By Joel Achenbach, Ariana Eunjung Cha, Ben Guarino and Chelsea Janes,
Washington Post – June 1, 2020 at 8:36 p.m. EDT

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Has the novel coronavirus in Italy changed in some significant way? That was the suggestion of a top doctor in northern Italy who reports that patients to his hospital have been showing up with lower levels of the virus in their upper respiratory tracts compared with those two months ago.

Alberto Zangrillo, head of San Raffaele Hospital in Milan, roiled the global public health community on Sunday when he told RAI, the national TV station, that “the virus clinically no longer exists in Italy,” with patients showing minute amounts of virus in nasal swabs. Zangrillo theorized in a follow-up interview with The Washington Post that something different may be occurring “in the interaction between the virus and the human airway receptors.”

He added, “We cannot demonstrate that the virus has mutated, but we cannot ignore that our clinical findings have dramatically improved.”AD

The comments, which received widespread attention following a Reuters report, prompted vigorous pushback from Michael Ryan, a top official with the World Health Organization, who said Monday during an online news conference that “we need to be exceptionally careful not to create a sense that all of a sudden the virus by its own volition has now decided to be less pathogenic. That is not the case at all.”

The consensus among other experts interviewed Monday is that the clinical findings in Italy likely do not reflect any change in the virus itself.

Zangrillo’s clinical observations are more likely a reflection of the fact that with the peak of the outbreak long past, there is less virus in circulation, and people may be less likely to be exposed to high doses of it. In addition, only severely sick people were likely to be tested early on, compared with the situation now when even those with mild symptoms are more likely to get swabbed, experts said.AD

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The pandemic is evolving rapidly, with the rate of new cases declining in some hard-hit areas of the world, including northern Italy and New York City, while rising dramatically in Brazil, Peru and India. The virus, however, is mutating at a slow rate, experts say.

Some strains of the virus have become more dominant, but there is no firm evidence yet that any of them are more contagious or deadly, according to scientists who have reviewed recent genetic studies.

Vaughn Cooper, an infectious-disease expert at the University of Pittsburgh School of Medicine, said the new coronavirus mutates slowly compared with influenza and other microbes, and its genetic changes appear to be “mostly inconsequential.”

“I believe it’s safe to say that the differences that doctors are reporting in Italy are entirely due to changes to medical treatment and in human behavior, which limit transmission and numbers of new infections initiated by large inocula — a larger dose of virus appears to be worse — rather than changes in the virus itself,” he said.

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From NJ Spotlight

• New Jersey officials reported an additional 1,171 confirmed cases of COVID-19 today, for a statewide cumulative total of 158,844.
  • By counties, the most new positive results were reported in Middlesex (101), Essex (98), Passaic (95), Monmouth (86) and Mercer (85).
  • At the other end of the spectrum, a total of 37 new cases were reported in Cape May, Salem, Hunterdon, Warren and Sussex counties combined.
    
• Total COVID-19 deaths among New Jersey residents stand at 11,531, with an additional 131 confirmed fatalities reported today.The order of the counties with the most deaths remained the same: Essex (1,647), Bergen (1,567), Hudson (1,168), Union (1,060) and Middlesex (972).
  
• Globally, more than 360,000 have died, led by the United States, with more than 102,000 fatalities, according to Johns Hopkins University Coronavirus Resource Center.
  
• According to data reported by all 71 hospitals in the state, 2,707 patients were being treated for confirmed or suspected cases of COVID-19 as of last night, a decrease.720 of the current patients were in critical or intensive care, a second day where that number fell below 750.
  
• 544, or roughly 76% of those in critical care units, required ventilators.
  
• Regionally, 1,324 patients were in hospitals in the north, 776 in central Jersey and 607 in the south.
  
• Of those, 183 were new patients as of yesterday, roughly half the number reported the day before, and the first decline in three days.
  
• 231 COVID-19 patients were discharged, either to their homes or other care facilities.
  
• In comparison with other states, New Jersey is the highest in hospitalizations per capita, fourth in deaths per capita, and eighth in new daily cases per capita, according to the Murphy administration. (Above chart.)
   
• The daily, or spot, positivity rate of COVID-19 tests on May 26 stood unchanged at 6% statewide.Results of more than 716,411 tests have now been reported to state officials, including negatives, reflecting a significant boost in testing capacity in New Jersey.
  
• Some 26,000 tests were conducted on Wednesday alone.
  
• NJ Health Commissioner Judith Persichilli reported that the numbers of children with a rare and serious pediatric inflammatory ailment often referred to as Kawasaki disease had held steady, at 26, with no deaths.She also said preliminary data indicates the syndrome hits children of differently races at rates disproportionate to the ethnic composition of the state as a whole, with black children making up roughly 27% of cases and Hispanic children, nearly 30%.
  
• A total of 4,858 deaths among residents at 537 nursing homes and other long-term care centers in New Jersey have been laboratory confirmed as cases of COVID-19.LTCs in the state are reporting a cumulative total of 21,650 positive cases among residents, and 10,447 among staffers.
  
• They are also reporting the deaths of 105 staffers.
   

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