Digital Health Passports

NIIT APPII Digital Health Passport

The concept of digital health passports is fascinating. Could restless, travel-deprived humans receive this gift in 2021? Will digital passports rescue us from boredom and help people regain the freedom to travel, or will they create new, complex problems?

Eliminating Quarantines and Travel Bans

It’s unsurprising that the Covid pandemic has sent airlines, airports, regulatory organizations, global healthcare entities, blockchain firms, and others scrambling to develop an efficient method of traveler safety screening. Some hope digital health passports can eliminate arrival quarantines, travel bans. and airport restrictions, Clearly, “international air travel can’t enter a full recovery phase while the virus is as big a threat as it is today”.

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“Every optimistic forecast must be tempered by a recognition that the airline industry’s fortunes are inexorably linked to how quickly the corona virus is brought under control – a factor outside its control.” Lewis Harper, Managing Editor Airline Business Flight Global

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Apple and Google Covid-19 Contact Tracer – Forbes

This post summarizes interesting possibilities, as well as issues and consequences that may arise with the advent of digital health monitoring. There’s a ton of Internet data to sift through, and comprehending it all is dizzying! False information floating around complicates matters. Digital health projects include:

  • CommonPass
  • CDC V-Safe After Vaccination Health Checker
  • Airlines Digital Health Pass
  • IATA Travel Pass
  • ICC AOKpass
  • APPII App
  • VT Enterprises V-Health Passport
  • Trulioo Immunity Passports
Smartphone Screen Vector – Bigstock
Delayed Travel Again

Of course, I’m eager to travel, but feel sad and disappointed that the departure date keeps moving forward – sigh… Finding a viable digital way around the virus is complicated. ID verification showing that people received immunizations, tested negative for the virus, or had and now are immune to COVID-19 is more complex than imagined!

I’m 100% ready to vacate the familiar and take off again for the unknown. I’m not afraid of exploring new places that might cause others to gasp in horror, but am taking the covid pandemic seriously and want to make the wisest choices. For some, long-term confinement can be worse than suffering a painful demise. There comes a time to move on and live your life, and for me, that may be soon.

Addressing the covid elephant looming in the room is no small thing. Clearly, it’s a big hurdle, but I’m determined not to be defeated! Destination choices are somewhat limited for US passport holders, and unappealing, costly, mandatory arrival quarantines eliminate interest in many locations. Still, there are exciting possibilities, but the 2021 list is constantly changing.

If digital health passports come to fruition, they might make traveling easier in the age of Covid-19. However, research must address questions and sensitive privacy issues, like “accessibility and inclusion”. Nothing is simple about the “new normal”, we’re all experiencing and learning to accept.

CDC Covid Vaccination Card 20212
CommonPass

Healthcare Global is developing a “digital health pass system for documenting the Covid-19 test status of travelers”. The system, CommonPass, is being trialed at select airports worldwide. It’s designed to “allow safer cross-border travel by giving travellers and governments confidence in people’s Covid-19 status”.

Health Passport Worldwide Logo

During CommonPass trials, volunteers “take Covid-19 tests at certified labs and upload the results to their mobile phone”. Then, they complete health screening questionnaires required by their destination country. If the results confirm that they’re in compliance with the destination country’s entry requirements, a quick response code (QR) is generated for scanning by airline staff and border control officials. My trips include multiple destinations and countries, so I wonder how that would work?

Developed by The Commons Project Foundation, a Swiss-based non-profit “focusing on digital services for the common good,” CommonPass has some impressive supporters. International organizations observing their trials include The World Economic Forum (WEF). United States Customs and Border Protection (CBP), and Centers for Disease Control and Prevention (CDC). The Rockefeller Foundation, dedicated to improving the well-being of people everywhere, provided start-up funding for the CommonPass project.

Microchips for Humans – Shutterstock
Privacy Regulations and Ethics

In a statement, The Commons Project team said that CommonPass was designed to “protect personal data in compliance with relevant privacy regulations, including EU General Data Protection Regulations (GDPR)” – huh? A recent study published in The Lancet medical journal raises questions around the ethics of digital passports. The publication states that “steps must be taken to avoid the production of fraudulent immunity passports, and careful attention given to privacy concerns and information governance”. That seems like a no brainer. Can they do it?

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“Without the ability to trust Covid-19 tests and vaccine records across international borders, many countries will feel compelled to retain full travel bans and mandatory quarantines for as long as the pandemic persists.” Dr. Bradley Perkins, Chief Medical Officer of The Commons Project and former CDC Chief Strategy & Innovation Officer

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The Commons Project

According to Christoph Wolff, Head of Mobility at the World Economic Forum (WEF), “Individual national responses won’t be sufficient to address this global covid crisis. Bans, bubbles, and quarantines may provide short-term protection, but developed and developing nations alike need a long-term, flexible, risk-based approach like CommonPass”. OK, but that too seems like a no brainer…

CDC V-Safe After Vaccination Health Checker

V-safe After Vaccination Health Checker is a Center for Disease Control (CDC) smartphone-based app. It “uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination”. With the v-safe, you can inform CDC of side effects from the COVID-19 vaccine. V-safe also “reminds you to get your second COVID-19 vaccine dose if you need one”. Participants sign up on the CDC v-safe website. According to the CDC, “personal information is protected so that it stays confidential and private”.

