Not many virologists go viral. Nor do many microbiologists generate bacteriological numbers of followers on YouTube and Twitter.
But Professor Didier Raoult is not an ordinary microbiologist — as he would be the first to tell you. He is an iconoclast and an enemy of the French medical establishment. He has long white hair and a pointed white beard, which makes him look like a fictional wizard — perhaps more of a querulous Gandalf than a genial Dumbledore.
In the last two months, Raoult, 68, has become both famous and infamous. He has, he says, discovered a “game-changing”, cheap, off-the-shelf cure for Covid-19 — namely hydroxychloroquine, a common treatment for malaria.
His claims created a pandemic of controversy and conspiracy theories on both sides of the Atlantic. They have brought angry rebuttals from the medical establishment in France and beyond.
In the last few days, the Raoult game-changer appears to have fallen to bits. An extensive series of tests in American veteran hospitals concluded that, if anything, hydroxychloroquine increased the death rate among acute sufferers from Covid-19. A US state health agency warned that the two drug combination used by the professor could be “toxic”.
Didier Raoult is no quack. He is an eminent scientist with a long track-record of brilliant, original research, including his groundbreaking work on giant viruses (or ‘giruses’).
Some of his claims and methods have long been disputed. He is a climate change sceptic. He originally dismissed the Covid pandemic as a “crazy” fuss over the “death of three Chinese”. He rejects the standard, systematic methods of medical research — such as the use of control groups and placebos — as the plodding obsession of “bureaucrats” and “mathematicians”.
So if not a charlatan, is he a genius? President Emmanuel Macron visited him a few days ago in his medical institute in Marseille and declared him to be a “very great scientist”. Professor Raoult agrees. Many of his colleagues, though acknowledging his brilliance, believe that Raoult lost the plot some years ago.
They point to the fact that he has put his name to 3,062 research papers, including more than 30 since the beginning of this year — way beyond what most scientists claim in a lifetime. “How can anyone believe that a scientist can really take part in work leading to one publication a week?” asks the biologist and investigative writer, Nicolas Chevassus-au-Louis.
Nonetheless, Raoult has become in recent weeks a scientific super-hero for the young — the subject of memes and running anti-establishment jokes on French social media. He has also become an inspiration for the political Right on both sides of the Atlantic.
In France, the cautious official response to his ideas was used as a stick to beat the Emmanuel Macron and Edouard Philippe government for its allegedly “over-centralised” and “bureaucratic” response to the pandemic.
In America, the Marseille professor’s sweeping claims were taken up by Donald Trump and the alt-Right as proof that other approaches to Covid-19 — such as social and economic lockdowns and careful research — were the product of ‘Left-wing’ rather than ‘can-do’ thinking.
Raoult is also a favourite of conspiracy theorists. Official dismissals, or qualifications, of his claims are seized upon as proof that the pharmaceutical industry and its political lackeys are trying to bury a cheap, easy solution to the Covid-19 crisis. In other words, Big Pharma wants to make Big Bucks from Covid-19. Possibly they invented it.
Raoult’s claims — first posted by him not in a scientific journal but on YouTube in February — have not been dismissed out of hand by fellow scientists. Many other research programmes, 18 in France alone, are looking at the possible beneficial effects of hydroxychloroquine in treating Covid-19.
However, colleagues, and rivals, point out that the two sets of results published last month by Raoult and his Institut Hospitalo-universitaire Méditerranée Infection fall far below the usual standards of medical or scientific proof.
The first results, published on 20 March, covered only 30 patients and omitted one who died and three others who were admitted to intensive care. A second, published seven days later, covered 80 patients, of which 65 (or 81%), it was claimed, “got better and left hospital within five days”.
Critics pointed out that patients had been carefully selected and included some who exhibited few symptoms of Covid-19 or no symptoms at all. The eminent French geneticist Axel Kahn commented:
“Very interesting. Data from 600,000 cases shows that 85% are benign and 15% are severe, including 5% who need intensive care. Those are the same figures we find in the 80 people treated at IHU Marseille.”
In other words, the evidence of Raoult’s own study suggests that the effect of Hydroxychloroquine is…zero.
So who is Didier Raoult?
He was born in 1952 in Dakar in Senegal, still then a French colony. His father was an army doctor and his mother was a nurse.
