Professor Massimo Clementi is the director of the microbiology and virology laboratory at San Raffaele in Milan. He is the curator of the study behind Alberto Zangrillo’s controversial statement, in which he called the Coronavirus “clinically dead”. The analysis is still being published, but Clementi gave an interview to Corriere della Sera anticipating those “facts” on which Zangrillo said to base his positions.
The situation in intensive and sub-intensive care
At San Raffaele “not only do we no longer have new hospitalizations for Covid-19 in intensive care, but not even in semi-intensive care,” says Clementi. According to the data of the Civil Protection, in Italy the number of intensive care has been progressively decreasing for weeks (yesterday 435). The data alone, however, does not specify the numerical relationship between inputs and outputs, and is not sufficient to understand what the number (average or not) of new daily entries is. San Raffaele’s study is based, according to Clementi, on a general investigation, but the specific (and practical) focus is on what happens in the Milanese hospital.
According to the professor, the reason why “few patients and all with mild symptoms” have come to them in the last few weeks is that the replicative capacity of the virus in May is “enormously” weakened compared to what we had in March. This is a position deriving from the analysis of 200 patients in his hospital: “We have compared the viral load predicted in the samples taken with the swab – insists Clementi – and the results are extraordinary”.
The practical consequence of this “weakening” would therefore be the change in the cynical manifestation of Covid-19. Indeed, for Clementi we are facing a “different disease” than we had at the beginning (although there is no evidence that the pathogen has undergone a mutation, and a change in the viral load does not necessarily mean that it did ). “The gap is abysmal,” he says.
The cause is not yet clear, but, according to the researchers, it could probably be related to the “most favorable environmental conditions (for us, ed). ” But also to the fact that Sars-Cov-2 is replicating itself for a “co-adaptation to the guest”. That is: “the interest of the microorganism is to survive within the body and spread to other subjects: unattainable goals if the patient dies from the infection”.
A little more clarity
The fact that the replication capacity of Coronavirus has decreased compared to the beginning of the epidemic also means that the amount of virus present in a patient is less than in the first cases. To measure the quantity, Clementi has relied on some techniques already in use for AIDS, which consist in measuring the nucleic acids of the subjects (in this case the Sars-Cov-2 RNA), «or the copies of the virus detectable in the patient’s rhino-pharynx “. In the study on 200 patients, “there was an extremely significant gap between the viral load of patients hospitalized in March and those in May”.
So, in short, the emergency is definitely over? “Nobody can know,” says Clementi. It will really change things in a hypothetical second wave, he concludes, the way we will be able to react, “isolating patients, identifying contacts and entrusting them to local medicine to leave hospitals only in any serious cases”.