COVID19 update, June 22, 2020: Is the virus weakening from a “tiger” to a “feral cat”?; EU taking a harder stance on China

(1) Italian infectious diseases specialist Prof. Matteo Bassetti, who works at the St. Martin Hospital in Genoa, makes the claim that the virus has mutated into a weaker form, reports the Daily Telegraph (among many other outlets). Here is an archive copy: http://archive.is/1EWSp

Coronavirus has downgraded from a “tiger to a wild cat” and could die out on its own without a vaccine, an infectious diseases specialist has claimed.
Prof Matteo Bassetti, head of the infectious diseases clinic at the Policlinico San Martino hospital in Italy, told The Telegraph that Covid-19 has been losing its virulence in the last month and patients who would have previously died are now recovering.
[…] 
“The clinical impression I have is that the virus is changing in severity,” said Prof Bassetti.
“In March and early April the patterns were completely different. People were coming to the emergency department with a very difficult to manage illness and they needed oxygen and ventilation, some developed pneumonia.
“Now, in the past four weeks, the picture has completely changed in terms of patterns. There could be a lower viral load in the respiratory tract, probably due to a genetic mutation in the virus which has not yet been demonstrated scientifically. Also we are now more aware of the disease and able to manage it.
It was like an aggressive tiger in March and April but now it’s like a wild cat. Even elderly patients, aged 80 or 90, are now sitting up in bed and they are breathing without help. The same patients would have died in two or three days before.
“I think the virus has mutated because our immune system reacts to the virus and we have a lower viral load now due to the lockdown, mask-wearing, social distancing. We still have to demonstrate why it’s different now.

Wishful thinking? Though this sort of thing has been known to happen in the past. Viruses that kill off their hosts quickly (such as Ebola and MERS) don’t get to spread their genome as well as those who just make their hosts sick, so there is “evolutionary pressure”, if you like. 

[UPDATE: A reader comments: “I don’t remember where I read it, but I recall a journal article from back when I was a bio/pre-nursing major that postulated that no disease with an infection mortality rate above ~5% would ever go global despite air travel, unless artificially spread, or had a crazy long (>1month) incubation period, because any bug that deadly kills enough people that the infected population ends up quarantined almost by default, no matter where. It seemed quite logical to me.”]

There is, of course, another possible explanation. Vitamin D deficiency is surprisingly prevalent in northern Italy, especially in winter. With the summer weather and people again being able to go outside — particularly indulge in the Italian pastime of sitting outside with one’s coffee and/or pasta — people may simply be less deficient and their immune systems better able to face the challenge of the virus.

The proof in the pudding would be to sequence the genome of COVID19 from this putative “new strain” and see if it really is different in anything that would affect the spike, the replicase (a.k.a, RdRp), or another part of the viral machinery. Absent that, my money is on vitamin D.

(2) Die Welt  (in German) reports on unprecedented complications in the relations between the EU and China, in the context of an EU summit meeting in Brussels on the subject.  The misinformation/Fake News campaign to diffuse the regime’s responsibility for the epidemic is one factor, the de facto abolition of Hong Kong’s internal autonomy is another. Then there are the “reshoring” efforts to bring vital production of medical supplies and PPE back to Europe in order not to be dependent on a fragile supply chain.

The article also cites measures to impede hostile takeovers of struggling companies by Chinese state-backed “bargain hunters” . 

They say about pressuring China,  “Trump does it his way, we do it our way, [albeit] less aggressive [sic].” The journalist comments that China has thus far not gotten any significant pushback for its behavior, and that pressure from European side might make them think again.

(3) The American Chemical Society has a special virtual issue on COVID-19 research across its extensive portfolio of research journals in various areas of chemistry, plus (alas) some what I shall charitably describe as “advocacy papers” and opinion pieces. But that still leaves a lot of original research papers: one that jumped out at me was this one about the role of glutathione deficiency (see our earlier blog post)

https://doi.org/10.1021/acsinfecdis.0c00288

ADDENDUM (hat tip: Mrs. Arbel). Dr. Shelton, about 15 minutes into this video, has some advice for people enhancing their vitamin D through sunbathing: “he says after sun exposure don’t shower off the body oils on large body areas … that’s where the vitamin D is still being made for a day …”

COVID19 update, April 14, 2020: vitamin D, zinc, testing; end of globalization as we know it?

(1) Roger Seheult MD in his latest update gives a clear discussion of RT-PCR (reverse transcriptase polymerase chain reaction) testing vs. antibody testing.

