Immunity passport

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An Italian health pass (fede di sanità) for travel during times of plague, 1722

An immunity passport or vaccine passport, also known as an immunity certificate,[1] recovery certificate[2] or release certificate[3] is a document, in both paper and digital format, attesting that its bearer is immune to a contagious disease.[4] Similar to quarantine, public certification is an action that governments can take to mitigate an epidemic.[5]

An immunity passport is not the same as a vaccination record or vaccination certificate proving someone has received certain vaccines verified by the medical records of the clinic where the vaccines were given.[6] The Carte Jaune ("yellow card") is an official vaccination record issued by the World Health Organization (WHO). It has been argued that the primary difference is that vaccination certificates such as the Carte Jaune incentivise individuals to obtain vaccination against a disease, while immunity passports incentivise individuals to get infected with and recover from a disease.[7]

The concept of immunity passports has drawn much attention during the COVID-19 pandemic as a potential way to contain the pandemic and permit faster economic recovery.[8] This could include a "health passport" for people who have either been vaccinated or otherwise developed immunity by surviving COVID-19.

Concept[edit]

Immunity certificates are a legal document granted by a testing authority following a serology test demonstrating that the bearer has antibodies making them immune to a disease. These antibodies can either be produced naturally by recovering from the disease, or triggered through vaccination. Such certificates are of practical use only if all of the following conditions can be satisfied:[9][10][11][12]

  • Recovered or vaccinated patients have protective immunity that prevents them from being reinfected
  • The protective immunity is long-lasting
  • The pathogen mutates sufficiently slowly for immunity to work against most strains
  • Immunity tests have low false-positive rates

If reliable immunity certificates were available, they could be used to exempt holders from quarantine and social distancing restrictions, permitting them to travel and work in most areas, including high-risk occupations such as medical care.

COVID-19[edit]

As of May 2020, it remained unclear if any of these conditions have been met for COVID-19.[9] On 24 April 2020, the World Health Organization (WHO) stated that "At this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an 'immunity passport'".[4] For example, research published in April 2021 shows that the Pfizer vaccine effect lasts for at least six months.[13]

Due to the imbalance in the distribution of vaccines in the developing world, there are concerns about the inequity of immunity passports for travellers. In a 15 April 2021 meeting published 4 days later, the World Health Organisation’s emergency committee opposed immunity passports, saying "States Parties are strongly encouraged to acknowledge the potential for requirements of proof of vaccination to deepen inequities and promote differential freedom of movement". [14]

However, many countries may increasingly consider the vaccination status of travellers when deciding to allow them entry or whether to require them to quarantine. “Some sort of vaccine certificate will be important” to reboot travel and tourism, according to Dr David Nabarro, special envoy on COVID-19 for the World Health Organization (WHO), in February 2021.[15] Countries experimenting with or seriously considering COVID-19 immunity passports include Aruba,[16] Britain,[17] Israel[18] and Canada.[19]

In some cases, an immunity passport will be combined with a vaccination certificate, so that both people who survived COVID-19 and people who have been vaccinated will use the same type of documentation. In January 2021, Israel announced that all Israelis who have received their second vaccination as well as all who have recovered from infection will be eligible for a "green passport" that will exempt them from isolation requirements[20] and mandatory COVID-19 tests, including those on arrival from overseas.[21] The passport will be valid for 6 months.[21]

In March 2021, the WHO's director of digital health and innovation Bernardo Mariano said that "We don't approve the fact that a vaccinations passport should be a condition for travel."[22] Lawmakers in several US states are also prematurely considering legislation to prohibit COVID-19 immunity passports.[23]

As of 4 April 2021, it is not yet clear whether vaccinated people that remain asymptomatic are still contagious and are thus silent spreaders of the virus putting unvaccinated people at risk. "A lot of people are thinking that once they get vaccinated, they’re not going to have to wear masks any more," said Michal Tal, an immunologist at Stanford University. "It’s really going to be critical for them to know if they have to keep wearing masks, because they could still be contagious."[24]

Map of U.S. states implementing or banning (in Green) Covid-19 vaccine passports.[1][2][3][4][5]

Marjorie Taylor Greene, a newly elected Republican US Representative for Georgia, told her supporters on Facebook in early April 2021 that "something called a vaccine passport" was a form of "corporate communism" and part of a Democratic effort to control people's lives.[25] However, a representative survey of the U.S. population showed that, prior to the issue becoming politicized, public views on immunity passports were evenly split and the divide crossed, rather than followed, political and ideological lines.[26]

