Alexei Navalny: Did he recover unusually quickly?

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Alexej Navalny during his stay at the Berlin Charité

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Alexei Navalny / EPA-EFE / Shutterstock

After a month or so, the Russian Kremlin critic Alexej Navalny was able to leave the Berlin Charité.

His attending doctors consider a full recovery possible, but any long-term consequences of the poisoning could only be assessed later, the clinic said.

On Instagram, he reports that the 44-year-old has not yet fully recovered.

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 could no longer throw it.

According to analyzes by several laboratories, Navalny had been poisoned with a chemical nerve agent from the Novichok group.

These substances belong to the so-called organophosphates.

The 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 can lose consciousness and your heart can stop.

At worst, they die.

The blockade of the enzyme by the Novichok poison is permanent.

In order for those affected to recover, their body must gradually regenerate the enzyme.

"It is crucial that a poisoning victim receives intensive medical care as quickly as possible," says Marc-Michael Blum, who until a year ago was head of the laboratory of the Organization for the Prohibition of Chemical Weapons (OVCW) in Rijswijk, the Netherlands.

In the case of Navalny, that was the case after the emergency landing of his plane in Omsk.

"Once you have stabilized the patient, you can give the body the time it needs to recover. Good accompanying therapy helps." 

Navalny was comparatively young and fit

Navalny was treated at the Charité for a total of 32 days, 24 of them in the intensive care unit.

On September 7th, the clinic reported that it was able to wake the patient out of the coma maintained by medication, and that mechanical ventilation was also stopped shortly afterwards.

According to Blum, how long the recovery takes depends on the individual circumstances.

First there is the dose of the poison administered.

"A milligram less or more can make all the difference."

The absorption of nerve agents into the body cannot be properly dosed.

Navalny may have received a comparatively low dose by accident.

The general condition of the patient before the poisoning is also important.

"Navalny was comparatively young and comparatively fit," says Blum.

"This helps."

The role of age is also shown by the case of Sergej Skripal, who was poisoned in Great Britain in 2018 and investigated 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 hospital for 36 days, about as long as Kremlin critic Navalny.

For the clinical toxicologist Florian Eyer from the Universitätsklinikum rechts der Isar at the Technical University of Munich, as he says, the length of Nawalny's hospital stay for this type of poisoning is "on the normal spectrum".

If there are no complications, it is an expected amount of time it will take the body to resume normal functions.

It becomes more difficult, according to Eyer, if intensive care patients had further problems during treatment: These could be pneumonia caused by artificial ventilation, thromboses, stomach ulcers or pulmonary embolisms.

Navalny seems to have been spared major ailments of this kind.

However, he has not fully recovered either.

A few days before his discharge from Charité, he published the photo of himself on the stairs with the words: "Now I'm a guy whose legs tremble when he walks the stairs."

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