Within states and in the relations between them, as in individuals, the coronavirus searches out and exacerbates the underlying morbidities, exaggerating them until total system failure. When the international system collapses, it will be with Covid, and not of it.

The greatest morbidity the virus has latched onto in the global order is the rivalry between the United States and China. This contest is not new — International Relations scholars have long debated the ‘Thucydides Trap,’ named after the agonising and destructive struggle between Athens and Sparta chronicled by the Greek historian, wherein a rising power is inexorably drawn into conflict with the hegemon it displaces.

When Germany challenged British hegemony at the beginning of the last century, the first wave of globalisation ended in global conflict and then a pandemic; we must hope that this current pandemic, rapidly bringing about the end of the second wave of globalisation, will not similarly end in confrontation between the two great powers.

In this coming struggle, America is starting with a great and self-inflicted handicap. Obama’s attempts to reposition US foreign policy away from its destructive and self-defeating entanglement in the Islamic world and towards the coming confrontation with China failed, distracted by the bloody chaos brought about by the Arab Spring and by the Washington foreign policy “blob’s” unwillingness to wean itself off wars it cannot win.

Trump’s much-touted withdrawal from the Middle East has likewise seen the US bolster its forces in the region with tens of thousands more troops than his term began with, and allowed his Secretary of State Mike Pompeo to pursue a burning fixation with regime change in Iran that is unlikely to end in America’s favour.

America has frittered away 5 trillion dollars on its Middle Eastern adventures, indebting itself to China in the process, and burned its domestic and international political capital to an unimaginable degree —with nothing at all to show for it. Now that the architects of this self-inflicted catastrophe wish us to join them in their next global adventure, we must think carefully.

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What Boris Johnson could learn from Emmanuel Macron

By Aris Roussinos

Let’s remember how we got here. Only a couple of months ago, warning about dependence on China and the fragility of our supply chains, and urging decoupling from the aspiring hegemon, was viewed as the preserve of cranks of Right and Left, considered romantic at best and xenophobic at worst.

When Trump urged the same thing for the United States, China’s autocrat Xi was treated to a standing ovation at Davos, and hailed as the new champion of the global liberal order. But now Larry Summers, the high priest of globalisation and of America’s offshoring to China, is warning us against fragile supply chains and the urgency of decoupling with no reference at all his long and glittering career midwifing this catastrophe. Here is the global system, finally stripped of all illusions.

The result is the total discrediting of the US-led order, an order of which China’s rise is as much a direct product as it is a challenge.

The truth is that globalisation, the central political dream of Clinton and Blair, Obama and Cameron, was never real. It was a process by which advanced Western economies unilaterally surrendered their manufacturing capacity to a rival, growing power, China, which instead of reciprocating according to the Panglossian calculations of the neoliberal theorists, practiced a traditional and ruthless mercantilism in pursuit of its own interests. As the American political theorist Michael Lind recently wrote in Tablet:

“Politicians pushing globalization like Clinton may have told the public that the purpose of NAFTA and of China’s admission to the World Trade Organization (WTO) was to open the closed markets of Mexico and China to ‘American products made on American soil, everything from corn to chemicals to computers.’ But U.S. multinationals and their lobbyists 20 years ago knew that was not true. Their goal from the beginning was to transfer the production of many products from American soil to Mexican soil or Chinese soil, to take advantage of foreign low-wage, nonunion labor, and in some cases foreign government subsidies and other favors.”

The idea that a global liberal order could, like an iPhone, be designed in America and made in China was the product, where it was sincerely held, of pure ideological delusion. In its entire 5,000 year history, China has not spent one single day as a liberal democracy. The belief that a repressive autocratic regime would suddenly transform into a liberal democracy by being handed more wealth and power was patently absurd. Yet it is the people who held and promoted this claim for decades who intend to lead the world into a great power confrontation — against the China for whose rise they are directly responsible.

