In the absence of a cure or vaccine, social distancing is the most effective weapon we currently have in our fight against the coronavirus. Although this measure is absolutely necessary right now to save thousands, if not millions, of lives it is also very costly and getting more so with every passing day. As the economic damage escalates, social distancing measures will inevitably lead to real human suffering – ever more unemployment, inequality, poverty, sickness and death. Some governments can mitigate the damage, but none can really do that for an extended period.
So the question becomes: How can we get people safely back to work as soon as possible?
The answer is massive testing combined with a trusted global database of who is already immune to the virus.
If you are already immune to the virus, there is absolutely no reason for you to stay home because you can neither get sick, nor transmit the virus to others.
One way of acquiring immunity is through a vaccine. However, a mass roll-out of such a vaccine against Covid-19 is almost certainly at least 12-18 months away. So this will work, but not in the short term.
The second way of gaining immunity is by catching the virus and overcoming the disease. Although the data is still preliminary, there is a general consensus among experts that people who have had the disease develop antibodies that protect them from getting reinfected for months and possibly even a few years. According to existing studies, a very large proportion of people who have been infected with Covid-19 will not realize because they show no or only very mild symptoms. This could be anywhere between 15% and 80% of all cases. So a lot of people may already be sheltering in place who really do not need to.
We therefore urgently need to put in place a “coronavirus green card”, a system that can reliably identify the "coronavirus safe" people. They will fall into one of 3 categories:
- They tested positive for being infected with the virus and then later tested negative, i.e. they fully recovered
- They tested positive for having antibodies against the virus
- They were vaccinated against the virus (once the vaccine is available)
The coronavirus green card system would need to consist of two components:
- Reliable testing methods
- Trusted records of test results
The reliable testing method is currently an issue but can be resolved. Tests already exist and are being rolled out for both current and past infections. Most of the testing done at the moment focuses on identifying current infections. However, a number of governments, including UK's, are actively working on launching a mass roll-out of antibody tests to detect past infections as well.
Many if not most of the existing tests are not sufficiently reliable yet and there are even reports of utterly useless tests being peddled by some suppliers. To be reliable, the test for a current infection would have a false negative rate that is very close to zero (to be sure that if the test says that a person is not sick, it is really the case that she is not infected), while the test for antibodies would need to have a zero false positive rate (to be sure that if the test says that a person has antibodies against the virus, she really does have them.) We therefore need to figure out a reliable testing protocol that would probably have to include things like certified testing kits and when a test has to be repeated.
The other critical part of the coronavirus green card system is a trusted record of the test results. Effectively this means a reliable database that contains real time data on who has been tested and with what result. To be really useful, it should be a truly global database that is acceptable to and accepted by any country in the world, from the US and France to India and China. If it were truly global, the database would significantly help in accelerating the easing of travel restrictions imposed by most countries in response to the virus. Right now, when a government is afraid of new infections coming in from abroad, it feels the only way to solve it is by imposing 2-week quarantine for all new arrivals and/or banning any foreign travellers outright. This effectively shuts down any business travel, as well some entire sectors of the economy, such as tourism. However, if the border control officials could reliably check whether the visitor has a test result proving that he either already has the antibodies against the virus or that he has tested negative for a current infection say within 24 hours before travelling, he could be let into the country without any risk. One could potentially even imagine a system of coronavirus-free flights, where the test status would be checked for every international traveller before being allowed to board the plane.
To be widely trusted and accepted, the record keeping system would at minimum need to be:
- Designed and operated in a way that could be in principle trusted by any government in the world
- Able to uniquely identify each individual
- Protecting individual privacy, by enabling the owner of the data to control whom she lets access her records
- Open/interoperable with other solutions and applications, from health records to platform applications
Furthermore, any database is only as trustworthy as the data in it, including the data inputting process. In other words, the system would need to ensure not only that the test results are based on reliable testing kits, but that the positive / negative result has been entered into it correctly. One way of ensuring that would be to provide database editing rights only to test providers approved by governments, such as official medical labs. However, if the system were to be rolled out to hundreds of millions or billions of people, it should also be able to accept results from self-testing kits that people could take at home. That would mean that each test kit would need to be uniquely identifiable and traceable. It would also need to provide a unique output based on the test result, in a way that would effectively prevent the person taking the test from entering a false result into the database.
We believe that the technologies to put this coronavirus green card system in place quickly and securely already exist. Incidentally, this may turn out to be the killer app for distributed ledger technologies, i.e. blockchain, where the components of an overall solution already exist, including applications such as self-sovereign ID and supply chain tracing. But there may be other, more classical solutions, which might be even more suited.
With economic damage accelerating every day, the world cannot wait for this coronavirus green card system any longer. Several of us in the Druid Collective have therefore started working on this as part of our SolveCovid19 tech initiative. If you believe that you can help us accelerate this work -- through your own expertise, connections or relevant existing component solutions and relevant initiatives that you know -- please get in touch.
by Martin Bruncko (Founder of Steam Capital), Michael Altendorf (Founder of Adtelligence) and Patrick Schneider-Sikorsky (Board member at Senzo Health)