Q: Professor Didier Raoult, what do you think about
the press release announcing the
preliminary findings of the RECOVERY study?
As usual, I think that
you have to be careful before you see
the data. The data as they
were communicated in the interview that was
given by the author to France Soir [French Newspaper] are
a little surreal. Actually, we have
the impression that the idea of common grounds
between people who make
science and medicine have completely
disappeared. So, we can look at things in order to
understand why there are such
differences between studies.
Firstly: the criteria for defining
the disease. In RECOVERY, as in
other studies, including one very
large study that just came out in the
New England Journal of Medicine for
prophylaxis, there are some patients who have not
been diagnosed with
COVID, but were looking like
patients who might have COVID,
without any test.
It's something that's extremely
astonishing, all the more so since many
these studies were done before we
began to understand the disease,
the real and most important criterion
to diagnose, a posteriori,
people who had COVID, is the fact that
they no longer smell the smells - anosmia - and
this one was not known at the beginning, it was not
identified yet. So we can't say
whether someone has a COVID or not,
based on the definition that was taken
in RECOVERY. We don't know what disease they had!
They were ‘sick’. And so we
do not know the proportion of
those who did not have any test
to confirm, from those who have been
tested. Which is quite amazing!
That in a country like England,
they can't do a test to include or exclude
a sick person, showing that he indeed has the
Disease for which they are going to treat him.
It's spectacular.
The second thing is:  what we know now
Versus what we didn't know
before understanding the disease, although it
resembles: most viral infectious
diseases , it develops the
same way. There's a stage where it's the
virus that talks, it's the virus that
leads to manifestations that are felt.
And then secondly,
the reaction that we have against the
virus is starting to become important. In
this disease, it ends up becoming
extremely important in unbalancing
our entire immune system. And finally,
the third part, when people are
in intensive care,
we're in a game where there are
tissue damage. And this is the
ICU specialist whose job it is.  So, in the
early stages of the virus, you need to give
anti-viral drugs.
At the second late stage, you have to give
Medicines, if possible, against
the immune reaction. That's why we
talk about corticosteroids, or
monoclonal antibodies. And finally, at the
the final stage comes the role of the
ICU specialist to save these people, and
keep them alive until the
Tissues repair. So we can't
provide the same medication for those
three stages of the disease. All those trials
were done even before
we began to understand the disease.
That's why we can't do
trials before starting to
understand the disease.
The third thing: these dosages that were given.
For example, here, we give the dose
that I am used to giving in the
bacterial infections that I treat
with hydroxychloroquine, which is 600 mg per
day
It's a dose that I know, it's a
dose used by many
rheumatologists. In France,
the DISCOVERY trial uses a lower dosage
(400mg) and RECOVERY uses doses
that no one has ever used: 2400 milligrams
on the first day. That's 4 times
the dose we use. The good news is
is that obviously hydroxychloroquine
is not toxic because
4 times the dose we use, and
nothing happened on the hearts,
whereas 15 days ago, we were
told that they were all dying of
heart rhythm disorders.
So at least it's a good trials
to assess the toxicity and we see that the
toxicity even at these doses is very
low, as they did not report
any toxicity associated with it.  Then there's the
follow-up: most of these studies do not
reports any virological follow-up. So,
once again, the sick people who are
at a late stage don't even have viruses anymore in them.
You can't even find a virus when you
tests them, in most cases. But those
that still have viruses, the way to
to know if we can cure them,
remove the viruses, is to do tests
for viruses. Most studies
don't even have the means to perform these
tests,
although it is in very rich countries.
Ourselves, when we included sick patients,
we of course followed
their PCRs regularly to determine whether
they were still positive on their
viral charge.
Because it's one of the major elements
to assess effectiveness. And then, finally,
mortality:
it's incredible! From one study
to another, the deaths that are
reported… And there in both groups, there is
about 25% mortality!
It should be noted that in France, the
mortality of hospitalized people is
less than half of that. So we're wondering
where they went to find those sick people.
Even here in Marseille, in intensive care,
I looked at the numbers again, the mortality at
28 days is 15.6%.
In the ICUs!
How do you get mortality rates
at 25%,
and if you go from one study to another
you have, at the beginning, the Chinese, who
were taken by surprise, reporting
mortality rates in the order of 46%.
And then there are studies that have
reported fatalities of 25%, 20%.
The Americans who did their
study on Redemsivir reported some
mortality, both on  placebo
and in people who had
the Remdesivir, of around 10%.
So it's incomprehensible! If you
will, we cannot manage, provided the
the way they include patients,
to know what they've included. Did they
included all the people who were
sick?
In it, how much of it is
of people who actually had that disease?
We don't understand how they provided care!
Listen: honestly, here, when you walk into
An ICU here,
You are twice as likely
to come out of it alive than when you're in
this study, really! So there are some
substantive questions here: what are we talking about?
What are we comparing? Who is it
that have performed the trials? How could
doses of this magnitude be validated?
By the way, the Indians, and so it's a
world that is turned upside down, it's the
Indians who now say to Oxford
"you don't know how to use hydroxychloroquine,
because you're using doses
which are 4 times the one we use."
The Indians, they're used to
to prescribe hydroxychloroquine.
So we have some kind of paradox. We do not understand anymore
what is done
institutionally and officially, because
it seems that the basic elements of
Knowledge, in particular regarding these
diseases and these drugs, has
completely disappeared. So there's a real
question here. And so we can see
published just about anything.
Except that, afterwards, over time, and that's what
will come out, we'll see
the real mortality. Some will have to do acrobatics
to hide how many dead there has been
during that very episode. And we'll see
the differences in mortality, which will be
the peacemaker, the teller of truth. That'll be:
where people died the most.
At the moment, it is in the countries which are the richest,
in which some thought, some have been
obsessed with the idea of organizing trials
before even knowing
the disease. It is there where mortality was the highest.
Q: Thank you.