Globalisation was always the grand illusion of naive liberalism, taken advantage of by illiberal and non-liberal actors to pursue their own ends. It is the liberals, the TINA bluechecks, who are the artless rubes in this story. Indeed, it is they who deserve much of the blame now being directed at China. In Lind’s words:

“The United States has not been the naive victim of cunning Chinese masterminds. On the contrary, in the last generation many members of America’s elite have sought to get rich personally by selling or renting out America’s crown jewels—intellectual property, manufacturing capacity, high-end real estate, even university resources—to the elite of another country. When asked whether the rapid dismantling, in a few decades, of much of an industrial base built up painstakingly over two centuries has been bad for the United States, the typical reply by members of the U.S. establishment is an incoherent word salad of messianic liberal ideology and neoclassical economics. We are fighting global poverty by employing Chinese factory workers for a pittance! Don’t you understand Ricardo’s theory of comparative advantage?”

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Get ready for Fortress Europe

By Aris Roussinos

For a brief few decades, the shift in production to China made a handful of Western individuals unimaginably rich, while lowering the living standards of the middle and working class. It began to turn the First World into a Third World society of stratified, vastly uneven wealth even as it raised China into a First World superpower. For the benefit of a few billionaires, Western societies have immiserated their voter base, dramatically weakened themselves, and helped shorten the lives of hundreds of thousands of their own people.

These events didn’t just happen. Factories didn’t just uproot themselves and migrate to China like flocks of concrete geese. These were conscious, willed acts presented to us as faits accomplis — which we must now consciously and painfully undo, in full historical awareness of how this all took place.

It was in winning the first Cold War that the United States set the stage for its own eclipse, though our own entanglement in this mess is the product of the Second World War. In 1945, the United States found itself the victor through its possession of a vast industrial base, sheltered by geography from the destruction we European powers had wrought upon ourselves. The Soviet Union could not keep up with America’s industrial power, able to churn out both weapons and consumer goods with dizzying speed and sophistication.

Yet when the rival superpower collapsed, exhausted, the United States took the wrong lessons from the fall of communism. American policymakers convinced themselves their global dominance was due to the success of their liberal ideology rather than of their industrial might, and that the sudden, unexpected disintegration of the Soviet Union was due to the vindication of liberalism rather than of the awakened nationalism of Russia’s subject peoples.

Drunk on victory, and searching for a new project, American policymakers decided to remake the world in their own image. In 1993, the National Security Strategy of US National Security Adviser Anthony Lake and Secretary of State Warren Christopher melded the doctrine of imperial hegemony with the free market orthodoxies that had taken root in the Reagan era. As the realist International Relations scholar Patrick Porter notes:

“Christopher’s version assumed that the United States ‘must maintain its military strength’, ‘stem the proliferation of weapons of mass destruction’, and ‘knock down barriers to global trade’. Lake’s premise was that ‘America’s power, authority, and example provide unparalleled opportunities to lead,’ that its security rested on the rise of market democracy abroad.”

Our present moment, in all its dangers, results from this fusion of the two strands of liberalism at the very apogee of American power: the belief that the unfettered free movement of goods, capital, services and people would raise global living standards to endless new heights, and that it was America’s manifest destiny to oversee a worldwide liberal order of free trade and unchallenged US hegemony.

Distractedly giving away the industrial base that won them the first Cold War to their rival in the second, American administrations of both parties plunged headfirst into the post-historical future. It took less than a decade for reality to crash into the World Trade Center, but by then it was too late. America’s policymakers had been captured by their grand delusion, and they refused to let it go even as the empire found itself over-extended in war after war, entered into with noble liberal aims utterly divorced from reality, and from which it was unable to extricate itself.

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How apocalyptic is now?

By John Gray

Just one decade after 9/11, despite America’s mauling in Iraq, pious liberals saw in the Arab Spring a chance to spread their creed to oppressed masses crying out for liberal democracy, and watched with confused horror as the armed factions of the Middle East turned instead to the older and more powerful forces of religious fervour, ethnic conflict and sectarian hatred. Lost in a fantasy world of their own imagining, Americans could not begin to understand the world they dreamed of changing.

America’s rapid rise to global hegemony and equally rapid decline is a grand historical tragedy of the highest order, and as in classical tragedy, the root cause is the protagonist’s central character flaw. Born of 18^th-century liberal ideals, and centred on a sacred set of texts, a constitution and declaration of independence debated with rabbinical exactitude and religious fervour, for the United States, that flaw is its civic religion of liberalism.

