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Alberta Premier Jason Kenney takes questions after announcing new COVID-19 measures for Alberta in Calgary on Sept. 15.Jeff McIntosh/The Canadian Press

Alberta Premier Jason Kenney said he has asked health officials to explore whether evidence of naturally acquired COVID-19 antibodies could be used in lieu of proof-of-vaccine under the province’s new passport system.

Mr. Kenney answered questions from the public on Facebook last week after announcing a vaccine passport system for non-essential businesses. Multiple viewers asked whether people who previously had COVID-19, and therefore have some degree of natural protection against reinfection, still needed to get immunized to access services.

“We are looking at that,” he said, pointing out that Israel and Denmark allow people who can prove they recovered from COVID-19 to access services that require proof-of-vaccination or a recent negative test. “I’ve asked that we look more closely at that to see if we can replicate that as a feature of our program here.”

A potential exception, however, will not be coming soon. Mr. Kenney said Alberta cannot afford to wait weeks developing a system that would account for proof of antibodies, especially given the current crisis in the health care system and the waning effect of naturally acquired protection.

“The highest level of protection you can have is to have some antibodies through prior infection and to be vaccinated. That kind of gives you COVID superpowers,” he said. “If you’ve recovered, yes, you have a good level of protection but you can improve that by getting vaccinated.”

Alberta’s intensive-care units are overwhelmed with unvaccinated COVID-19 patients and the province last week declared a health emergency. On Thursday, Alberta postponed all non-emergency surgeries to free up equipment, space and staff for makeshift ICU beds.

Stephanie Smith, an infectious-diseases physician, said that while people who recover from COVID-19 have antibodies, it is unclear how long their immunity against the coronavirus lasts. In Denmark’s passport system, proof of a positive PCR test taken within the previous 12 months is acceptable. In Israel, people who have recovered from COVID-19 have passport privileges until the end of 2021. However, effective Oct. 1, passport privileges for recovered individuals will expire six months after the date that person receives a recovery certificate.

Serology tests could be used to check for antibodies, but that will take time and money. And even if someone boasted COVID-19 antibodies, it does not necessarily mean they are protected, Dr. Smith said.

“It is not a perfect correlation,” she said.

Adding another element to Alberta’s passport system, which the government calls a “restriction exemption program,” would further complicate an already confusing policy, she added.

Ameeta Singh, an infectious-diseases specialist at the University of Alberta, said that while people who contracted COVID-19 should still get vaccinated, it would be “reasonable” for a passport program to accept documentation of antibodies, within a certain period of time, instead of a record of immunization.

Alberta Health “strongly” recommends people previously infected with COVID-19 get vaccinated, according to spokesman Tom McMillan. The government has not yet decided whether it will broaden its passport system to include antibodies swimming in those who have recovered from the illness.

“Evidence about the extent and duration of immunity from prior COVID-19 infection is still emerging,” he said.

Starting Monday, non-essential businesses in Alberta will face public-health restrictions, such as restaurants closing their indoor dining rooms, unless they implement the vaccine passport system. In order to access services, Albertans will have to provide proof they are vaccinated or a negative COVID-19 test taken within the previous 72 hours. This does not apply to children under 12, who are not eligible for the shot, and people with medical exemptions.

Ilan Schwartz, an infectious-diseases physician at the University of Alberta, described the restrictions as confusing, convoluted and “ultimately compromised because the Premier has clearly pandered to those who vehemently oppose vaccination.”

“There are so many loopholes and exceptions and exemptions, and [the Premier] has just really tried so hard to appease this beleaguered group of voters, that he has created a confusing and, in all likelihood, ineffectual intervention,” Dr. Schwartz said.

He added that it is likely far too late for even broad restrictions to effectively turn things around.

“These were required four weeks ago in order to avert disaster,” he said. “While I can certainly find fault with the way that this has been specifically drafted and announced, I think that the much more important thing is that this is far too late to salvage the collapse of our critical-care capacity in the province.”

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