations. The Electronic Frontier Foundation, a digital rights group, argues that using smartphone-based verification to access public places would create a two-tier system that prevents people who cannot work, shop or attend school because they don’t have a phone. access to tests.
In addition to ethical considerations, there is the separate question of whether the fragile US healthcare technology infrastructure can withstand a flood of new applications exploiting vaccine data.
Databases containing immunization records vary in quality from state to state and may not be able to handle a wave of real-time queries about vaccination status, said Deanne Kasim, executive director of Change Healthcare, who is part of a consortium that includes Microsoft and Salesforce working on passport standards and technology. His company advocates a “lighter elevator” and associates with pharmacies, which have more robust record-keeping systems.
There are also privacy considerations. Requiring people to store test results and vaccinations in digital format can expose them to the type of data breach that proliferated during the pandemic. “We wanted the data to reside on the patients’ phone,” rather than a database, where individuals can control the data, said Kasim.
Efforts to create passports can also come up against legal barriers, said Rebecca Coyle, executive director of the American Immunization Registry Association. Privacy laws restrict the type of data that some records may share. Technology interests asked the national HHS coordinator for health technology to issue a national guideline so that “different solutions return the same information,” said Coyle.
Some states are trying to preempt the feds and regulate the still-nascent camp, Kasim said. Several legislatures, for example, have introduced bills to prevent discrimination against people with religious objections or health conditions that may prevent them from being immunized.
The passport debate is also engulfing Europe, where governments are trying to reconcile the promise of freedom of movement with privacy issues. The European Union is studying a “digital green certificate” that could allow the 27 member states to reopen their travels and slow the spread of the virus.
A group from the World Health Organization is warning that strict privacy and anti-discrimination protections are a necessity. “Immunity certification, even when available and reliable, should never be used as the primary strategy for reducing the effects of the Covid-19 pandemic,” he concluded.
Erin Banco contributed reports.