While we at least, like our neighbours in Europe, have older traditions on which to draw, and with which we can temper liberalism’s zealous certainties, America was liberal from the start and will remain so until the end; with no countervailing influence, in America liberalism mutated into a fundamentalist religion. It is only through this zealot’s devotion to liberalism that American policymakers sincerely believed they could bomb Afghan shepherds and bribe the Chinese politburo into becoming fellow acolytes.

Their certainty in liberalism’s manifest destiny to spread itself over every corner of the earth goes beyond reasonable analysis: it is a purely religious faith. Despite the failure of its devotees to achieve success wherever they have tried it, they will not stop, and cannot. It is a compulsion, a religious duty impossible for them to abandon, shared by both factions.

America’s crusading zeal is not just for export: through some magical process, all manner of political thought is in the United States transmuted into religion. Trump’s opponents on the liberal and radical left have mangled French postmodernist theory into a dour and millenarian Calvinism. On the populist right, the QAnon conspiracy theory is rapidly evolving into a widespread religious cult, a Manichaen heresy with Trump as its central vengeful deity.

Now the two opposing sects of American liberalism, conventionally characterised as political parties, are at war with each other, in a so far relatively bloodless battle for the nation’s soul. What the Reformation did tragically for Christianity in Europe, America’s political culture war is repeating farcically with liberalism.

If we observe the American war on Covid, we see it is America’s Chernobyl moment as much as China’s. The United States is by far the world’s worst-affected country in terms of total numbers, and its outbreak is still far from over. The symbolism of American states forming regional blocs to counteract the incompetence and total incapacity of its central government to save lives or arrest the virus’s progress lends weight to The Atlantic’s charge that the US now resembles a failed state.

The image of the Surgeon General of the richest and most powerful empire that has ever existed instructing Americans in a Twitter video how to improvise a mask out of a T-shirt — a T-shirt prominently advertising an opioid overdose antidote — is a potent symbol of deep and existential rot.

It is a country embroiled in political conflict over even the basic facts of science, from biology to medicine: because the American President promoted one potential Covid cure, half the country became devoted to its efficacy, and the other to its harmfulness. Had Trump condemned hydroxychloroquine, no doubt the same war would have taken place in reverse, with liberal commentators ostentatiously guzzling the drug on video to widespread approval.

Trump is a morbid symptom of this chaos, rather than its cause. The forthcoming election, which pits two gerontocrats of dubious mental acuity against each other, resembles the late Soviet era, before the regime collapsed under its own absurdities. America indeed represents a strange inversion of the Soviet collapse: the economy dwarfs that of any other nation, save China; its empire is still intact, and its military spans the globe more powerfully than any single challenger.

Yet at its centre the US echoes post-Soviet Russia in its epidemics of death by drug overdose, in its collapsing middle class, its worsening health outcomes and declining life expectancies, the capture of the state and economy by rapacious oligarchs, and in the occasional bouts of interethnic violence leading to demonstrations, riots and broader political dysfunction.

As the veteran American diplomat Richard Haass sadly observes: “Long before COVID-19 ravaged the earth, there had already been a precipitous decline in the appeal of the American model. Thanks to persistent political gridlock, gun violence, the mismanagement that led to the 2008 global financial crisis, the opioid epidemic, and more, what America represented grew increasingly unattractive to many. The federal government’s slow, incoherent, and all too often ineffective response to the pandemic will reinforce the already widespread view that the United States has lost its way.”

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What, then, is the appeal of this model to wavering allies in a new Cold War? The idea it can be considered a viable model of governance to follow is now patently absurd. As I sit typing this, troops are deployed on the streets of cities across the country, their Humvees still painted desert tan, as looters smash and burn and ransack shops, and protestors march against rubber bullets and tear gas; the tools of imperial policing are now brought to bear on the metropole.