I spoke to an industry insider about why not more antibody testing yet? I was told that first-generation antibody testing kits achieved accuracies of around 30%, which are “worse than useless”. But accuracies are steadily improving, and we should soon be looking at something comparable in accuracy to a good RT-PCR.

In response to reader demand, Dr. Seheult also gives a link to a hydrotherapy regime that might be useful for prophylaxis and for treatment of mild cases — but only in addition to more conventional approaches: https://www.hydro4covid.com

(2) Nursing school instructor John Campbell, in his latest update, hammers a lot on the beneficial effect of vitamin D for the human immune system. In fact, he looks at the different mortality statistics for ethnic groups in NYC, and finds it fascinating that everybody comes up with socio-economic explanations while overlooking something obvious: at northern latitudes, vitamin D deficiency is quite common among dark-skinned people. (In fact, both the white and “yellow” skin types evolutionarily started as mutations that just happened to allow humans to thrive in less-sunny northern regions.)

He strongly recommends everybody who does not already enjoy abundant sunshine take vitamin D supplements to boost their immune systems — especially people with darker skin types.

On a related note, he looks at the surprisingly mild statistics of the epidemic in Australia, and notes that this militates in favor of seasonality — but again stresses the beneficial effect of vitamin D in the sunny Australian summer and early fall. (I note that South Africa too has so far dodged a major bullet.)

He also notes that homes for the elderly everywhere have appalling statistics — it takes only one or two cases to cause a major outbreak in one unless you really know what you are doing.

One more thing: out of 459 newly diagnosed cases in South Korea, 228 are imports from the USA. While he admits this will not be a representative sample of the US population (whoever still travels may be a businessman or some sort of expert), it does have implications for the Dunkelziffer/”dark case load” in the USA.

(3) Speaking of nutrition, a number of doctors advocate zinc supplements. [Full disclosure: I have been taking such since the beginning of the crisis.] This is emphatically not quack science: zinc is an essential nutrient, and in fact the most common transition metal in the body outside the bloodstream. (Iron in hemoglobin is the most common one if you include it.) Hundreds of physiological processes depend on zinc in the catalytic site of an enzyme, as a co-catalyst or modulator, or as a structural element. This includes the immune system too: I was struck between the similarity between some early COVID19 symptoms (such as loss of taste and smell) and those of zinc deficiency (presumably because Zn is mobilized in great amounts for the immune system). Here is an academic review article on the roles of zinc in the antiviral immune system.

Particularly people who live on vegetarian diets are at risk for Zn deficiency — those who primarily live on red meats or seafood least so.

(4) Urban geographer Joel Kotkin, in a must-read essay , explains how COVID19 (and whatever similar epidemics may lay in our future) will make dense urban centers less attractive to live in. He notes NYC accounts for nearly half of COVID19 mortality in the USA, greater Milan for half the cases in Italy and almost 3/5 of deaths,… “Simply put, pandemics are bad for dense urban areas, particularly those that are diverse and relatively free. This has been very much the case since antiquity. The more global and vital an urban system—Rome, Alexandria, Cairo, Venice, Florence, London, Paris—the more susceptible it is to the pandemics that seem to be occurring regularly over the past two decades. Cities no doubt will recover, particularly if real estate prices continue to fall, but the pandemics limit their upward trajectory and will continue to drive people elsewhere.”

On a related note, former director of the World Bank’s research department Branko Milanovic, https://www.standaard.be/cnt/dmf20200327_04904960 interviewed in De Standaard (in Dutch) argues that (my paraphrase) “We went for the extremes of globalization because technology enabled it. COVID19 showed such an economy is brittle.” He does see a return to some form of globalized economy the day after the crisis, but not again to this extreme extent.

It is noteworthy that such “the end of globalization as we know it” rhetoric is not the province of just the American populist “right”, but that one can hear similar voices around the globe and the political spectrum from the German establishment center-right to the left. I was (pleasantly) surprised to read a scathing article in The Guardian (!!) about the way some Chinese academic publications about the origins of the virus had to be airbrushed by CCP regime fiat. “Oceania is not at war with Eurasia.” [On a related note, Taiwan released an Email from December in which it warned the WHO about patients with a new, SARS-like lung disease.]

The American Interest looks at the long, hard road to decoupling from China. An article in De Standaard (in Dutch) entitled “[shoddy m]asks as a canary in the coalmine”, looks at the trend towards what it calls with an English neologism “reshoring” — bringing production back home to have better control over supply chain and especially quality. This process is said to have been going on for a while in Belgium, but is now being accelerated by COVID19.

Finally, feelgood story of the day: at age 107, a Dutch woman named Cornelia Ras is now the oldest person to survive a bout with COVID19 .