relevance of hydroxychloroquine?
since the beginning of the pandemic we talk a lot here about the treatment (currently under test)
several countries France usa brazil have already built up stocks.
here I translate (as I can) the interview of professor raoult the instigator of this treatment to my regional newspaper.
https://www.laprovence.com/article/...tretien-avec-le-professeur-marseillais-didier
""He won't budge. Despite the echo of political and medical mistrust regarding his clinical trial, the IHU boss is convinced of the relevance of hydroxychloroquine to treat patients with Covid-19. Despite the media psychosis and his daily death toll, he repeats: you are more likely to die from something other than the Chinese virus. Whereas yesterday evening the president of the Scientific Council Jean-François Delfraissy solemnly called for a massive screening strategy, Didier Raoult had recommended it and implemented it as soon as the first Wuhan returnees arrived. In the corridors of the IHU, one slips that in this health crisis, "he put his balls on the table". History will tell if the shocking Professor Raoult was right. Meet him.
627 deaths in one day and 40,000 cases of Covid-19 in Italy, this is no longer the "grippette" (little flu) you were talking about a few weeks ago ...
Prof. Didier Raoult: In all likelihood, you don't understand at first glance. All situations must be put into perspective. What infectious disease did all the press get excited about last year? Measles. In the end, there were 1,000 cases with one death and there was an announcement every day in the media. The world of information lives in a parallel world to mine, the world of observation. We have gone from exaggeration to disconnection. There are 2.6 million deaths from respiratory infections in the world every year, can you imagine that the 5,000, 10,000 or even 100,000 will change the statistics?
We're not talking about statistics, we're talking about human beings, entire confined populations...
Pr Didier Raoult: What else do you want to talk about? People die, yes. The greatest excess mortality in France in recent years was in 2017: 10,000 additional deaths in winter, we don't even know if it's the flu. 10,000 deaths is a lot. We'll see if we can kill 10,000, but I doubt it.
The statistical argument is therefore the only prism...
Pr Didier Raoult: In Marseille, we diagnosed 120 positive cases, there were two deaths over 87 years old. They also died last year. Out of 100 samples taken from people who have a respiratory infection, these are rather serious cases. When we test 20 viruses and 8 bacteria, there are 50% of which we don't know what they have, that's our great ignorance. For all the others, there are 19 seasonal viruses, which also kill. Endemic coronaviruses kill more here than in China. I'm constantly confronting the causes of death throughout the region with this kind of rising anxiety bellows. Right now we're more likely to die from something other than Covid-19. Old age, co-morbidities and late treatment are all factors in mortality. It may be unheard of, but that's the reality. The only thing I'm interested in are the datas, the raw data. The data will stay, the opinions will change... I'm not telling the future, but I'm not terrified of it at all.
How do you explain the situation in eastern France?
Pr Didier Raoult: I am a scientist, that's what is missing in this country; a large part of the political and administrative world reacts as you do (the media, editor's note). We must not react like that. The only data I am interested in is observational data, I have no opinion. Only the press talks about what's happening in the East, I don't have any data. For Italy, they said worse, I received an analysis, it's like elsewhere, it's people over 75 years old. The Japanese have made a very nice experimental model by confining older cruise passengers to the Diamond Princess. We saw that it was contagious; 700 people caught it. But despite a very fragile population, only 1% died. This is the observed reality. When there are 1,000 deaths in the east, I will say yes, it is serious.
You're always going against the flow of the speech...
Pr Didier Raoult: Just because there are a few people in Paris who think certain things doesn't mean I'm against the current. In my world, I'm a world star, I'm not against the tide at all. I do science, not politics. Infectious diseases, it's not very complicated, it's diagnosis and treatment. It's the B-A ba, if people don't know the B-A ba of infectious diseases or chloroquine, which is learned in the third year of medical school, I can't do anything about it. I'm not going to reeducate the people who are remaking the world on TV sets. I don't care what anybody else thinks. I'm not an outsider. I'm the one who's ahead of the curve. The real question is: how did this country come to be in such a state that one prefers to listen to people who don't know rather than those who do?
24 patients are being followed in the clinical trial, how many people have been treated since...
Prof. Didier Raoult: We've dealt with others, but I won't tell you how many. I will inform the ministry first.
After six days of treatment, the viral load of 75% of patients is negative, but are they cured?
Pr Didier Raoult: They are cured of the virus. But if you have lung lesions, they won't disappear in three days. We don't know for the moment either if, once cured, you can get sick again, this has not been described by the Chinese who are two months ahead of us.
What about the 25% that are still positive? Is their situation getting worse as they say around the 7th and 8th days?
Prof. Didier Raoult: We haven't had any aggravation in the cases treated, but we don't see people in serious states. For the moment, serious cases are those that are neither detected nor treated and that arrive with very serious respiratory insufficiency. They go directly to intensive care and they will die there. If we detect and treat people early, there is a much better chance of saving them than 48 hours before the terminal phase.
Your strategy since the beginning of the epidemic has been to mobilize the entire IHU to do mass screening, why hasn't this been a national strategy from the beginning?
Pr Didier Raoult: That's not my strategy, it's common sense. I don't know why it's not a national strategy, it's a political choice. I'm doing my duty, period. I do what I have to do, I play my part in a play. But I didn't invent the theatre, nor the text. I'm the only one with classical thinking about infectious diseases when everyone's losing their nerves...
What about the side effects of hydroxychloroquine treatment?
Prof. Didier Raoult: What they say about side effects is simply delusional. These are people who haven't opened a medical book in years. More than a billion people have attente them, people who suffer from lupus have been taking them for decades.... I'm very familiar with these drugs, I've treated 4,000 people with Plaquenil over the last 20 years. It's not me who's weird, it's the people who are ignorant. I'm not going to learn about the toxicity of this drug.
The government has announced expanded testing of hydroxychloroquine, but by teams independent of yours, why?
Prof. Didier Raoult: That's normal. Until 30 or 40 years ago, when we were faced with diseases that were poorly treated or not treated at all, we didn't give a damn about the methodology. The first guy who had a staphylococcal infection was given penicillin, he was cured and everyone was happy. As we became more and more competent, we had to do double-blind studies and then make data public so that there would be no cheaters, particularly because of the financial stakes. Today, we know from the Chinese that the average carry of the virus is 20 days. We have the means to measure the viral load; we can see that it is falling, so it is working. We didn't need a control group. I'm glad we're expanding the trials with drugs that work, I'm just a doctor. If you have doubts about my credibility, that's not my problem. There are people being treated all over the world, I don't feel any more responsible for the patients in Paris than I do in Korea. It's the smart ones who get the best care. I'm not trying to be arrogant. If people don't want to look at the numbers, there's nothing I can do about it. We've done 2/3 of the tests in France, we've set up a war machine. Afterwards, you can't make a donkey drink when it's not thirsty.
