When a handful of doctors in northern Italy recently claimed that the virus that causes COVID-19 appears to be losing steam, that it no longer seems to be the same “biological bomb” it was when the pandemic first hit, expert reaction ranged from bewilderment to horror. Some thought something must have been lost in translation.

Then, only days later, Dr. Donald Yealy, chief of emergency medicine at the University of Pittsburgh Medical Centre, a US$21 billion health enterprise that spans 40 hospitals across western and central Pennsylvania, New York State and Maryland, gathered his notes for his latest press briefing.

Yealy remarked that, anecdotally, COVID-19 cases seem less severe than a few weeks ago. People aren’t requiring as much intensive care. The proportion needing to be placed on a ventilator to help them breathe has fallen. The total amount of the virus in those who test positive seems “much less” than in the earlier stages of the crisis.

Yealy said he wasn’t attributing the observations “solely or even predominantly” to mutations. “We simply don’t know.” Viral pandemics are dynamic and complicated, he said. They wax and wane. Numerous factors could be at play.

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