Didier Raoult is convinced of this: he has found "the" most effective remedy for treating patients with Covid-19. Director of the Mediterranean Infection Marseille University Hospital Institute (Bouches-du-Rhône), this infectiologist, specialist in emerging tropical infectious diseases, says that chloroquine, an antimalarial used for decades and well known to travelers as Nivaquine, has dramatic effects on the ongoing epidemic.
Six days after giving it to patients with Covid-19, he said, only 25% of them were still carrying the virus, while 90% of those who had not received this treatment were still positive. If some of his colleagues do not take him seriously, questioning his methods and the results of his therapeutic trials, the Minister of Health, Olivier Véran, announced on Saturday March 21 that this treatment would be tested "on a larger scale "
"I asked that Professor Raoult's study be reproduced [...] in other hospitals, by other independent teams, said the minister. I am that of extremely close. The government remains cautious, however, because Pr Raoult's results were obtained on 24 patients only, without placebo. "No country in the world has ever granted a treatment authorization on the basis of a study like this," underlines Olivier Véran.
Le Parisien - Today in France joined Professor Raoult, who judges it "immoral" not to administer chloroquine to Covid-19 patients now.
The government has authorized a large clinical trial to test the effect of chloroquine on the coronavirus. Is it important to you to have obtained this?
DIDIER RAOULT. No I do not care. I think there are people who live on the Moon and who compare the therapeutic trials of AIDS with an emerging infectious disease. I, like any doctor, once it has been shown that a treatment is effective, I find it immoral not to administer it. It's that simple.
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What do you say to the doctors who call for caution and are reserved about your tests and the effect of chloroquine, especially in the absence of further studies?
Understand me well: I am a scientist and I think like a scientist with verifiable elements. I have produced more data on infectious diseases than anyone in the world. I'm a doctor, I see sick people. I have 75 hospitalized patients, 600 consultations per day. So the opinions of each other, if you knew how I don't care. In my team, we are pragmatic people, not TV set birds.
How did you come to work on chloroquine and tell yourself that it could be effective in treating coronavirus?
The problem in this country is that the people who speak are of gross ignorance. I did a scientific study on chloroquine and viruses thirteen years ago which was published. Since then, four other studies by other authors have shown that the coronavirus is sensitive to chloroquine. All this is not new. It is suffocating that the circle of decision-makers is not even informed of the state of the science. We knew about the potential effectiveness of chloroquine on viral culture models. We knew it was an effective antiviral. We decided in our experiments to add a treatment of azithromicyne (an antibiotic against bacterial pneumonia, Editor's note) to avoid bacterial secondary infections. The results were dramatic in patients with Covid-19 when azithromycin was added to hydroxychloroquine.
What do you expect from larger-scale trials around chloroquine?
Nothing at all. With my team, we believe we have found a cure. And in terms of medical ethics, I believe that I have no right as a doctor not to use the only treatment that has so far proven successful. I am convinced that in the end everyone will use this treatment. It's just a matter of time before people agree to eat their hats and say, this is the thing to do.
In what form and for how long do you administer chloroquine to your patients?
Hydroxychloroquine is given at a dose of 600 mg per day for ten days (in the form of Plaquenil, the name of the medicine, Editor's note) in the form of tablets administered three times a day. And 250 mg azithromycin twice the first day and then once a day for five days.
Is it a treatment that can be taken to prevent the disease?
We do not know it.
When you administer it, how long does it take for a Covid-19 patient to heal?
What we know for the moment is that the virus disappears after six days.
Do you understand, however, that some of your colleagues call for caution with this treatment?
People give their opinion on everything, but I only speak of what I know: I do not give my opinion on the composition of the France team finally! Each his trade. Scientific communication in this country today is akin to bistro conversation.
But are there not rules of prudence to respect before administering a new treatment?
To those who say that we need thirty multicenter studies and a thousand patients included, I answer that if we were to apply the rules of current methodologists, we would have to redo a study on the interest of the parachute. Take 100 people, half with parachutes and the other without and count the dead at the end to see what is most effective. When you have a treatment that works against zero other treatment available, this treatment should become the benchmark. And it's my freedom to prescribe as a doctor. We do not have to obey government orders to treat the sick. The recommendations of the High Health Authority are an indication, but it does not oblige you. Since Hippocrates, the doctor has done for the best, in the state of his knowledge and in the state of science.
What about the risks of serious undesirable effects linked to taking chloroquine, especially at high doses?
Contrary to what some people say on television, Nivaquine (the name of one of the drugs designed based on chloroquine, Editor's note) is rather less toxic than Doliprane or aspirin taken in high doses. In any case, a drug should not be taken lightly and always prescribed by a general practitioner.
Are you aware of the immense hope for healing for patients?
I see above all that there are doctors who write to me from all over the world every day to find out how we treat diseases with hydroxychloroquine. I received calls from Massachusetts General Hospital and the Mayo Clinic in London. The two biggest specialists in the world, one of infectious diseases, the other of antibiotic treatments, contacted me to ask me for details on how to set up this treatment. And even Donald Trump tweeted about the results of our tests. It is only in this country that it is not clear who I am! It is not because we do not live inside the Paris ring road that we do not do science. This country became Versailles in the 18th century!
HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains - Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents) .....
- Donald J. Trump (@realDonaldTrump) March 21, 2020What do you mean ?
We are asking Franco-French and even Parisian-Parisian questions. But Paris is completely out of step with the rest of the world. Take the example of South Korea and China, where there are no more cases. In these two countries, they have long decided to carry out large-scale tests to be able to diagnose infected patients earlier. This is the basic principle of managing infectious diseases. But we have reached a level of madness such that doctors on TV sets no longer advise to diagnose the disease, but tell people to stay confined to their homes. It’s not medicine.
Do you think that confining the population will not be effective?
Never before has this been done in modern times. We were doing this in the 19th century for cholera in Marseille. The idea of confining people to block infectious diseases has never been proven. We don't even know if it works. It is social improvisation and we do not measure its collateral effects at all. What will happen when people are going to stay locked up, behind closed doors, for 30 or 40 days? In China, there have been reports of suicides for fear of the coronavirus. Some will fight among themselves.
Should we, as the World Health Organization demands, generalize tests in France?
Let us have the courage to say it: the French-style tambouille, it does not work. France is only 5000 tests a day when Germany performs 160,000 per week! There is a kind of discord. In infectious diseases, we diagnose people and, once we get the result, we treat them. Especially since we are starting to see people carrying the virus, apparently without clinical signs, but who, in a non-negligible number of cases, have lung lesions visible on CT showing that they are sick. If these people are not treated in time, there is a reasonable risk that they will be found in intensive care where they will not be caught. Testing people only when they are already seriously ill is therefore an extremely artificial way of increasing mortality.
And should we generalize the wearing of masks?
It is difficult to assess. We know that they are important for healthcare personnel, because they are the rare people who really have very, very close relationships with patients when they examine them, sometimes 20 cm from their face. It is unclear how far viruses fly. But certainly not more than a meter. So, beyond this distance, it may not make much sense to wear a mask. In any case, it is to hospitals that these masks must be sent as a priority in order to protect caregivers. In Italy and China, an extremely large part of the patients turned out to be healthcare personnel.