On 15 March 2021, the US federal government opined that it should not be the one verifying COVID-19 vaccination[27] and that any processes developed should be free, private and secure when Andy Slavitt, White House senior adviser for COVID-19 response, stated: "It should be private. The data should be secure. Access to it should be free. It should be available both digitally and in paper and in multiple languages. And it should be open source." He also said "It's not the role of the government to hold that data and to do that". Later, on 6 April 2021, an announcement was made that the US federal government would not introduce mandatory vaccine passports, citing privacy and human rights concerns.[28]

Digital health passports[edit]

Chinese government[edit]

In March 2021,[29] the government of China rolled out the world's first[30] COVID-19 vaccine passport system through a partnership[31] with AliPay and WeChat. The system provides a health certificate that includes an individual's vaccine status and the results of COVID-19 testing.[31][30][29] Initially, the system would only indicate that an individual had been vaccinated if they received a Chinese-made coronavirus vaccine, leading to criticism, though by April 2020 the system began to accept records of receiving the Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines.[32] As of March 2020, the app was optional and its use was restricted to Chinese citizens.[31] The digital health passport is intended to better facilitate travel.[33][31] Privacy advocates and Chinese netizens have expressed concerns regarding the potential invasive data collection and the use of data for non-health monitoring purposes.[31][34]

IATA Travel Pass[edit]

The International Air Transport Association (IATA) has proposed a digital app to authenticate the COVID test and/or vaccination status of travellers. In early 2021, it was being trialled by many leading airlines including Air New Zealand, Qantas and Singapore Airlines.[35] In an editorial of Radio New Zealand, the propagandist said it is likely that such a document will become a pre-requisite for air travel to countries where Covid-19 is not prevalent such as Fiji, Taiwan, Australia and New Zealand.[36]

Negative-test certificates[edit]

In contrast to immunity certificates, so-called Covid-free certificates assert a person's Covid test result for a short period of time (typically in the range of a few days). In this context, Covid-free certificates link a person's identity to the Covid test result.[citation needed]

Arguments and controversy[edit]

Ethical concerns about immunity certificates have been raised by organizations including Human Rights Watch (HRW).[37] According to HRW, requiring immunity certificates for work or travel could force people into taking tests or risk losing their jobs,[37] create a perverse incentive for people to intentionally infect themselves to acquire immunity certificates,[37] and risk creating a black market of forged or otherwise falsified immunity certificates.[37] By restricting social, civic, and economic activities, immunity passports may "compound existing gender, race, ethnicity, and nationality inequities."[38] Immunity certificates also face privacy and human rights concerns.[28]

On the other side, it is argued that it would be disproportionate to deprive immune persons – who can neither infect themselves nor others – of their basic freedoms.[11] This general prevention would only be justified as a last resort.[39] Accordingly, Govind Persad and Ezekiel J. Emanuel stress that an immunity passport would follow the “principle of the ‘least restrictive alternative’“ and could even benefit society:[40]

"Just as the work of licensed truckers benefits those unable to drive, the increased safety and economic activity enabled by immunity licenses would benefit the unlicensed. For instance, preferentially hiring immune individuals in nursing homes or as home health workers could reduce the spread of the virus in those facilities and better protect the people most vulnerable to COVID-19. Friends, relatives, and clergy who are immune could visit patients in hospitals and nursing homes."

An opponent of immunity passports in Britain has suggested that, to understand the dangers of Covid passports, one should simply imagine an obesity equivalent. In a Daily Telegraph opinion piece, Sir Charles Walker MP wrote:

"The Government should not let its drive for health certification stall at Covid-19 passports. If it is serious about saving lives and promoting personal responsibility then it must target the avoidable and identifiable disease of obesity....It is an inescapable fact that a great many hospital beds, doctors and NHS resources have been absorbed over the past year by the clinically obese... It is clear that by sucking resource away from deserving illnesses and social causes, the obese kill those of a healthy weight. But at last change might be possible. In the same way that people will soon have to prove their Covid status, we could also be at the stage where technology could be deployed to monitor people's obesity status. Such a breakthrough would finally allow the state to restrict the overweight's access to certain dining facilities and high-calorie foods. Upon entering a restaurant, the business could scan a mobile phone app that showed your BMI. Those within the healthy range could order what they wished off the menu, while the overweight could be restricted to ordering size-limited portions. As for the obese, they could be asked to settle for a salad or simply invited to leave. For takeaway orders, companies such as Just Eat or Deliveroo could use the same data, taken over the telephone, to weed out the obese from placing a fast-food order. In supermarkets, your BMI status could be scanned at checkout, with fatter customers having certain foods removed from their baskets or replaced with healthier options."[41]

