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Italians Find Promise of Antibodies Remains Elusive, for Now Italians Find Promise of Antibodies Remains Elusive, for Now
(32 minutes later)
ROME — Cooped up, stir crazy and desperate for their lives back, many Europeans and Americans have seized on antibodies and their promise of potential immunity to the coronavirus as the golden ticket to reopen societies and economies.ROME — Cooped up, stir crazy and desperate for their lives back, many Europeans and Americans have seized on antibodies and their promise of potential immunity to the coronavirus as the golden ticket to reopen societies and economies.
Not long ago, politicians in Italy — which, as the epicenter of Europe’s contagion, is further in the pandemic’s cycle than other Western nations — proposed issuing licenses to those who had beaten the virus and developed the right antibodies to get back to work.Not long ago, politicians in Italy — which, as the epicenter of Europe’s contagion, is further in the pandemic’s cycle than other Western nations — proposed issuing licenses to those who had beaten the virus and developed the right antibodies to get back to work.
Researchers and politicians in China, the United States, Germany, Britain and beyond have latched onto antibodies as a potential solution to the virus and an outlet from containment measures.Researchers and politicians in China, the United States, Germany, Britain and beyond have latched onto antibodies as a potential solution to the virus and an outlet from containment measures.
But that talk, always ahead of the science, has grown more muted in recent weeks. With the research refusing to cooperate, experts in Italy say the promise of antibodies may not be what people have imagined. At least for now.But that talk, always ahead of the science, has grown more muted in recent weeks. With the research refusing to cooperate, experts in Italy say the promise of antibodies may not be what people have imagined. At least for now.
“We don’t know if everyone who has had the disease has developed an acceptable protective immunity,” said Dr. Alessandro Venturi, the president of the San Matteo hospital in the Lombardy town of Pavia. The hospital validated the antibody screening test used for mapping the virus in Lombardy, Italy’s hardest hit region.“We don’t know if everyone who has had the disease has developed an acceptable protective immunity,” said Dr. Alessandro Venturi, the president of the San Matteo hospital in the Lombardy town of Pavia. The hospital validated the antibody screening test used for mapping the virus in Lombardy, Italy’s hardest hit region.
Infected people develop different quantities of antibodies, and researchers are still studying the level that offers protection, and for how long.Infected people develop different quantities of antibodies, and researchers are still studying the level that offers protection, and for how long.
“We don’t know how long they last,” Dr. Venturi said. ‘‘This is the central point.”“We don’t know how long they last,” Dr. Venturi said. ‘‘This is the central point.”
That is tough news not only for Italy, which is loosening its lockdown on Monday, but for the rest of the world.That is tough news not only for Italy, which is loosening its lockdown on Monday, but for the rest of the world.
Italy’s government will soon start testing 150,000 people for antibodies for a “sample survey on the spread of the infection,” according to its website.Italy’s government will soon start testing 150,000 people for antibodies for a “sample survey on the spread of the infection,” according to its website.
Many regions, including Lombardy and Veneto, are still doing such screenings. But whereas last month the presidents of those regions promoted the idea of issuing licenses to members of an immune work force, now they have downgraded the tests from panacea to a research tool.Many regions, including Lombardy and Veneto, are still doing such screenings. But whereas last month the presidents of those regions promoted the idea of issuing licenses to members of an immune work force, now they have downgraded the tests from panacea to a research tool.
“Immunity licenses are just rubbish,” said Mario Plebani, the coordinator of the antibody tests for the Veneto region.“Immunity licenses are just rubbish,” said Mario Plebani, the coordinator of the antibody tests for the Veneto region.
Politicians and experts have tried to lower expectations. But that has not stopped citizens, desperate to know if they have had the virus and are protected from it, and companies, eager to return to normalcy, from flocking to antibody screenings.Politicians and experts have tried to lower expectations. But that has not stopped citizens, desperate to know if they have had the virus and are protected from it, and companies, eager to return to normalcy, from flocking to antibody screenings.
Many businesses in the region have been paying for employees to get the tests, so that they could go back to work if they tested negative for the virus or positive for the antibodies.Many businesses in the region have been paying for employees to get the tests, so that they could go back to work if they tested negative for the virus or positive for the antibodies.
Dr. Venturi said those tests were essentially “useless” because they did not describe whether a person had the right level of antibodies and because no one knew yet how long they lasted.Dr. Venturi said those tests were essentially “useless” because they did not describe whether a person had the right level of antibodies and because no one knew yet how long they lasted.
