A world leader in the field of infectious diseases and member of the scientific council dedicated to the coronavirus, Didier Raoult fears the runaway against a coronavirus which he has been inviting for weeks to treat.
Director of the Mediterranean Infection Institute in Marseille, Professor Didier Raoult is one of the most recognized French infectious diseases specialists in the world. He notably joined the multidisciplinary committee of 11 experts formed in March by the executive, assembled to "enlighten public decision in the management of the health situation linked to the coronavirus".
But in this crisis, he believes he is little heard by French health authorities when he is conducting a clinical trial on an old antimalarial drug used in China against Covid-19. Faced with the reality of the epidemic, he recommends not to panic and to detect the patients without waiting for their case to get worse to better treat them.
Marianne: What does the evolution of the coronavirus epidemic inspire in you?
Didier Raoult: I don't let myself get into terror. I do not know how to guess the future and I am not used to believe the most excited who have always been wrong in their modeling. I analyze from day to day, and the evolution, today, it is some 6,000 deaths in the world, including approximately 3,500 in China where the epidemic ends, and 127 in France. I am surprised that we are talking about a very significant cause of mortality, and even a health crisis of the century, when in 2017 the flu and other respiratory infections killed between 14,000 and 20,000 people in France. Maybe the statistics will be very different at the end of the epidemic, but today I do not see a major problem in terms of mortality.
We can only test this mortality if we integrate forms that are not very symptomatic
As a scientist, I am interested in what is done in the world to analyze the solutions associated with the best results. Most countries had not taken the type of decision announced by France, except Italy with not very remarkable success. Germany did not make this choice, neither did South Korea, although it was hit hard. In China, only the Wuhan region has been quarantined, where there have been 2,500 deaths, while the virus has been everywhere else. But mortality has not spread. We are taking measures that have nothing to do with those of countries that have controlled the epidemic. Maybe it's a stroke of genius, or not. It is especially important to reduce things to their proportion, because the interpretation that one gives ends up completely biasing the vision.
Isn't this virus particularly contagious and dangerous?
Dangerousness, I don't know what that means. It depends on the sample we observe. We can look in South Korea where we have done what I advocate from the start, namely to detect and treat, or in the greatest madness carried out in Japan by wedging elderly people on a cruise ship, an experimental model equivalent to putting together twenty mice including four infected to see how many will be contaminated. In both cases, mortality was relatively low, and in Korea it was one of the lowest in the world. In our center in Marseille, the only fatal case arrived after wandering from hospital to hospital. An 89-year-old lady who had been in intensive care for ten days when she was diagnosed. Mortality will obviously be higher for people identified in intensive care than with early detection. It will depend on the quality of care, and we can only test this mortality if we integrate mild symptoms.
In China, suicides of anguished people are reported
We have undoubtedly carried out more tests of the coronavirus than all the other French laboratories combined, with both moderate and severe forms. PACA [Southeastern France] may be spared with just one death, but that would prove that the generalizations are wrong. The ecosystems are different between inner Paris, Wuhan, the PACA region, and there is the unmeasurable risk because chaotic super-contaminators, difficult to understand. We still know now how to measure viral loads and we see that people have quantities of virus a million times greater than others. Logically, this can play a role in contamination, along with other things like behavior. The fact remains that today most of our patients come for respiratory symptoms due to the twenty or so other viruses circulating, or because they met someone who had the coronavirus. They are frantic and want to know if they don't have something that will kill them. Fear is very contagious. In China, suicides of anxious people have been reported. Do not play with fear.
Do you think we're getting carried away dangerously?
Yes. What are the practical details? In 2019, there were 2.6 million deaths worldwide from acute respiratory infection. In your opinion, what influence will the coronavirus have in this? Before significantly modifying these statistics, he will have to kill a lot ... And who knows if it will not stop overnight without knowing why like SARS, or if we be will finished with it in March, as is usual with the flu. All this means that I am not particularly moved, and think above all of detecting and treating.
You are conducting a clinical trial of treatment with chloroquine. Do you have any initial results?
I will present them this week, but will not invent anything. Dr. Zhong Nanshan, who successfully managed the Chinese coronavirus epidemic, has shown that chloroquine improves the clinical picture. In Saudi Arabia, the country where there has been the most coronavirus in recent years, Ziad Memish also recommends it as a basic treatment. These two scientists are the best in the world for treating coronaviruses, but in France, perhaps because one is Chinese and the other Arab, we don't listen to them. In South Korea, chloroquine is also in the official protocol, as in Iran.
Coronaviruses come from these countries and those who offer this product know them. I transmit things that others should also transmit if they read, followed what is done abroad and realized that the Chinese have become the largest producers of science in the world. I am only doing a confirmatory study at the level of viral load, the only element really measurable today, except to include thousands of people for analyzes which will arrive in several months, without immediate result.
Viral load, on the other hand, is easy to watch and answers the essential question of transmissibility. Its average duration is 12 to 14 days, and Doctor Zhong has already shown that chloroquine reduces the persistence of the virus to four days. Among all the products tested, it is the most harmless in terms of side effects, the cheapest, and it has at least partially shown its effectiveness. Good news to announce. This will have an effect, including in a population where one can fear dying from something that cannot be treated. I don't understand why we don't use it. It's weird at a time when we keep talking about globalization. In France we're asked to provide results already found elsewhere.
Your statements about chloroquine have been labeled "fake news"
At the end of February, I made a video in which I presented the Chinese results. It was posted and shared on Facebook, which qualified it as "fake news" after advice from a World decoder. The Ministry of Health website then posted that I was spreading fake news, but quickly removed it. And two weeks later, the ministry asked me to enter the scientific council dedicated to the coronavirus ...
Are you heard there?
I say what I think, but the council does not translate it into action. It's called scientific advice, but it's political. I'm like an alien there.