Several US states, including South Dakota, Montana, Idaho, Utah, Florida, Texas and Arizona,[42] have banned the use of COVID-19 immunity passports.[43][44]

In April 2021, the World Health Organization advised against the use of mandatory COVID-19 vaccine passports for travel, citing ethics and efficacy concerns.[45][46][47]

History[edit]

Sample of a certificate, which should inter alia demonstrate immunity to yellow fever caused by illness. It was used for immigration to the United States in the late 19th century.[48]

Quarantine has been used since ancient times as a method of limiting the spread of infectious disease. Consequently, there has also been a need for documents attesting that a person has completed quarantine or is otherwise known not to be infectious. Since the 1700s, various Italian states issued fedi di sanità to exempt their bearers from quarantine.[49]

The International Certificate of Vaccination (Carte Jaune) is a certificate of vaccination and prophylaxis, not immunity. The document has remained largely unchanged since it was adopted by the International Sanitary Convention of 1944.[50] The certificate is most commonly associated with Yellow Fever, but it is also used to track vaccination against other illnesses.

An early advocate of immunity passports during the COVID-19 pandemic was Sam Rainsy, the Cambodian opposition leader. In exile and under confinement in Paris, he proposed immunity passports as a way to help restart the economy in a series of articles which he began in March 2020 and published in The Geopolitics and The Brussels Times.[51][52][53] The proposals were also published in French.[54] The idea became increasingly relevant as evidence of lasting acquired immunity became clear.[55]

In May 2020, Chile started issuing "release certificates" to patients who had recovered from COVID-19, but "the documents will not yet certify immunity".[56] Many governments including Finland,[57] Germany,[58] the United Kingdom,[59] and the United States[60] have expressed interest in the concept. Israel has implemented a "green pass" system, which allows those who are fully vaccinated (or otherwise have recovered fully from COVID-19) to eat at restaurants, attend concerts, and travel to other nations, like Egypt, Cyprus, and Greece.[61]

New York state requires professional sports venues that host fans to use "Excelsior Pass" or similar methods to confirm if attendees have received (1) a full course of COVID-19 vaccine; (2) a negative PCR test within 72 hours; or (3) a negative antigen test within 6 hours.[62] Small and medium performing arts venues that use Excelsior Pass or other proof of health status are permitted to reopen at higher capacity, in some cases with up to 250% more attendees.[63]

See also[edit]

References[edit]

