Doctors say covid-19 at UPMC is declining in virulence, infection levels

Covid-19 is declining in both virulence and infection levels among patients at the state’s largest health care system, UPMC officials said Thursday.

Dr. Donald Yealy, who heads emergency medicine at the system that has hospitals across the state, said both the ratio of patients testing positive for the virus and the viral load of those infected have been on the downturn since late April. Fewer patients are requiring ventilators to help them breathe.

He said UPMC has safely treated and discharged 500 covid-19 patients since the start of the pandemic in March.

“We’ve tested 30,000 and the positivity rate was less than 4%. We tested 8,000 with no symptoms and only 21 came back positive,” Yealy said.

Given those numbers, Yealy said that the risk of being involved in a car crash while traveling across the state on the Pennsylvania Turnpike is greater than the risk of contracting covid-19 here.

He said results of testing here seem to mirror reports from northern Italy, where doctors have seen less virulent cases among those who have been infected recently. He said that has not been the case universally and pointed to South America, where the virus is still raging strong.

Researchers can’t pinpoint exactly why they’re seeing lower viral loads and infection rates. Yealy said it could be a combination of several factors. He said viruses tend to mutate with time, can interact with the weather and may be less infectious when those carrying the virus have a lower viral load.

“And, finally, we are probably making better decisions about who needs what kind of care,” he said.

Pittsburgh-based Dr. Amesh Adalja, a fellow of the Infectious Diseases Society of America, said UPMC’s report marks a “very good development” in the ongoing battle against covid-19.

“It is true that this area has fared very well. …But the virus is very heterogeneous, even in different parts of the state,” Adalja said.

Like Yealy, he has heard the reports from northern Italy. But Adalja said it is important to try to determine why this has happened.

“We need to compare these patients with the earlier patients,” he said. “Is there something different about the patients? Is there something different about the timing of the testing? We need to look at the genetic sequencing of the virus in the past compared to now, and I don’t think it is very different. I think it’s worth further study.”

Dr. David Nace, the chief medical officer for UPMC Senior Communities, said UPMC is in the process of testing all residents in its 30 senior living centers but has not seen a single case of covid-19 among its 3,000 residents to date.

Asked why UPMC facilities have escaped the virus that cut a lethal swath through Pennsylvania nursing homes and assisted living facilities, accounting for two-thirds of the state’s covid-19 deaths, Nace said UPMC’s resources and expertise provided a strong foundation for safety in its senior living facilities.

He said leadership in those facilities had daily command center calls with experts from the academic medical center and stressed the proper use of personal protective equipment among staff.

As counties across the state prepared to enter new phases of reopening from the covid-19 shutdown this week, state records put the virus’s toll at more than 73,400 infections and 5,742 deaths.

Yealy said UPMC hospitals, which reduced admissions by half to prepare for a surge of covid-19 patients at the height of the pandemic, have since returned to nearly 100% of their normal patient count.

He said UPMC experts have collaborated on a book to help coaches safely resume team sports and worked closely with the state lawmakers to craft a law that sets specific readiness guidelines for long-term care facilities.

Although he would not rule out the possibility that the virus could rebound, Yealy said it appears safe for the region to begin reopening. But he said following public health advisories, including staying home from work if you feel sick, wearing a mask in enclosed spaces and maintaining social distancing, remain important precautions.

“Those simple things are far more important than worrying about ‘should I take a medicine or have a test,’” Yealy said.