Life in the UK is slowly returning to a semblance of normality. The Prime Minister has confirmed a further round of relaxation of Covid rules from Monday, with indoor hospitality and household mixing returning. Initial rules have also been set out to allow international travel to resume from next week. Underlying all of this is the incredible progress the country has made on vaccinations: 35m people have now had their first dose, 17m both doses.
The UK is in a strong position and we have much to be proud about. But this new normality is fragile, particularly as our borders reopen. Much of Europe is engulfed in a severe third wave of the virus, India is facing record-breaking case numbers and surging numbers are still evident in Brazil. In this global context new variants are emerging, particularly in India, and until the whole world is safely vaccinated, nowhere is fully safe. As we have seen with existing variants - particularly the Brazil and Kent mutations - these threats emerge quickly and can undo a lot of the hard work restrictions have achieved. The longer the wait until the whole world is vaccinated, the greater the possibility of a new variant emerging that is more resistant to vaccines, deadlier, or more infectious.
The UK Government announced it will enable the NHS app to securely prove vaccination status, which will help facilitate UK citizens travelling safely. This is an important step in the right direction. But further action is required.
While it is important for people to be able to show their vaccination status, this is only half of the puzzle. For a health pass to be fully effective and afford us the chance to reopen with confidence, it must also cover testing. This is the case for a number of reasons: First, it will be some months before we are all vaccinated. Second, even fully vaccinated people can still carry and transmit the virus. Third, we know that vaccine efficacy is time limited and top up vaccines will be needed, so antibody testing again becomes a key part of the picture on responding to the virus. Fourth, until we have global coverage with the vaccine we remain at grave danger of worse variants of the virus emerging.
The Government has accepted the importance of mass testing, which is why each household can now order free home lateral flow tests and why it is being done systematically in schools. A viable health pass should combine displaying both vaccine and testing status. This would allow travel to open safely, with careful monitoring of the status of those arriving. Critically, it could then act also as a domestic pass.
As indoor gathering resumes, and the wider June unlocking gradually looms on the horizon, the public remains clear it supports a digital pass showing someone’s Covid status. And for a substantial set of businesses, it will make sense to have a mechanism to allow their employees and customers to prove their health status before they step into the building. There is no legal or technical barrier to businesses doing this and private sector solutions will inevitably emerge.
Given the factors set out above, particularly that the whole world will not be vaccinated in the immediate future, it is clear that being able to show whether you have the virus or not will be a vital tool in combating the spread of the virus. As offices, night clubs, sporting events fully reopen we will need to be able to display our Covid status.
The media debate about health passes has all too often focused on philosophical issues such as to whether determining access to settings based on an individual’s health status is desirable. It has frequently based itself on false premises, such as the idea that some settings will only be accessible to those who have been vaccinated, or that health passes will be legally required to enter all shops, pubs and restaurants. On the first set of arguments, we are already doing just that through isolation requirements for those with possible Covid symptoms, and mass testing embeds this practice. On the second, neither of these approaches has been advocated by either the Government or (to our knowledge) any other credible organisation. The relevant question comes down to a very simple trade-off: do we prefer blanket restrictions to return in the event of further spikes of the virus, or do we prefer a targeted approach that allows all of us without the virus to continue life as normal?
A digital Covid identity can be easily created that is both secure and simple to use. An app could allow people to access their secure health records but only disclose the information that is relevant, in a verifiable way. The NHS app is a workable platform for this as it already has secure user authentication process and links to health records to show vaccine status and results of PCR tests taken through the NHS testing service. The technology also exists to enable people to securely and verifiably upload the results of the rapid lateral flow tests being distributed across the country; and there may be a case for facilitating this so that a negative LF test result can be used as a trustworthy credential via a digital health pass. More widely the Government should establish clear parameters that domestic Covid passes should fall within - what they display, how and their security levels- to enable to best of the private sector to then step in. Internationally, they should lead the coordination effort so as to make sure national systems are mutually acceptable. As a first step, they can support the Good Health Pass Collaborative and the principles it sets out for a viable international pass.
We have come so far with our response to Covid. After so many lives so tragically lost, we have the means to live alongside the virus in our grasp. Only by introducing a digital health pass that shows both testing and vaccine status can we ensure these hard-won gains are not lost.