Plan A – Thrive and Survive COVID-19
Author: David A. Hanscom, MD, orthopedic spine surgeon, Oakland, CA
Contributors: Polyvagal Work Group
The main problem with the COVID-19 virus is not that we catch it, but that it is so deadly that it can kill you.
There are two ways of stopping a deadly pandemic. One is through developing immunity, either by exposure to the virus or by inoculation with a vaccine. The other is simply to prevent people from dying. The key is to prevent the inflammatory response from reaching a level that destroys tissues and its host’s organ systems.
The graph (left) illustrates the issue. CYTOKINES Cytokines are small proteins that serve as messengers, transmitting higher-level signals and coordinating activities at the cellular level.
They are central to modulating the immune system and inflammatory response. There are two kinds of cytokines: pro-inflammatory (Pro-I) and anti-inflammatory (Anti-I). While Pro-I cytokines protect us by warding off acute perils, Anti-I cytokines keep us safe by allowing us to regenerate, thrive, and prepare us for battle with environmental enemies.
Both Pro-I and Anti-I cytokines are necessary for survival—one to defend against threat, the other for growth and regeneration. However, sustained elevations of Anti-I can destroy parts of the body and give rise to chronic mental and physical disease. In acute situations, levels of Pro-I may spiral out of control and cause failure of multiple organs.
This is the cause of ARDS (adult respiratory distress syndrome), the most common cause of death from corona virus, which impedes the lungs from providing oxygen to the blood, resulting in a high mortality rate.
One term used to describe the excessive elevation of the inflammatory cytokines is “cytokine storm.” It is unclear whether there really is a “storm” or whether the normal rise of already elevated cytokines pushes people over the critical threshold of tissue edema and destruction.