Guest post by Christian Lehman
How I would have loved it if a brilliant genius, in the style of Jeff Goldblum in Jurassic Park, had discovered, on a corner of a grubby lab bench, THE miracle treatment for Sars-cov-2! How I would have clapped if, working fast, very fast, too fast for the eyes of mere mortals, this magnificent hero had blazed brilliantly ahead and saved millions of lives, so proving the accuracy of his hypothesis before an awestruck world. But we’re not in a Hollywood style blockbuster.
When Didier Raoult launched his first study on chloroquine he was basing it on three things: a verifiable fact, an assertion, and an intuition.
The verifiable fact is that in a test-tube (in vitro), and not in tests in humans (in vivo), chloroquine is active against SARS-cov-2 , the virus of Covid19. The fact that this in vitro action exists in a number of other viruses, without ever having given good results in humans, even increasing mortality in the case of chikungunya, would suggest the need for some degree of caution.
A reservation swept aside by Raoult’s following assertion: a Chinese study has just emerged which demonstrates that chloroquine brings about spectacular improvement and is recommended for all clinically positive infections involving the Chinese corona virus. Unfortunately, nearly two months after this scoop the world still awaits the slightest corroboration of what seems more and more like an elaborate media bluff.
Finally, intuition is what Didier Raoult is still defending today, stubbornly, in ever weirder videos. The idea that a researcher outside the select Parisian elite, who has been knocking around for a long time, a practical man, can see at once straight to the heart of the matter, while a horde of followers bogged down in their standard procedures would take months to get going.
So Didier Raoult launches studies, raising great hopes by his attitude of complete certainty, his media facility. Hopes so great that nobody, in the media or at the heart of politics, thinks of questioning him. Who would imagine that a respected scientist with an impressive CV would throw himself blindly into a con?
Didier Raoult’s studies follow one after another, piling up errors and approximations, crazily rigged.
Thus, in the first study, out of 42 patients, among those treated by the Didier Raoult procedure, one dies, and three are hospitalised because of deterioration in their condition. And by a wave of a magic wand (which in France and elsewhere should be called a fraud)… all four are excluded from the results when they should have been considered as failures of hydroxychloroquine.
Somewhere along the way Didier Raoult will add Azithromycine to Hydroxychloroquine, and will conclude that the combination is more efficacious than HCQ alone, though the difference, on six patients only, is not significant.
The criterion established to judge the success of the trial was to be a check for the virus in the nasal passages around 14 days. The study will be halted on the sixth day, and the diminution in the intranasal viral load will be treated as a proof of efficacity/effectiveness (without any knowledge of whether this disappearance might simply indicate the migration of the virus to the pulmonary level).
Children of 10 years old will be included in one of the extensions of the study, without their consent.
A second study will be launched as a follow-up, while the first will be published under doubtful conditions and immediately disowned by the International Society of Antibacterial Chemotherapy, and this second study in which Didier Raoult and his team choose which patients to treat (thus intervening in their therapy in an illness offering 95% of spontaneous recoveries) is declared as a simple observational study (without intervention by doctors on the development of events), instead of an interventional study. This means that obtaining the obligatory agreement from the Agence Nationale de Securite du Medicament can be avoided.
All this takes place as if, paralysed by the obvious shambles of the government’s management of the epidemic, nobody dares to utter an objection. Bypassing any requirement to seek the agreement of the ethical committee, the Marseille Institute awards itself a blessing and at the end of March treats 80 patients with Hydroxychloroquine, because “that is what we are told to do by the Hippocratic oath which we have taken”. So Didier Raoult, on a hunch, will prescribe potentially cardiotoxic and untested medicines to asymptomatic patients, in violation of the fundamental rules of ethics concerning the prescription of medicines.
There would be, there will be much to be said on the inaction of agencies, of institutions, of politicians, faced with the forward flight of a man who trails behind him tens of thousands of frightened people, thousands of conspiracy theorists and hundreds of hate-filled trolls who have turned themselves into virologists in a couple of hours spent on YouTube gobbling down the videos of their Guru.
But what most interests me in the first place is Didier Raoult’s rationale, that certainty that the Hippocratic oath (which at no point mentions the right to enter into freestyle experimentation on human beings), his medical degree, and personal intuition, constitute a sort of trump card. Let us remind ourselves one more time. Didier Raoult is a microbiologist, a specialist in viruses and bacteria. He has no experience of therapeutic research, and the gross errors which he commits in the development of his studies and in the analysis of his results and his publication procedures are not linked, as he would like us to believe, to the emergence of a new paradigm, but to the rancid re-emergence of something which we hoped had disappeared, the overweening power of untouchable and tyrannical “mandarins” , medical overlords incapable of allowing themselves to be called into question.
