For a prestigious Argentine scientist, "the coronavirus does not deserve that the planet is in a state of total stop"
Pablo Goldschmidt, a renowned virologist, spoke to Infobae from Monaco - where he lives and is undergoing his French quarantine - and launched a controversy over the number of cases and the adequacy of the WHO, the obscure reason for so many deaths in Lombardy, Italy, and blamed poor health systems for the deaths rather than the virus.
By Hugo Martín 28-03-2020
As someone who swims against the tide, Dr Paul Goldschmidt (born in our country 65 years ago - he turned two days ago - who has been living in France for 40 years), has been fighting the panic of viruses for years. His book "People and Microbes", in which he explains the psychosis caused by the H1N1 flu and SARS, bears witness to this.
Now, this retired virologist from the French Ministry of Health, who spends his days in his department in Monaco, is taking action against the calculations made by the World Health Organization about the scope of the coronavirus COVID-19, which has already infected 595953 people and killed 27333 (690 and 17 respectively in Argentina), although Goldschmidt will put it into perspective.
"We are all locked up. There are drones in Nice that are fining people from the air. Look as far as this control has gone. You have to read Hannah Arendt, look at the origins of totalitarianism. When someone puts fear into the people, they do what they want with it…”, he maintains. And if you point out to them that because of their age they’re in the risk group, they’ll take it: "But of course... we're all at risk. But there are people in their 80s who are fantastic."
-Why do you claim that there is unwarranted paranoia about the coronavirus?
-Look, these kinds of diseases don't deserve the planet to be in a state of total cessation, unless there are predictions that are realistic.
-And there aren't?
At Imperial College London, which has a very good epidemiology and mathematical prediction service, there is a professor, (Neil) Ferguson, who has modelled the flattening or non-flattening curves in epidemiology. And that was taken for all government policy decisions on the advice of the World Health Organization, without discussing or questioning the equations. I started to analyze this from the beginning and I saw that there was something strange. That didn't close me down. The night before last, this Mr Ferguson said that the projection they made should be massively reduced - the word he used in English - with regard to the numbers of deaths.
-What does it mean?
-That, for example, for the United States he projected with his model -which everyone is using right now without even questioning it-, 2,200,000 deaths; and 500,000 in the United Kingdom if measures were not taken to flatten the curve and all that that meant. Now he says no, that the predictions don't seem to be accurate. The same thing happened with H1N1. They predicted a lot fewer deaths now, as long as the closing measures like those taken by governments are maintained. The estimates are much lower.
-But because of the blockade...
-He says the blockade is going to keep them. But the blockade to flatten the curve was made according to the first calculations, which gave a higher transmissibility and mortality coefficient. But now he says it's not like it was before, that it's in the order of 3 or 2.5, within the flu values. And he said on Wednesday that, because of the estimates he reviewed and the closure measures adopted by the British government, hospitals are going to treat infected people and about 20,000 people will die from the virus... or because of the excitement that other illnesses associated with the virus are going to cause.
-What kind of ailments?
-Infarcts, strokes... Because you go to hospital and if you die from a heart attack, they'll say you died from the virus. The problem is that now everything gets mixed up. A person who arrives for a suicide attempt and who took a remedy for a cold, died from the virus. Someone with a mishandled stroke, if they have a cold, died from the virus, not the stroke. He says the numbers need to be corrected because that's all that's being considered. Of course, there is another epidemiologist in Oxford who says he is surprised that the Imperial College model has been so unconditionally accepted by international organizations. They're doing another kind of predictive model and they say that this virus has spread in an invisible and uncontrolled way at least a month earlier than anyone would have suspected, and if you start testing the population probably half of them will have been infected, and then the mortality is much lower and the risk is much lower too. If that's true, one in a thousand infected would be the one who gets sick and would need hospitalization, because 86 percent don't have serious symptoms. This appeared yesterday in England.
-What does this change for the health care system?
-Of every 100 people who go to see a doctor, 86 percent suffer from flu syndrome. The doctor, in that case, will do a blood test and ask for four parameters, which the laboratory can do in half an hour or an hour. There you can find out whether or not the person has a viral infection. It won't tell you if you have a coronavirus. He has a virus. Influenza, adeno, anything else. But you need labs that can make dimers, C-reactive proteins, blood counts... If the positive dimers are high, there's gonna be some damage to the lung. And they do liver enzymes and ask for an ionogram to see how the potassium is doing. If they do, the person has a virus, whether it's corona or not. If those things aren't altered, they send him home and give him flu treatment. Do you understand? So far there's no need to panic, and we're talking about 85 percent of the people. It happened in Korea, China, and all over the world.
-What happens to the 15 percent who do get a viral infection?
- It can be serious. The only way to know is to do a PCR test, which is not accessible in every city, province or laboratory. The cost of each test is $30 or $40 and it requires very well trained staff and materials. I was just in Argentina in December, and I gave a talk on how to develop home-made molecular biology tests that are not expensive. But to develop them you have to wait at least two months. You have to buy the ones from Korea, because the Chinese at this moment have a quite serious problem, many people don't want to buy them anymore. But even if you buy the best test in Korea, there are 20 percent false negatives.
