Controversial doctor

In France, controversial doctor stirs coronavirus debate

Didier Raoult touts the use of an anti-malarial drug to treat Covid-19, pitching him head-to-head with public health authorities.

By ELISA BRAUN

Sitting behind his desk in a hospital in the southern French city of Marseille, Didier Raoult has convinced thousands, including the U.S. president, that a common antimalarial drug can save people infected by Covid-19.

In a few short weeks, the controversial microbiologist has become France’s best-known doctor after announcing the coronavirus “endgame” on Youtube.

He is also a ticking time bomb for the government and health authorities, as his supporters and some high-profile politicians challenge official policy on battling the coronavirus.

“Why don’t we use it?” Bruno Retailleau, the head of conservative group Les Républicains in the Senate, asked on France Inter. “It has one advantage: It is not expensive. … Is it because Big Pharma labs would like to make money on the back of our fellow citizens?” he added.

The antimalarial chloroquine and its related compound, hydroxychloroquine, have been the focus of intense debate in France since Raoult, the head of a university hospital institute in Marseille, announced what he said were promising results on a small sample of patients in late February.

Since then, people have been queuing outside his hospital to get treatment, despite warnings from the scientific community about problems with the way Raoult designed and carried out his trials — the results of which were not peer-reviewed prior to publication.

Raoult's team examined a small number of patients, and chose which received treatment with the malaria drug and which did not. That breaks with standard practice in clinical trials of randomly assigning patients to treatment or control groups to avoid bias. The scientists also failed to collect full data from some patients, failing to follow the study protocol they had designed.

Raoult’s social media followers — his YouTube updates attract over a million views — express outrage that health authorities are not freely allowing the use of the drug, forcing the government to publicly justify its strict guidelines on chloroquine, which is marketed only as an antimalarial drug and for specific conditions such as lupus.

“Dr. Raoult’s study involves 24 people. What kind of health minister would I be if, on the basis of a single study conducted on 24 people, I told French people to take a medicine that could lead to cardiac complications in some people?” said Health Minister Olivier Véran on France 2.

Chloroquine and its compounds have been used to treat Covid-19 patients in several affected countries, including China, but Raoult’s comments contrast with his peers’ approach, who have treated it as one of several medications showing potential. It’s part of four treatments currently tested in an EU-wide clinical trial called Discovery.

In the U.S., President Donald Trump’s push for the decades-old malaria medicine — he vowed to “make that drug available almost immediately” — disrupted public health agencies’ coronavirus response.

Raoult’s latest study, published online on Friday, raised a fresh wave of criticism from the scientific community.

Some patients treated with hydroxychloroquine reportedly died of cardiac arrest, according to newspaper Le Point, raising serious concerns about the risks associated with the treatment.

‘Maverick’ doctor

A self-described “maverick” in the medical community, 68-year-old Raoult is a reputed scientist in his microbiology field — noticeably for his work on giant viruses — yet he cuts a controversial figure for his skeptical comments on Darwin’s law, climate change, some vaccines and even recommendations about exposure to the sun and alcohol consumption.

“I don’t care what others think,” he told local newspaper La Provence. “I’m not an outsider, I’m the one that is the furthest ahead.”

His free spirit attitude and his battles with the Parisian elite have turned him into a media sensation.

“Paris has a sort of 18th century Versailles syndrome. … Everybody talks to everybody, recommends each other among friends, it’s very endogamic,” Raoult told Libération. “The world doesn’t work like that anymore.”

Public officials are taking him seriously, up to the highest level.

Raoult was officially a member of the first scientific council set up by French President Emmanuel Macron to advise him on the coronavirus epidemic, although he stopped attending meetings after a disagreement over the level of screening and testing.

“There is no bad blood between Didier Raoult and the Élysée,” a spokesperson for the president told POLITICO, adding that Macron himself associated with him early on within scientific advisory boards to the government.

“I hear impatience,” Véran said during a press conference with Prime Minister Edouard Philippe Saturday. “I am talking regularly to Professor Raoult,” he added, while pointing at the lack of scientific consensus over his results.

The government last week allowed chloroquine to be used under strict medical supervision in hospitals, following the go-ahead from public health watchdog the High Council for Public Health, which said it could be used for the most serious Covid-19 cases after agreement between caregivers.

Raoult was quick to thank Véran on Twitter, touting the move as a victory, despite later government clarifications that the decision strictly followed guidelines from health authorities.

Raoult has some 371,000 supporters on his Facebook group, and over 200,000 followers on Twitter. Eric Drouet, an influential figure in France’s Yellow Jackets protest movement, and Juan Branco, a lawyer and political activist, have lent their support and helped the professor become a social media star.

Conspiracy theorists now use “Dr. Raoult” keywords as a way to engage in online debates, which risks making the public health messages barely audible to many people.

“We are now living in a world of fake news and hyper-communication where it becomes very complicated for public authorities and crisis management players to distinguish between the true and the false,” said David Gruson, a former health adviser to ex-Prime Minister François Fillon.

In terms of health policy, “there is now a greater sensitivity to media phenomena on the one hand and, on the other hand, a willingness not to lose the sense of protecting patients’ interests,” he added.

France Inter radio reported cases of patients threatening to sue hospitals if they don’t get chloroquine, while some Facebook users post very popular “chloroquine diaries.”

The resulting surge in demand at French pharmacies has alarmed experts who warn against overhyping unproven medicines, and fear there will be shortages for lupus patients who use chloroquine to avoid inflammations associated with their auto-immune disease, France 24 reported.

Politically, Macron’s opponents are only too happy to use Raoult and his popularity to undermine the government’s message in the coronavirus crisis.

“Didier Raoult is too unloved by all those beautiful persons [from the government] not to arouse interest,” said Jean-Luc Mélenchon, a leading far left opponent of Macron, on his blog.

Far-right leaders have also sided with Raoult, with National Rally leader Marine Le Pen saying that general practitioners should be allowed to prescribe chloroquine “right away,” and questioning the government’s assessment of the situation.