0:00:00.000,0:00:02.730 Professor Didier Raoult what is the evolution of the epidemic 0:00:02.730,0:00:06.839 currently, and what is its situation in the history of sanitary crises? Well, 0:00:06.839,0:00:13.469 the evolution of the epidemic, as you will see, as far as we are concerned, the epidemic is 0:00:13.469,0:00:18.690 progressively disappearing. So we had, at the maximum, at its peak, 0:00:18.690,0:00:24.869 we had up to 368 new cases per day, and now we are closer to 0:00:24.869,0:00:32.450 60-80 per day, so we have a very significant decrease 0:00:32.450,0:00:37.050 of the number of cases detected; even more significant among people who come 0:00:37.050,0:00:41.730 to get tested when they are asymptomatic. So it's possible, 0:00:41.730,0:00:47.850 it was one of the possibilities I had talked about among others, that the epidemic 0:00:47.850,0:00:51.149 will disappear this spring, and that in a few weeks 0:00:51.149,0:00:55.410 there will be no new cases for reasons that are often very strange, and that are 0:00:55.410,0:00:58.320 things that we are used to seeing most of the time with viral respiratory 0:00:58.320,0:01:02.579 diseases. So it is quite unoriginal. If we try to 0:01:02.579,0:01:06.540 place this, to place it in the context of epidemics, of sanitary crises, 0:01:06.540,0:01:13.350 you see that we can measure sanitary crises with these images. 0:01:13.350,0:01:20.920 One, you see that for summer sanitary crises; you remember the heat wave in 2003, 0:01:20.920,0:01:25.510 the heat wave of 83 that I saw, you see that in summer, if you monitor as things 0:01:25.510,0:01:28.210 progress, you can detect sanitary crises very easily. 0:01:28.210,0:01:32.500 It was one of the propositions that I had made when I had done a report 0:01:32.500,0:01:37.030 for the ministery of health, its cabinet DGS didn't want to take it into consideration 0:01:37.030,0:01:39.670 unfortunately, as that is what has to be done because it allows detecting 0:01:39.670,0:01:42.520 real sanitary crises. So if we try to see if 0:01:42.520,0:01:49.180 currently the sanitary crisis has an incidence on mortality in France, 0:01:49.180,0:01:55.479 the answer is no, sanitary crises that during the winter made a significant difference 0:01:55.479,0:02:05.229 were in 1997, 2000, 2009 and 2017. But we are very far currently if we 0:02:05.229,0:02:11.230 cumulate, you see, the months of December until March of the sanitary crisis in 2017, where there had 0:02:11.230,0:02:15.040 been a lot of cases of the H3N2 flu. It happens to be the case that this year there was much less 0:02:15.040,0:02:19.000 flu and less VRS, which means that the increase in mortality 0:02:19.000,0:02:22.739 linked to this new virus 0:02:22.810,0:02:26.650 is not noticeable significantly in the totality of the population. 0:02:26.650,0:02:31.209 Of course, there are other phenomenons, it is multifactorial, but we cannot 0:02:31.209,0:02:36.010 say, and you know that I hate making predictions, but still I had predicted that this 0:02:36.010,0:02:39.670 sanitary crisis would not modify the life expectancy of French people. It is 0:02:39.670,0:02:43.930 the case, we will do the accounting. No more by the way than in China, 3000 or 4000 deaths 0:02:43.930,0:02:49.989 don't modify significantly the life expectancy of 1.3 or 1.4 billion Chinese for the year, 0:02:49.989,0:02:54.580 it is not true. So it is, again, a good thing to react to sanitary crises, 0:02:54.580,0:02:57.790 to manage them, but we should manage them without anxiety, 0:02:57.790,0:03:01.269 without worry, being the most professional possible, managing things as they come, 0:03:01.269,0:03:04.959 trying to diagnose, isolate, treat the patients to avoid 0:03:04.959,0:03:09.549 having more deaths than elsewhere. That's it. So that is something that seems to me 0:03:09.549,0:03:14.920 very important. Regarding the treatment, where are you at? Regarding the treatment, 0:03:14.920,0:03:19.380 we are very happy, we are now, which is often the case 0:03:19.380,0:03:24.190 when we confront a problem, we have generally, very quickly, the highest 0:03:24.190,0:03:27.519 number of cases in the world. So it is practically the case on all diseases we have 0:03:27.519,0:03:31.420 engaged. There are about ten like this in which we have had the largest series 0:03:31.420,0:03:34.900 of patients in the world. And so I think that on Covid we have now 0:03:34.900,0:03:37.480 probably the largest series in the world in 0:03:37.480,0:03:50.049 a single hospital center. Here we have tested, 76,000 serums of 32,000 patients, 4,296 0:03:50.049,0:03:56.200 were positive. Here we have treated at the IHU [hospital] Méditerranée [Marseilles] infections for more than 0:03:56.200,0:03:59.709 3000 patients, 2600 were treated according to our protocol 0:03:59.709,0:04:03.700 hydroxychloroquine plus azithromycine, among which 10 are dead, which means we 0:04:03.700,0:04:08.079 confirm that we have a mortality that is less than 0.5% for the time being, which is 0:04:08.079,0:04:13.299 one of the results, or THE result that is the most spectacular in the world today. 