Here is a translation of the interview published today by Professor Didier Raoult, which covers not only the therapeutic successes, which he describes as spectacular, at the IHU in Marseille, but also the ineffectiveness of alternative treatments, especially remdesivir, and the stock market speculation associated with this molecule. Professor Didier Raoult took the opportunity to criticize the methodology used for a publication on remdesivir in the prestigious New England Journal of Medicine. He also questions the preference given in industrialized countries to new molecules and describes as extremely brutal the campaign in France against the use of simple, inexpensive drugs such as hydroxychloroquine and azithromycin. It’s important to stress that the interview comments on the context of Marseille, where Professor Raoult’s university hospital is located. The situation in the rest of France is totally different, as the French government has not approved a generalization, at the scale of the country, of the treatment protocol used by Professor Raoult and his team.
The transcript of the interview in French can be found here.
This is the video, released today, that is translated here.
Q: Professor Didier Raoult, what is the evolution of the epidemic and currently what is its place in the history of health crises
So, regarding the evolution of the epidemic, for us, it is gradually disappearing. We had, up to the maximum at the peak, up to 368 new cases per day and now we are more in the region of 60 or 80 per day. So a very very significant decrease in the number of cases detected, and even more significant in the people who come to be detected while they are asymptomatic. So it is possible – this is one of the possibilities that previously I mentioned among others – that the epidemic will disappear in the spring and that within a few weeks, there will be no more cases, for reasons often extremely strange and which are things that we are used to seeing for most viral respiratory diseases. So it’s pretty common.
If we put that in the context of epidemics, of health crises, you see we can measure health crises with these images (see video). You see the summer health crises. You recall the heat wave of 2003, the heat wave of 1983. You see that in the summer, if you monitor as you go, you can detect health crises very easily. This is one of the proposals I made when I made a report to the Ministry of Health, yet the General Directorate of Health did not want to take it into account, and unfortunately that is what is required to detect real health crises.
If we try to see if the current health crisis has an impact on mortality in France, the answer is no. The health crises which played a significant difference during the winter are in 1997, 2000, 2009 and 2017. But we are very far now, if we combine the months of December to March, from the health crisis of 2017 where there was had a lot of H3N2 flu. I find that this year there has been less influenza and less RSV (Respiratory syncytial virus), which means that the increase in mortality linked to this new virus is not significantly visible in the general population.
Of course there are other phenomena. It’s multifactorial, but we can’t say that, and I hate making predictions, but still I predicted that this health crisis would not change the life expectancy of French people, and it will be the case. We will do the computations. It’s similar in China. 3,000 or 4,000 deaths do not change the life expectancy of the 1.3 or 1.4 billion Chinese people in the year. It’s not true. So, again, it’s good to deal with health crises and to manage them. You have to manage them without anxiety, without worry, by being as professional as possible and by managing things step by step. You need to try to diagnose, to isolate and to treat the sick, to avoid more deaths than elsewhere. This is a point that seems very important to me.
Q: Professor Raoult, where are you at in terms of treatment?
In terms of treatment, we are very happy. We are now, which is often the case when we tackle a problem, we have very generally the biggest trials series in the world. And that’s practically for all the diseases that we’ve tackled. There are a dozen like that in which we have the largest series of patients worldwide. So I think that for COVID, we probably now have the biggest series of patients, in a single research center. Here, we tested 76,000 serums of 32,000 patients, and 4296 were positive.
Over 3000 people have been treated here at IHU Méditerranée Infections. 2600 were treated with our hydroxychloroquine plus azithromycin protocol, of which 10 are dead, that is to say we confirm that we have a mortality which is less than 0 5% for the moment, which is the result that is the most spectacular in the world today. So here we are very happy. This therapy is so spectacular in reality, people find it so easy to see that it works, that it is spreading.
There are surveys that were made in particular by a medical research institute called Sermo, which show that for doctors around the world, the first treatment of all today is azithromycin in 50% of the cases, and hydroxychloroquine or chloroquine in 44% of the cases. It’s massive, and it means that practitioners are embracing it because it just works.
