Uncontrolled Spread: Why COVID-19 Crushed Us and How We Can Defeat the Next Pandemic

by Scott Gottlieb

Often the harm from a virus results from the injury it causes directly to these tissues. In other cases, the peril it brings owes to how our immune system responds to it. The same inflammatory response that our body mounts as a way to attack a virus can also damage our organs if that process gets out of whack. That’s true in hepatitis. It’s the inflammation that hepatitis triggers in our liver that does much of the damage.15 It was also true with COVID. For many patients, the most severe consequences of COVID weren’t the direct effect of the coronavirus on their lungs, but rather the exaggerated immune response their bodies unleashed to kill the virus. Because the SARS-CoV-2 virus was novel, meaning that human beings had never encountered it before and thus had no established means to combat it, the human immune system tended to overreact. In the most severe cases, it could trigger a “cytokine storm,” a cascading activation of immune cells, which in turn excrete small proteins called cytokines. In the normal sequence of our body’s functions, cytokines help coordinate our response to viral invaders and recruit other immune cells to the site of an infection. But if all the cytokines get dumped into our blood simultaneously, too many immune cells can get recruited to the site of the infection, creating an abrupt and severe hyperinflammation that can damage organs.16 It was a cytokine storm that ended up killing many people from COVID.