Coming in worldwide, the results of the first correctly executed studies carried out on Hydroxychloroquine, are globally negative. The only line of defence which appears to be left to Didier Raoult is the excuse of having acted in an emergency. Comparing himself one day to Clemenceau, the next to Foch, he sees himself as a fantasy wartime leader, alone capable of facing up to the situation, far from the prevarications of the dismal adherents to scientific method. All that the media seem to have retained from his recent video, entitled “The Lesson of Short Epidemics” is his assertion that Covid19 is a seasonal illness, destined to disappear, and that “in a month there will be no more new cases”. The work of all of us who wrote articles and posted warnings on social media: ordinary GPs, cardiologists, emergency and resuscitation specialists, would seem to have borne fruit. The assertion of the mighty soothsayer who in January scoffed as he told us “when three Chinese who die, that sparks off a world alert” will not wash any longer. But how many people realise that, if Didier Raoult is pushing his latest intuition, it is because only a short epidemic will allow him to justify a posteriori having acted brazenly in an emergency. If Covid19 settles in the long-term, he will not be able to escape a minutely detailed autopsy of his statements and his actions. And the result will be devastating.
20 Responses to HYDROXYCHLOROQUINE: This is NOT a Hollywood blockbuster ( Part 3)
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I understand the general tone of this, and I agree to a large extent, but in all fairness there are a number of mistakes or wrong statements in this post. as far as I know, Raoult does not treat asymptomatic people, they must have symptoms ; as far as I know, he actually does research and has a record of abut two thousand scientific publications (which may certainly sound odd, but it’s a fact; he publishes on average one scientific article very two days); he now claims a death toll 1/3 rd of the death toll anywhere else. To make it clear, I have no sympathy for this man, and his methods are really disgusting, but he shouldn’t be treated with similar methods as his. Best regards
Raoult is a microbiologist, he signs each and every paper his institute puts forth, as do many head honchos. Who in his right mind actually believes anyone puts forth one paper every two days and actually DOES the research. these are microbiology papers, NOT clinical studies, and THAT is the problem, he doesn’t know the basics of clinical research. I’ll leave you with this quote” the smaller the sample in a clinical trial, the more significant the results”…
and he can claim all he wants. death toll in his region is the average death toll in France, around 0.5%. he only treats able bodied people who come to get tested at his institute. The sick, the elderly, go direct to hospitals. and finally, let me remind you that in his first study, he makes 4 people in the HCQ arm SIMPLY DISAPPEAR because three are hospitalised and one dies. Withthat kind of scam, I can claim anything, even to make you immortal
A bad case of the Nobel Disease – sans Nobel.
Dear Edzard
You might find this article interesting. Notwithstanding the issues with regarding absence of blind trials, I feel that the demonisation of the ionophores in question is likely to be viewed as certain scientists/clinicians protecting their god-like status since knowledge of these pharmaceuticals seems to have gotten into the hands of the proletariat. Maybe all should chill, and discuss this issue with a patient-centric approach and leave the upmanships to those with some kind of tawdry personal vested interest.
https://wattsupwiththat.com/2020/05/02/pseudo-science-behind-the-assault-on-hydroxychloroquine/
Stay safe and productive, sir, and keep rattling the cages of the SCAMmers.
I do not find an article on a global climate change denying website a worthwhile resource to examine.
Not only the proletariat. Trump too. He knows what’s what. Hydroxy… chlorine, anyone?
Climate change is not a Chinese hoax he now says, but neither is it man-made – it’s nature. However, he says coronavirus19 isn’t nature, it’s man-made – in a Chinese military laboratory.
It probably was made in China – facilitated transmission via animal food markets.
But what does Trump care about truth? Trump cares about Trump and nothing but the Trump.
As a member of the proletariat and not also an expert in the treatment of infectious diseases/virologist/pharmacologist and so on I have to leave the question of the appropriateness of hydroxychloroquine in treating covid19 to the scientific community to resolve.
I am definitely not of the view that the medical establishment wishes to protect their god like status and I think it is insulting to the hundred of thousands of clinicians dealing with this virus to suggest otherwise. I don’t think I would feel very god like as doctor going to work knowing that I will probably be witnessing several deaths from covid 19.
I am much more prone to the view that championing a cheap and readily available drug is a very good way for politicians to gain the media attention they crave.
Certainly, not probably, and possibly also the death of colleagues. I would expect them to feel rather vulnerable and not God-like at all. In the UK we have clinicians with inadequate personal pretection equipment who nevertheless continue to do their job because it is their duty to do so, and we have doctors coming out of retirement to go and work on the front line, some of whom have lost their lives as a result, because they do not feel that it is right to do nothing when they have the skills to help.
