While remdesivir became the standard of care against Covid-19 in the United States thanks to White House Health Advisor Anthony Fauci, the molecule of Gilead Sciences had already arrived in France, with complimentary coverage by the media. Strangely, remdesivir emerged as a treatment for Covid-19 without any evidence of efficacy.
This is the English version of an article by French journalist, E. Roche, whose articles appear in several national magazines, general and specialized news outlets. It initially appeared on the blog of sociologist Laurent Mucchielli, PhD, on Mediapart. You can find the original in French at:
On March 19, Donald Trump presented hydroxychloroquine, at a press conference, as a treatment that could be a “game changer” against the coronavirus. His main health adviser Anthony Fauci, the director of the National Institute of Allergy (NIAID), however, expressed his disagreement a few days later by taking the opposite side and favoring the remdesivir medication instead.
The Gilead Sciences molecule had already been tested by NIAID since February 21, which only started trials with hydroxychloroquine in April, on patients requiring hospitalization, even if hydroxychloroquine, or HCQ, is mostly recommended for earlier treatment. The strong interest manifested in recent days in France for remdesivir is no coincidence. It arrives from the United States, with the help of the media.
THE ARMY OF THE TWELVE APES
On April 16, leaked documents exposed glowing comments by Kathleen Mullane, a specialist in infectious diseases at the University of Medicine in Chicago, about Remdesivir: in an internal video originally sent to her colleagues, the researcher enthusiastically described an ongoing trial of around 100 patients being treated. And despite a press release from the University which recalled that drawing conclusions at such early stage was premature, many media in Europe immediately relayed the information.
In France, a dispatch from AFP was going to relate this “leak” as well as another development presenting Remdesivir advantageously. The latter was a research about 12 monkeys and was published by NIAIDI on April 17. In addition to the interpretative limits of such a study on animals, the fact that two researchers who participated in it were employees (and shareholders) of Gilead was unfortunately not clarified.
All of this promptly found its way on online media in France:
La Tribune “Covid-19: the experimental antiviral Remdesivir effective in slowing the progression of the virus” – Science et Avenir “The antiviral Remdesivir slows the progression of Covid-19 in monkeys” – Europe 1 “An experimental antiviral slows the progression of coronavirus in monkeys “- Le Figaro ” Antiviral Remdesivir slows the progression of Covid-19 in monkeys “- i24news ” Antiviral Remdesivir slows the progression of Covid-19 in monkeys “- Yahoo News ” Remdesivir would cure patients with Covid-19 quickly “
ActuOrange ” The antiviral remdesivir slows the progression of Covid-19 in monkeys “- La Croix “Antiviral Remdesivir slows the progression of Covid-19 in monkeys” – Mediapart “On the treatment track, the patent war is declared “
There was a reference to the “Chicago leak” in the edition of 20 / 04: “Friday April 17, (…) the specialized media Statnews revealed the preliminary results of a study carried out at a Chicago hospital: patients treated with Remdesivir leave the hospital in less than a week. So there are many hopes.”
Beyond the astonishing and pretty uniform compliments, several economic web media, BFM Bourse , Capital and Les Echos insisted on the importance of this development: “The American Gilead rises on the Stock Exchange after information was leaked about the efficiency Remdesivir against Covid-19 ”. This brought an improvement in the stock value, with an increase of more than 10% in the Gilead Sciences share.
For a drug which had hitherto shown nothing tangible, and with such fragile and inconsistent information to rely upon, this represents a media operation out of the ordinary.
“WHO DOES NOT KNOW HOW TO DISSIMULATE DOES NOT KNOW HOW TO RULE”
(QUI NESCIT DISSIMULARE NESCIT REGNARE)
On April 23, another publication leaked from the WHO website, this time revealed by the Financial Times, in its article “Gilead antiviral drug remdesivir flops in first trial.” This referred to a Chinese study with a completely different verdict on Remdesivir.
“Remdesivir use was not associated with a difference in time to clinical improvement … Remdesivir was not associated with clinical or virological benefits …”
What happened then? WHO quickly removed the study, claiming an oversight error (which is possible as the study had not yet been submitted for peer review).
In the French online press, and for the general public, it was complicated to retrace these events. Only three web articles mentioned this setback concerning the Gilead Sciences molecule: Science et Avenir, Le Parisien and Le Monde.
No media did take up this study with negative results about Remdesivir, as it continued to be presented in a pretty positive light. Le Monde (with AFP) indicated that these results are “not final.” It quotes the pharmaceutical company which explains that the study “does not allow drawing significant conclusions from a statistical point of view . (…) Trends in the data suggest that Remdesivir has a beneficial side, particularly for patients treated early. ” If the pharmaceutical company says so …
The three articles nonetheless mention the “significant” side effects of the drug being developed which forced the study to be stopped for 18 out of 158 patients. But two articles also took the opportunity to criticize the use of… hydroxychloroquine , “Deemed not conclusive.” Some journalistic reflexes are hard to lose …
Hydroxychloroquine was however available for outpatient use without delay, with this promising characteristics of being able, at the beginning of the disease, to reduce the aggravations, to avoid heavy hospitalizations and, consequently, to reduce the number of deaths.