It is surely impossible to view the US at this point as anything other than a cautionary tale, a burning city on a hill, which evokes only the desire for our own society to avoid its fate. In his Tablet essay, Lind glumly muses about a near-future United States withering into a “deindustrialized, English-speaking version of a Latin American republic, specializing in commodities, real estate, tourism, and perhaps transnational tax evasion, with decayed factories scattered across the continent and a nepotistic rentier oligarchy clustered in a few big coastal cities”.

While an America in decline may throw up a more competent caudillo than Trump in time, it is difficult to reasonably conclude that it possesses the societal solidarity to wage a decades-long, global struggle against a near-competitor. It is hard to imagine an American governing class scandalised at calling Covid a Chinese virus waging an existential conflict against China to a successful conclusion.

The country’s politics were torn apart, for four years, by a handful of Russian Facebook posts promoting Trump; how then will it cope with China’s far greater penetration of social media, of American commerce and industry, of universities and politics, of all the institutions of 21^st century American life? We do not know, yet, who will win this year’s election, nor whether the losing party, will, as in the previous election, attempt to overturn the result and further delegitimise the entire political process.

Perhaps the era of losing parties accepting election results has gone for good in America, now both sides view their opponents as a Schmittian enemy to be vanquished for eternity. America is too lost in its own internal conflict to contemplate a grander, global struggle with any confidence.

In any case, America’s foreign policy is disastrous in its own terms, even before Covid started coursing through its system. As the International Relations scholar Philip Cunliffe observes, America is that curious paradox, a revisionist hegemon, restlessly driven by ideology to overturn the very global order it charges itself with maintaining, producing what he terms a “cosmopolitan dystopia” that undermines America’s own position.

American attempts to overturn regimes which offend its liberal values have produced overwhelmingly negative results for the global system, spreading chaos and enhancing the reach and power of its geopolitical rivals. America’s record in these endless wars has not been one of success. Defeated, outflanked by Iran in Iraq, and clutching defeat from the jaws of victory in eastern Syria, America’s hegemonic military power and tactical skill has been relentlessly undermined by the total detachment from reality displayed by the Washington blob which determines the goals and course of the nation’s wars.

In a manner we can safely assume is not replicated in China, the architects of America’s endless policy failures, like the Iraq War, are not punished by the system, but awarded further sinecures and promotions by an establishment which rewards failure and hobbles success. Defeat is baked in from the outset: the rot is now so widespread it will likely become terminal.

American decline is starkly measurable in outcomes, even as its ballooning defence budgets sap the country’s economy. The United States can no longer keep its client states from each other’s throats, causing wars to break out even within the US alliance system: Qatar and Turkey’s attempts to establish Muslim Brotherhood governance projects across the Middle East and North Africa are directly challenged by the UAE, Egypt and Saudi Arabia’s support for notionally secular strongmen, in a proxy conflict dragging in France and Russia and threatening Europe’s security.

Even a recent coup attempt in a bankrupt and unstable South American country failed despite Pompeo’s loudly-voiced support, which should have been America playing in easy mode. As in any horror movie, the threat’s coming from inside the building: all America’s rivals need do, like Russia in Syria, is exploit the contradictions and weaknesses of US policy, and turn the superpower’s weight and power against it at minimal cost and risk to themselves.

Unlike Iraq, or the Taliban emirate, however, there is fortunately little prospect of the United States engaging in open conflict with China. As Pentagon planners warn, it is unlikely that America will win even a limited naval engagement in China’s Pacific sphere of influence, let alone attempt a ground war against a billion-strong nuclear power.

Instead, we can expect a hybrid war that stops short of open confrontation, involving information warfare on social media, the hacking and sabotage of key infrastructure, the economic blackmail and extortion of allies through sanctions and tariffs and a dangerous jockeying for position as Covid accelerates the collapse of weak states across the ME and Africa, already teetering on the edge of failure.

The internet will surely emerge as a central battleground, and one which poses a far greater risk to America’s open, divided, and already-penetrated system than to China’s hermetically-sealed national internet: indeed, it is doubtful the worldwide web as we currently understand it will long survive a great power confrontation.

As hacked power grids and water treatment plants fail, and passenger planes mysteriously fall out of the sky, and top secret documents are released on social media, the rest of the world will find itself in the uncomfortable position of deciding which side presents the safest bet: and Covid has begun this process sooner than anyone expected.