It works in a very interesting way, which would probably make people think about the method. And then came out a paper on remdesivir, in the New England Journal of Medicine, which is an affront to all existing methodologies, since for the first time they dare publishing a study where there is no comparison. They compare this treatment to nothing, not even historically so it’s extraordinary, and therefore the only thing that we note is that there is considerable toxicity, that is to say that there are 60% with side effects , which means that this medication cannot be used outside of patients with a very severe form of the disease. But the patients who have a very serious form of the disease, as we know here, in reality have almost no more viruses, which are are no longer there. They are at a different stage, which means that if this drug cannot be given to patients other than patients who have a very severe form. In these very severe forms, the medication is useless.
The debate will gradually come down to very few treatments. The other drug, which was also test in the Discovery trials, showed that it was totally ineffective in the same indication. This means that things will get rapidly clearer regarding the molecules that we can really use, and when we can use them. When patients are at an advanced stage of resuscitation, in reality, the antiviral drugs will have a relatively modest activity because there are very few viruses left and our experience is that we saw patients who were dead, and that they had no more viruses any longer. It is difficult to see how an antiviral drug prescribed at this stage could have the least effectiveness. The treatment, it is for the moderate forms, it is for the severe forms, but which are not in resuscitation.
This is interesting, because among the authors, the people who have critisized our methods, this is the first time that I see an article published without any comparator, historical, geographic, or anything. It’s just as if I don’t know in how many cities in the world we gave a little remdesivir to people who were sick and all that. Perhaps with a ghost writer, that is to say an ad-hoc author who gathered all this data with very little biological data, and then to say, listen, here we have given remdesivir.
This is interesting because it is one of the publications that will allow us to follow with interest the absolutely extraordinary fluctuations
of Gilead’s stock market action. I know there is a newspaper that accuses me of having conflicts of interest with Sanofi, because I spoke with Sanofi when IHU Marseille was created. This is what we were asked. They had to have at least two or three manufacturers to be associated in order to be able to produce the medication in France. I had talked to Sanofi to do what I do now, but without Sanofi, that is to say the repositioning of molecules that already exist. Then the discussions collapsed, so we didn’t work with Sanofi.
But if I were a Sanofi advisor, I would be an extremely bad advisor because Sanofi keeps losing money while Gilead’s advisers are good advisers for Gilead because Gilead has made a lot of money since COVID started. Although the value of the share is modulated by the fact that we communicate on the fact that there are alternative treatments or that WHO decides that remdesivir is the big treatment, and you can see the share price going up.
These are all things that are interesting and that is surely one of the parameters – I don’t know how to interpret it more than that – but these are absolutely colossal sums. We are talking about the capitalization of Gilead. This is quite a huge thing so it is interesting to see the fluctuations in these share prices based on press reports of effectiveness, or replacement therapy. You see that I if I was still a hidden advisor to Sanofi, I would advise them to fire me because frankly they are losing money. They have lost 20% of their stock value from the start. So what I know is that I am not a very good financial advisor. I think that Gilead’s financial advisers, despite the total lack of evidence of the effectiveness of remdesivir, are much better since they attracted considerable funding. Voilà.
Q: Do you have any new data regarding the toxicity of the hydroxychloroquine / azithromycin therapy?
We do that of course with our cardiologist friends. There are a few people who they told us “listen, those, we prefer you don’t treat them,” so we didn’t. It’s not a lot of people, but it’s not worth taking risks that are useless. And second of the 2600 patients we included, we had no problems. 2600, it’s starting to be a big number. So I think all of these are debates. I still think that the first work we did, methodologically – nothing to do with what was published in New England Journal of Medicine – had an external control group, so there was a comparison, there was a point of comparison which was the viral load. On the contrary, in the New England paper, there is no point of comparison, we are not looking at healing, neither clinical nor viral. (In our study), there were comparisons, one with hydroxychloroquine, and the other with azithromycin in addition to hydroxychloroquine.
What strikes me in the current situation is that the current mortality in the richest countries is much higher than in the Eastern World. China, Korea, the Eastern countries which are also rich but have a lower mortality. Same applies for poorer countries. We end up wondering if having an industry with extremely new drugs has become an advantage or a disadvantage under these conditions, that is to say that people in Africa, they do not have much choice. So for them, I don’t think it’s a lot of trouble for them to take Plaquenil and azithromycin. It costs nothing. While in France there is an extremely brutal fight against the use of simple and inexpensive drugs. And I don’t know if this has consequences for mortality in France. But this is a good question. In any case, when we see the difference in mortality in Marseille compared to other locations in France with a comparable population, we can frankly ask the question now if it is better to take two old drugs that work or new drugs that we are not sure they work and that we know they have complication, that they have very important side effects.