The Antimalarial Hydroxychloroquine in COVID-19 Treatment: This Is Not a Hollywood Blockbuster!

This article continues our piece, "The Story of French Doctor Didier Raoult, Who Started the Debate on the Antimalarial Hydroxychloroquine for Coronavirus Treatment".

How thrilled I would be if a brilliant genius like Jeff Goldblum in Jurassic Park discovered a miraculous treatment for the novel coronavirus (SARS-CoV-2) in a corner of a cluttered laboratory bench! How I would applaud if this magnificent hero, working too fast for ordinary mortals to follow, saved millions of lives by proving his hypothesis before anyone else in front of a terrified world. But we are not in a Hollywood blockbuster!..

When Didier Raoult began his first study of chloroquine, he based it on three things: a verifiable finding, a claim and intuition.

The verifiable finding was that chloroquine was effective against SARS-CoV-2 in test tubes (in vitro, for example cell culture experiments), rather than in living experimental systems (in vivo, for example animal experiments). This in-vitro activity also exists for many other viruses, yet no beneficial clinical effect has been observed in patients, and it has even been associated with increased mortality (death rates), as observed in Chikungunya fever. This should have made the need for caution clear.

This situation, which called for skepticism, was brushed aside with Raoult’s words: ‘‘A Chinese clinical study has emerged showing that chloroquine produces extraordinary improvement in all infections positive for the Chinese (!) coronavirus and supporting its use in all these patients.’’ Two months after this sensational announcement, the world is still waiting for even the slightest evidence for what looks like an elaborate media bluff.

The final element Didier Raoult still stubbornly defends in ever stranger videos is intuition. Unlike selected Parisian elites who have long wasted time and would take months to make progress while trapped in standard procedures, this practical man can get to the root of the problem and quickly see the solution.

With his highly confident media presence, he raises enormous hopes and begins his studies. Expectations are so high that nobody in the media or politics thinks to question him.

Who could imagine that a respected scientist with an impressive résumé would blindly lead himself into a deception?

Didier Raoult’s studies follow one after another, accompanied, of course, by wildly manipulated conclusions and an ever-growing accumulation of errors…

In the first study, one of the 42 patients receiving Didier Raoult’s approach dies and three are hospitalized because their condition worsens. These four patients, who should have counted as hydroxychloroquine treatment failures, are excluded from the results as if by a magic wand (something that should be called fraud anywhere in the world, including France)…

Later, Didier Raoult adds azithromycin to his approach and concludes that the combination is more effective than hydroxychloroquine alone, although a difference observed in only 6 patients is not scientifically meaningful…

Initially, Didier Raoult defines the criterion for success as detecting the virus in patients’ nasal samples over approximately 14 days. Yet the study is cut short on day 6, and a reduction in intranasal viral load is accepted as evidence of efficacy (apparently unaware that this might simply mean the virus had moved down to lung level). A 10-year-old child is also included in one study arm without consent.

While the results of the first study—immediately rejected by the International Society of Antimicrobial Chemotherapy—are about to be published under questionable circumstances, a second study begins as a follow-up. It is announced as observational, although Didier Raoult and his team select which patients will receive treatment (introducing bias in a disease that already resolves spontaneously in 95% of cases). Calling it observational also removes the need for the normally mandatory authorization from the French medicines agency (Agence Nationale de Securite du Medicament)!..

With governments seemingly paralyzed by the chaos of managing the epidemic, nobody dares object. The Marseille Institute issues itself a decision bypassing the requirement for ethics committee approval and has given hydroxychloroquine to 80 patients by the end of March. After all, having taken the ‘‘Hippocratic Oath’’ supposedly requires it… Didier Raoult thus tests this potentially cardiotoxic drug on patients on the basis of intuition (!), disregarding the most basic ethical issues.

There is so much to say about the inaction of institutes, institutions and politicians in the face of this man, who leads tens of thousands of frightened people, thousands of conspiracy theories, and hundreds of trolls who became virologists within hours after watching a few videos by their ‘‘Guru’’…

What interests me most, however, is Didier Raoult’s rationale: how he has turned his certainty about the Hippocratic Oath (which nowhere grants a right to experiment freely on people!), his medical degree and his personal intuition into what he imagines is a trump card. Let us remind ourselves once more: Didier Raoult is a microbiologist. He has no experience in therapeutic research, his studies contain serious errors, and his methods of analyzing results are inconsistent. He wants us to believe a new paradigm has emerged. What he is actually doing is nothing other than perpetuating the rotten tyranny of arrogant medical barons, unaware of the need to question themselves, whom we had hoped no longer existed!

The results of the first scientifically rigorous clinical trial of hydroxychloroquine are announced worldwide, showing that the drug is ineffective (see the translation of the related study). Didier Raoult’s only remaining defense seems to be that he acted in extraordinary times. One day he compares himself with Clemenceau, the next with Foch, imagining himself a wartime leader, the only person capable of handling the situation! As if his evasive answers to questions about ignoring scientific methodology did not exist… From his video published on April 21, ‘‘A Short Lesson on Epidemics – La Leçon Des Êpidêmies Courtes,’’ all the media take away is the claim that Covid-19 is seasonal and will disappear on its own (in his words, ‘‘There will be no new cases within one month’’). Today, the warnings from those who have followed science from the start seem finally to be bearing fruit: the esteemed soothsayer’s claim collapses alongside his January mockery, ‘‘The whole world is going crazy because three Chinese people died!’’ In fact, Didier Raoult shamelessly emphasizes the one thing that might soften the consequences of his actions: the claim that he acted under emergency conditions during a very short epidemic. But how many people will notice? If Covid-19 stays with us for a long time, he will not escape a thorough examination of his actions and statements, and the consequences for him will be devastating! 

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