(NYTIMES) - When an 87-year-old California 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.
It was an elaborate workaround, especially considering that 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, Arizona - 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 non-living.
From Moscow and Phoenix to China and 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 scepticism 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 California 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.
Mr Max More, the 57-year-old former president of Alcor, said 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," he 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."
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 that 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 US$200,000 (S$272,000).
"Perhaps the coronavirus made them realise their life is the most important thing they have and made them want to invest in their own future," said Ms Valeriya Udalova, 61, 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.
Mr 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-19 brings home the fact that they are not immortal," Mr Yount, 78, said during a recent stint working in the organisation's office in Silicon Valley.
The American Society of Cryonics has been offering support services since 1969 but stores its 30 cryopreserved members at another organisation, 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.
After averaging one cryopreservation a month in the 18 months before the pandemic, Alcor has dealt with just six since January last year, 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-19.
Visa and quarantine rules threatened delays of up to four weeks to reach their bodies, and the company often had to rely on local associates to deal with its clients, who died in South Korea, France, Ukraine and Russia.
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, making it difficult to recruit clients.
Cost of living in the future
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 ages two 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 Mr 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 US$200,000 to handle a whole body and US$80,000 for a neuro.
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 terms 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."