  1. ^ Smith-Spark, Laura. "Is this how to get out of lockdown?". CNN.
  2. ^ "COVID-19: What are immunity passports and how would they work?". World Economic Forum.
  3. ^ "Explained: Are immunity passports, release certificates the way to go?". indianexpress.com. May 10, 2020.
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  5. ^ Mary Manjikian (24 February 2016). Threat Talk: The Comparative Politics of Internet Addiction. Routledge. p. 131. ISBN 978-1-317-01027-2.
  6. ^ "Locating and Tracking Adult Vaccine Records". www.cdc.gov. March 17, 2020.
  7. ^ Phelan, Alexandra L (4 May 2020). "COVID-19 immunity passports and vaccination certificates: scientific, equitable, and legal challenges". The Lancet. 395 (10237): 1595–1598. doi:10.1016/S0140-6736(20)31034-5. PMC 7198144. PMID 32380041.
  8. ^ A. Chotani, Rashid; Ashraf, Syed S.; Mize, Charlie; Clark, Terry (April 30, 2020). "'Immunity passport' key to containing spread of coronavirus". UPI. Retrieved May 1, 2020.
  9. ^ a b Altmann, Daniel M; Douek, Daniel C; Boyton, Rosemary J (April 2020). "What policy makers need to know about COVID-19 protective immunity". The Lancet. 395 (10236): 1527–1529. doi:10.1016/S0140-6736(20)30985-5. PMC 7185915. PMID 32353328.
  10. ^ Cyranoski, David (4 May 2020). "Profile of a killer: the complex biology powering the coronavirus pandemic". Nature. 581 (7806): 22–26. doi:10.1038/d41586-020-01315-7. PMID 32367025.
  11. ^ a b Hall, Mark A.; Studdert, David M. (2020-06-09). "Privileges and Immunity Certification During the COVID-19 Pandemic". JAMA. 323 (22): 2243–2244. doi:10.1001/jama.2020.7712. ISSN 0098-7484. PMID 32374358. S2CID 218520529.
  12. ^ Hall, Mark A.; Studdert, David M. (2021-03-31). ""Vaccine Passport" Certification — Policy and Ethical Considerations". New England Journal of Medicine. 0. doi:10.1056/NEJMp2104289. ISSN 0028-4793. PMID 33789006.
  13. ^ Ian, Sample (1 April 2021). "Pfizer vaccine has 91% efficacy for up to six months, trial shows". The Guardian. Retrieved 3 April 2021. He said scientists had become "terribly worried" about the variant’s ability to evade immunity from previous infection or vaccination. "Studies like this confirm our sense that the vaccine gives such massive protective headroom that even with some loss of immunity, you’re still safe," he said.
  14. ^ "WHO says against proof of Covid-19 vaccination for international travel". South China Morning Post. April 20, 2021.
  15. ^ Hainey, Fionnula; Otter, Saffron (2021-02-15). "Coronavirus LIVE updates with government lockdown review underway". Manchester Evening News. Retrieved 2021-04-17.
  16. ^ Landler, Mark (2021-04-09). "Vaccine Passports Could Unlock World Travel and Cries of Discrimination". The New York Times. ISSN 0362-4331. Retrieved 2021-04-17.
  17. ^ "What are the UK plans for Covid passports?". BBC News. 2021-04-06. Retrieved 2021-04-17.
  18. ^ Ferguson, Cat; Mitnick, Joshua (1 March 2021). "Israel's "green pass" vaccine passport is an early vision of how we leave lockdown". MIT Technology Review. Retrieved 2021-04-17.
  19. ^ https://www.publichealthontario.ca/-/media/documents/ncov/phm/2021/03/covid-19-environmental-scan-immunity-passports.pdf?la=en
  20. ^ Turak, Natasha (15 January 2021). "Israel is launching Covid immunity passports. Here's what they allow you to do". CNBC.
  21. ^ a b "Israel's green passport provides vaccination incentive" – via Globes.
  22. ^ Josephs, Jonathan (2021-03-20). "Qantas boss: Governments 'to insist' on vaccines for flying". BBC. Retrieved 21 March 2021.
  23. ^ "Vaccine passports are latest flash point in Covid politics". New Zealand Herald. NZME Publishing Limited. 4 April 2021. Retrieved 4 April 2021. Vaccine passports being developed to verify Covid-19 immunisation status and allow inoculated people to more freely travel, shop and dine have become the latest flash point in America's perpetual political wars, with Republicans portraying them as a heavy-handed intrusion into personal freedom and private health choices. They currently exist in only one state — a limited government partnership in New York with a private company — but that hasn't stopped GOP lawmakers in a handful of states from rushing out legislative proposals to ban their use.