Some virologists said they worried that all the hype around antibodies would lead to bad behavior among those who consider themselves invincible, thus leading to more infections.Some virologists said they worried that all the hype around antibodies would lead to bad behavior among those who consider themselves invincible, thus leading to more infections.
“I am very worried that the irresponsible use of serological tests will jeopardize phase two,” the start of Italy’s reopening, Dr. Alberto Mantovani, a leading Italian immunologist, told the TV channel Sky TG24 last week.“I am very worried that the irresponsible use of serological tests will jeopardize phase two,” the start of Italy’s reopening, Dr. Alberto Mantovani, a leading Italian immunologist, told the TV channel Sky TG24 last week.
But Dr. Venturi said antibodies with the ability to neutralize the virus still had important functions, including for developing plasma that could aid patients, and still held the potential for breakthroughs that could eventually help Italy reopen more fully.But Dr. Venturi said antibodies with the ability to neutralize the virus still had important functions, including for developing plasma that could aid patients, and still held the potential for breakthroughs that could eventually help Italy reopen more fully.
His Humanitas research hospital near Milan treated Italy’s first known coronavirus patient and has deep experience with the virus. It has been examining the 2 or 3 percent of people in the region who swab tests show are actively infected but whose blood also contains the antibodies — known as immunoglobulin G, or IgG, antibodies — that should neutralize the virus. In other words, these people are no longer contagious.His Humanitas research hospital near Milan treated Italy’s first known coronavirus patient and has deep experience with the virus. It has been examining the 2 or 3 percent of people in the region who swab tests show are actively infected but whose blood also contains the antibodies — known as immunoglobulin G, or IgG, antibodies — that should neutralize the virus. In other words, these people are no longer contagious.
In those cases, Dr. Venturi said, the virus did not replicate and cause a broader infection.In those cases, Dr. Venturi said, the virus did not replicate and cause a broader infection.
“It means it’s not contagious,” he said, adding that the hospital’s study is being scaled up as its researchers seek 200 such cases from throughout Lombardy, where they estimate 10 percent of the roughly 10 million residents have contracted the virus.“It means it’s not contagious,” he said, adding that the hospital’s study is being scaled up as its researchers seek 200 such cases from throughout Lombardy, where they estimate 10 percent of the roughly 10 million residents have contracted the virus.
Locating those cases has not been easy considering the rarity of finding someone who has both the desired antibodies and the virus contemporaneously.Locating those cases has not been easy considering the rarity of finding someone who has both the desired antibodies and the virus contemporaneously.
Results will take weeks more, but if confirmed, he said, it would show that people who test positive for an adequate level of neutralizing IgG antibodies do not pose a danger of contagion.Results will take weeks more, but if confirmed, he said, it would show that people who test positive for an adequate level of neutralizing IgG antibodies do not pose a danger of contagion.
In theory, even those lucky few would not need to wait for two consecutive negative swab tests — which sometimes take months — before being released from quarantine and allowed back to work. “It would be like a negative test result,” he said.In theory, even those lucky few would not need to wait for two consecutive negative swab tests — which sometimes take months — before being released from quarantine and allowed back to work. “It would be like a negative test result,” he said.
In the meantime, though, Dr. Venturi said it was impossible to consider a work force made up only of people showing neutralizing antibodies.In the meantime, though, Dr. Venturi said it was impossible to consider a work force made up only of people showing neutralizing antibodies.
Instead, he said, Italy’s reopening phase needs to rely on uninfected people, which he considered to be 90 percent of the population, and on social distancing and other protective measures.Instead, he said, Italy’s reopening phase needs to rely on uninfected people, which he considered to be 90 percent of the population, and on social distancing and other protective measures.
In talking about immunity licenses, he said, politicians have “gotten ahead of themselves.”In talking about immunity licenses, he said, politicians have “gotten ahead of themselves.”
This past week, the office of Lombardy’s president, Attilio Fontana, who had predicted that immunity licenses would be in place by April 21, said everyone still needed to follow recommended lockdown measures.This past week, the office of Lombardy’s president, Attilio Fontana, who had predicted that immunity licenses would be in place by April 21, said everyone still needed to follow recommended lockdown measures.
“There is no immunity license,” Giulio Gallera, the region’s top health official, said. Updated June 24, 2020
Still, as some mayors continue to promote antibody tests as a possible way out of lockdown, people have waited for hours in gymnasiums to have their blood drawn. Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
Paolo Passaggio, 45, an exporter of home appliances, jumped at the chance when the mayor of his small Lombardy town, Robbio, recently offered antibody screening.
Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. “There is no immunity license,” Giulio Gallera, the region’s top health official, said.
Still, as some mayors continue to promote antibody tests as a possible way out of lockdown, people have waited for hours in gymnasiums to have their blood drawn.
