COVID Mutation: Positive, Negative, Unknown

"I am not saying it's [COVID-19] gone away -- the message isn't to declare victory, or say that we have this beaten. But it's fair to say that the experience with the virus is changing."
"[People in this region -- 40 hospitals across western and central Pennsylvania, New York State and Maryland] don't seem to have the same level of sickness as a few weeks ago."
"It's just a general, crude observation. Perhaps we're better at treating patients."
"This particular virus doesn't look like it's changing a lot. But it's a possibility to think about. There are probably six different factors at play and we won't understand all of this. This is a virus that no one knew anything about eight months ago."
Dr.Donald Yealy, chief, emergency medicine, University of Pittsburgh Medical Centre

"We ourselves have seen the D614G gene in sequences of our own. So it's here."
"What's hard to tease out is, when you do see changes -- you might see anywhere between half a dozen and a dozen changes in any given virus -- is to really understand what the significance is."
"[The virus that finally reached us in Canada] would have been passed so many more times in humans than it did at the beginning of the outbreak [in Wuhan]. We have a lot of blind spots as far as the genome goes."
Dr.Samira Mubareka, medical microbiologist, Toronto Sunnybrook Hospital

"We have to make sure that whatever statements we make are backed up by good, hard science, so it's reproducible."
"Because the downside is really bad if you mislead the public to think that the virus is no longer as potent as it once was. People will of course relax their vigilance and succumb to a disease they probably could have avoided."
David Kelvin, immunologist, Dalhousie University

"I'll just be honest and upfront. We don't know. We just don't know if it's weakening."
"We don't have data on this; we haven't tested this. But who knows, maybe the coronaviruses that cause mild cold-like symptoms could have been lethal in human populations many, many years ago."
The virus and the host learned to co-adapt."
Arinjay Banerjee, Institute of Infectious Diseases, McMaster University

While there are some subtle genetic changes in COVID-19 around the world, none have resulted in differences in the way the virus spreads or the type of disease it causes, the WHO has said. AAMIR QURESHI/AFP via Getty Images

Wishing won't make it so; the world has been horribly overwhelmed by the dramatic, sudden incursion of a global threat to human health and longevity, and everyone, from government, the medical/health community, and the ordinary person on the street, entertains hope that it will depart as suddenly (and mysteriously) as it arrived. Leaving us to pick up the pieces of a word turned upside- down and inside-out. Eight million people who were infected to various degrees before stabilization and perhaps left with unknown after-effects; almost a half-million dead of its effects, the world economy in tatters, and confidence in the future shaken to the essential core.

So when anecdotal 'evidence' of a possible change for the better in the effects of the SARS-CoV-2 virus brings a wave of fresh air and hope for an end to this universal nightmare through the auspices of a handful of doctors in northern Italy claiming the virus causing COVID-19 seems to be less affective, no longer appears to be the "biological bomb" it appeared when it first raged onto the world stage the public grasps it for relief. And then the medical chief of a $21 billion health complex spanning a range of hospitals in a handful of U.S. states held a press briefing stating the impression that COVID cases latterly seen appear less severe than those of a mere few weeks earlier.

Dr. Yealy explained that viral pandemics are complicated, volatile, dynamic, they come and they go, they wax and they wane. A multitude of factors could be involved; and he was not attributing the observations "solely or even predominantly" to the outcome of possible mutations. Yet, at a time when the world in the West, while expressing relief that the lockdown that was imposed is gradually being lifted, are being informed that it is too early to lift all restrictions, and that an anticipated second wave may be on the horizon, the balloon of hope is gently pricked and deflated.

Dr.Yealy spoke of observations in a particular part of the United States. No such lifting of the effects of the virus have been in evidence in Canada, on the other hand. So even while Dr.Yealy claims that people in the region he represents "don't seem to have the same level of sickness as a few weeks ago", Canadian doctors respond that nothing of the sort has been seen in Canda; no evidence of lost potency: "In short, no", Dr.Alan Drummond representing the Canadian Association of Emergency Physicians remarked.

