By Jean-Dominique Michel
Such was the thunderous statement made on February 26 by the world’s top infectious disease specialist (according to the expertscape ranking), which was nevertheless greeted with scepticism and even sarcasm by the scientific community. Three weeks later, reality is proving him right. Revealing in passing that we would be almost completely wrong about the virus. Which is in fact excellent news!
So here we are, they say, in a “state of war”. New certainly for our generations who (except for the oldest) have known only times of peace. Europe is under a virtual curfew, with massive restrictions on individual freedoms and an economic and social breakdown that promises to be dramatic. The speeches of the heads of state are getting hotter and hotter: we are “under attack”, the enemy is “invisible”, “devious”, “fearsome”, but we will overcome it! This kind of vocabulary seems from another age. The reality is more prosaic: we are being contaminated on a large scale by a virus that is a pure product of the meeting between human stupidity (the cramming of wild animals of various species in cages in unhealthy markets…) and the inventiveness of living things. The beast thus crossed the inter-species barrier and spread from there among humans. This is not a war, we can never defeat or eradicate this creature. We can protect ourselves from its damage yes, then we’ll have to learn to live with it. Which requires a different kind of intelligence than just health martial slogans…
Introductory Precaution
I have said it over and over again: in these times of collective mobilization, we all have to scrupulously respect the measures that are being imposed. Even if we doubt them or find them inadequate, none of us can give ourselves the right to follow our own ideas. This compliance – which I have always advocated – is something I feel unconditionally about.
However, this civil obedience must above all not lead to a ban on thinking or speaking. These are highly traumatic times, with considerable damage to the population. Giving meaning to what we are living, getting information, daring to ask questions is not only an inalienable right but also a vital necessity!
I have read quite a few ironic comments about the sudden number of amateur virologists or epidemiologists speaking out on social networks, which I can understand. But I think, on the other hand, that the more citizens take an interest in what is happening to us, the more they will inform or even document themselves, the more it will help us to engage in a dialogue about what we are experiencing, which is essential both for our individual mental health and our collective resilience.
I have sometimes been told that I have a responsibility as a scientist, that the analyses I can do (no matter how relevant they are) can be misinterpreted or push people to do anything. So let me remind you: we all have to follow the instructions of the authorities without discussion. And let us strictly refrain from self-medication, especially with regard to the substances I will mention later. Used without strict medical supervision, they can indeed be dangerous. That being said, let’s go!
What I’m talking about…
I’m a health anthropologist and public health expert. For more than 30 years, my job has consisted in studying health care practices and sanitary devices. I am reaching an age where we (hopefully) know that we are not the navel of the world and (with a few exceptions) that we have not invented the butter-cutting wire. I have a few references in my field, such as being (despite the embarrassing immodesty of this statement) one of today’s best connoisseurs of the processes of salutogenesis and recovery as well as the determinants of health. As a result, I have been invited to teach in some fifteen university and university graduate programs in health (UNIGE and UNIL medical faculties, EPFL, IHEID, Universities of Montreal, Fribourg, Neuchâtel, etc.). I have practiced my profession outside of academic circles, preferring to act within health policies as well as in the field. I have created various innovative socio-sanitary devices, particularly in mental health, some of which are still used today.
I apologise for this little display. It is the price to pay for my (modest) competence in what I am now going to put forward.
Banal or not banal?
Since the beginning of the emergence of the coronavirus, I share my analysis that this is a banal epidemic. The term can be shocking when there are deaths, and even more so in the health crisis and the collective hallucinated drama we are experiencing. However, the data are there: the usual respiratory diseases that we experience every year make good year bad year 2’600’000 deaths throughout the world. With Covid-19, we are, in the fourth month, at 9’000 deaths, and with the country initially the most affected which managed to control the epidemic. We are very far from having a statistically significant effect with regard to the usual mortality and in particular seasonal excess mortality.
