What it feels like to survive COVID-19’s dreaded “cytokine storm”

A doctor and coronavirus patient in recovery describes his experience surviving COVID-19's worst side effect

The cytokine storm affects a substantial number of severe COVID-19 patients, enough that it has become the subject of a subset of medical research into COVID-19. Those unlucky enough to experience cytokine storm will have their bodies and especially lungs flooded with cytokines, immune system helper molecules, as their immune system struggles to fight off the invading virus and the dead lung cells it produces en masse. The overreaction results in the immune system building up too many of these kinds of cells, which can lead to respiratory distress or bacterial pneumonia and, ultimately, death.

Not everyone who experiences a cytokine storm will die, fortunately. Such is the case of Jonathan Raskin, a 69-year-old pulmonologist who practices medicine in New York City, and who contracted coronavirus a few weeks ago and is currently in recovery. After self-isolating at home, Dr. Raskin's temperature swelled to 102.8°; he spent several days in the hospital in a very bad state (by his own admission) before slowly recovering. As a pulmonologist, Dr. Raskin's insights into what was happening to his own body are particularly keen, as he had a medical understanding of what was happening as it happened to him.

My lab work was stunningly bad. A normal white count might be between 4.5 and 10. My white cell count was at 2,000. My lymphocytes — which are the cells that fight in a virus, normally fall somewhere between 1000 and 1,500 — they were under 200. I don't know if you know the term but the early cells that fight infection are called "bands," and you don't have [them] normally — I had 20% bands. My platelet count was around 100,000, which is low, and I knew I was in trouble.

In the current context, we believe we have a biomarker of this condition, a serum level of a non-specific but is an acute phase reactant called serum ferritin. It looks like it may be to be one of the more reliable biomarkers of cytokine dysregulation. A serum ferritin is normally below 400 in our lab, mine was 18,000!

The Earth Is Telling Us We Must Rethink Our Growth Society

As the pandemic builds, most people, led by government officials and policy wonks, perceive the threat solely in terms of human health and its impact on the national economy. Consistent with the prevailing vision, mainstream media call almost exclusively on physicians and epidemiologists, financiers and economists to assess the consequences of the viral outbreak.

However horrific the COVID-19 pandemic may seem, it is merely one symptom of gross human ecological dysfunction. The prospect of economic implosion is directly connected. The overarching reality is that the human enterprise is in a state of overshoot.

We are using nature’s goods and life-support services faster than ecosystems can regenerate. There are simply too many people consuming too much stuff. Even at current global average levels of consumption (about a third of the Canadian average) the human population far exceeds the long-term carrying capacity of Earth. We’d need almost five Earth-like planets to support just the present world population indefinitely at Canadian average material standards. Gaian theory tells us that life continuously creates the conditions necessary for life. Yet humanity has gone rogue, rapidly destroying those conditions.

When will the media call on systems ecologists to explain what’s really going on? If they did, we might learn the following:

* That the current pandemic is an inevitable consequence of human populations everywhere expanding into the habitats of other species with which we have had little previous contact (H. sapiens is the most invasive of “invasive species”).

* That the pandemic results from sometimes desperately impoverished people eating bushmeat, the flesh of wild species carrying potentially dangerous pathogens.

*That contagious disease is readily propagated because of densification and urbanization — think Wuhan or New York — but particularly (as we may soon see) because of the severe overcrowding of vulnerable people in the burgeoning slums and barrios of the developing world.

* That the coronavirus thrives because three billion people still lack basic hand-washing facilities and more than four billion lack adequate sanitation services.

A population ecologist might even dare explain that, even when it comes to human numbers, whatever goes up must come down.