Paola Muti prepared for a rapid spread of the coronavirus to the 800 close-knit islanders, many of whom she knows well. Her mother was born on Giglio Island and often stays in the family home with her charming view of the sea through the living room windows.
But the days passed and none of the Giglio islanders developed symptoms of COVID-19 even though conditions seemed favorable for the disease to spread like a forest fire.
The Gigliesi, as the residents are known, socialize on the steep alleys near the harbor or on the granite steps that serve as narrow streets in the Castle Hill neighborhood, with houses densely built against the remains of an erected fortress. centuries ago to protect against pirates
Dr. Armando Schiaffino, the only doctor on the island for about 40 years, shared Muti’s concern that there would be a local outbreak.
“Every time a common childhood disease, such as scarlet fever, measles or chicken pox, in a few days practically everyone becomes infected” in Giglio, he said in an interview at his office near the port.
Muti, a breast cancer researcher at the University of Milan, where she is a professor of epidemiology, decided to try to find out why it wasn’t happening this time.
Were the residents infected but showed no symptoms? Was it something genetic? Anything else? Or just luck?
“Dr. Schiaffino came to me and said, ‘Hey, look, Paola, this is incredible. In this complete pandemic, with all the cases that came to the island, no one is sick.’ So I said to myself: ‘Well, here we can do a study, right? I’m here,’ “Muti said.
By then Muti was trapped on the island by Italy’s strict blockade rules. What was especially puzzling to her was that many of the islanders had had close contact with visitors.
The first known case of Giglio COVID-19 was a man in his 60s who arrived on February 18, a couple of days before Italy’s first “native case” was diagnosed in the north. The man came to Giglio for a relative’s funeral and had been “coughing all the way” through the service, Muti said.
The virus is spread mainly through drops when someone coughs, sneezes, or speaks. The man returned to the ferry the same day to dry land and died three weeks later in a hospital.
On March 5, four days before the national closure was declared, three more visitors arrived from the continent and would test positive on the island. One of them was a German man from northern Italy, the initial epicenter of the European outbreak. He socialized for several days with longtime friends in Giglio, including in public restaurants. After a week, due to a strong cough, he was examined on the island and the result was positive. He isolated himself in a house in Giglio.
There were other known cases, including an islander who had lived in Australia for two years before returning to Giglio in mid-March during the closure to see his parents. Three days after reaching Giglio, he developed a mild fever and tested positive, Muti said. He isolated himself in his parents’ house.
No other case has emerged in Giglio, even since the blockade was lifted in early June, and tourists have been pouring in from all over Italy.
Giglio is part of Tuscany, and his health office quickly dispatched kits to detect antibodies and see if others may have had COVID-19. In late April, just before the travel restrictions for the first lockout were reduced, the islanders were tested for blood, lining up in front of the island’s school and the doctor’s office.
Of the approximately 800 residents throughout the year, 723 volunteered for the test.
“We all wanted to do it, to be calm” about any possible infection, but also “to help science,” said Simone Madaro, who had been working in the cemetery while the infected man had been reunited with his grieving companions.
The Rev. Lorenzo Pasquotti, the priest who led the service for about 50 mourners, and who was evaluated, recalled: “After the funeral, there were greetings, hugs and kisses,” as is customary. Then came the procession to the cemetery, where “there were more hugs and kisses.”
Of the islanders examined, only one was found to have antibodies, an old man from Gigliese who had 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 native population, Muti had come to no conclusion as she prepared to leave the island this month. She plans to write her study for eventual publication.
Muti surmised that the islanders may not have been exposed to enough COVID-19 to become infected.
That possibility was also expressed by Massimo Andreoni, head of infectious diseases at the Tor Vergata hospital in Rome. He noted that some patients are simply less able to spread the disease for reasons that are still unclear.
Chance could have played a role, said Daniel Altmann, professor of immunology at Imperial College London. “It could be something more or less trivial: nobody was infected because luckily there was little contact,” he said in an email exchange.
Or Altmann also noted that “it could be something important and exotic,” as a common genetic variant among the island’s population.
With many of the Gigliesi marrying between generations, Muti would like to do a genetic study one day if she could get funding.
Giglio is found in crystal clear waters at a protected regional marine sanctuary, and the islanders express their relief that they live in a natural environment that they like to think is good for health, regardless of what Muti’s study determines.
“As an island, depending on the environment, we are fine, right?” Domenico Pignatelli said, as the old man kept company with friends in chairs located on a stony street at the top of Giglio.
Copyright © 2020 by The Associated Press. All rights reserved.
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