Postcard From France

Sceptics in France have a different perspective on COVID-19 from sceptics in Britain. There it is all about statistics, dodgy PCR tests, and lockdowns versus the Great Barrington Declaration. Here it is about treatment. The face of treatment is Professor Didier Raoult. Didier Raoult has become a household name in France. Some people think he’s wonderful, others distrust him, a man with long white hair and a beard, but absolutely everybody knows about him.

As well as being head of IHU Méditerranée, the huge university hospital in Marseilles, and a world-renowned expert in infectious diseases, he is also a member of the scientific council round Emmanuel Macron, the French equivalent of SAGE. Right at the start he walked out, slamming the door behind him, because he couldn’t work with such a bunch of charlatans. He didn’t call them that in so many words, but that is what he implied. He also mentioned their conflicts of interest with Big Pharma. Raoult is no maverick carping from the side lines. It’s as though someone like Chris Whitty or Patrick Vallance had gone rogue. It’s even better, because Raoult is a hospital doctor. He still wears a white coat.

Raoult and his colleagues at the IHU put out videos several times a week. Some of these have over a million views. So even though he is never invited to speak as an expert on mainstream media and even though the so-called experts are do everything they can to try to discredit him, his voice is heard.

What does he say? COVID-19 is a new illness. (Not just a bad cold or hyped-up flu then.) The genome has been sequenced. (So, you do have something to work with, despite what some sceptics say.) You must use PCR tests. (Raoult is a great believer in the PCR test, properly administered up to 35 cycles.) You isolate positive cases and treat them with a combination of hydroxychloroquine (to reduce viral load), and azithromycin (to reduce the risk of cytokine storm). This was what he was doing back in March. He has subsequently added zinc to the protocol.

A few days later there’s no virus left, and patients can be moved out of isolation on to an ordinary ward. No need for tubes. Test, isolate, treat. As simple as hands, face, space. Only those who were on their last legs before they were infected end up dying. Caught early enough, COVID-19 is easier to treat than the flu which, as we know, is anything but anodyne.

Throughout March and April, the advice of the French Government was to stay at home and take paracetamol if you felt you might have a cold coming on. That is still the official position of the WHO. But COVID-19 is tricky because your blood oxygen levels can drop dangerously low before you notice that anything is wrong. It’s called “happy hypoxia.” Once you can hardly breathe you rush to hospital and it’s straight into intensive care with you. By that time, it’s too late for hydroxychloroquine because there is almost no virus left for it to get rid of and damage to your lungs may already have occurred.

Then the media show terrifying pictures of patients being airlifted from one end of France to another because there is no more room in ICU. Of course, this situation could have been avoided even without hydroxychloroquine if private hospitals down the road, which had beds available, had been asked to help. It could also have been avoided if public hospitals hadn’t been trimmed back to the bare bone to leave virtually no spare capacity to deal with an epidemic situation.

So instead of locking up millions of healthy people, closing bars and restaurants, driving small businesses to the wall and mandating masks indoors and out on pain of a fine, it might be a good idea to provide everyone with an oxygen monitor. Then, if your oxygen level goes down you hurry to hospital. At that stage you won’t end up in ICU. Better still, as soon as symptoms appear, your doctor prescribes hydroxychloroquine. You need never go to hospital at all. You might not need hydroxychloroquine. You might feel fine again just with vitamin D and vitamin C. But it would be reassuring to know that it was there, just in case.

Unfortunately, in France you no longer have the option. Hydroxychloroquine is an anti-malarial drug which has been around for nearly a hundred years. In terms of side effects, it is a lot less dangerous than paracetamol. Some people have had eye problems after taking it for a year. In the case of COVID-19, you would be taking it for no more than a few days. Until January this year hydroxychloroquine could be bought at any chemist under the brand name “plaquenil.” Then the health minister, Agnès Buzyn put plaquenil on a list of “poisonous substances” requiring a doctor’s prescription. After she resigned (got the sack) the new health minister, Olivier Véran, told doctors they were no longer allowed to prescribe it. Though that prohibition was overturned, many doctors are not aware of this and most chemists don’t stock it. Olivier Véran has put pressure on Sanofi, the manufacturer, not to sell it.