-What if the result is a coronavirus COVID-19?
-If you have a viral infection, and you say I have a fever (over 38.5 for two days), I'm tired, coughing, I feel short of breath, and also, for a very rare reason, I lose my taste and smell, the only way out is an MRI or a lung scan. There is no other. An X-ray does not always give good results. If the radiologist says there is an infection compatible with coronavirus pneumonia, that person has to be admitted to intensive care, but that is for a maximum of five percent of people. Now, if you don't have MRIs or CT scans, what do you do? You don't know, and that's where the problems start.
-Is there no solution in that case?
-What the Koreans do, and now the French are claiming paternity, is to give an antibiotic, like amoxicillin with clavulanic and hydroxychloroquine.
-Does hydroxychloroquine work?
-It's the only thing that can be given now. There's no hard evidence, but it's better than nothing. It's treated like pneumonia. The difference with classic pneumonia is that this time the hydroxychloroquine is added, but only if the doctor does an electrocardiogram and measures the patient's potassium. Because it changes the heart's conductivity, and after three pills the electrocardiograms bring surprises. You can't just give it to anyone. That's why in France there was a negotiation between Public Health and the professor from Marseille who took the procedures from Korea (Didier Raoult) and said they were for everybody... but no. It is for those who have a doctor who follows them, because if they have a heart rhythm disorder, if their potassium drops, the remedy can be worse than the disease. But in the end, we're talking about these people having to be hospitalized. And here comes the big question.
-What is it?
-That you have to be in an intensive care unit with trained people. Are there people trained in every country and city for intensive care? Are there enough people who know how to put in a laryngoscope to intubate patients? Are there nurses and doctors who have been made responsible by the State for training them to deal with that? The answer is "no". And there aren't enough machines either. There are six times as many ventilators in Germany as there are in Italy. And ten times fewer deaths from the same pathology. In Europe there are 80,000 therapy beds with trained personnel, an average of 12 per 100,000 inhabitants; in the United States there are 28 per 100,000; in Germany, 29; in Portugal, 4.2; in Spain, 10.3, but the problem is that there 78 percent of those who attend these beds are trained for medical-surgical therapy and coronary unit, people who know how to handle heart attacks and strokes, but the State did not train pneumonologists to take charge of this type of crisis. So how far is the virus alone responsible?
-Is it Italy, the country where they say everything went wrong?
-The problem in Italy is much more serious and needs to be analysed separately. There the mortality rate is very high, and people are singing the hymn, but they don't know that for 25 years they have been closing beds and not creating doctors' positions. And much less, intensive care doctors working in hospitals. What this is talking about is that it's not just the virus. There are 75,000 people diagnosed and 7,400 dead, 9 percent of them dead. It means something.
-How do you see the Argentinean health system?
-I couldn't say. The Argentinean system is complicated. There are state hospitals, private hospitals, municipal hospitals, union hospitals. When I was there last year, everything was working at the Fernandez Hospital, but you can't go to the Clinicas because the elevator wasn't running. And as for the professionals, I don't know at this moment how pneumonology is. There are good individuals, brilliant people, but in general, I don't know.
-You say there's no need for paranoia, and that's fine. But if in China they had to create hospitals out of nothing, this is different from a common flu, something happens...
-Look. Anyone who coughs goes to intensive care. Last year, in the United States there were 460,000 people with pneumonia, in therapy. This year I don't know if there will be 100,000. It's not like that. People run to the hospital for anything. And the nurses and doctors were not trained, because until three months ago it didn't matter. Patients are put on oxygen masks, and over 100 elderly people in a south Rome nursing home died 11 in one morning. Did the virus kill them? Maybe they were with the corona. But what if they'd been properly cared for? They didn't even have procedures! In China, at first the mortality rate was 9 per cent, and now they're at one. In Italy they're at 9, but it's going down because they're learning to work. That they're learning means that they weren't trained, that there was no infrastructure. There is a patriotic sense, people go to the window, but doctors are not heroes, they are workers who are going to put their backs into it but they are not trained. They are put in front of dramatic situations, and many do not know what they should do. The procedures were not written down. Only now it is known. That's why I ask, is the virus alone responsible for these deaths? They say that the bodies are accumulating, but in Spain, yesterday, they showed that last year there were the same number of deaths.
-But dead from what cause?
-Because of heart attacks or pneumonia. Now they're all from COVID-19. But last year they didn't start taking nasal samples from all the dead.
-You mean what they call COVID-19 deaths aren't from that cause?
-That's probably COVID-19, but that's where last year there were other respiratory viruses. I'm sure there were, because influenza killed a lot of people in Spain and Italy. But they were dying of pneumonia, without putting any labels on them. Now. We have already analysed the lack of respirators, of training, of staff, of doctors and nurses, who in Italy shout every day because they don't open charges in public hospitals. There were practically no therapy services in the small towns. So far one reasons, but pushing the reasoning to the limit, I start looking at the causes of death in Lombardy, where more people died. And what I'm about to tell you was not published by anyone.