Paolo Passaggio, 45, an exporter of home appliances, jumped at the chance when the mayor of his small Lombardy town, Robbio, recently offered antibody screening.
“I did it to free myself of this doubt,” said Mr. Passaggio, who last month showed Covid-19 symptoms, including a low fever. Unable to get tested for the virus, as swabs are generally reserved for the hospitalized, he took precautions to avoid contaminating others, including staying isolated for weeks.“I did it to free myself of this doubt,” said Mr. Passaggio, who last month showed Covid-19 symptoms, including a low fever. Unable to get tested for the virus, as swabs are generally reserved for the hospitalized, he took precautions to avoid contaminating others, including staying isolated for weeks.
Last Tuesday he got the results: high levels of immunoglobulin G, or IgG, antibodies. Mr. Passaggio said he understood from doctors on television that it meant a degree of immunity, confidence he was not a danger to others and that he could possibly “go to work before someone else.”Last Tuesday he got the results: high levels of immunoglobulin G, or IgG, antibodies. Mr. Passaggio said he understood from doctors on television that it meant a degree of immunity, confidence he was not a danger to others and that he could possibly “go to work before someone else.”
Health experts say that is far from clear. But in any case, Mr. Passaggio said he did not plan to alter his behavior drastically. While he aimed to see his elderly parents for the first time in months, he expected to stay in the yard and wear a mask.Health experts say that is far from clear. But in any case, Mr. Passaggio said he did not plan to alter his behavior drastically. While he aimed to see his elderly parents for the first time in months, he expected to stay in the yard and wear a mask.
Some of Italy’s mayors, furious that testing for the virus has not been more widespread, argue that antibody screening is important psychologically, scientifically and practically. They have clung to the hope that immunity licenses will become available to those with the right antibodies.Some of Italy’s mayors, furious that testing for the virus has not been more widespread, argue that antibody screening is important psychologically, scientifically and practically. They have clung to the hope that immunity licenses will become available to those with the right antibodies.
“We were the trailblazers,” said Roberto Francese, the mayor of Robbio, which began testing in April. “Now, everybody is doing it.”“We were the trailblazers,” said Roberto Francese, the mayor of Robbio, which began testing in April. “Now, everybody is doing it.”
Mr. Francese said that a month ago, 50 people in the town showed clear symptoms of the virus, but that the health authorities failed to test them. They got sick, and then their relatives got sick and cases kept building.Mr. Francese said that a month ago, 50 people in the town showed clear symptoms of the virus, but that the health authorities failed to test them. They got sick, and then their relatives got sick and cases kept building.
The town, out of desperation, tracked down serological tests offered by a Chinese factory that the mayor said had an 96 percent accuracy rate, and which he said Italy’s national research center had approved.The town, out of desperation, tracked down serological tests offered by a Chinese factory that the mayor said had an 96 percent accuracy rate, and which he said Italy’s national research center had approved.
Robbio has already tested about half of its residents and found and isolated many positive cases, about half of whom had symptoms, he said. He also said that the tests had shown 12 percent had IgG antibodies.Robbio has already tested about half of its residents and found and isolated many positive cases, about half of whom had symptoms, he said. He also said that the tests had shown 12 percent had IgG antibodies.
He said he considered those people “immune and thus would be eligible” for an eventual immunity license, despite health experts’ doubts.He said he considered those people “immune and thus would be eligible” for an eventual immunity license, despite health experts’ doubts.
Mayor Luca Dure’ of Cisliano, also in Lombardy, said tests showing the presence of protective antibodies would “determine a sort of license of immunity” at some point in the phase of reopening beginning on Monday.Mayor Luca Dure’ of Cisliano, also in Lombardy, said tests showing the presence of protective antibodies would “determine a sort of license of immunity” at some point in the phase of reopening beginning on Monday.
“We don’t know how long, but surely for some months, they can remain in the blood for a year or two,” he said, calling this “surely a positive thing.”“We don’t know how long, but surely for some months, they can remain in the blood for a year or two,” he said, calling this “surely a positive thing.”
Even someone with IgG antibodies must act responsibly, Mr. Dure’ said.Even someone with IgG antibodies must act responsibly, Mr. Dure’ said.
“It’s not like a person can go to the theater or dancing at the disco,” he said, but people could feel a measure of safety.“It’s not like a person can go to the theater or dancing at the disco,” he said, but people could feel a measure of safety.
“We cannot wait anymore,” he said.“We cannot wait anymore,” he said.
Emma Bubola contributed reporting from Milan.Emma Bubola contributed reporting from Milan.