But there was a lack of political support for Hydroxychloroquine, as the government modelled its positions on the wishes of its Scientific Council, which is known to be hostile to Professor Didier Raoult.
Instead of looking in more depth into the potential of Hydroxychloroquine, a smear campaign was conducted, based on a reasoning reliance on the dogma of Evidence Based Medicine, presented as a kind of absolute reference. This resulted in fine in a form of ban for those medical doctors who wanted to prescribe Hydroxychloroquine.
Gilead Sciences shares declined after the leak of the Chinese study showing that Remdesivir had almost no impact on the disease, but by just under 5%. The trend remained bullish.
FORMIDABLE HYDROXYCHLOROQUINE SIDE-EFFECTS UNCOVERED
At the same time (April 24-25), in France, a communication from the National Medicines Safety Agency (ANSM) about Plaquenil (and Kaletra) informed about formidable side effects associated with hydroxychloroquine.
Little perspective in the figures, little data about the profile of the patients, a scientific literature far from unanimously sharing this same observation … A charge, in line with many editorials in the media?
Then dozens of articles appeared in all the major French media:
The HuffPost “Covid-19, The Medicines Agency warns against“ serious side effects ”of treatments” – RTL.fr : “Reports of“ adverse effects ”of treatments on the rise …” – 20 Minutes : “Coronavirus, increase in” serious side effects “” – Le Parisien : “Coronavirus, increase in” serious side effects “of treatments, in particular with hydroxychloroquine” –
Orange News : “Coronavirus, the Medicines Agency alerts on the” side effects “of treatments …” – France Info : “The number of reports of” serious side effects “of treatments against Covid-19 is increasing … “- L’Express :” The worrying “serious side effects” of Covid-19 treatments “-
Europe 1 : “Coronavirus, the“ serious side effects ”of treatments are increasing” – The Obs : “Coronavirus, increase in reports of“ serious side effects ”of treatments” – La Voix du Nord : “Chloroquine, Medicines Agency is alarmed by the “serious side effects” of treatments against Covid ”- CNEWS.fr “ Increase in reports of “serious side effects” from treatments tested against Covid-19 ”- FRANCE 24 “ Covid-19, increase in reports of “serious side effects” of treatments ”
“Side effects”, “undesirable effects”, “serious effects” were suddenly reported, yet they remained very discreet for more than fifty years of over the counter prescription, and with hardly any mention in international studies until 2020. The old molecule, offering many more safety guarantees than a new one, still in a test phase, became systematically described by the media as the most dangerous.
If the news, little is explained about the different stages of use of these molecules, to address the question of efficacy. The media usually took up the question of treatments available superficially, and partially. Such double standard did not help to feed a healthy public debate and to have a meaningful discussion about health policy.
DR FAUCI GETS INTO ACTION
In the United States, Doctor Fauci from the National Institutes of Health (NIH, of which NIAID is a member) spoke at a press briefing and said the Gilead Sciences molecule represented a breakthrough.
And he quoted a study carried out on 1063 patients, randomized, with placebos, which is supposed to correspond to the obsessional desideratum of those supporting the pure and hard methods of evidence-based medicine.
“The data shows that remdesivir has a clear-cut significant positive effect in diminishing the time to recover… It’s highly significant if you look at the time to recovery being shorter in the remdesivir arm it was 11 days compared to 15 days… We think looking forward this is very optimistic…” said Dr Fauci.
The reduction in the viral load, sometimes described by the anti-Raoult as “cosmetic,” is highlighted. Patients on placebos were withdrawn from the trial to receive remdesivir treatment: according to doctor Fauci, this was imposed by an ethical obligation, so that patients from the placebo group could get access to the treatment. A real miracle therapy it seems …
Everything seemed to have been done to obtain such result, including changing the methodology for measuring the result . Will this make the “methodological experts” and other relentless anti-Raoult people leap? Did such surprising result alert anyone, especially after the publication of much less favorable studies, indicating no real benefit a treatment with significant side effects?
FINANCIAL STAKES AND LOBBYING
We could only congratulate ourselves on the possible good results of a molecule against Covid-19. But when the media transform to this point the findings and observations of a study, it is because there are other forces in play.
In the United States, Remdesivir was approved in record time by the Food and Drug Association (FDA) and welcomed by President Trump on April 29. This provides the right for the molecule to be injected outside the framework of a clinical trial. The treatment reached this decisive stage in a record time. But is it an emergency against the virus? Not really.
According to federal sources, Gilead had never invested so much money with members of Congress in the first quarter of 2020: more than $ 2.5 million. Congress which, subsequently, passed laws advantageous for pharmaceutical companies, in particular vis-à-vis the funding of research which is carried out with public money without consideration for subsequent regulation of the price of drugs.
This FDA milestone appeared to have been crucial to the finances of Gilead Sciences. The laboratory is still trying to lighten the payment of its taxes and is optimizing the use of a patented molecule initially dedicated to treating the Ebola virus. This allows to multiply possible gains on all fronts.
The pharmaceutical company has had the fine role of offering a few units of its treatment to try to silence any controversy in the United States. But it is careful not to communicate about the future sale price of the treatment. In this logic, having the support of the media is crucial. All around the world.
