Publisher Health

When an 87-year-old Californian man was wheeled into an operating room just outside Phoenix last year, the pandemic was at its height and medical protocols were being upended across the country.

A case like his would normally have required 14 or more bags of fluids to be pumped into him, but now that posed a problem.

Had he been infected with the coronavirus, tiny aerosol droplets could have escaped and infected staff, so the operating team had adopted new procedures that reduced the effectiveness of the treatment but used fewer liquids.

It was an elaborate workaround, especially considering the patient had been declared legally dead more than a day earlier.

He had arrived in the operating room of Alcor Life Extension Foundation — located in an industrial park near the airport in Scottsdale, Ariz. — packed in dry ice and ready to be “cryopreserved,” or stored at deep-freeze temperatures, in the hope that one day, perhaps decades or centuries from now, he could be brought back to life.

As it turns out, the pandemic that has affected billions of lives around the world has also had an impact on the nonliving.

From Moscow to Phoenix and from China to rural Australia, the major players in the business of preserving bodies at extremely low temperatures say the pandemic has brought new stresses to an industry that has long faced skepticism or outright hostility from medical and legal establishments that have dismissed it as quack science or fraud.

In some cases, Covid-19 precautions have limited the parts of the body that can be pumped full of protective chemicals to curb the damage caused by freezing.

Alcor, which has been in business since 1972, adopted new rules in its operating room last year that restricted the application of its medical-grade antifreeze solution to only the patient’s brain, leaving everything below the neck unprotected.

In the case of the Californian man, things were even worse because he had died without completing the normal legal and financial arrangements with Alcor, so no standby team had been on hand for his death. By the time he arrived at Alcor’s facility, too much time had elapsed for the team to be able to successfully circulate the protective chemicals, even to the brain.

That meant that when the patient was eventually sealed into a sleeping bag and stored in a large thermos-like aluminum vat filled with liquid nitrogen that cooled it to minus 320 degrees Fahrenheit (minus 196 Celsius), ice crystals formed between the cells of his body, poking countless holes in cell membranes.

Max More, the 57-year-old former president of Alcor, said that the damage caused by this patient’s “straight freeze” could probably still be repaired by future scientists, especially if there was only limited damage to the brain, which is often removed and stored alone in what is known in the trade as a “neuro” preservation.

“I have always been signed up for a neuro myself,” Mr. More said. “I don’t really understand why people want to take their broken-down old body with them. In the future it’ll probably be easier to start from scratch and just regenerate the body anyway.”

“The important stuff is up here as far as I am concerned,” he said, pointing to his sandy-blond crop of hair in a Zoom call. “That is where my personality lives and my memories are … all the rest is replaceable.”

Cryopreserving in a Pandemic

Supporters of cryonics insist that death is a process of deterioration rather than simply the moment when the heart stops, and that rapid intervention can act as a “freeze frame” on life, allowing super-chilled preservation to serve as an ambulance to the future.

They usually concede there is no guarantee that future science will ever be able to repair and reanimate the body but even a long shot, they argue, is better than the odds of revival — zero — if the body is turned to dust or ashes. If you are starting out dead, they say, you have nothing to lose.

During the pandemic, a heightened awareness of mortality seems to have led to more interest in signing up for cryopreservation procedures that can cost north of $200,000.

“Perhaps the coronavirus made them realize their life is the most important thing they have and made them want to invest in their own future,” said Valeriya Udalova, 61, the chief executive of KrioRus, which has been operating in Moscow since 2006. Both KrioRus and Alcor said they had received a record number of inquiries in recent months.

Jim Yount, who has been a member of the American Cryonics Society for 49 years, said he has often seen health crises or the death of a loved one bring cryonics to the front of people’s minds.

“Something like Covid brings home the fact that they are not immortal,” said Mr. Yount, 78, during a recent stint working in the organization’s office in Silicon Valley.

The American Cryonics Society has been offering support services since 1969 but stores its 30 cryopreserved members at another organization, the Cryonics Institute, near Detroit.

Alcor, the most expensive and best-known cryonics company in the United States, said the pandemic forced it to cancel public tours of its Scottsdale operation. It has also been harder to reach clients quickly, both because of travel restrictions and limitations on hospital access.

“Usually we like to get to the hospital beforehand if we have advance notice that the patient is terminal so we can talk to the staff, get to know the layout and how we are going to get the patient out of there as quickly as possible,” said Mr. More, who is now a spokesman for Alcor.

The company stocked up on chemicals at the start of the pandemic, he said, “but actually we dodged a bullet for our members because fortunately we have had very few deaths.”

After averaging about one cryopreservation a month in the 18 months before the pandemic, Alcor has dealt with just six since January 2020, perhaps through a combination of luck and clients heeding the company’s plea to avoid risky activities during the pandemic.