Airlines Digital Health Pass

In yet another project, airline industry leaders are coordinating efforts to create a digital passport that indicates whether a passenger has been vaccinated for Covid-19. The International Air Transport Association (IATA) announced it’s in the “final phase of development for what it hopes will boost traveler confidence and become universally accepted documentation”.

Australian airline Qantas is reportedly making plans requiring all passengers to get vaccinated before international flights. Alan Joyce, Qantas CEO, thinks other carriers will follow suit.

Benefits of a Covid Vaccine – cdc.gov
IATA Travel Pass

International Air Transport (IATA) is engineering a “digital travel pass” that’s in its last stages of development. The pass is designed to verify information “seamlessly among testing labs, airlines, governments, and travelers”. The Covid-19 pass “directs travelers to verified testing centers and labs at their departure points that match the rules and standards for wherever they’re going, with the hope of avoiding restrictions on arrival”. Sounds too good to be true!

Bigstock Immunity Passport App

Governments will be able to use the IATA Travel Pass with other services or as a standalone program for their borders. “It will be free to use for travelers and governments, with airlines paying a small fee per passenger.”

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“Testing is the first key to enable international travel without quarantine measures. The second key is the global information infrastructure needed to securely manage, share, and verify test data matched with traveler identities in compliance with border control requirements.” Alexandre de Juniac, IATA CEO

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ICC AOKpass

International SOS, an “organization for standardization,” is an “independent, non-governmental organization with 165 member countries”. It’s the world’s largest developer of “voluntary international standards”. ISOS partnered with the Swiss SGS Group and International Chamber of Commerce (ICC) to launch the ICC AOKpass mobile app. The app is “taunted as a secure way to present medical information”. ICC AOKpass provides a “privacy-preserving, digitally authenticated, secure, portable copy of medical records approved by a medical professional and is only accessible by the individual involved”.

InterestingEngineering.com

“ICC AOKpass technology is built on three core principles – privacy, security, and portability – enabling individuals to present their health status without losing control of their medical information.” The information never leaves an individual’s phone. Verification technology “validates the digital signature of an individual’s pass to ensure authenticity”. Then, the pass is “verified without showing personal or medical information”. This sounds like a sales pitch.

AOKpass App – International SOS
APPII App

NIIT Technologies partnered with online verification platform APPII to develop a digital health passport solution that helps determine and verify the health status of an individual. Those using the APPII app can “biometrically verify themselves”, have their coronavirus status “catalogued through self-declaration or via an authorized verifier”, and use an app to verify their health status”.

International Certificate of Vaccination

In theory, health passports have been around for some time. The International Certificate of Vaccination – also known as a “yellow shot card” – is a simple paper-based process you attach to your passport. My card is tattered and falling apart. I’ve had almost every immunization known to man and even started logging annual flu shots.

Potential Fraud and Passenger Data Breaches

As Covid continues to restrict travel, criminals will likely seize the opportunity to capitalize by selling bogus Covid-19 test and vaccine certificates and faking the names of genuine laboratories. They might find easy targets at airports, on the Internet, and via mobile messaging apps.

No doubt countries with ask for “verifiable” certificates, although it’s questionable how that’s defined. Passengers carrying fake Covid-19 test results in order to travel “undermine efforts to limit the spread of the disease and open up air travel again”.

“The possibility of barcodes and QR codes being hacked is also a real issue and, therefore, any airline who considers using this form of authentication for Covid-19 testing risks a breach of passenger data.”

Public Key Encryption

With using apps to deal with sensitive personal data, privacy issues come to mind. Some say data held in a digital passport platform will be “encrypted,” with only the individual involved having full authority to allow access to the information.

Ada Lovelace Institute

Focusing on privacy issues and the EU GDPR, Bill Buchanan, Professor of Cryptology, Edinburgh Napier University, says: “It’s unbelievable that we still live in a world of paper. Everything we’ve created since the start of the Internet is paper-based. We need to move into the 21st century and develop digital credibility.”

“The foundation of this world has already been created with paper. The true way to create our digital identity is to have what’s called a public key encryption (PKI) stored on your smartphone. The PKI would carry a unique identity, so everyone in the world could prove their identity through a public key.”

