Leaders are considering whether to extend coronavirus certification for those who have recovered from the virus, so it is in line with certificates for vaccinated people at 12 months. Health minister Tanel Kiik (Center) urges caution, while the undersecretary at his ministry said unnamed experts opposed it. At the same time, leaders of the government's coronavirus advisory council, and of the Health Board (Terviseamet) have tentatively supported harmonization.
Kiik also noted a common EU approach, while not ruling out Estonia having its own internal certification, or at least holding further discussions on the issue.
At present, vaccinated people get a 12-month certificate, if they have completed the vaccination course, whereas those who recover from a bout with COVID-19 get a certificate valid for half that amount of time, i.e. six months.
These two types of certification are from this week the only acceptable means for admission to a wide range of public events, venues and activities, while a recent negative test is no longer sufficient, save for under-18s.
Fresh research from abroad finds that risk factors for of a formerly infected person who had since recovered, is not any higher than that of vaccinated person.
Speaking at the regular government press conference Thursday, health minister Kiik said that, given an individual who returns positive from a coronavirus PCR test: "Can be very seriously ill, or has had a strong immune response, or it can also show that the viral RNA has been found in their system, or they may have been very mildly exposed to the virus – or not even have had it at all."
"Taking into consideration people who have only been exposed to the virus briefly, it would be risky to extend the validity of the coronavirus certificate," Kiik said.
Health Board deputy director: Likelihood of reinfection may depend on how severely patient suffered in first place
However, Mari-Anne Härma, Deputy Director General at the Health Board, says that cases in Estonia so far demonstrate that the probability of re-infection may depend on how severely an individual had suffered from the virus for the first time.
She said: "As a rule, if one presents with just very mild symptoms - and some people have also reported that they had completely asymptomatic coronavirus - then they have a slightly higher probability of being re-infected."
Very few people in Estonia have been re-infected multiple times, she added. "There are a few hundred; up to four hundred of these around," she said, putting the overall figure at around 0.2 percent of cases.
Kiik said that Estonia's rules at present coincide with the EU's, whereas they could diverge. "If we now want to change something in the Estonian state, it means that we have to create a completely new certificate, a completely new format. It would not be valid within the EU, but it could theoretically be valid nationally."
Ministry undersecretary: Our experts not in favor of extending recovery certification term
Heidi Alasepp, Undersecretary at the Ministry of Social Affairs, Tanel Kiik's ministry, had stated in a written comment that prolonging coronavirus certification in the case of those who have recovered has indeed been under discussion, but not supported on the whole, particularly with regard to those who had been hospitalized due to the virus or suffered from it severely.
Alasepp wrote: "Our experts are not in favor of extending the validity of the certificate," without, ERR reports, naming the experts.
"There are no studies confirming that most patients from among different patient groups find long-term permanent protection against the disease, after discharge," she went on.
Irja Lutsar: Being reckless about the virus in the hope of later recovering is playing 'Russian roulette'
The government's coronavirus advisory council chief, Professor Irja Lutsar, says there is no certainty yet that recovery from the virus is a better bet than vaccination, "But we probably have enough knowledge to state that one is not worse than the other."
"Of course, this does not mean that people should not get vaccinated. Those who are considering trying to get immunity by being reckless are playing a kind of Russian roulette," Lutsar went on.
"Contracting and recovering from the virus creates strong immunity, but we never know who might develop a very serious illness and who might end up needing intensive care," she went on.
Ministry undersecretary: Most European countries not going with 12-month recovery certification
Heidi Alasepp noted urged caution in her letter, noting European states are generally not extend certification validity, while those that have, have much higher rates of vaccine coverage.
"Only two countries - Denmark and Norway - have extended the validity of the certificate today, and these countries differ significantly from us in terms of their high level of vaccination," Alasepp wrote.
Kiik: Complicated debate
While Mari-Anne Härma said a decision would likely be made in the near future, Tanel Kiik said he was not so optimistic.
Kiik said: "It is quite a complicated scientific debate; it is quite complicated technically, for the EU, because the agreement is currently following the logic of a six-month term. We may be able come back to these discussions someday, but I definitely do not recommend anyone wait."
Marje Oona, a member of the Committee of Experts on Immunoprophylaxis, says EU principles and the rules currently in force had been established when the data on both vaccinations and recovery re much scantier than at present, and agreed that a 12-month certification period could work.
Justice chancellor: 12-month certificate of recovery might be viable
Andres Merits, also on the government's scientific council – headed by Irja Lutsar – agreed with the latter, saying that: "All currently available research from Estonia demonstrates that the immune protection of survivors is at least equal, according to Estonia, even better than the average vaccine recipients."
"The risks associated with recovery are dozens of times higher than the risks associated with vaccination, depending on age," Merits added.
"But if it was already the case that a person had recovered, then there is absolutely no reason to ignore scientific data and say that for whatever reason, they cannot get a 12-month coronavirus certificate."
Chancellor of Justice Ülle Madise told the Riigikogu's Social Affairs Committee Monday that extending the certification of those who had recovered to 12 months might be viable, contingent on what other countries are doing.
"It is not a question of crossing borders," Madise said, noting that the rules of the destination country must be followed when crossing the border anyway.
"The question is which rules apply in Estonia. And EU rules do not prohibit Estonia from taking into account the evidence of antibodies, or the proof of recovery, for a longer period of time," she went on.
Editor: Andrew Whyte