Chile will become the first country in the world to start issuing COVID-19 immunity cards to people who have recovered from the virus, an idea is being considered by, among others, the United States, Germany and Italy. It assumes that a person has already had the disease, has recovered, has quarantined and is now safe to interact with other people without getting sick again or infecting anyone else.

But it raises some thorny medical and ethical questions.

Are current coronavirus immunity tests good enough to be trusted? And if that’s the case, will countries issuing these quick immunity tests create two-tier societies, where people with COVID-19 immunity certificates be allowed to go to work, and the rest will be discriminated against?

I put these questions to Chilean President Sebastián Piñera in an extended interview shortly before his country’s official start of the massive COVID-19 immunity program on Monday.

Piñera readily admitted that existing antibody tests are not 100% accurate. But he added that they are the best current option to get people back to work and start reopening the economy.

“The test does not give an absolute guarantee of immunity, but we have consulted with scientists all over the world, and they have told us that it’s highly reliable,” Piñera told me.

He added that, “There is very high possibility that a person who has already had the disease and recovered has very little chances of getting the virus again, or of spreading it to others.”

While Germany and other countries have already started issuing COVID-19 immunity cards in an experimental way, Chile will do it on a much-larger scale.

Asked why he’s rushing to issue immunity cards instead of waiting for other countries to try it first, Piñera said that Chile is in a good position to launch this program.

It already has done the most COVID-19 tests per capita in Latin America and has the lowest death rate from the virus in the region, Piñera said.

Chile has done 6,300 COVID-19 tests per million people, 10 times more than some of its neighbors, he said. The country of 19 million had reported 168 COVID-19 deaths by April 24.

After several weeks of focusing mainly on fighting the pandemic by isolating people, Chile’s infection curve is flattening. Now the country has almost as many COVID-19-recovered people as newly infected ones. Therefore, it’s time to do something to start reopening the economy, Piñera told me.

In addition to keeping what he described as “flexible lockdowns” to stop the pandemic, “we also have to take care of another fundamental concern, which is that there be no unemployment, poverty, hunger, anxiety, bankruptcies, and an economic and social crisis,” he said. “That can produce as much damage, or more, than the health crisis we’re going through.”

Asked whether the immunity-card system will lead to discrimination against people who don’t have the certificates, Chilean officials respond that will be a short-term fix to start reopening the economy while a COVID-19 vaccine is found. Most scientists predict that a vaccine may be ready within 10 to 16 months.

It’s hard to know whether Chile’s immunity cards will work, but U.S. officials are considering the idea. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said recently that it’s “possible” that Americans may be given such forms of identification.

“This is something that’s being discussed,” Fauci told CNN on April 10. “I think it might actually have some merit, under certain circumstances.”

Judging from what I’m hearing from other scientists, there are still questions on how effective the antibody tests are. Also, there are questions about whether people who have recovered from the virus are truly immune. South Korea has reported more than 100 cases of people who had COVID-19 and got infected again after their quarantine period.

And there is also the fear that, if employers start requiring COVID-19 immunity cards to people applying for jobs, many people - especially younger ones, who are less likely to die of the disease - may intentionally infect themselves.

But, at least until a vaccine is found, several countries may decide that issuing immunity cards will be a risk worth taking to avoid economic catastrophe. We’ll have to watch the Chilean experiment closely. We could soon see it being rolled out in our own country. — -


Andres Oppenheimer is a Latin America correspondent for the Miami Herald.