InfoMed – Magzter
Airline Passenger Testing

Abhi Chacko, Head of Commercial and Innovation Gatwick Airport, pointed out that in the UK “there’s already a capacity problem testing in public and private labs”. He added, that for health passports to become viable, “the government or the airlines can introduce a rule in which you are either tested 24 hours before travel, or have immunity valid for six months or one year”. That “information needs to be passed on to the airline and airport before they allow passengers to go through”.

A “new generation UK passport” will be introduced in 2020-2021. The “new blue non-EU document is electronic”.

Airport Social Distancing and Disinfecting

Chacko described some examples of solutions airports are exploring to ensure a safe experience. These include temperature screening, using ultraviolet light technology to disinfect hand luggage, trays, and handrails, deploying robotics for cleaning, and applying antimicrobial coatings to high-touch surfaces.

Travel Risk Map 2020 – LoyaltyLobby

He said: “It’s a bit impractical to have social distancing in the airport environment, so my preference is to see people wearing masks, to protect themselves and others”. Technology could “reduce queues and bring an orderly process”. Gatwick Airport came up with “Bingo Boarding”. With this concept, boarding sequences are displayed by seat assignment, and passengers walk to the jet bridge at the time shown.

Bingo Boarding Gatwick Airport – travelmole.com
Country Consistency – Transport Health Authority

Shashank Nigam, CEO Simplifying, spoke from an airline passenger perspective and agreed that “health passports will give passengers an opportunity to skip the tedious health checks that are likely to become mandatory at airports”.

Nigam pointed out that the “real issue is inconsistencies between countries, and this is what governments, airlines, and regulators will have to address, before they can bring back their passengers”.

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In his recent report, titled The Rise of Sanitized Travel, “Nigam describes how he expects to see post-Covid-19 travel guided by a global Transport Health Authority (THA), just like 9/11 led to the creation of the Transportation Security Administration (TSA) in the United States”.

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Sanitized Travel Infographic – simpliflying.com

European Tech Firms and EU Country Requirements

Fintech Global Berhad company TransferWise is building immunity passports that are being tested in Estonia. Other companies working on immunity passports include UK start-ups Onfido and Yoti, and Germany’s IDNow. The US government is reportedly talking with Onfido about developing biometric immunity certification technology. I tried using TransferWise for banking during a 2019 trip to Berlin. It might work well for EU residents, but created a big mess for me as a US citizen. Hopefully, they will continue to make improvements.

“Swiss security firm SICPA, French platform OpenHealth, and Estonian blockchain Guardtime formed a consortium to develop a blockchain-based COVID-19 health passport. The solution will be used to issue and manage health passports and enable real-time monitoring of immunity levels among the population.”

Denmark may be the first EU country to launch “coronavirus passports”. Acting finance minister Morten Bødskov, Lars Sandahl Sørensen, the CEO of Danish Industry, and Brian Mikkelsen, the CEO of the Danish Chamber of Commerce, are discussing the launch of a coronavirus passport in 2021.

The Danish digital passport will document and prove that the holder was vaccinated against COVID-19. Several of Denmark’s neighbouring countries demand a negative test result from visiting foreigners.

Trulioo Immunity Passports – pymnts.com
Antibodies and Short-Term Immunity

There are question marks about digital corona-certificates. For example, is it feasible to trust antibody tests, or are people with antibodies contagious to others?

Universal Biometric Identity – biometricupdate.com

Experts think anyone infected with Covid-19 will develop “short-term immunity” from re-infection. However, no one knows how “robust” that immunity is. Most tests are not “sophisticated enough to reveal the extent of a person’s immunity, or for how long it will last. Even the best performing tests return a number of false positives”.

Global Healthcare Information Software – Virtual-Strategy

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“Personally, I think there could be more guidance coming from the likes of the UN International Civil Aviation Organization (ICAO) or International Air Transport Association (IATA) on travel. Different countries, airports, and airlines are currently experimenting with different solutions. Now is the time to have some sort of common guidelines, so everyone can be aligned around aviation travel requirements.” Abhi Chacko, Head of Commercial & Innovation Gatwick Airport

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A recent report by London-based artificial intelligence research group, Ada Lovelace Institute, warned that immunity passports “pose extremely high risks in terms of discrimination, social cohesion, exclusion, and vulnerability.”

Immunity passports could “make life more difficult for people who are not immune, but the certificate is a way of ensuring that people who have struggled to survive the virus are not prevented from doing things or going places”.

Trulioo Canadian-Based Electronic Identity Verification Company
VST Enterprises V-Health Passport

British cybersecurity firm, VST Enterprises, shared details of their V-Health Passport, which runs on the cybersecurity tech VCode. The passport is “ready to hit the ground running and checks Covid tests, including antibody and antigen testing”.