I followed Stephen Hicks’s link:
https://wattsupwiththat.com/2020/05/02/pseudo-science-behind-the-assault-on-hydroxychloroquine/
but rather gave up reading part-way through. The author is clearly not a clinician, and does not seem to understand that the only appropriate use of chloroquine or hydroxychloroquine in Covid-19 is in the context of a clinical trial. He also does not seem to realise that the coronavirus frequently infects the heart, causing viral myocarditis, and that there is an additional risk in giving cardiotoxic drugs (read the data sheet!) to this group, particularly in higher doses than those used for other indications. I also find it odd that he seems to know that hydroxychloroquine is the better of the two drugs for Covid-19 when there are no data available to answer that question, or indeed whether either of them have a role to play.
good article on a related subject:
https://issues.org/pandemic-science-out-of-control/#.Xq23umZWWfE.mailto
@EE
HCQ is effective for Covid-19
https://www.youtube.com/watch?v=obwbNEIkrFk&feature=share&fbclid=IwAR2juVtvaxaUVy_IZ5GgRn—LsoTjPqZ9d2apR0xha9xb2WZccV6Tb_V_w
I don’t find news articles very helpful, particularly as journalists tend to misinterpret the findings of medical studies. The 90% figure quoted here, for instance, is based on the proportion of a group of patients who recovered after being given hydroxychloroquine, with no control group to tell us what would have happened without it.
Here is a link to the AAPS statement the video was based on:
https://docs.google.com/document/d/1545C_dJWMIAgqeLEsfo2U8Kq5WprDuARXrJl6N1aDjY/edit
It details a number of research papers. Some are in cell culture, many aren’t randomised (one uses controls from another treatment centre!), many are pre-releases prior to peer review, and for the randomised trials the numbers are very small. Many of the sources quoted aren’t research papers at all.
This is not sufficient evidence on which to base medical protocols and highlights the need for proper randomised trials. If treatments are adopted without proper evidence to justify them we will never know whether they actually work and enormous harm can result.
Hydroxychloroquine is cheap and readily available. Its pharmacology is well established. It must be one of the easiest interventions to investigate properly and indeed there are a lot of trials still ongoing. Let’s not pre-empt the results.
For a summary of the current evidence regarding hydroxychloroquine you could look here:
https://www.cebm.net/covid-19/hydroxychloroquine-for-covid-19-what-do-the-clinical-trials-tell-us/
Journalists frequently make a hash of it when reporting medical studies – even when they don’t have an axe to grind.
Presenters at OANN do their job properly – grinding the axe of the far right
@Dr. JMK
Thanks doc, good links
So there is no consensus on HCQ+AZ efficacy. When this occurs, one may ask if there is some political or monetary motivation behind some studies.
I find it interesting that no studies mentioned from either of the links provided specified anything about administering zinc in conjunction with HCQ or HCQ+AZ.
Many of the doctors that have obtained good success using HCQ are giving zinc simultaneously with the HCQ. Perhaps the zinc plays a larger part in the recovery than many might acknowledge.
My sister, whom was a RN for 40 years told me many years ago. At the first onset of a cold coming on, take vitiman C+ Zinc…. I don’t know where she came up with that regimen, but I have always remembered this, and found it to be effective enough for me to keep following her advise.
“So there is no consensus on HCQ+AZ efficacy. When this occurs, one may ask if there is some political or monetary motivation behind some studies.”
yes, when one is a paranoid moron, sure!
https://www.washingtonpost.com/gdpr-consent/?next_url=https%3a%2f%2fwww.washingtonpost.com%2foutlook%2f2020%2f05%2f05%2fcoronavirus-conspiracy-theories-pandemic%2f
There is most certainly some political and monetary motivation behind the AAPS. A great deal of it. The publicity that the treatment has received is something they will want to profit from. See wikipedia for more information.
https://en.wikipedia.org/wiki/One_America_News_Network
https://en.wikipedia.org/wiki/Association_of_American_Physicians_and_Surgeons
There seems to be lately a trend towards more studies in favor of chloroquine
The VA study in the US was a sham. Giving the HCQ to patients that are already on ventilators. That’s tantamount to finding out if a bullet proof vest is effective by shooting someone in the chest then putting the bullet proof vest on them. If the person lives the vest was effective. If the person dies than it was ineffective. How stupid! Once the cytokine storm takes place, its irrelevant if the virus is dead or alive. The damage is done by the cytokine storm not the virus itself. I can tell you another reason why so many nursing home patients died. Its not just being old and underlying conditions. I was a medication nurse for 23 years. At least 50% of patients on average were taking Tylenol routinely for their aches and pains and those that weren’t on it routinely got it as soon as they spiked the slightest fever or got an ache or pain. Now a virus comes along and their First round of immune response which is a fever is completely knocked out by the Tylenol. Now their immune system has to call in the big guns leading to the cytokine storm. Big Pharma the CDC / WHO are being fed billions to find a vaccine/cure. They need to patent something new to make the big bucks. HCQ costs around $20.00 to treat a person for Covid. and it has a long safety record. Before studies even took place I was absolutely convinced HCQ would never be approved because there was too much money to gain by not approving it.
The VA study of HCQ was a complete Sham. It was tantamount to finding out if a bullet proof vest works by shooting someone thru the chest then putting the vest on them. If the person lives it was effective. If they died then the vest didn’t work. How stupid ! Once the cytokine storm takes place its to late. The damage is done whether the virus is dead or alive. Big pharma, CDC and the WHO take in billions to find a vaccine/cure. Something they can patent will make big money. Of course an old cheap drug will never be approved. There is to much money to be made by insuring HCQ doesn’t work.
please say it again, and again, and again … eventually it might become true!