23 April 2020
L’Affaire Raoult
Covid-19 and an eccentric professor reveal an old fault-line in French society.
By Richard Pooley
He is an outsider who has risen to the top but never been accepted as a member of the élite, which he openly despises and whose members loathe him in equal measure. He is not a professional politician but has courted the powerful from early on in his career. He has a history of playing fast and loose with the facts, of not following established scientific procedures, of cutting corners to get the results he wants. He adores the limelight and is convinced that he alone can fix the Covid-19 problem, if only the world will acknowledge his genius. He completely dominates the operation he runs, not allowing anyone else to make major decisions. He has been the subject of numerous complaints of bullying, unfair dismissal and sexual harassment. He has strong opinions on subjects about which he has no expertise, stating that “global warming is uncertain and human responsibility is questionable”, and questioning Darwin’s Theory of Evolution. On January 21st, when the new coronavirus was apparently still confined to China, he mocked those who warned of an approaching pandemic: “The world has gone completely mad. Three people in China die from a virus and it makes the world news.” He is renowned throughout his country for the state of his hair.
You will have guessed already that I am not describing President Trump. Yet the similarities between the Donald and French virologist, Professor Didier Raoult, are legion. It is therefore extraordinary that the former appears not to know of the existence of Le Didier, as I feel the French should now be calling their man. For it is the US president who has been the French professor’s greatest propagandist in the past four weeks. Perhaps the Donald does know of Le Didier but wants to put himself and America first. Maybe he can’t bring himself to praise anyone from “Socialist France”.
By February 25th Raoult had changed his mind about Covid-19. He released a video from his Institut Hospital-Universitaire Méditerranée Infection (IHU) in Marseille in which he described Chinese experiments with hydroxychloroquine in laudatory terms. He entitled the video “Coronavirus; endgame!” Hydroxychloroquine is a derivative of chloroquine, a drug I remember taking to protect me from getting malaria when a teenager in Africa, but which is also used to treat lupus and rheumatoid arthritis. He started his own clinical study. For six days, twenty-four patients who had tested positive for Covid-19 were given 600mg of hydroxycloroquine and 250mg of azithromycin, an antibiotic to counter bacterial pneumonia. On March 16th, Raoult published his results, again in a video: eighteen of the twenty-four no longer had the virus. 90% of the control group, which had not taken Raoult’s drug cocktail, still tested positive for Covid-19. It was these results that were posted by Elon Musk on Twitter and hence seen by Trump. On March 21st the Donald tweeted that “HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine.”
Raoult must have been thrilled by such an endorsement, although no doubt wishing Trump had mentioned his name, and immediately embarked on a second study. Frankly, he should have been pleased that Trump had got the spelling right and not claimed, as he had the day before, that the US Food & Drug Administration had approved the “very powerful drug chloroquine”. They hadn’t. Chloroquine is much more toxic than its derivative. Someone in Arizona presumably heard what Trump said and died on March 23rd after taking chloroquine phosphate, normally used to clean aquaria. Several were poisoned in Nigeria where the anti-malaria drug, a staple of pharmacies there, was panic-bought. Despite labelling African countries as “shitholes” in January 2018, Trump is listened to in Africa, with deadly consequences. He has also been listened to in many other places and a drug which patients with lupus and rheumatoid arthritis depend on is suddenly in short supply.
The reaction in France tells us much about French society. People in the south, especially in and around Marseille, began demanding in print media and online that the French government treat all Covid-19 patients with the hydroxychloroquine / azithromycin combination. Queues formed outside Raoult’s IHU when the professor announced that all who came would be tested for the virus, contrary to the government’s policy of keeping such tests for those most in danger of contracting it. Christian Estrosi, the mayor of Nice, who had tested positive for Covid-19, took Raoult’s medicine and lived. He lobbied the government to fast-track a large-scale clinical trial of hydroxychloroquine / azithromycin. An IFOP poll found that 59% of respondents were in favour of the treatment recommended by Raoult, even though hardly any of them can have understood the science behind it.
