Dr. Philip McMillan, John McMillan

In the early days of the COVID-19 pandemic, Dr. Shankara Chetty, a South African general practitioner, took an unconventional approach to treating the mysterious disease. When the spreading virus reached his small town, Dr. Chetty moved out of his house, isolating himself from his family for their protection, and pitched a tent outside his home. This makeshift clinic, bathed in sunlight and open to the fresh air, became his new base of operations. His clinical experiences and observations here would later prove invaluable in unraveling the complexities of what we now understand as the Spike-Triggered AutOimmune Response Mechanism (STORM).

Dr. Chetty meticulously examined each patient, carefully documenting their symptoms and progression. He implemented a rigorous triage system, keeping patients separated to minimize the risk of transmission. The tent, with its natural ventilation, proved to be an ideal setting for safely treating potentially infectious individuals.

After observing a few dozen infected individuals he noticed a peculiar pattern that would shape our understanding of COVID-19’s progression. Several days after the onset of symptoms a subset of patients began to exhibit a rapid and alarming desaturation in their oxygen levels. Intrigued by this pattern, he advised his patients to alert him the moment they experienced any breathlessness.

The Eighth Day

The breakthrough came when five patients returned with breathing difficulties. To Dr. Chetty’s astonishment, all of the five became breathless on precisely the eighth day after the onset of their initial symptoms. This revelation was particularly striking because these patients had shown good clinical improvement in the days prior to the decline. One patient had even felt well enough to play squash on the seventh day, only to collapse on the eighth with severe breathlessness.

This puzzling pattern repeated itself with alarming consistency. Dr. Chetty drew on his medical knowledge and intuition, realizing that the rapid decompensation resembled an allergic reaction more than a typical viral infection. This insight led to the hypothesis that his patients might be experiencing a hypersensitivity reaction to viral proteins on the eighth day.

In light of these discoveries, Dr. Chetty adapted his treatment approach. He started using a combination of steroids to suppress inappropriate immune responses and antihistamines to manage the allergic-like reactions. To his relief and excitement, patients quickly responded, showing marked improvement within hours. His unorthodox approach and keen observations led to a treatment protocol that has saved over fourteen thousand lives over the duration of the pandemic.

When the COVID-19 vaccines became available Dr. Chetty was concerned. These vaccines had been designed to produce spike protein, which he believed was the primary pathogen causing mortality and morbidity by triggering hypersensitivity responses. In his clinical observations, Dr. Chetty noted an unexpected pattern among vaccinated patients. Many presented with COVID-like symptoms 7-10 days post-vaccination. Upon conducting blood tests, he found that these symptoms were not due to viral infection but rather to the spike protein produced by the vaccine. These patients appeared to bypass the initial viral phase of the illness, instead experiencing symptoms typically associated with the later stages of COVID-19 (from around day 8 onwards in a natural infection).

This phenomenon appears to be because the vaccine-induced spike protein is causing patients to experience the later-stage symptoms of COVID-19 without going through the initial viral phase of the illness. This is a potential problem with the mRNA vaccination approach, creating a complex situation where patients were experiencing COVID-like symptoms due to vaccine-induced spike protein rather than an actual viral infection.

Understanding STORM in the Lungs: From Infection to Immune Response

STORM, which stands for Spike-Triggered AutOimmune Response Mechanism, is a hypothesis by Dr Philip McMillan proposed to explain some of the complex and long-lasting effects of COVID-19. This concept suggests that the spike proteins from the SARS-CoV-2 virus or vaccines can trigger autoimmune responses in the body, leading to various health complications.

When the COVID-19 virus enters the lungs, it targets specific cells that have a particular receptor called ACE2, including alveolar epithelial cells and endothelial cells. The virus’s spike protein binds to ACE2, facilitating entry and initiating the infection cycle. Once inside, the virus triggers the body’s first line of defense – the innate immune system. This system quickly recognizes that something foreign has entered the body and sounds the alarm.

Doctor’s observations of vaccinated patients bypassing the initial viral phase of the illness and then suddenly getting worse from the eighth day onward align with what we now understand about STORM (Spike-Triggered AutOimmune Response Mechanism). The core idea of STORM is that when the immune system encounters the spike protein, either through infection or vaccination, it can sometimes overreact or become dysregulated. This overreaction can cause the immune system to mistakenly attack the body’s own cells and tissues, particularly those that express the ACE2 receptor, which is the primary target of the SARS-CoV-2 spike protein.

In the STORM hypothesis, this autoimmune response can affect multiple organ systems, including the lungs, heart, brain, kidneys, and vascular system. The mechanism involves various components of the immune system, with a particular focus on overactive macrophages and immune tolerance with IgG4 antibodies. Macrophages, when excessively activated, can release a storm of inflammatory cytokines, leading to widespread inflammation and tissue damage. Meanwhile, IgG4 antibodies, which typically play a role in immune tolerance, may paradoxically allow the virus to circulate more freely, potentially leading to a condition described as viral sepsis.

How STORM Affects the Lungs

The immune system’s overreaction in STORM can lead to several serious lung disorders:

• Acute Respiratory Distress Syndrome (ARDS): This condition causes severe breathing difficulties and low oxygen levels in the blood. This was observed in patients who suddenly struggled to breathe on the eighth day of illness.
• Pulmonary Fibrosis: Over time, the damage from inflammation can lead to scarring in the lungs, making it harder to breathe normally.
• Pulmonary Hypertension: The damage to blood vessels in the lungs can increase pressure in these vessels, straining the heart.
• Persistent Cough: Ongoing inflammation with bronchitis can irritate the airways, causing a long-lasting cough.
• Reduced Lung Function: The lungs may become less efficient at transferring oxygen to the blood, leading to fatigue and difficulty with physical activities.

Preventing STORM

The approach of using steroids and antihistamines has influenced how we think about preventing STORM. Some key strategies include:

• Vaccination: While current vaccines mainly protect against severe initial infection, they may also help reduce the risk of STORM through IgG4 immune tolerance. It is unclear if this is the best strategy going forward to manage this process.
• Early Treatment: Quick action with antiviral medications when someone is infected might help prevent the immune system from overreacting later.
• Lifestyle Factors: Maintaining overall health through good diet, regular exercise, and stress management can help support a balanced immune response.
• Vitamin D: Adequate levels of this vitamin have been linked to better outcomes in COVID-19 and may help regulate immune responses.

Treating STORM

Current treatments for STORM often involve carefully suppressing the overactive immune response. This approach must be balanced to avoid leaving the body vulnerable to other infections. Treating STORM often may involves immunosuppression and other comprehensive strategies that are described in detail in our book “Disease X: Are You Prepared?”