0:04:13.299,0:04:18.949 That's it, we are very happy, the therapies, by the way this therapy, 0:04:18.949,0:04:22.970 whether or not it is, is so spectacular, 0:04:22.970,0:04:27.530 in reality, people have so much ease in seeing that it works, 0:04:27.530,0:04:33.370 that it is spreading, and there are studies that are done, in particular 0:04:33.370,0:04:39.050 an institute that surveys doctors that is called SERMO, that shows 0:04:39.050,0:04:43.310 globally, among doctors that are taking care of this, the first treatment 0:04:43.310,0:04:47.539 among all of them currently is azithromycine in 50% of cases and hydroxychloroquine 0:04:47.539,0:04:52.729 or chloroquine in 44% of cases. That's massive. It means that 0:04:52.729,0:04:56.180 practitioners are adopting it because, simply, it works. 0:04:56.180,0:05:01.310 In a very interesting way, that will probably give a lot to think 0:05:01.310,0:05:05.389 to people on the method, came out a paper on the redemsivir in the New England [Journal of Medicine] 0:05:05.389,0:05:11.090 that defies every [known] methodology, as for the first time 0:05:11.090,0:05:16.280 we dare publish a study where there is no comparison, i.e. 0:05:16.280,0:05:20.389 we compare this treatment with nothing else, not even historically. It is extraordinary, 0:05:20.389,0:05:26.050 and so the only thing that is noted, is that there is a considerable toxicity 0:05:26.050,0:05:30.680 i.e. there is 60% of side effects, which means that 0:05:30.680,0:05:33.740 this medicine cannot be used except for patients that have a form 0:05:33.740,0:05:36.500 very serious, but patients that have a form very serious, 0:05:36.500,0:05:40.550 we know it here, in reality, have almost no virus, or no virus at all: they are not 0:05:40.550,0:05:44.479 at that stage. They are at another stage. Which means that if this medicine 0:05:44.479,0:05:48.560 cannot be given to patients other than those who have a very serious form, 0:05:48.560,0:05:53.770 and that in very serious forms it is useless, 0:05:53.770,0:05:59.620 the debate will slowly decrease, as the other medicine that was 0:05:59.620,0:06:05.440 also proposed in the Discovery arm [research], Vidovira, showed that it was 0:06:05.440,0:06:07.569 totally ineffective in the same indication. 0:06:07.569,0:06:10.990 So this means that things, the outlook will become clearer 0:06:10.990,0:06:14.319 for molecules that we can actually use and for when we can use them. 0:06:14.319,0:06:17.400 But in all forms, in cases that are at this stage, 0:06:17.400,0:06:25.360 in reanimation, in reality the antivirals will have an effectiveness relatively 0:06:25.360,0:06:29.860 modest, because there is very little virus, it is our experience, we even had 0:06:29.860,0:06:32.889 patients that died and that had no virus left. We don't see 0:06:32.889,0:06:35.949 how an antiviral prescribed at this stage could be the least effective. 0:06:35.949,0:06:40.300 So the treatment, it's in the moderate forms, 0:06:40.300,0:06:44.650 in the forms that are serious but that are not in reanimation, that will 0:06:44.650,0:06:47.860 allow to get things done. But it is interesting because among the others, the people 0:06:47.860,0:06:51.099 who had commented on our methods, it is the first time I see 0:06:51.099,0:06:56.889 a paper published without any comparison, neither historical, or geographical, 0:06:56.889,0:07:01.150 or anything else. It's just that, I don't know in how many cities in the world, we have given 0:07:01.150,0:07:04.180 a bit of remdesivir to people who were sick, and all that maybe 0:07:04.180,0:07:10.060 with a ghost writer, meaning an ad hoc author, gathered 0:07:10.060,0:07:13.060 all this data, with very little biological data, to say listen 0:07:13.060,0:07:18.250 we have given remdesivir. That's all. It is interesting because maybe that 0:07:18.250,0:07:23.009 it is one of the publications that will allow following with interest the 0:07:23.009,0:07:28.599 absolutely extraordinary fluctuations of the Gilead stock price, and so I know that 0:07:28.599,0:07:33.819 there is a publication that is accusing me of having conflicts of interest with Sanofi, 0:07:33.819,0:07:37.330 because I talked with Sanofi at the time we created the IHU [hospital], it was 0:07:37.330,0:07:40.289 what was asked of us, we had to find at least one, two or three 0:07:40.289,0:07:44.229 industrial partners that were associated in order to do development in France, 0:07:44.229,0:07:48.190 and translational research. So I had talked with Sanofi to 0:07:48.190,0:07:52.180 do what I'm doing now but without Sanofi, i.e. 0:07:52.180,0:07:54.539 repositioning of molecules that exist already, 0:07:54.539,0:07:59.259 and then the discussions failed so we did not work with Sanofi, but you see, 0:07:59.259,0:08:03.229 you look at all this thing, if I had to, I was the consultant for Sanofi, 0:08:03.229,0:08:06.379 I would be an extremely bad advisor, because Sanofi 0:08:06.379,0:08:09.919 is losing money non-stop, while the advisors of Gilead are very 0:08:09.919,0:08:14.389 good advisors because Gilead made a lot of money 0:08:14.389,0:08:18.889 since the beginning of Covid, even though the stock price is modulated by 0:08:18.889,0:08:21.339 the fact that we communicate on the fact that there are alternative treatments, 0:08:21.339,0:08:26.930 chloroquine, or that the WHO decides that remdesivir is the big treatment ... pssht! 