KrioRus, the only operator with cryostorage facilities in Europe, was busier than ever and performed nine cryopreservations during the pandemic, according to Ms. Udalova, with some of the deaths caused indirectly by Covid.

Visa and quarantine rules threatened delays of up to four weeks to reach their bodies, and the company often had to rely on small local associates to deal with its clients, who died in South Korea, France, Ukraine and Russia.

Different problems have emerged in Australia, which has had some of the world’s most restrictive Covid border controls.

Southern Cryonics, a start-up, was unable to fly in foreign experts to train its staff, forcing it to delay by a year the planned opening of a facility capable of storing 40 bodies.

In China, the newest major player in cryonics, the Yinfeng Life Science Research Institute had to stop public visits to its facility in Jinan, the capital of Shandong province, which has made it difficult to recruit clients.

The Cost of Maybe, Possibly Living a Bit Longer

More than 50 years after the first cryopreservations, there are now about 500 people stored in vats around the world, the great majority of them in the United States.

The Cryonics Institute, for instance, holds 206 bodies while Alcor has 182 bodies or neuros of people aged 2 to 101. KrioRus has 80, and there are a handful of others held by smaller operations.

The Chinese performed their first cryopreservation in 2017, and Yinfeng’s storage vats hold only a dozen clients. But Aaron Drake, the clinical director of the company, who moved to China after seven years as head of Alcor’s medical response team, noted that it took Alcor more than three times as long to reach that number of preserved bodies.

Yinfeng has priced itself at the top of the market alongside Alcor, which charges $200,000 to handle a whole body and $80,000 for a neuro.

Alcor has the largest number of people who have committed to paying its fees: 1,385, from 34 countries. (Fees are often funded with life insurance policies.) The Chinese have about 60 customers who have committed, while KrioRus said it has recruited 400 customers from 20 countries.

The Cryonics Institute has a different business model, charging basic fees as low as $28,000 with up to $60,000 more required if the members want transport and rapid “standby” teams like Alcor’s.

KrioRus is even cheaper, although it plans to raise its fees when it completes its current move from a corrugated metal warehouse 30 miles northeast of Moscow to a much larger facility being built in Tver, 105 miles northwest of the capital.

Alcor’s fees are so much higher mostly because the company places $115,000 of its “whole body” fee in a trust to guarantee future care of its patients, such as topping up the liquid nitrogen. That trust is managed by Morgan Stanley and is now worth more than $15 million.

Mr. Drake said he believes the Chinese are “hopeful that they will be able to outpace the American companies and they have built a program capable of doing that.”

The strongest reason for believing China will come to dominate the field is not just its population of 1.4 billion people but its domestic attitude toward cryopreservation. Far from being confined to the scientific fringe, Yinfeng is the only cryonics group that is supported by government and embraced by mainstream researchers.

“Our little business unit is owned by a private biotech firm that has about 8,000 employees and partners with the government on a lot of projects,” Mr. Drake said. He added that it is “well integrated into the hospital systems and cooperates with research institutes and universities.”

The cooperation in China is a long way from the situation in Russia, where Evgeny Alexandrov, the chair of a Commission on Pseudoscience started by the official Academy of Sciences, has derided cryonics as “an exclusively commercial undertaking that does not have any scientific basis.”

In the United States, the Society of Cryobiology, whose members study the effects of low temperatures on living tissues for procedures such as IVF, adopted a bylaw in the 1980s threatening to expel any member who took part in “any practice or application of freezing deceased persons in anticipation of their reanimation.”

The society’s past president Arthur Rowe wrote that “believing cryonics could reanimate somebody who has been frozen is like believing you can turn hamburger back into a cow,” while another past president said the work of cadaver freezers edged more toward “fraud than either faith or science.”

The society has since eased off, and while its formal position is that cryonics “is an act of speculation or hope, not science,” it no longer bans its members from the practice.

Mr. More at Alcor said there is much less hostility from the medical and scientific establishments now than just five years ago, when there was often tension between rapid response teams and hospitals.

“It was quite common for us to show up at a hospital, try to explain what we’re doing and they would say, ‘You want to do what? Not in my hospital you don’t!’” he said.

“They wouldn’t let us in, so we would have to wait outside and it would slow things down, but that just doesn’t happen anymore. Usually the staff have seen one of the documentaries on science channels and they know something about what we do.”

“Typically the reaction now is: ‘Oh, this is fascinating, I’ve never seen this happen.’”

Peter Tsolakides, 71, a former marketing executive for Exxon Mobil and a founder of the Australian start-up Southern Cryonics, said he is grateful that people in the country “tend to have an open mind about new things.”

“I don’t think any public resistance will crop up here, and the state department of health has been really positive and helpful,” he said.

An important difference between Yinfeng and most other operators is the Chinese firm’s greater willingness to preserve people who die without having expressed any interest in being put on ice.

This is seen as an important ethical question in the West, given that it could come as quite a shock for somebody to die, perhaps after coming to peace with their fate, only to wake up blinking at the ceiling lights of a laboratory a few decades or centuries later.

