One year after the start of the Covid-19 outbreak, there is light at the end of the tunnel.
The light is the vaccine, presented in the medias as the silver bullet to stop the pandemic and to restart the world. Combined with the vaccine, travel health apps are presented as the solution to lift international travel restrictions. Is the air travel industry really ready for restart? What is the big picture?
Is the vaccine a silver bullet to stop the pandemic?
When WHO declared the pandemic last March, I did not expect a vaccine to be available by end 2020, given the requirements of tests and approvals for new vaccines. Basically, the principle of vaccines is that 1) a vaccine prevents from infection by a virus and from the disease and 2) vaccinating most of a population will prevent any outbreak. The vaccine may have a lifetime effectiveness, as this is the case for example with the measles vaccine[i].
The good news is that vaccines are rolling out, but given the short time elapsed there are still major pending questions. Does the vaccine prevent infection by the SARS-CoV-2 virus? Does it prevent severe COVID-19 illness? Does it prevent transmission? Not sure[ii]. Indeed, a vaccinated person may get infected and still transmit the virus but will not develop the severe form of disease that requires intensive care in hospital.
In theory, if a large majority of the population is vaccinated, the virus will stop circulating in this population, which is known as the herd immunity[iii]. This means the end of the outbreak in this population, enabling to “flatten the curve” of COVID-19-related deaths, which was the objective of the lockdowns. In an immunized population, the restrictions can be lifted: restaurants and other meaningful “non-essential” activities can re-open.
Does the vaccine mean the restart of air travel?
Let’s look at a foreign visitor to an immunized country: if the visitor is infected when entering the country (despite the negative PCR test), at worst a few people may be contaminated but, as they are vaccinated, they will not develop the disease and it will not trigger any outbreak. The epidemic risk is low, the quarantine is not necessary, the borders can re-open, as in Seychelles by Mid-March[iv]. Following this logic, for an immunized country, the vaccine means the end of the pandemic and the negative PCR tests mean the restart of air travel.
Now let’s look at a foreign visitor to a non-immunized country: a proof of non-infection should still be required, i.e. a negative PCR test in the case of COVID-19, but the vaccine should not be required for visitors because it does not reduce virus transmission. This position is currently reflected by WHO, as an interim position on the matter (5 Feb 2021), recommending that it’s too early for government to require proof of vaccination to travel because the impact of the vaccine on reduced virus transmission is still unclear[v]. WHO considered the scientific, ethical, legal and technological dimensions of such a sensitive position.
Why do we need a travel health app or pass?
Whether it’s for a PCR test or a vaccine certificate, paper documents have the benefit that anyone can carry them and read them, however they come with the usual drawback that travelers may lose their valuable piece of paper and it can easily be forged. This business case reminds me of the transition from paper boarding to mobile boarding passes between 2005 and 2010, although at the time IATA focused on harmonizing the data stored in the barcode and let travelers store the passes in airline apps or phone wallet.
Why would airlines not provide travelers with a solution to store their digital receipts of their tests and vaccinations? I remember early reactions suggesting that airlines should not get involved in this because health data are personal and sensitive. While airlines indeed have no interest in storing health data, they need to ensure that efficient passenger processes are in place. They may also want to play a role in restoring trust in travel by providing smart tools.
The reference to “Travel health pass” suggests an app designed for travelers, mainly targeting the international air travelers who face the most severe and fluctuating restrictions; while the reference to “Digital vaccine passport”[vi] focuses mainly on the status of vaccination and refers to the WHO yellow booklet[vii]. In a simple set-up I imagine that I could save one pass for Covid-19 and one for yellow fever, both in a wallet on a mobile phone, like boarding passes. For now, let’s assume we need a dedicated app and call it the “travel health app”, a personal health app dedicated to travel needs.
What’s the big picture?
For travel health apps to be successful, three critical drivers must happen:
- Publication of health guidelines by a uniquely recognized scientific voice about the virus and the effectiveness of the vaccines, the tests and the protection measures
- Harmonization of travel restrictions, whereby governments need to agree on a set of measures (vaccine, tests, quarantine) and predictability and transparency on how they are applied.
- A digital identity framework, which can uniquely provide digital identities to people and companies, or in our case travelers and test labs.
Without these must-haves, even the best travel health pass becomes useless.
While the first item falls naturally into the remit of WHO, there is no obvious body in charge of harmonizing the bio-safety measures imposed by governments. Airlines do their best to implement the measures in an efficient way to make a better customer experience. I provide more context in my White Paper on page 20, where the “traveler health data wallet” is one proposal of a bio-safety strategy[viii].
Various countries look into developing their own “Digital vaccine passport” in the continuity of the “Covid tracing apps”, as a condition to let vaccinated people move freely, for example the EU have announced their plans[ix]. Given the relative (sub-optimal) success of Covid tracing apps in the population, it’s difficult to predict how successful the new apps may be, unless they are mandated to enter public spaces.
Global standards and coordinated approach
Unfortunately, observers are confused with the proliferation of initiatives around these “digital vaccine passports”[x]. There are a few attempts at creating global standards. An initiative was created to “weave” the current efforts together, recognizing that one single solution will not be implemented globally. Called “Good Health Pass” it has brought on board a fairly good list of partners such as ACI, Amadeus, AOKpass, Clear, The Commons Project, Daon, IBM, ICC, MasterCard, SITA, Sovrin and YOTI[xi]. Another initiative, called “Vaccination Credential Initiative” focuses on the processing of Covid vaccination records, in particular the trust in the record. It is supported by companies like Microsoft, The Commons Project, Oracle and Salesforce[xii]. Finally, there is a “COVID-19 credentials initiative”, focused on a standard for verifiable (digital) credentials[xiii]
These initiatives fill a gap which is traditionally owned by United Nations entities, WHO for health matters such as vaccine certificates and ICAO for travel matters such as passports and visas[xiv]. The harmonization must take place at three levels: content, data and technology. Governments need to agree on the content, e.g. what questions to ask in the declaration forms, what kind of answers to expect. Once the content is defined, the format of the data must be consistent, e.g. description of a vaccine dose. Finally, if several apps need to communicate, for example a traveler may have an app from their country of origin, one for the destination and one provided by the airline, the technology should be inter-operable, e.g. the digital identity of the traveler.