0:08:26.930,0:08:30.710 We see the stock price climb, and all that are things that are 0:08:30.710,0:08:34.880 interesting, and it is certainly among the parameters, I don't know how to interpret it 0:08:34.880,0:08:40.010 more than that, but the sums of money are absolutely gigantic. We are, 0:08:40.010,0:08:45.949 by the market capitalization of Gilead, it's something absolutely huge, so it's 0:08:45.949,0:08:49.339 interesting to see, you see, the fluctuations of its stock price depending on 0:08:49.339,0:08:56.810 the announcements made in the press, and the efficacy of substitutive treatments. And so 0:08:56.810,0:09:01.550 you see that if I was, again, a hidden consultant for Sanofi, I would 0:09:01.550,0:09:04.880 recommend that they fire me, because frankly, they are losing money, they have 0:09:04.880,0:09:10.250 lost 20% of value in their stock since the beggining of this action. So, 0:09:10.250,0:09:14.180 what I already knew, I'm not a very good financial advisor. I think that 0:09:14.180,0:09:17.690 the financial advisors - despite the total absence of efficacy 0:09:17.690,0:09:21.980 of remdesivir, their [Gilead's] advisors are much better than me, as it has taken an 0:09:21.980,0:09:26.750 absolutely huge proportion in financial terms. That's it. Do you have 0:09:26.750,0:09:30.350 new data regarding the toxicity of treatments based on hydroxychloroquine 0:09:30.350,0:09:36.740 and azithromycine? Well we have seen, here and now, we have, 0:09:36.740,0:09:41.000 well of course we did that with our friends the cardiologists, there are a few 0:09:41.000,0:09:43.880 patients for which they tell us listen, these ones we would rather that you not treat them, 0:09:43.880,0:09:48.290 so we don't treat them, it does not represent a lot of people, 0:09:48.290,0:09:53.270 but it is unnecessary to take risks that are not useful, so on the 2600 0:09:53.270,0:09:56.300 we did include, we didn't have any any problem; it's starting to be a lot, 2600. 0:09:56.300,0:10:00.140 So I think that all these debates 0:10:00.140,0:10:03.800 at the beginning, when we start, I still think that the first work that we did, 0:10:03.800,0:10:06.740 methodologically, nothing to do with the work of the New England [Journal of Medicine], 0:10:06.740,0:10:10.250 there was an external geographic group, that was mixed, there was comparison, 0:10:10.250,0:10:15.920 there was a point of comparison that was viral carriage, while in the 0:10:15.920,0:10:18.890 paper of the New England there is no point comparison. They don't look at healing rates, 0:10:18.890,0:10:24.020 there is no comparison, neither clinical, nor viral, and we had internal comparisons, 0:10:24.020,0:10:28.010 between hydroxychloroquine and hydroxychloroquine plus azithromycine. As far as I'm concerned, 0:10:28.010,0:10:36.430 what surprises me the most in the current situation, is that mortality 0:10:36.430,0:10:44.990 currently in the richest countries is much higher than either 0:10:44.990,0:10:48.740 in the eastern part of the World, China, Korea, eastern countries that are rich too 0:10:48.740,0:10:53.390 but have a lower mortality, or in the poorest countries. So we finish 0:10:53.390,0:10:56.990 by asking if having an industry with medicine that are very new, 0:10:56.990,0:11:00.920 is actually an advantage or a disadvantage in such conditions. 0:11:00.920,0:11:04.610 I mean that people in Africa don't have much choice so 0:11:04.610,0:11:08.570 for them there isn't much problem to take Plaquenil [hydroxychloroquine], 0:11:08.570,0:11:12.550 and azithromycine, it doesn't cost them anything, while in France however there is a struggle 0:11:12.550,0:11:17.000 that is extremely brutal against the usage of very simple medicine 0:11:17.000,0:11:24.020 that are very cheap and that ... I don't know if that has consequences on mortality 0:11:24.020,0:11:27.410 in France, but it is an interesting question. In any case when we observe the difference 0:11:27.410,0:11:33.110 in mortality between here, in Marseilles, and other places in France 0:11:33.110,0:11:36.950 where the population and the state of the epidemic is comparable, we can honestly ask 0:11:36.950,0:11:39.470 whether it is indeed best to take old medicine that work well 0:11:39.470,0:11:42.740 or new medicine that we are not sure whether they work at all, and that 0:11:42.740,0:11:47.990 we know have complications, very serious side effects. 0:11:47.990,0:11:50.990 Thank you.