Born in 1945, the American Empire was the global boomer, sitting astride the earth like it was a ride-on lawnmower, frittering away his children’s inheritance on cheap Chinese gewgaws and blaming everyone else for his poor decisions and for the decline of his powers. It is natural then, that it will be laid low by what is cruelly termed the Boomer plague, and we will do well to escape the hardship and bloodshed that attends the collapse of empires with as little harm to ourselves as possible.

Those two drugs and their potential for treating the Covid-19 have been in the news a lot recently. Hydroxychloroquine in particular has received a lot of attention, because one Donald J Trump has apparently been taking it. The US president had tweeted in March about a different study, headed by the French scientist and Asterix character lookalike Didier Raoult, stating (capitalisation his):

“HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine … Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents) be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST, and GOD BLESS EVERYONE!”

That study, by the way, contained the same basic statistical error as the remdesivir one. That error, for those interested: they divided people into two groups, one who’d taken the drug and one control group. Then they looked at whether people’s conditions improved after a certain time. 

But for some reason, both studies took people who’d died out of their results: one in the hydroxychloroquine study (and three people who ended up in the ICU); seven in the remdesivir one. “Dying” is pretty obviously “not improving” — but because those deaths were removed (and because the deaths fell disproportionately among the treatment group rather than the control), it made the drugs’ results look better than they were.

That wasn’t the only problem with the two. They were also tiny (remdesivir study, 61 subjects; hydroxychloroquine study, 42 subjects, 16 of whom were controls) and, in the case of the latter, not randomised — the control group was some people in another hospital, and some patients who’d refused to be given the drug. This is all on top of an earlier remdesivir study that seems to have changed what it was looking for half-way through, a tried and tested way of making unsuccessful drug trials look successful.

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Is it safe to reopen schools?

By Tom Chivers

We’re living in a strange and frightening time, and we’re relying heavily on medical science to save us from it. Vaccine trials, drug trials; antibody testing to discover how many people have had it and therefore how deadly it is; studies on whether children are likely to get or pass on the disease, to see if it’s safe to reopen schools. We desperately need good science done quickly.

And science has changed, as a result. Studies are coming out faster. “Preprint” papers, studies which have been carried out and posted by the authors to an open-access server like ArXiv, PsyArXiv or MedRxiv, have been around for years, and had been becoming more popular even before Covid-19. They’re a good idea, in many ways: they allow other scientists to examine studies and check them for problems ahead of official publication, in a way that the standard peer-review system doesn’t.

But they are, as that implies, not peer-reviewed. Peer review is certainly far from perfect — the remdesivir study I mentioned in the first paragraph was peer-reviewed and still the statistical error got through; and there are major systemic problems with it which are too complex to go into here. But it does act as a basic sense check. Preprints are a useful system, but they can’t replace peer-review entirely.

I’m used to seeing press releases and expert comments appear in my inbox about new scientific papers. Usually, the bulk of them are embargoed: big red letters at the top of the email saying “please do not publish before 08:00 BST 24 May” or whatever. Now, the large majority of them are preprints, available immediately. Everything is happening faster.

That is fine, and as it should be — and as a science writer, it’s hard to resist. I love a preprint as much as the next deadline-pressed journalist with no institutional journal access. (See?) But, in the end, as XKCD reminds us, an un-peer-reviewed study could also be described as “a PDF”. Some contain a vital contribution to scientific knowledge; some are worse-than-useless garbage. (That is also true of peer-reviewed studies, I should admit; but slightly less so.) It requires some skill to tell which is which, or who to trust.

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We should be very wary of the R value

By Tom Chivers

Since peer-reviewed papers are being rushed through, too, it means that there is a lot more noise in the system than there usually is; a lot more garbage. That’s not anyone’s fault, it’s inherent in trying to do things quickly. (“Cheap, fast, good. Choose two.”)