As a teenager, he was a poor student who only just passed his baccalaureate after leaving school early to study at home. He took the ill-considered, literary ‘option L’ of the ‘bac’ rather than mathematical or scientific ‘option S’ — the shame of all shames for a French medical family.
The young Raoult spent several chaotic (or formative) years back-packing and working on merchant ships before his father dragooned him into medical school in Marseilles. He once told the city’s newspaper, Le Provençal: “All the doctors that I knew here wanted to be the best in Marseilles. I wanted to be champion of the world, based in Marseilles.”
Arguably, he succeeded. In 2003, in collaboration with the geneticist, Jean-Michel Claverie, he made a breakthrough in the study of giant viruses — viruses as large as bacteria — which contain many genes not found in other forms of life. His work in the 1980s on rickettsia (a category of bacteria), had already won him international recognition
Claverie recalled: “We worked together. We published many fine things together. Then we fell out in a big way. Now we’re rivals but I still have enormous respect for him as a scientist.”
Raoult, who insisted on remaining in Marseilles, became an outspoken critic of the Paris medical establishment, which he regards as plodding, uptight and bureaucratic. He has become a hero to a rebellious city which loves to boost the claims of its one literary success (Marcel Pagnol) and its many footballing geniuses (from Eric Cantona to Zinedine Zidane).
Didier Raoult is, in fact, a kind of medical-scientific Eric Cantona. His behaviour, and appearance, have become increasingly unconventional. Asked why he wears his hair long and a pointy beard, he replied: “Because it pisses them off.”
“Them” is, without a doubt, the Paris medical and scientific world.
His obsession with the glacial progress of traditional medical research — the use of control groups, placebos, peer reviews — may largely explain his decision to stake his reputation on hydroxychloroquine. Raoult argues that, faced with a deadly new disease, medicine and science have no right to cling to their cautious, academic behaviour patterns.
In an op-ed article for Le Monde last month, he referred to the ‘parachute paradigm’ — a jokey concept invented by two young British scientists in 2003 as a challenge to traditional medical research. (Briefly: to test the effectiveness of a new kind of parachute, researchers ask 100 people to jump out of an aeroplane. 50 of them wear parachutes; 50 wear empty backpacks.)
Raoult argues that promising off-the-shelf drugs should be extensively used in a medical crisis, like Ebola or Covid-19, not tested endlessly in parachute paradigm studies in which placebos are given to very sick people. “It is time,” he wrote in Le Monde, “for doctors to reclaim their place alongside philosophers and people with a humanist or religious cast of mind and get rid of all the mathematicians and weather-forecasters who have invaded our field.”
He hints in the same article that the traditional caution of researchers is influenced by the lobbying of Big Pharma. Other researchers react furiously to such claims. They point to the terrible history of thalidomide, the drug which caused foetal deformations in the 1950s and 1960s, and more recently to Mediator, a proprietary drug sold as a slimming cure in France, which has been blamed for hundreds of deaths. The first moral duty of doctors, they say, is “not to make things worse”.
Raoult administers hydroxychloroquine in combination with a pulmonary antibiotic called azithromycine. Anxious to try his miracle cure, queues of people have formed outside his institute. Local politicians have spoken about him in almost apocalyptic terms as a great scientist and a great Frenchman.
Renaud Muselier, centre-Right President of the Provence-Cote d’Azur Region, himself a doctor and former student of Raoult, said: “He’s a genius. He is inspired by the idea of the greatness of France — the liberty of expression, liberty of thought. His vision is very Gaullist.”
Others complain that Raoult, with his wild claims, has single-handledly destroyed confidence in the French government and French medical establishment and their handling of the Covid crisis.
“Raoul smashed national unity by taking up such a rebellious point of view,” one senior member of Macron’s La République En Marche (LREM) party said. “It was a great exploit. Single-handedly, he discredited everything that politicians and scientists were saying.”
That may be a little over the top. The French have less reason than the British or Americans to criticise their government’s performance but they do have some cause for complaint and they are congenitally quick to complain.
The person who is likely to emerge with the most discredit from the chloroquine craze is Didier Raoult. He risks being seen not as Dumbledore or as Gandalf, but as the Wizard of Oz.
Of the 18 independent French tests of the drug, none has yet found any significant effect on patients suffering from Covid-19. The US veterans’ hospital tests, the largest so far, published this week, found that there were slightly more deaths amongst patients who took the drug than those who did not.
Professor Raoult has yet to comment. He is perhaps looking for a parachute.