-What did you see?
-In Italy, in Lombardy, that's where most people die from mesothelioma. All the fibre cement factories that used asbestos were there. Until 1992, when it was banned, it was on roofs and factory insulation. The walls had asbestos, which long crystals that reach the lung, which can then heal, or not. Mesothelioma is the lung cancer caused by asbestosis or asbestos. In the autopsies carried out in Lombardy in the last ten years, 85 percent were due to occupational exposure. Malignant tumors with pulmonary and peritoneal location. And until '92, no one banned the use. Lombardy has ten million inhabitants, it is the place that has more employees in the asbestos industry, the place in the world with more asbestosis. But in addition, asbestos sticks to clothes, to fibres. The haute couture clothes of northern Italy are made by women seamstresses. You can believe that between 2000 and 2012 there were 4,442 malignant mesotheliomas (2,850 in men and 1,592 in women), invasive lung cancer from asbestos exposure. And it's growing. This year there were 3.6 percent more than in previous years in men and 3.3 in women over 65. And until 2030 there will be 20,000 more.
-What's the connection with the coronavirus? -I don't know.
-That in that region, punished by lack of means, the closing of beds, lack of breathing apparatus, we find older people, with lungs with cancer or chronic injuries, which makes a viral infection turns into a deadly one. A lung attacked by a mineral fibre will have a different reaction to a healthy lung. And it is no coincidence that more people die where asbestos factories are located.
-But COVID-19 kills more than the common flu...
-All viral infections can be fatal. The difference is that this one caused a panic and the others didn't. Last year a lot of people died from the flu and no one closed the planet. So what happens now?
-I'm asking you, what happens?
-I don't know...
-But what do you perceive, a conspiracy?
-No, that's immediately apparent. Last year there were 36 million people with the flu in the United States. 370,000 were hospitalized and 22,000 died. Is that clear? And no one closed any airports. In France, there are 33,000 cases, but when 23,000 elderly people died in nursing homes due to a heat wave, the country did not close either. There's something very strange here.
-That's why I insist, what do you see?
-A serious error by the WHO experts, which I denounced from the beginning. Do you know what a pandemic means? It doesn't mean serious or severe illness. It means that many countries have a disease. Every year there's a cold pandemic, and nobody closes anything down! Shouldn't we put all this into perspective?
-But COVID-19 is very contagious, doctor...
-Yes, like the cold, which is how people die in nursing homes. They didn't used to count them, now they do. There were over half a million cases of pneumonia in the world last year. There are a million people who can get meningitis in Africa, and it's transmitted by saliva, and planes come and go. And nobody cares about anything. There are 135,000 people who are going to walk around with tuberculosis in Latin America, and nobody makes a fuss. To me, when something makes a lot of noise like with the corona... It's getting very theatrical. From the first day I said that the accounts didn't add up, like when the H1N1 flu appeared.
-And what would you do?
-I'm not an authority to say what I would do, but I see a lack of training and materials. So, first, I would train the staff for what is to come. In three weeks, when they see the signs of the disease, they are going to be the ones to push for the new measures. Look at what is happening in Germany. Mortality is ten times lower because there are specialists in pneumonology and intensive pulmonary therapy. Well, let's do courses in Argentina, and all over the world. Doctors can't be thrown out on the spur of the moment in front of a person who can't breathe. When these people are trained, the figures will show that these five percent of serious cases will be able to be treated in hospitals. And that the rest will fall under their own weight.
-Does the quarantine have to be stopped?
-When the system is in place, with trained staff, equipment, drugs and infrastructure, yes, it doesn't make any sense. As things stand now, you cannot say anything about quarantine because you do not know how many people will be infected and whether the intensive care beds and staff will be sufficient for 5 per cent of them. The measure is not because of the virus, but because of the risk of not being able to take care of people who are in a critical situation. I don't know if it's wrong, because there are no objective figures. At most, it is good that they have stopped because the WHO forced their hand, and once the quarantine is lifted it cannot be stopped. But we should compare it with last year's death figures. The panic is absurd. There are 690 positive... How many were tested? 30 million or a thousand? 17 died, I want to see how many died in nursing homes or in their homes from pneumonia due to pneumococcus or hemophilus, which there are many in Argentina, last year.
-How do you evaluate what the government is doing, then?
- With that said, I think the government is acting very well and very cautiously. But the international authority pushes them with the mortality figures provided by the WHO experts, who do the mathematical calculations. But this is not bad faith, but incompetence. There is no one behind it. But I insist, in Argentina they are doing things right and seriously. I think Ginés is very good. And Carla Vizzotti is a woman who knows what she is doing, she is very competent, she knows, she studies. When you are with people who are studious, who are not pamphleteers, who are serious, they give you confidence. I talked to her and she impressed me. I've never seen that level of training in public health. They do things the best they can with the budget they have.
-But you don't think so about the World Health Organization.
-Not at all.