And over the last few months, we’ve seen an awful lot of things catch people’s attention: the apparent link between a country’s Covid-19 outcomes and BCG vaccination; the use of plasma from recovered patients’ blood as a treatment; the idea that smoking offers protection (or very much doesn’t). Zinc, vitamin D. Many, perhaps most, of these will turn out to be nonsense.

You might — and some do — say: so what? People are dying in hospitals; who cares whether the remdesivir trials are imperfect, let’s throw it at people and see what happens. We’re in a burning building, we might as well use this bedsheet as a parachute and see what happens.

But we’re not in a burning building. Covid-19 is terrible and frightening, but it’s not a death sentence for most people; in London, it seems that 17% of people have had the disease, which works out as an infection fatality rate of about 0.5% — one person in every 200 dying. It could be higher in reality; it’s a complicated thing to measure. But that’s probably not too far off. Most people who get it will get better.

And drugs are not harmless. According to the FDA, remdesivir’s side effects include liver damage; hydroxychloroquine has  this list of possible unwanted outcomes. Some drugs actively worsen people’s chances of survival. If we start giving these drugs to people, there’s a strong possibility that we’ll end up killing a few of them.

More than that: there’s this thing that the psychologist and serial debunker of bad science Nick Brown, calls “scientific hysteresis”. Hysteresis is when something gets pushed out of shape by something and then doesn’t fully reform to its original position.

The idea of scientific hysteresis is that when a scientific idea — vaccines cause autism, say, or power-posing makes you confident — gains traction, it changes the shape of public opinion. Now, more people believe that thing than previously did.

If those ideas are debunked,  as both those examples essentially have been, there is no reason to believe them any more. The original reason has been removed. But often, public opinion does not reshape properly; still, there’s a lingering deformation. People still believe that vaccines cause autism or that standing with your legs apart will get you a pay rise; some of them might not believe it as strongly, but there’s a lingering “wasn’t there…” feeling. This phenomenon, under the name “canonisation of false facts”, appears to be real, and it’s a real problem in psychology and other disciplines where many purported facts are being overturned by the replication crisis.

This is the danger of we in the media, or the public, or any presidents who happen to be passing, leaping on studies into hydroxychloroquine or remdesivir or convalescent plasma and holding them up as saviours. Most of them probably won’t be, but there will still be thousands of people who think they are, and pressure on doctors and regulators to provide them.

I can’t see a way of getting science done quickly without lots of these sorts of mistakes being made; I suppose the only thing I can do is call for the media to be extra careful about reporting on interesting new treatments, and to really stress the uncertainties and possible mistakes. 

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Is the lockdown doing more harm than good?

By Tom Chivers

If you want a salutary lesson in all this, last week, a huge and much better study — 96,000 patients, almost 15,000 of whom received hydroxychloroquine or chloroquine — was published by the Lancet. It wasn’t a full randomised controlled trial, but it used the 81,000 subjects who received other treatments as a control.

(For the record, that means there were pre-existing differences between the intervention group and the control, making the results harder to be confident in, although the researchers did their best to account for those differences statistically.)

The study found that the subjects given the drug not only did no better than those who weren’t — if I’m reading the study right, they were several times more likely to suffer from cardiac arrhythmia — and, more importantly, about 30% more likely to die. 

Fast science is happening. It has to happen. But the rest of us (especially those of us who make science public and well-known) need to be extra careful to make it clear that fast science is not the same thing as good science, because sometimes people will die.

ADDENDUM: I said a few posts ago that I was going to try to make more falsifiable predictions, but I haven’t managed it since, so I’m going to get back on the horse.

• By 20 May 2021, at least one systematic review published in a top-50 impact factor journal looking at randomised controlled trials into remdesivir for Covid-19 will have found some benefit of mortality (55% confidence)
• By 20 May 2021, no systematic reviews of randomised controlled trials into hydroxychloroquine published in top-50 impact factor journals will have found any benefit of mortality (60% confidence)

I gather from a superforecaster friend that the time you put into forecasting is one of the strongest predictors for how well you do, so having bashed these out in two minutes, I expect them to be dreadful. Hence the low confidence.

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.

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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.

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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.

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Don't put too much faith in Covid-19 metrics

By Tom Chivers

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.”

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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”.

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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.

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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.