The V-Health Passport not only “confirms who you are, as it’s been verified alongside your passport, but also your Covid-19 test status and exactly when the test was administered”. The Covid-19 test is taken by a health professional who “uploads the information into the app, using a traffic light system. Red signifies a positive test, green indicates negative, and amber is the countdown clock until the next test”.

Those using the V-Health Passport are “identifiable by comparing it against their ID, without sharing personal information online”.

© Getty Images courtneyk
Privacy Fears

Some note that while “national lockdowns seemed implausible less than a year ago, the Covid-19 virus might become a civil liberties game-changer”. They wonder if the “introduction of vaccination cards will force people to carry immunity passports?” Some fear this type of thinking is dangerous and liken it to the initiation of compulsory medical procedures.

Coronavirus Covid-9 Immunity Test – ledgerinsights.com

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“Could our freedom to travel, attend sports functions, music and cultural events, or even go shopping, be dependent on having had a Covid-19 vaccination? That nightmarish prospect is what a number of independent ‘outside the tent’ thinkers (usually labelled ’conspiracy theorists’ – or worse) have been warning for several months now.” Neil Clark Journalist, Writer, Broadcaster, and Blogger www.neilclark66.blogspot.com

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Clark recalls British Travel Record Cards used for “keeping a record of inoculations and booster jabs needed for travel to African and Asian countries”. He notes that comparing this card to the new British National Health Service NHS Covid-19 vaccine card is like “comparing a vaccination record with a pass card that has the potential to become a compulsory carry-at-all-times photo ID required to access music concerts and sports events”. Clark wonders if this is “implicit coercion,” where airlines and restaurants refuse to let people in unless they’ve had the vaccination? “Would a digital Covid-19 passport give its holders rights and privileges that other members of the community do not have?”

British Covid-19 Vaccination Card – The New York Times

Clark points out that Dr. Kelly Moore, Associate Director of the Immunization Action Coalition, said: “Everyone will be issued a written card that they can put in their wallet and that will tell them what they’ve had and when their next dose is due.”

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“Is it going to be a case of written vaccination cards today, digital immunity passports tomorrow? If you still think that’s far-fetched, remember, the idea of democratic nations imposing rolling national lockdowns would have seemed implausible just twelve months ago….” Neil Clark, Journalist, Writer, Broadcaster, and Blogger

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Covid-19 Microchip – Politifact
ID2020 Digital Identity

ID2020 is an interesting “public-private coalition of organizations pushing for digital identity” since 2016. They’ve “advocated for digital ID approaches that are ethical and privacy-protecting “. Members include “representatives from Microsoft and Accenture, as well as NGOs, academia, blockchain firms, and others”.

“In 2018, ID2020 Alliance Partners, working with the UN High Commissioner for Refugees (UNHCR), drafted a formal articulation of their perspective on ethical approaches to digital identity.” The ID2020 Alliance Manifesto “lays out shared principles and is a starting point to guide the future of global digital identity”.

ID2020 Alliance Manifesto – medium.com

I’m researching ID2020, including accusations that it’s doing research on “embedded microchips”. The organization was “falsely accused of being part of fictitious plans that allege Bill Gates supports mandatory vaccination and the implantation of microchips or quantum dot tattoos into patients”. Yikes!

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“The digital identity components of an immunity passport are a means, not an end in itself. The goal of the immunity passport has to be its role in public health and the easing of restrictions surrounding the lockdown; its goal should not be the spread of ‘digital identity’. That would be using the pandemic, and the deaths of hundreds of thousands of people across the world to achieve an unrelated self-promotional goal.”

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Known Traveler Digital Identity System – Trulioo
Trulioo Immunity Passports

Trulioo, a Canadian company based in Vancouver, British Columbia, has the goal of developing an “immunity passport” that provides “evidence a person is immune to Covid-19 and capable of traveling “without risking the population at a destination, or attending an event without risking themselves or becoming a Covid-19 carrier”. They say the concept is basically the same as “age verification that an individual is old enough to participate in an age-restricted activity”. Hummmmm?

By many expert accounts, “the most effective way to ensure that you don’t catch or spread Covid-19 is to have immunity, either through a vaccine or antibodies”. It’s still uncertain if “antibodies confer immunity, or how long that immunity would last”. Theoretically, a person with immunity would be “safe to travel, attend large-scale events, and otherwise participate in society without risk to themselves or others”.

ID2020 – Facebook
What Next?

Not sure what I learned from this research, except that there’s definitely more to learn. The situation seems to get more complicated every day. Although I try to remain optimistic, Covid-19 looms ominously behind almost everything we do these days. Hopefully, developing digital health passports and other effective means of electronic monitoring will provide an answer and help save the day for travelers! Somehow, the complicated ideas in process need to come together, addressing common questions and concerns. The barrage of high-tech projects, e.g., blockchain, VCode®, encryption, crypto agility, etc. is happening fast, and some nuances may be too complicated for most humans.

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