Even Didier Raoult can no longer obtain as much plaquenil as he needs. The Agence Nationale de Sécurité Médicale refuses to provide a ‘temporary authorisation for use’. So, Didier Raoult is suing the ANSM for endangering lives. Not to be outdone, the Ordre des Médecins, a body which is similar to the General Medical Council, is suing Didier Raoult for – wait for it – charlatanism! To be continued… If it weren’t a matter of life or death it would be a French farce.

Anyone can look up the numerous studies which demonstrate convincingly the effectiveness of HCQ in the treatment of COVID-19. In France we are fortunate in not having to comb through medical journals; we have Didier Raoult’s videos to explain it to us. He must be doing something right because while deaths from (with) COVID-19 in France are currently running at 807 per million, there has been virtually no increase in mortality in the Marseilles region this year.

Maybe Marseilles got lucky. Then you see that India, which recommends hydroxychloroquine, has 99 deaths per million. Maybe it’s the warm climate. But Germany, right next door to France, has 201 deaths per million. Maybe the Germans are under-counting, but the country shows no increase in overall mortality. Maybe Germany has better health care. Or maybe the huge increase in prescriptions of hydroxychloroquine between February and March had something to do with it. The numbers are clear; countries that prescribe hydroxychloroquine have 80% fewer deaths than those that don’t.

In Britain, as I pointed out at the start, even sceptics don’t talk much about treatment. So, it is almost possible for you to believe that the Government is genuinely worried about overflowing hospitals and too many deaths. Sceptics in France don’t have that comfort. Day in, day out guests on news programmes drum into us that there is no treatment. They say in so many words that hydroxychloroquine doesn’t work. We know that’s not true. We know the Government knows it’s not true. We can only conclude that the Government doesn’t care if people die. Back in March before many studies had been done, Raoult was already having good results with hydroxychloroquine. Even if his claims were exaggerated, you would think that if the Government wanted to save lives without ruining its economy would be looking for any port in a storm. Instead the health minister grumbled that there were no randomised control studies. Not only did he refuse to recommend hydroxychloroquine, but he actively hindered its prescription.

At that point, the Government was betting on remdesivir, a treatment developed by the U.S. pharmaceutical company Gilead for ebola. At least one member of France’s (in)famous scientific council receives enormous sums of money from Gilead. Didier Raoult recognised this person’s voice in the anonymous caller who woke him up in the middle of the night to threaten him with dire consequences if he mentioned hydroxychloroquine. Remdesivir costs over 2000 euros a pop, causes kidney problems and doesn’t work. Raoult had been pointing this out for months. Hydroxychloroquine costs about four. Nevertheless, in October the European Commission signed a contract with Gilead for half a million doses. (The UK, despite Brexit, was one of the lucky beneficiaries.) In November even the WHO turned against remdesivir. Gilead won’t mind too much. Thanks to remdesivir it earned $900 million in the third quarter of 2020. I doubt if it will hand the money back.

Vaccinations can now take over where remdesivir left off. People must be convinced by fair means or foul that vaccination is the only way we will ever return to normal. Too much money is involved. The problem with HCQ is that it’s cheap. The fact that it works must be kept quiet.

Now it seems the second wave is washing over us. Once again, sceptical perspectives are different in Britain and France. There it is all about infection rates and numbers in hospital. Here it is also about genomes. A few months ago, Raoult said that fears of a second wave were fantastical. Now that infections are rising again, his opponents are trying to make him eat his words. Raoult is having none of it. His hospital has whole teams busy sequencing variants of SARS-CoV-2. The one that is causing the current increase in cases is not the same as the one that wreaked havoc in spring. It is different again from the one in summer which arrived from North Africa, spread through Europe without doing much damage and disappeared. In Marseilles they have treated at least fifteen patients who have caught COVID-19 again this autumn after already catching it in March. The variants of the virus have recombined. It is not a second wave, but a new wave. As in the old wave, most people don’t have to worry too much. But if you can catch it twice, a vaccination is not necessarily the answer. Raoult for one doesn’t seem to think so. He must be ridiculed. Or silenced.

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April 2024
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