I have said it before and I will say it again: the same political or journalistic treatment applied to any episode of seasonal flu would terrify us just as much as the current epidemic. Just as the staging (with live counts of the victims) of any major health problem, whether it be cardiovascular disease, cancer or the effects of air pollution, would make us shudder with fright just as much, if not infinitely more!
We now know that Covid-19 is benign in the absence of pre-existing pathology. The most recent data from Italy confirm that 99% of the deceased suffered from one to three chronic pathologies (hypertension, diabetes, cardiovascular diseases, cancers, etc.) with an average age of the victims of 79.5 years (median 80.5) and very few losses below the age of 65.
The four biggest factors causing chronic diseases are :
– Junk food.
– Pollution.
– Stress.
– Physical inactivity.
Chronic diseases would be 80% preventable if we gave ourselves the means to protect the population instead of sacrificing their health to industrial interests. For decades, we have granted culpable facilities to highly toxic industries to the detriment of the common good and the health of the population (for a development of this observation, refer to the following article).
We must dare to say it: it is not the virus that kills (it is benign for healthy people), it is the chronic pathologies that have been allowed to develop for decades.
Stats and probas in madness
There is another problem: the rates of complications and mortality in particular, which we are told we have to deal with day after day, are meaningless. In the absence of systematic screening of the population, we have no reliable data to which to refer with the data we have (number of reported cases and deaths).
This is a classic in epidemiology: if you only screen for deaths, you will achieve a 100% mortality rate! If you test only the critical cases, you will have less but still much more than in reality. If you screen a lot, you will have many cases, whereas if you screen few, the number of cases will be low. The current cacophony just doesn’t give you any idea of how the virus is actually progressing and spreading.
The most credible estimates suggest that the number of people reported is much lower (by a factor of up to 1/47 according to the best estimates) than the number of people actually infected, about half of whom will not even realize they have contracted the virus. For a fearsome killer, it can be rather nice…
We therefore have no idea at this stage of the true extent of the spread of the virus. The good news is that the actual data (especially complication and mortality rates) can only be much lower than what is commonly believed. The actual mortality, as announced in a previous article, should in fact be at most 0.3% and probably even less. This is less than one tenth of the first figures put forward by the WHO.
The latest statistics from China put the number of people infected (and therefore most probably immunized) at 800,000 for 3,118 deaths. This is effectively a mortality rate of 3/1000.
End of the world or not?!
Similarly, the projections that are made to imagine the number of possible deaths are nothing less than delusional. They are based on an artificial and maximal “forcing” of all values and coefficients. They are made by people who work in offices, in front of computers and have no idea of either the realities on the ground or clinical infectiology, resulting in absurd fictions. We could give them the benefit of creativity and science fiction. Unfortunately, these projections, literally psychotic, do massive damage.
My experience in mental health makes me strictly avoid ready-made expressions such as “schizophrenia” or “psychosis”, which are almost always misused in a way that is derogatory to the people concerned. Medically, psychosis is characterized by cognitive, perceptual and emotional distortions that lead to a loss of contact with reality. Here, unfortunately, the term is fully indicated.
I appeal to my colleagues in the Faculty of Medicine and other academic institutes to stop producing and peddling false and anxiety-provoking models. These experts protect themselves by recognizing, as a precaution of language, the outrageous nature of their formalizations, as journalists scrupulously mention (to their credit), one nevertheless diligently constructs a feeling of the end of the world which not only has absolutely no reason to be, but is itself profoundly harmful!
We can certainly give credit to our leaders for envisaging the worst of the worst of the worst on the basis of these fantasies so as not to take the slightest risk of it happening. In the meantime, we are constructing a -collective- hallucination on the basis of figures that mean nothing. The reality, once again, is that this epidemic is far less problematic and dangerous than what is claimed. Viewing the first video referenced at the end of the article will give the reader the necessary elements to understand the validity of this assertion.
Yes, but all these deaths and clogged services?!