The travel health apps
Besides the countries developing their own Covid apps, various players will provide solutions based on their respective focus and strengths, from the level of data security to the network of accredited labs or the ability to check the latest travel restrictions. They may have a commercial motive or a non-profit one, such as public health or travel freedom. All the solutions provide:
- A digital experience bringing automation and security compared to paper certificates
- An app for the traveler to collect the vaccine and PCR test certificates from the labs and to store them
The solutions are at different stage of implementation, some are live with airlines while some are still being tested. Here are a few of them, in no particular order, with their respective positioning:
- Daon, as a software company with expertise in digital identity, launched a “digital health passport” targeting air travel called VeriFLY[xv]. They enable real-time verification of health credentials such as Covid test results.
- The Commons Project, as a non-profit trust, was quick to jump on the opportunity and to propose a solution called CommonPass[xvi]. They partnered with the World Economic Forum to give it more visibility and global traction.
- IBM, as a tech company, stresses that its “Digital Health Pass” is blockchain-based[xvii]. Indeed, there are security needs for the apps, privacy needs for the personal data, with blockchain used for the digital identity, among many other relevant blockchain use cases in aviation[xviii].
- IATA, as a travel association, focuses its “Travel Health Pass” on the ability to check international travel restrictions[xix]. This is interesting but should be checked first at time of shopping for flights. IATA partnered with Evernym, a digital identity company, for the ability to verify the health credentials.
- Clear, a company which provides identity verification at airport security, proposes the “Health Pass”. It leverages their presence in airports and the enrollment of travelers[xx].
- AOKPass is a solution supported by the International Chamber of Commerce, International SOS, a travel security firm, and SGS, an inspection company. Their focus is naturally on the global network of medical facilities[xxi].
- Airside provides a mobile solution called “Mobile passport”, it has expanded to handle heath records such as lab test results for Covid-19[xxii].
- SITA, a travel-industry owned tech provider, was the most recent one to communicate on the topic with their “Health Protect”[xxiii]. Being active in passenger facilitation and border processes, SITA proposes to connect existing “travel health apps” with their products handling the “real” passports.
In summary (apologies to the solutions I missed), the proliferation of new solutions is a positive sign of innovation in the air travel industry which should inevitably lead to consolidation and harmonization in the near future.
Conclusion
At this stage, the coordination and harmonization of processes between governments remains the priority, otherwise regardless of the app it will be a chaotic experience for all travelers. Airlines should test and learn from the apps, while relentlessly promoting harmonization of standards. Eventually apps will be rolled out and customers will decide, as usual and as the Covid tracing apps showed us.
[i] WHO – Measles vaccine https://www.who.int/ith/vaccines/measles/en/
[ii] Denver Post – Can vaccinated people still spread the coronavirus? https://www.denverpost.com/2021/02/27/can-vaccinated-people-still-spread-the-coronavirus/
[iii] WHO – Herd immunity, lockdowns and COVID-19 https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19
[iv] Seychelles Travel Advisory https://advisory.seychelles.travel/
[v] WHO – Considerations on proof of COVID-19 vaccination for international travelers https://www.who.int/news-room/articles-detail/interim-position-paper-considerations-regarding-proof-of-covid-19-vaccination-for-international-travellers.
[vi] New York Times – Coming soon: the “Vaccine Passport” https://www.nytimes.com/2021/02/04/travel/coronavirus-vaccine-passports.html
[vii] WHO – International Certificate of Vaccination https://www.who.int/ihr/ports_airports/icvp_note/en/
[viii] Threedot – 30 proposals to restart air travel White Paper https://www.linkedin.com/feed/update/urn:li:activity:6767859127285780480
[ix] Euronews – EU plans to boost summer travel with its proposal for a digital vaccine passport https://www.euronews.com/travel/2021/03/02/eu-plans-to-boost-summer-travel-with-its-proposal-for-a-digital-vaccine-passport
[x] Financial Times (for subscribers) – Business needs a more unified approach to vaccine passports https://www.ft.com/content/3995af05-6bde-47f7-9f43-8eacc4600b43
[xi] Good Health Pass https://www.goodhealthpass.org/
[xii] Vaccination Credential Initiative https://vaccinationcredential.org
[xiii] COVID-19 Credentials Initiative https://www.covidcreds.org/
[xiv] ICAO – Machine Readable Travel Documents https://www.icao.int/publications/pages/publication.aspx?docnum=9303
[xv] Daon VeriFLY https://www.daon.com/products/verifly
[xvi] CommonPass https://commonpass.org/
[xvii] IBM – Digital Health Pass https://www.ibm.com/products/digital-health-pass
[xviii] IATA – Blockchain in Aviation White Paper https://www.iata.org/en/publications/blockchain/
[xix] IATA – Travel Pass initiative https://www.iata.org/en/programs/passenger/travel-pass/
[xx] CLEAR Health Pass https://www.clearme.com/healthpass
[xxi] AOKPass https://www.aokpass.com/
[xxii] Airside Digital identify solution https://www.airsidemobile.com/
[xxiii] SITA Health Protect https://www.sita.aero/solutions/sita-at-borders/border-management/sita-health-protect/
