Professor Raoult presents here an epistemological analysis and justifies his scientific methodology concerning the treatment of COVID-19. He considers randomized studies with large cohorts unsuitable for the present situation. Here are excerpts from an interview with French journalist Julien Cottereau from Europe 1.
Commentary: Why is this extremely important. Because it goes to the crux of the matter. Not only do randomized studies involve many patients, many of them – the so called “placebo patients” – may die because of lack of treatment, but they take considerable amount of time. And with an ongoing pandemic, no such time is available. In many countries, such as the UK, the official policy is to wait for their results before authorizing the use of Hydroxychloroquine-based or any other treatment. Same thing in other countries such as Canada, except in New-Brunswick. Consequently, numerous people who are suffering from COVID-19 are denied a treatment that has already been found effective by the scientific methodology used by Professor Didier Raoult and his team.
(see transcript of the French original here)
Q: What a lot of doctors blame you for is your methodology, the lack of a control group. Why didn’t you change your methodology with your new study when it could have silenced some critics.
I am an epistemologist, I am a scientist of the science. What people believe, the fact that they believe that this (randomized with control group) methodology is suitable for this situation, testifies to the fact that they have absolutely no knowledge of the history of medicine, of the history of science.
In infectious diseases, this methodology has hardly ever been used to show the effectiveness of a drug, because in infectious diseases, it is extremely easy to measure whether the microbe disappears or does not disappear.
Afterwards, habits were taken. In large part, these large studies were made necessary by the pharmaceutical industry, and everyone ended up mistaking this methodology for science.
It’s not science, it’s a habit, it’s a way of approaching problems, and there has never been any evidence that this type of study is more effective than what we we call historical studies, i.e. the comparison of the results of a treatment with what happens before this treatment has been applied.
It is a story of scientific specialists. It’s not a TV set story. It is complicated. There are now people, who are neither practitioners nor scientists, whose profession has become to be a sort of controller of the work of others. They think, and I think they are sincere, that these (randomized) studies are really necessary, that this is really how we must do things.
But it’s a fashion. When I was young, the fashion was not to treat infectious disease without first having done an experimental model, which has fallen into disuse now… We thought it was dramatic if an experimental model had not be done. These are scientific fashions. It is not a scientific reality.
The scientific reality in the area of infectious diseases is quite simple. It was also simple for AIDS. When we had an effective medication with three patients, we knew it. There were no more viruses in the blood. There was no need to study with 10,000 people.
Randomized studies have become an enormously cumbersome process, which occupies a number of people, in which we end up forgetting that the only thing that is important in medicine is efficiency. It is the method which must adapt to the question, and not the question which must adapt to the method.
Q: But why is this contentious, since you are so confident? No one can question your competence. Why is it so contentious today?
Again, this is because there is now a whole architecture of thought. It’s very difficult to change a way of thinking when people are used to it… We have accustomed people to doing huge cohorts, with multi-center studies, with arms to actually work on small improvements …
This creates thought patterns, this creates thought mechanisms that are ingrained, that make people who have done this their whole life end up thinking that this is science.
Note: according to Expertscape.com, Professor Didier Raoult is the world’s #1 expert in communicable diseases: http://expertscape.com/ex/communicable+diseases