Robert HARNEIS -TDO-(FRANCE)- Interview with Professor Didier Raoult in the Parisien newspaper. He is known worldwide as a French physician and microbiologist. He holds M.D. and Ph.D. degrees and specializes in infectious diseases. In 1984, Didier Raoult created the Rickettsia Unit at Aix-Marseille University (AMU). He also teaches infectious diseases in the Faculty of Medicine of Aix-Marseille University, and since 1982 has supervised many M.D. and Ph.D. degrees.
LE PARISIEN – The government has authorized a large scale clinical trial to test the effect of Chloroquine on Coronavirus. Is having got that to happen important for you?
DIDIER RAOULT – No, I couldn’t care less. I think there are people living on the Moon and who contrast controlled trials for Aids with trials for a new infectious disease. Like any other doctor, once a treatment has been shown to be effective, I find it immoral not to use it. It is as simple as that.
LE PARISIEN – What do you say to doctors who recommend caution and have reservations about your trials and the effect of Chloroquine, particularly in the absence of more extensive trials?
DIDIER RAOULT – Let me make myself clear: I am a scientist and I think like a scientist with verifiable evidence. I have produced more data about infectious diseases than anybody else in the world. I am a doctor, I see sick patients. I have 75 patients in hospital, 600 consultations a day.
So, regarding the opinions of other people, I couldn’t care less. In my team we are practical people, not birds for television interviews.
LE PARISIEN – How did you come to work on Chloroquine with the idea that it could be an effective treatment for Coronavirus?
DIDIER RAOULT - The problem in this country is that the people that talk are abysmally ignorant. I did a scientific study of Chloroquine and viruses, which was published, thirteen years ago. Since then four other studies by other authors have shown that Coronavirus responds to Chloroquine. None of that is new.
That the group of decision makers do not even know about the latest science takes my breath away. We knew about the potential effect of Chloroquine on cultured viral samples. It was known that it was an effective antiviral.
We decided in our experiments to add a course of treatment of azithromicyne (an antibiotic used against bacterial pneumonia - ed).
When we added azithromycine to hydrochloroquine, in treating patients suffering from Covid-19, the results were spectacular.
LE PARISIEN – What do you expect from the bigger scale trials on Chloroquine?
DIDIER RAOULT – Nothing at all. With my team we think we have found a treatment. And as far as medical ethics are concerned, I do not think I have the right as a doctor not to use the only treatment which has so far worked.
I am convinced that in the end everybody will use this treatment. It is only a matter of time before people agree to eat their hats and to say that is what should be done.
LE PARISIEN – In what form and for how long do you administer chloroquine to your patients?
DIDIER RAOULT - We give hydro chloroquine in doses of 600mg per day for 10 days (the name of the medicine is Plaquenil – ed.) in tablet form administered three times a day. And 250 mg of azithromycine twice a day for the first day and then once a day for five days.
LE PARISIEN – Is it a treatment that can be taken as a preventive?
DIDIER RAOULT – We don’t know.
LE PARISIEN – When you apply the treatment, after how long can a patient with Covid 19 be cured?
DIDIER RAOULT – What we know for the moment is that the virus disappears after six days.
LE PARISIEN – Even so, do you understand why certain of your colleagues are cautious about this treatment?
DIDIER RAOULT – People give their opinions about everything but I only talk of things I know about, I don’t give my opinion about the French football team! Each to his own. Today, scientific communication in this country is on the level of a chat in a bistro.
LE PARISIEN – But aren’t there precautionary rules to follow before using a new treatment?
DIDIER RAOULT – To those who say there has to be thirty multi-centered studies with a thousand patients, I reply that if we had to apply these existing methodological rules, we would have to re-do a study on the usefulness of the parachute. Take a hundred people, half with parachutes and half without and count the dead at the end to see which is the best method.
When you have a treatment that works versus zero other available treatments, this treatment should be the norm.
And I am free to proscribe it as a doctor. It is not necessary to obey the orders of the state to treat patients. The recommendations of the Health Authority are advice, but not binding. Since Hippocrates, the doctor does what is best, to the best of his knowledge according to the state of scientific knowledge.
LE PARISIEN – What of the risks of serious undesirable side effects connected with taking chloroquine, especially high doses?
DIDIER RAOULT – Contrary to what certain people say on the television, Nivaquine (name of a medicine based on chloroquine – ed.) is rather less toxic than a strong dose of Doliprane or Aspirin.
In any event, a medicine should not be taken lightly and always prescribed by a general practitioner.
LE PARISIEN – Are you aware that you have given rise to an immense amount of hope of a cure for affected patients?
DIDIER RAOULT – What I see, essentially, is that there are doctors writing to me from all over the world every day to know how to treat patients with hydroxy chloroquine. I have had calls from Massachusetts General Hospital and the Mayo Clinic in London.
The two world leading specialists, one of infectious diseases and the other for antibiotics have contacted me to ask for details on how to put this treatment into effect.
Even Donald Trump has tweeted on the results of our tests. It is only in this country that people don’t quite know who I am! Just because you don’t live inside the Périphérique (the dual carriageway round Paris – tr.) does not mean that you can’t do science. This country has become Versailles in the 18th Century.
LE PARISIEN - What do you mean by that?
DIDIER RAOULT – Discussions are going on between French people or even between Parisians. But Paris is completely out of touch with the rest of the world.
Take the example of South Korea and China where there are no more cases. In these two countries, they decided a long time ago to do tests on a great scale to be able to diagnose infected patients more quickly. It is the basic rule in dealing with infectious diseases.
But we have arrived at a degree of madness where doctors in television studios do not advise diagnosing the illness, but tell people to stay shut up at home. That is not medicine.
LE PARISIEN – You don’t think that shutting up the population will be effective?
DIDIER RAOULT – We have never done this in modern times. It was done in the 19th Century for Cholera in Marseille. The theory of isolating people to stop the spread of an infectious disease has never been successfully tested. We don’t even know if it works. What is going to happen when people are shut up in their homes for 30 or 40 days? In China there are reports of suicides out of fear of Coronavirus. Some people will be fighting amongst themselves.
LE PARISIEN – Should we, as recommended by the WHO carry out extensive testing in France?
DIDIER RAOULT –We have to have the courage to say it: the mish mash ‘à la française’ does not work. France is only at 5000 tests a day whilst in Germany they are carrying 160,000 a week! There is a sort of dissonance. With infectious diseases, you diagnose the patient and when you have the result you treat them. Particularly as we are starting to see people with the virus apparently without visible symptoms, but who in quite a lot of cases have pulmonary lesions visible on the scanner, showing they are ill. If these people are not treated in time there is a reasonable risk that we will have them in recovery or that we will lose them. Not to test people until they are seriously ill is thus an extremely artificial way of increasing mortality.
LE PARISEN – And should everybody wear masks?
DIDIER RAOULT –It is difficult to evaluate. We know that it is important for health workers because they are the rare people who have really have very close contact with sick patients when they examine them, sometimes 20cm from their faces.
We don’t really know how far the virus reaches. But certainly not more than a meter. So beyond that distance perhaps it does not make sense to wear a mask.
In any event, the hospitals should have the priority for masks to safeguard health workers. In Italy and in China, a considerable percentage of the sick turned out in the end to be health workers.
[Translation Robert Harneis – The article in French is here: --https://www.upr.fr/actualite/pour-comprendre-les-enjeux-du-traitement-du-coronavirus-par-la-chloroquine-nous-vous-conseillons-de-lire-lentretien-du-professeur-raoult-dans-le-parisien-du-22-mars-2020/]