"In the last ten days, we still put five patients on extracorporeal life support, the most extreme support that we have for people who are failing mechanical ventilation", explained Dr.Niall Ferguson, who has observed no sign of "weakening" or a lesser need of Toronto General Hospital's life support program known as ECMO, of the most severe cases of COVID received for extraordinary efforts at resuscitation.

Scientists at Scripps Research in Florida this week reported in a pre-print paper that a genetic mutation seen in the virus now circulating through Europe and the U.S., no increases of "infectivity" of a significant nature have been seen. The D614G mutation quadrupled the number of spikes on the virus, used to grab onto human cells, making them more effective in breaking into them and infecting them, and then begin the massive reproduction of new viruses that will be shed, looking for additional human interiors to nurture and continue breeding the virus.

Coffee is served in the Caffe Peru bar in Rome, Wednesday, where a large plexiglass division was mounted over the counter to protect bartenders and customers from Covid-19 as they enjoy their drinks. (AP Photo/Andrew Medichini)

Over 40,000 genomic sequences have been uploaded to websites that are publicly available and scientists scour the genetic codes to read the 30,000 chemical letters searching for changes, then comparing sequences from other countries. Some subtle alterations have been seen, but none have yet resulted in differences in the manner in which the virus spreads, much less the type of disease it causes, according to the World Health Organization.

On entering a host, a virus replicates by the thousands and RNA viruses like the novel coronavirus are capable of accumulating small, random mutations, a result of the molecular protocol used by the virus to copy itself sometimes going awry. "It makes errors, and sometimes if those errors benefit the virus they'll be selected for -- they'll persist and get passed on and on because there is some kind of fitness advantage", explained Dr.Mubareka.

On occasion less potent versions of a virus emerge, however. Arizona State University researchers found a single sample missing a piece of its genome where 81 of the letters were missing, after sampling nasal swab samples from 382 COVID-positive patients. In 2003 the SARS outbreak saw a similar mutation, one that scientists believe was the causal effect of a much less severe disease emerging, later in the outbreak.

Intensive care unit, Papa Giovanni XXIII Hospital, Bergamo, Italy

Dr. Banerjee of McMaster University explained that ideally a pathogen is a clever virus, one that learns to coexcist with its host "because if a host dies, if the individual dies, the virus dies with it". A virus has every reason to protect its own survival by ensuring its presence in a  human body doesn't result in that human body expiring, and with its death its own aspirations to continue replicating and spreading is destroyed. Its purpose is to make the leap from the infected to the uninfected; spreading its replicated version to the next victim, and thus sustain the virus population.

Rome, Italy, May 2, 2020: Patient carried from LTC home to hospital

"[Italy has suffered some of the world's worst death tolls from COVID-19, but fewer people are now admitted to hospital in comparison to three months earlier; while in some regions] even the patients that are admitted, especially in emergency, are less severe."
"They have fever, some respiratory symptoms. They have cough. But even in similar ages, they don't have the same aggressive picture they had three months ago."
"I am not suggesting not to use the masks, or not to wash the hands or not stay one metre away from the other."
"I am just giving the clinical impression, and the clinical impression is the disease is different. I am more optimistic than I was three months ago."
Dr.Matteo Bassetti, director, infectious disease clinic, San Martino Hospital, Genoa, Italy

"In reality, the virus clinically no longer exists in Italy,"
"The swabs that were performed over the last ten days showed a viral load in quantitative terms that was absolutely infinitesimal compared to the ones carried out a month or two months ago."
Alberto Zangrillo, head, San Raffaele Hospital, Milan, northern region of Lombardy

A doctor cares for an elderly patient with COVID-19 on June 18, 2020 in Santiago, Chile. While there are reports in some places that COVID-19 appears to be weakening, in other places it appears as potent as ever. Marcelo Hernandez/Getty Images