“We don’t like to take third-party cases,” Mr. More said. “If someone phones up and says, ‘Uncle Fred is dying, I want to get him cryopreserved,’ we need to ask a bunch of questions before we even consider accepting that case.”

“Is there any evidence that Uncle Fred actually was interested in being cryopreserved? Because if not, we don’t want to do it. Are there any family members who are really opposed to it? Because we don’t want to have to go into a legal battle.”

The litigious bent in the United States make its cryonics firms especially twitchy. There have been many lawsuits by relatives of the deceased trying to stop the expensive cryonics procedure.

“You have relatives who think, ‘Now you’re dead, I can overrule your wishes and just take your money,’” Mr. More said. “It’s amazing how often people try to do that.”

The relatives of one client failed to inform Alcor that he had died and instead had him embalmed and buried in Europe. When Alcor found out a year later, it confirmed that his contract said he wanted to be cryopreserved no matter how much time had elapsed, so the company got a court order and had the body returned to Arizona.

Mr. Drake said that the primacy that Western society places on an individual’s choice in such cases is “a big difference with Eastern culture.”

“In China it has to do with what the family members want, just like with medical treatments,” he said. “Let’s say Grandpa gets cancer in China. Many times they won’t even tell Grandpa he has cancer, and the other family members will decide what treatments should be done.”

“They might then say, ‘Let’s have Grandpa cryopreserved,’ and it has to be a unanimous agreement of the whole family — but not including the individual who actually goes through it.”

Ms. Udalova said the Russian system is somewhere in the middle. Somebody who dies without leaving written proof of their intentions can still be cryopreserved if two witnesses testify that is what the deceased wanted.

That may help explain an intriguing difference in the gender balance of people who have been preserved.

Men outnumber women by almost three to one among Alcor’s clients, and the imbalance is even greater among people registered with the Australian start-up. But there is an almost even gender balance among KrioRus’s 80 patients.

“That is because of a cultural situation here in Russia,” Ms. Udalova said from her office in northern Moscow.

“Our clients are mostly men, but they often cryopreserve their mothers first, because Russian men are brought up only by their mothers.”

When those male clients eventually join their mothers in the firm’s metal vats, the gender balance will likely tip toward more men, she said.

The Chinese, like the Russian men who want to embark on any new life with their mothers by their side, are also baffled by the tendency of American men to plan a solo journey into the future.

“In the States you get some family members signing up together, but you get a lot more individuals signing themselves up and the Chinese don’t really get that,” Mr. Drake said.

“I think in almost all the cases in China so far, you’ve had a family member signing up their loved one who is near death.”

If waking up alone in the future does not appeal, there is a growing trend in the United States of people paying tens or even hundreds of thousands of dollars to cryopreserve their pets, with the cost based largely on the animal’s size.

“If you want us to do your horse it is going to be different from your cat’s brain,” Mr. More said. “We seem to be having more pets than humans at the moment, and that’s fine with dogs but it’s kind of tricky for cats and anything smaller because of their tiny blood vessels.”

“If you want to store a whole big dog, that’s going to cost about as much as a human because of its size. My wife and I had our dog Oscar cryopreserved. He was a large golden doodle, but we basically just had his brain stored to make it more affordable because I’m in neuro anyway.”

In Russia, KrioRus’s preserved cats and dogs have been joined by five hamsters, two rabbits and a chinchilla.

Life After the Deep Freeze

To smooth the jolt of trying to resume life in the future, most cryonics firms offer to store keepsakes, “memory books” and digital discs to help a revived patient rebuild memories or simply cope with nostalgia. Alcor uses a salt mine in Kansas for storage and is also working on options for putting money into a personal trust to finance a future life.

A final edge the Chinese cryonicists enjoy is a more accommodating cultural environment, as Western religions tend to be more focused on the concepts of heaven and hell, and the body and brains being merely the repositories of an eternal soul rather than machines that can be switched off and on.

Mr. More, for one, has little patience with religious critics of cryonics. “Where in the Bible or the Quran, or the Bhagavad Gita does it say, ‘Thou shalt not do cryonics’? It doesn’t. In fact in the Bible there are some people living for centuries.”

“Remember,” he added, “we are not talking about letting people live forever, just maybe a few hundred years more, and that’s nothing compared to eternity.”

When Christians complain that they would not like to be dragged back from heaven by having their body revived, Mr. More reminds them that they may be traveling from the other direction.

“Are you sure you’re not going downstairs?” he asks. “And if so, don’t you want an escape clause? Cryonics might give you a chance to come back and do some good works so you will have a better chance of getting to heaven.”

Ms. Udalova in Moscow said some of her clients cover their bases by opting for both cryonics and a church funeral.

“Russian priests always agree to do the religious service,” she said. “You just have dry ice in the coffin in the church.”