Many thoughts come to my mind on this.
1. 100% sure there will be people who try to purposely inoculate themselves. Good or bad?
As I posted in another thread, there are instances of patients coming into the ED and trying to hide their past or current flu like symptoms because they don’t want to be quarantined, putting everyone in the ED at higher risk.
2. There is reasonable knowledge (even Fauci saying he would bet it is so) but no definitive conclusion by a study that this particular virus exempts people who were once infected. More on this in point 3 below.
3. There are enough studies to conclude that titer levels detected over time through serological tests is highly associated to severity of the disease. So, what does this mean for someone who had only mild symptoms, or no symptoms, being a vector? Not answered scientifically yet. For example, with MERS, it was shown that patients with mild symptoms did not have any detectable antibodies even at the 3-month post initial symptoms timeframe.
4. Related to 2 and 3, does the health department have a criteria for what level of titer detected can a certificate be issued?
5. The health department should NOT base any certification decisions on patients who used at-home tests. So many ways someone can cheat that.
6. Make sure the sensitivity and specificity of the particular test(s) used is high enough. And since no test is 100% sensitive and specific, require successive tests as confirmation. This is even SOP with presumptive cases. So, it better be to let people out.
7. It’s a good idea. As long as enough precautions and the right procedures are in place.