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Luck? Genetics? An Italian island spared the hearth of COVID

GIGLIO ISLAND, Italy (AP) – Cut on a small Italian island, a cancer researcher is becoming increasingly anxious to hear that one and then three other visitors have contracted COVID-19.

Paola Muti prepared for the rapid spread of the coronavirus to the 800 closely intertwined islanders, many of whom she knew well. Her mother was born on the island of Giglio and often stays in the family home with her charming sea view through the windows of the salon.

But days passed and none of the Giglio residents developed any symptoms of COVID-1

9, although conditions seemed conducive to the spread of the disease like wildfire.

Giglisi, as the inhabitants are known, socialize in the steep alleys near the harbor or on the granite steps that serve as narrow streets in the castle district of the hill, with densely packed houses built against the remains of a fortress built centuries ago to protect from pirates.

Dr. Armando Chiafino, the only doctor on the island for about 40 years, shared Muti’s concerns that there would be a local outbreak.

“Every time a common childhood disease, such as scarlet fever, measles or chickenpox, strikes, virtually everyone becomes infected with Giglio within a few days,” he said in an interview at his office near the port.

Muti, a researcher on breast cancer at the University of Milan, where he is a professor of epidemiology, decided to try to understand why this was not happening this time.

Residents were probably infected but showed no symptoms? Was it something genetic? Anything else? Or just pure luck?

“Dr. Chiafino came to me and said, ‘Hey, look, Paola, this is amazing. In this complete pandemic, in any case, no one is sick. So I said to myself,’ Yes, here we can. ‘ “Let’s do some research, shall we? I’m here,” Muti said.

Until then, Muti had been trapped on the island under Italy’s strict lock rules. It is particularly puzzling that many of the islanders have had close contact with visitors.

Giglio’s first known case of COVID-19 was a man in his 60s who arrived on February 18, a few days before Italy’s first “native case” was diagnosed in the north. The man came to Gilio for the funeral of a relative and “coughed through” during the service, Muti said.

The virus is spread mainly by droplets when someone coughs, sneezes or talks. The man returned to the ferry to the mainland the same day and died three weeks later in hospital.

On March 5, four days before the announcement of the national blockade, three more visitors came from the mainland and will test positively on the island. One of them was a German from northern Italy, the original epicenter of the European epidemic. He spent several days socializing with longtime friends in Giglio, including in public places. A week later, due to a bad cough, he was tested on the island and the result was positive. He isolates himself in Giglio’s house.

There were other notorious cases, including an islander who lived in Australia for two years before slipping back to Gillio in mid-March during a lock-up to see his parents. Three days after arriving at Giglio, he developed a mild fever and tested positive, Muti said. He isolates himself in his parents’ home.

No other cases occurred on Giglio, including after the blockade was lifted in early June and tourists from all over Italy arrived.

Giglio is part of Tuscany, and his health office is quickly sending antibody test kits to see if others may have had COVID-19. In late April, just before the first travel restrictions were lifted, the islanders tested their blood, arranged outside the school and the doctor’s office on the island.

Of the 800 or so year-round residents, 723 voluntarily undergo tests.

“We all wanted to do it ‘to be calm’ about any possible infection, but also to help science,” said Simone Madaro, who worked at the cemetery as the infected man reunited with fellow mourners.

The Rev. Lorenzo Pascuti, the priest who conducted the service for about 50 mourners and who himself was tested, recalled: “After the funeral there were greetings, hugs and kisses,” as is customary. Then the procession came to the cemetery, where “there were more hugs and kisses.”

Of the islanders tested, only one was found to have antibodies, an elderly man from Gigliese who sailed the same ferry to the island with the German visitor, Muti said.

Intrigued as to why the “virus did not appear to interact” with the island’s indigenous people, Muti had not reached conclusions as he prepared to leave the island this month. She plans to write her study for possible publication.

It is possible, Muti suggested, that the islanders were not exposed to enough COVID-19 to become infected.

This possibility was also expressed by Massimo Andreoni, head of infectious diseases at the Roman hospital in Tor Vergata. He noted that some patients are simply less able to spread the disease for reasons that are still unclear.

Chance may have played a role, said Daniel Altman, a professor of immunology at Imperial College London. “It could be something more or less trivial – no one got infected because luckily there were few contacts,” he said in an email exchange.

Or, Altmann also noted that “it could be something important and exotic,” as a genetic variant common among the island’s population.

With many of the Gigliesi getting married for generations, Muti would like to do genetic research one day if he can get funding.

Jilio is in pristine waters in a protected regional sea sanctuary, and the islanders are relieved to live in a natural environment they like to think is good for health, whatever Muti’s research determines.

“As an island, as long as the environment goes, we’re fine, aren’t we?” said Domenico Pinateli, as the old man kept company with friends in chairs set on a rocky street at the top of Giglio.

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