Why do so many French back Raoult? Because he is not one of the know-all, Parisian élite who dismiss any idea or solution which does not spring from their brilliant minds. Raoult himself has described Paris as being like “18th-century Versailles… where everybody talks to everybody, and recommends each other among friends. It’s very endogamic.” I had to look it up too. It’s somehow typical of Raoult, in truth a well-connected intellectual himself, that he uses a word which only the French intellectual élite he is attacking would understand. Endogamy is the practice of marrying within the same tribe or caste.
David Lee, a retired businessman who lives near Cannes, has been asking his French friends for their views on the French response to the pandemic. One, Jean-Philippe Compain, owner and chief executive of Aquasmart, a company based near Bordeaux, had this to say: “Look at the uproar [literally: raising of the shields] against Professor Raoult, a Provençal who had the audacity to propose a solution before the Parisian mandarins!!! The ultimate insult…” He actually wrote provencal which could be read as a provincial or someone from the provinces. He went on to say “Yet we notice that it is the provincials who are the most active, united, good-hearted, even though we see cowardly Parisians arriving in numbers, not thinking, THEM, of the health of those living in our provinces: Too bad we bring the virus from Paris!!!”
When members of the élite questioned Raoult’s methods (his first study had too small a patient sample, some of whom dropped out during it, and was not double-blinded) they were accused of Parisian arrogance, professional jealousy, or of being in the pay of Big Pharma. The Health Minister, Olivier Véran, asked on television : “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?” Few appear convinced. Véran is from Isère in south-east France but he attended the Paris-based Sciences Po, a prestigious grande école, and is a member of President Macron’s party, LREM. Ergo he is part of the metropolitan establishment.
France’s premier pharmaceutical company, Sanofi, has been accused of rubbishing Raoult because they won’t make any money if he is proved right. Bruno Retailleau, the leader of the conservative Les Républicains in the French Senate, asked “Why don’t we use it [Raoul’s treatment]? It has one advantage: it is not expensive. Is it because Big Pharma would like to make money on the back of our fellow citizens?” Yes, even Conservative politicians in France are anti big business.
Raoult’s second study had a bigger sample – eighty patients – but was so poorly conducted that it has been easy for his enemies to excoriate him. “Unfortunately, in the absence of a control group, it is extremely difficult to know whether the treatment is effective or not” said Arnaud Fontanet, epidemiologist at the Pasteur Institute and member of the government’s medical advisory team for Covid-19, when interviewed on RMC/BFM TV on April 10. Catherine Hill, a Paris-based French epidemiologist and biostatistician, is equally scathing: “These results are just null and void; they do not tell us anything about the effectiveness of the treatment.”
President Macron flew down to meet Raoult in his Marseille den on 9 April. Macron said this should not be seen as having “any political dimension.” He was there to get the facts and listen to what the professor had to say. And now a full trial of Raoult’s hydroxychloroquine / azithromycin treatment is being conducted. The reaction of the medical establishment was unforgiving: Macron was “legitimizing this researcher”. An editorial in Science accused the president of feeding “the craze around a treatment whose effectiveness is not proven.”
Should Raoult be proved right, the majority of French will delight in seeing the arrogant, endogamic Parisian establishment being made to look foolish. They will take pride in the fact that it was a Frenchman, and a provincial one at that, who saved the world. And fewer of them will die from Covid-19.
Should he be proved wrong, a minority of French will still be convinced that it was Big Pharma which suppressed the truth and made sure the hydroxychloroquine / azithromycin trial did not work.
Either way, provincial France has a new hero.
I must tell you of one thing which troubled me when doing the research for this article. On 6 April, the BBC’s Reality Check team published a report entitled “Coronavirus and chloroquine: Is there evidence it works?” There was not a single mention of Professor Raoult or his studies. What kind of reality check is that? From my perspective in France, the BBC seems far more interested by what is going on in the USA than in the UK’s nearest neighbours. I may come back to this next week.
