Lots of high-fiving about this on social media this morning, as it’s obviously wonderful news if true. But is it true?
Three things about it make me suspicious. One is the vagueness. What does he mean, specifically, that the virus is losing its potency? Two is the fact that Italian health officials don’t agree and are warning people not to underestimate the ongoing risk. And third is that the doctor packaged his assessment of the virus with a political take about lockdowns, insisting that Italy needs to get back to normal and that “[s]omeone has to take responsibility for terrorizing the country.” Is politics influencing his assessment of the threat?
This guy was also Berlusconi’s doctor for 30 years, for what it’s worth.
“In reality, the virus clinically no longer exists in Italy,” said Alberto Zangrillo, the head of the San Raffaele Hospital in Milan in the northern region of Lombardy, which has borne the brunt of Italy’s coronavirus contagion.
“The swabs that were performed over the last 10 days showed a viral load in quantitative terms that was absolutely infinitesimal compared to the ones carried out a month or two months ago,” he told RAI television…
Zangrillo said some experts were too alarmist about the prospect of a second wave of infections and politicians needed to take into account the new reality.
Another doctor in Genoa agreed with him, saying, “It is clear that today the COVID-19 disease is different.” But the head of the National Health Council called himself “baffled” at the suggestions that the risk has disappeared and a deputy at the health ministry said, “Pending scientific evidence to support the thesis that the virus has disappeared, I would invite those who say they are sure of it not to confuse Italians.”
The risk in Italy has certainly declined dramatically lately…
…but why? Was it the long lockdown choking off opportunities for transmission of the disease? Or did something qualitatively change about the virus itself, which is what Zangrillo seems to mean? If he has reason to believe that a more benign strain has evolved and has overtaken the more lethal strain that ravaged Lombardy and New York, he could have said so clearly. I haven’t read of any virologists, many of whom are tracking mutations based on genomic analysis, make that claim either.
Is it possible that the reason the viral load is so much lower in Italian patients now than it was two months ago is that people were being “re-infected” when the disease was prevalent? That is, back when it was circulating widely in February, maybe the average person absorbed X amount of it from an encounter with one infected person, then 2X after an encounter with a second infected person, and so on over the course of various daily interactions, until they reached some critical mass that triggered a severe case of the illness. Nowadays, because fewer Italians are infected (and are taking more precautions when they interact with each other), there are fewer encounters with infected people *and* probably less absorption of the virus in each interaction when a person does happen to interact with someone who’s infected.
There may not be a new strain, in other words. It may simply be that in mid-February an Italian would receive 10X of the virus over the span of a week, too much for his body to fight off, while nowadays he’s receiving X amount, which might not be enough to overwhelm the immune system. The Times published a story a few days ago noting that the evidence about the effect of the viral load on COVID-19 patients cuts both ways. On the one hand, some people with no symptoms seem to have just as much of the virus in their body as those who are sick. On the other hand, it’s usually the case with diseases that absorbing more of a particular pathogen makes you more likely to get sick from it. And one biologist told the paper that “It really takes a lot of these single-digit size droplets to [increase] the risk for you,” describing the sort of microscopic aerosolized particles that hang around in unventilated areas. Maybe, between physical distancing, mask-wearing, and attentiveness to ventilation, people in Italy — and the U.S. — have managed to cut down on the amount of coronavirus that the average person is breathing in, which has made a meaningful difference.
JUST IN: @ABC looked at 21 states that eased restrictions May 4 or earlier & found no major increase in hospitalizations, deaths or % of people testing positive in any of them. [SC, MT, GA, MS, SD, AR, CO, ID, IA, ND, OK, TN, TX, UT, WY, KS, FL, IN, MO, NE, OH] via @AMitrops
— Eric+ (@ericMstrauss) May 28, 2020
There’s some genuinely good news about coronavirus out of Europe and Scandinavia lately, even above and beyond the falling death tolls. Schools have been open in various countries for weeks now — and there’s been no second wave. The fear that kids will infect each other and then bring the virus home to the adults in their families appears to be unfounded, which is terrific. Why aren’t they spreading it, you ask? The answer *might* be that they’re just not physically capable.
Denmark, Austria, Norway, Finland, Singapore, Australia, New Zealand and most other countries that have reopened classrooms haven’t had outbreaks in schools or day-care centers…
“Our interpretation is that it may be that the children aren’t that important for the spread of infection,” Dr. Krause said. Infections in Denmark among all age groups have been decreasing since schools reopened, she added…
One reason for the absence of infections in schools could be that children below 10 have fewer of the receptors the virus uses to enter the body, said Prof. Herman Goossens, a medical microbiologist and coordinator of a European Union task force for researching Covid-19.
The number of so-called ACE2 receptors in some cells in the upper respiratory tract that the novel coronavirus uses as a gateway only starts to increase from the age of 10, making younger children comparatively less susceptible, he said.
Note the age mentioned, as older children may not be as invulnerable to infection as younger ones. In fact, there’s news today of a surge in COVID-19 cases in Israel that’s been traced back to a high school. A teacher, suspected to be a “super-spreader,” apparently came into work despite feeling sick; there are now 134 cases linked to the school. That’s obviously an example of someone not taking reasonable precautions to limit infections. Thankfully, given the slowing rate of infections across Europe, most people are behaving more prudently.
I’ll leave you with this, a birdseye view of the confirmed cases across the entire planet. Cases are increasing — while deaths are decreasing. Is there a new, less lethal strain of the virus out there?