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After about a month, the Russian Kremlin critic Alexej Navalny was able to leave the Berlin Charité. Doctors treating him believe that a full recovery is possible, but the long-term consequences of the poisoning could only be assessed later, the clinic said. He reports on Instagram that the 44-year-old has yet to make a full recovery. Navalny writes, for example, that he still needs to regain control of his fingers or be able to stand on one leg again. Or that he could catch a ball with his left hand but couldn’t throw it anymore.
According to the analyzes of several laboratories, Navalny had been poisoned with a chemical nerve agent from the Novichok group. These substances belong to the so-called organophosphates. Toxins block an enzyme in the body that plays an important role in communication between nerves and muscles. As a result of its blockage, poisoned people develop cramps and find it difficult to breathe. You may lose consciousness and your heart may stop. At worst, they die. The blockage of the enzyme by the Novichok venom is permanent. For those affected to recover, your body must gradually regenerate the enzyme.
“It is essential that a poisoning victim receives intensive medical care as soon as possible,” says Marc-Michael Blum, who until a year ago was head of the laboratory at the Organization for the Prohibition of Chemical Weapons (OVCW) in Rijswijk, the Netherlands. In Navalny’s case, that was the case after her plane’s emergency landing in Omsk. “Once you have stabilized the patient, you can give the body the time it needs to recover. Good support therapy helps.”
Navalny was comparatively young and fit
Navalny was treated in the Charité for a total of 32 days, 24 of them in the intensive care unit. On September 7, the clinic reported that the patient could be awakened from a coma maintained with medication and that a short time later mechanical ventilation was also suspended.
According to Blum, the length of recovery depends on individual circumstances. First is the dose of the poison administered. “One milligram less or more can make a difference.” The absorption of nerve agents in the body cannot be dosed correctly. Navalny may have received a comparatively low dose by accident.
The general condition of the patient before intoxication is also important. “Navalny was relatively young and relatively fit,” says Blum. “This helps.” The role of age is also shown in the case of Sergej Skripal, who was poisoned in Britain in 2018 and examined by Blum as head of an OPCW team. The then 66-year-old Russian double agent had to stay in hospital for more than a month longer than his significantly younger daughter, who was also poisoned. Julija Skripal was in the hospital for 36 days, almost as long as the Kremlin critic Navalny.
For the clinical toxicologist Florian Eyer of the Klinikum rechts der Isar of the Technical University of Munich, as he himself puts it, the length of Nawalny’s hospital stay for this type of intoxication is “in the normal spectrum”. If there were no complications, it is an expected amount of time that the body will need to resume its normal functions. It becomes more difficult, according to Eyer, if intensive care patients had more problems during treatment: These could be pneumonia caused by artificial ventilation, thrombosis, stomach ulcers, or pulmonary embolisms. It seems that Navalny has been spared major ailments of this kind.
However, he has not fully recovered either. A few days before his discharge from Charité, he posted the photo of himself on the stairs with the words: “Now I’m a guy whose legs shake when he walks down the stairs.”
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