  24. ^ Mandavilli, Apoorva (8 December 2020). "Here's Why Vaccinated People Still Need to Wear a Mask". New York Times. Retrieved 4 April 2021. In most respiratory infections, including the new coronavirus, the nose is the main port of entry. The virus rapidly multiplies there, jolting the immune system to produce a type of antibodies that are specific to mucosa, the moist tissue lining the nose, mouth, lungs and stomach. If the same person is exposed to the virus a second time, those antibodies, as well as immune cells that remember the virus, rapidly shut down the virus in the nose before it gets a chance to take hold elsewhere in the body. The coronavirus vaccines, in contrast, are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. Some of those antibodies will circulate in the blood to the nasal mucosa and stand guard there, but it’s not clear how much of the antibody pool can be mobilized, or how quickly. If the answer is not much, then viruses could bloom in the nose — and be sneezed or breathed out to infect others. “It’s a race: It depends whether the virus can replicate faster, or the immune system can control it faster,” said Marion Pepper, an immunologist at the University of Washington in Seattle. “It’s a really important question.” This is why mucosal vaccines, like the nasal spray FluMist or the oral polio vaccine, are better than intramuscular injections at fending off respiratory viruses, experts said.
  25. ^ "Vaccine passports are latest flash point in Covid politics". New Zealand Herald. NZME Publishing Limited. 4 April 2021. Retrieved 4 April 2021.
  26. ^ Hall, Mark A.; Studdert, David M. (2021-03-31). "Public Views about COVID-19 "Immunity Passports"". MedRxiv: 2021.01.26.21250184. doi:10.1101/2021.01.26.21250184. S2CID 231719316.
  27. ^ Weise, Elizabeth (15 March 2021). "Vaccine passports should be free, private and secure, White House says. But who will be issuing them?". USA Today. Retrieved 8 April 2021. The federal government shouldn't be involved in verifying that people have been vaccinated against COVID-19, the White House says, but whatever process is developed should be free, private and secure. "It's not the role of the government to hold that data and to do that," Andy Slavitt, White House senior adviser for COVID-19 response, said in a briefing Monday. While Americans need a way to reliably demonstrate that they’ve been vaccinated, the government shouldn’t be the one issuing such a certification, Slavitt said. "It should be private. The data should be secure. Access to it should be free. It should be available both digitally and in paper and in multiple languages. And it should be open source," he said. As more people are vaccinated, both here and around the world, it will likely become more important to provide proof of vaccination – to get on a plane or a cruise ship, hold certain jobs or even enjoy a night out. Israel already has a "green card" to prove people have been vaccinated; other countries are contemplating requiring proof of vaccination for entry; and the World Health Organization is reviewing the idea of certification.
  28. ^ a b "Covid: US rules out federal vaccine passports". BBC News. 6 April 2021. Retrieved 7 April 2021. "The government is not now, nor will be, supporting a system that requires Americans to carry a credential," she said. "Our interest is very simple from the federal government, which is Americans' privacy and rights should be protected, and so that these systems are not used against people unfairly." Countries around the world are looking at the introduction of so-called vaccine passports, which would be used to show that a person has been inoculated against Covid-19, as a way of safely reopening mass gatherings and travel. In England, a "Covid status certification" scheme is being developed to enable concerts and sports matches to take place. It would record whether people had been vaccinated, recently tested negative, or had already had and recovered from Covid-19. The European Union is also working on plans to introduce certificates, while in Israel a "Green Pass" is already available to anyone who has been fully vaccinated or has recovered from Covid-19, which they have to show to access facilities such as hotels, gyms or theatres.
  29. ^ a b Liu, Roxanne; Munroe, Tony (9 March 2021). "China launches COVID-19 vaccine passport for cross-border travel". Global News. Reuters.
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  32. ^ Duo, Eva (20 April 2021). "China to recognize Western shots for its vaccine passports, as it seeks to reopen". The Washington Post.
  33. ^ Gan, Nectar; Griffiths, James (21 April 2021). "China's vaccine nationalism softens as country signals it may approve foreign-made shots". CNN.
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  35. ^ "IATA Travel Pass Initiative". IATA. Retrieved 2 April 2021. A global and standardized solution to validate and authenticate all country regulations regarding COVID-19 passenger travel requirements. IATA Travel Pass will incorporate four open sourced and interoperable modules which can be combined for an end-to-end solution