Gilead’s stocks gained 8% in value after the declarations of Dr Fauci.
How do most of the French media deal with news from Remdesivir? Do they display as much distrust as towards hydroxychloroquine? Are they prepared to attack any methodological weakness? Or are they willing to compare by comparing the cost of this molecule under patent to that of HCQ, which is already paid in the public domain? No, rather it opted for story telling.
i24news evokes a “ray of hope around an antiviral against the Covid-19” . This sets the tone. The idea of glow is taken up in the form of a question by Le Parisien who ponders: it is not “the miracle drug”. This seems the refrain of many media. The daily reports that “the experimental drug accelerated the recovery time of the patients by 31%. “
And it adds for all practical purposes: “A hope shared by Wall Street investors since the stock of the pharmaceutical group Gilead which produces the drug has surged. ” If Wall Street begins to hope, all hopes are allowed.
According to ActuOrange : “ Remdesivir (is) a drug that helps patients recover from Covid-19. (…) The first drug to have proven its effectiveness against the new coronavirus. ” The finish line is crossed. What about public subsidies and big dividends now?
Sud Ouest: ” Coronavirus: five questions about Remdesivir, a drug that helps patients recover” The study provides “the demonstration that a drug can act, and it could therefore open the way to better treatments.” ” Pious hopes to succeed to others. RTL confirms: “Remdesivir is the first drug to have proven its effectiveness against the new coronavirus. ” Nothing less.
Les Echos : “The interest of this announcement comes from the fact that it is based on a large-scale clinical trial, involving a thousand patients, and rigorous since with placebo. Preliminary results, not yet published, show that patients treated with Remdesivir recovered within a median of 11 days, compared to 15 days for those who received placebo. ” We will stress the ” rigorous since with placebo,” especially after noticing the changes in methodology for measuring results …
Some small balancing notes, however: “On the other hand, these results do not show whether the drug saves lives: the mortality of the group of patients treated with Remdesivir was 8%, compared with 11.6% in the control group, a too small a difference to exclude that it is the result of chance.”
Le Point cites the FDA which authorized the use of the molecule: “It is reasonable to think that Remdesivir can be effective against Covid-19 (…) since there are no adequate alternative treatments , approved or available. “
One can contrast this with the medical guidelines for Asian countries such as China and South Korea, which quickly adopted hydroxychloroquine, as readily available, deployable and well-known.
Libération opted to show that Gilead Sciences knows how to be generous. But the paper does not look at the logic of future unregulated prices. “The American laboratory, whose boss was in the Oval Office for the announcement, will donate 1.5 million doses, enough to treat at least 140,000 patients.”
Incidentally, a criticism addressed to hydroxychloroquine then appeared: “a drug against malaria, had been authorized in emergency by the FDA on March 28, but since then, the FDA and a government panel have published warnings due to serious side effects on the heart. »
No word here about the patients treated with Remdesivir who had to urgently discontinue treatment for serious adverse effects …
France Info politely explored two problems related to Remdesivir. “Why should we remain cautious about these results?” and “When could the drug be widely available?”
The online magazine Mediapart did not take any risks to date (05/05) and limited itself to publishing the three press releases linked to the event.
Le Monde probably offered the most factual and detailed article, signed Hervé Morin. While emphasizing Evidence Based Medicine, provides however some indications of relatively balanced thinking.
One fact presented among others: “The trial evoked by Anthony Fauci and led by his institute belongs to this category, but its final results are not yet known – perhaps it is even still in progress – and in any case, it has not yet gone through the filter of peer review and publication in a scientific journal. “
La Voix du Nord, like strange voices indicating that the DISCOVERY program has been slowed down because of the Raoult controversy (when he needed nothing to get lost alone on the way), still accuses hydroxychloroquine of “serious side effects on the heart.” On the other hand, pretty diagrams are proposed, glorifying the mode of action of Remdesivir.
Let’s leave the last word to BFM Bourse : “The California biotech Gilead has already donated its current stock of 5 million doses of Remdesivir (…) and could have trouble benefiting from the provision of this experimental antiviral treatment against Covid-19, analysts said.”
In our opinion, we know however that we should not be worried for Gilead Sciences, as the lucrative part will come sooner or later.
WHEN EVALUATION TIME WILL COME
Serious criticism of Remdesivir cannot be found in the mainstream news media. The Gilead Sciences molecule benefits from favorable media treatment while hydroxychloroquine, accused of all ills, remains systematically criticized.
It is too late to balance the debate. However, in the weeks and months to come, there will be an assessment of the political choices that were made, and the non consideration of any global strategy relying on hydroxychloroquine.
Such strategy would have provided a sustained capacity to test the population (and to provide them with masks), to diagnose it, to target the fragile and sick patients, to target confinement and to temporarily allow doctors to offer a known treatment. Other countries, such as South Korea did so and led the way.
Then, beyond this question to those in power, the media, which has become very little diversified, will have to question itself.
Whether because of ignorance or of undue influence, what would have happened if the media had not contributed so strongly to steer the debate towards a dead end?