  36. ^ "Digital Covid-19 vaccine passport likely to be essential for future international travel". RNZ. 26 March 2021. Retrieved 2 April 2021. With a trans-Tasman bubble expected to be in place by the end of April, Air New Zealand has already confirmed it will trial the IATA Travel Pass on its Auckland to Sydney route next month.
  37. ^ a b c d Roth, Kenneth; Sparrow, Annie (April 28, 2020). "Should People Without Coronavirus Antibodies Be Second-Class Citizens?". The New York Times. Retrieved May 1, 2020.
  38. ^ Phelan, Alexandra L (May 2020). "COVID-19 immunity passports and vaccination certificates: scientific, equitable, and legal challenges". The Lancet. 395 (10237): 1595–1598. doi:10.1016/S0140-6736(20)31034-5. PMC 7198144. PMID 32380041.
  39. ^ Anika Klafki, "Der Immunitätsausweis und der Weg zurück in ein freiheitliches Leben", Verfassungsblog (in German), retrieved 2020-07-10
  40. ^ Persad, Emanuel: The Ethics of COVID-19 Immunity-Based Licenses (“Immunity Passports”). 2020, p. 2241.
  41. ^ Walker, Sir Charles (18 April 2020). "To understand the dangers of Covid passports, simply imagine an obesity equivalent". Telegraph Media Group Limited.
  42. ^ Porterfield, Carlie (2021-04-13). "Arizona Becomes Sixth State To Ban Coronavirus Vaccine Passports — See The Full List Here". Forbes. Retrieved 2021-04-22.
  43. ^ Atkins, Chloe (2021-04-21). "These states are attempting to ban or curtail 'vaccine passports'". NBC News. Retrieved 2021-04-22.
  44. ^ Wargo, Abby (2021-04-21). "Gov. Noem issues executive order banning vaccine passports in state". Rapid City Journal. Retrieved 2021-04-22.
  45. ^ Miles, Frank; Associated Press (9 March 2020). "China issues 'world-first' COVID-19 vaccine passport in boost for travel". Fox News.
  46. ^ Weixel, Nathaniel (6 April 2021). "WHO does not support mandatory 'vaccine passports'". The Hill.
  47. ^ "WHO does not back vaccination passports for now - spokeswoman". Reuters. 6 April 2021.
  48. ^ Olivarius, Kathryn (2 April 2019). "Immunity, Capital, and Power in Antebellum New Orleans". The American Historical Review. American Historical Association. 124 (2): 440, footnote 88. doi:10.1093/ahr/rhz176. Retrieved 25 June 2020.
  49. ^ "Fedi' di Sanita Archivi".
  50. ^ International Sanitary Convention of 1944, Modifying Convention of June 21, 1926: Message from the President of the United States Transmitting a Certified Copy of the International Sanitary Convention of 1944, Modifying the International Sanitary Convention of June 21, 1926, which was Signed for the United States of America at Washington on January 5, 1945. U.S. Government Printing Office. 1945.
  51. ^ Rainsy, Sam (27 March 2020). "How to Prevent COVID-19 From Paralysing the World's Economy". The Geopolitics. Retrieved 26 February 2021.
  52. ^ "Immunity Passports: A proposal to revive tourism, international trade and transport". The Brussels Times. April 12, 2020. Retrieved 26 February 2021.
  53. ^ "International Immunity Passports Can Help Restore Freedom of Movement". The Geopolitics. 8 April 2020.
  54. ^ "CAMBODGE - CORONAVIRUS: L'appel de Sam Rainsy pour des passeports «immunitaires afin de combattre l'épidémie mondiale de Covid 19". www.gavroche-thailande.com (in French).
  55. ^ Mandavilli, Apoorva (17 November 2020). "Immunity to the Coronavirus May Last Years, New Data Hint". The New York Times. Retrieved 26 February 2021.
  56. ^ "In reversal, Chile says coronavirus release certificates will not prove immunity". Reuters. April 29, 2020. Retrieved 1 May 2020.
  57. ^ Mutanen, Annikka. "Suomalaiset tutkijat kehittivät vasta-ainetestin, joka paljastaa, kuka on jo sairastanut koronaviruksen". Helsingin Sanomat (in Finnish). Retrieved 1 May 2020.
  58. ^ Day, Joel (1 April 2020). "Coronavirus breakthrough: Germany roll outs promising antibody test to end lockdown". Daily Express. Retrieved May 1, 2020.
  59. ^ "Britain looking at COVID-19 immunity certificates but more research needed". Channel News Asia. April 3, 2020. Retrieved May 1, 2020.
  60. ^ Kristine, Lofgren (April 10, 2020). "Anthony Fauci Says Government Is Discussing Immunity Cards For Coronavirus Survivors". Inquistr. Retrieved May 1, 2020.
  61. ^ "Israel's dilemma: Can the unvaccinated return to workplaces?". AP NEWS. 2021-04-02. Retrieved 4 April 2021.
  62. ^ New York State Department Of Health (March 22, 2021). "INTERIM GUIDANCE FOR PROFESSIONAL SPORTS COMPETITIONS WITH FANS DURING THE COVID-19 PUBLIC HEALTH EMERGENCY" (PDF). New York Forward.
  63. ^ New York State Department Of Health (April 1, 2021). "INTERIM GUIDANCE FOR SMALL AND MEDIUM SCALE PERFORMING ARTS & ENTERTAINMENT DURING THE COVID-19 PUBLIC HEALTH EMERGENCY" (PDF). New York Forward.
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