This is, alas, the real black spot: if it weren’t for these serious cases, the epidemic would be insignificant. It turns out that it leads to rare but dreadful complications. As Dr. Philippe Cottet, who is in the front line at the HUG, wrote to me: “It must be said that viral pneumonia is usually extremely rare in Switzerland. They have a rough clinical picture and sometimes fulminating evolution, the warning signs of which are difficult to identify compared to more benign cases. It is a real clinical challenge, not to mention the number of simultaneous cases…”.
It is the existence of these serious cases (absurdly estimated at 15% of cases, probably in reality 10 times less) that justifies not simply relying on group immunity. This is the process by which each person who contracts the virus and does not die from it becomes immune, the multiplication of the immune system leading to a collective effect of immune protection…
In the absence – until recently – of treatment to protect or cure those at risk, the choice to let immunity build by allowing the virus to circulate appeared to be too dangerous. The risk to vulnerable people is such that it would be ethically indefensible to move in this direction, given the seriousness of the possible consequences.
This is one of the difficulties of public health: both medicine and journalism work in this particular case. In medicine, that is why, for example, there is no “miracle cure”. Each person is likely to react differently to a treatment.
In journalism, the aim is to illustrate a topic with particular cases, thus showing images and words that are often shocking. In public health, we do not act at this singular “narrative” level. We collect data to see the exact contours of an issue. In Italy, for example, only 7 of the first 2,500 deaths were among people under the age of 50. These cases do exist, but fortunately they are marginal.
One possible cause for concern, however, is the assertion that there are a significant number of young people suffering from pneumonia and placed on respiratory assistance. Fortunately, they seem to survive, but it is the number of intensive care beds that is likely to be a problem if the overcrowding in the intensive care units continues.
It is in this complicated paradox between the great harmlessness of the virus to the vast majority of people and its extreme dangerousness in some cases that we are stuck. We then adopted measures that were absolutely contrary to good practice: we stopped screening people who might be ill and confined the population as a whole to stop the spread of the virus. These measures were actually medieval and problematic, since they only slowed down the epidemic at the risk of potentially even worse rebound phenomena. And that they lock up everyone while only a small minority is affected. All public health recommendations, on the other hand, are to detect as many cases as possible, and to confine only positive cases until they are no longer contagious.
General containment is a poor second-best way to deal with the epidemic, since there is a lack of everything that would allow us to fight it effectively…
Why did it come to this? Simply because we failed to put the right answers in place from the outset. The lack of tests and screening measures in particular is emblematic of this shipwreck: while Korea, Hong Kong and China made it their top priority, we were unbelievably passive in organising the provision of something technically simple.
The countries mentioned have used artificial intelligence in particular to identify the possible chains of transmission for each positive case (with smartphones, for example, we can make an inventory of the movements and therefore the contacts that the infected people had with other people in the 48 hours preceding the appearance of symptoms).
Finally, we have significantly reduced the capacity of our hospitals over the past decade and we are finding ourselves short of intensive care beds and resuscitation equipment. Statistics show that the countries most affected are those that have massively reduced the capacity of intensive care units.
None of this has been thought of, even though the risk of a pandemic is a major health risk. The truth is that we have been completely overwhelmed. It’s obviously easier to play on war metaphors than to acknowledge our tragic unpreparedness…
Game over?!
The world’s leading expert on communicable diseases is Didier Raoult. He’s French, looks like a Gaul out of Asterix or a ZZ top who would have put his guitar by the side of the road. He runs the Institut Hospitalier Universitaire (IHU) Méditerranée-Infection in Marseille, with more than 800 employees. This institution holds the most terrifying collection of “killer” bacteria and viruses and is one of the world’s leading centres of expertise in infectiology and microbiology. Professor Raoult is also ranked among the top ten French researchers by the journal Nature, both in terms of the number of his publications (over two thousand) and the number of citations by other researchers. Since the beginning of the millennium, he has followed the various viral epidemics that have struck people’s minds and has established close scientific contacts with his best Chinese colleagues. Among his achievements, he discovered treatments (notably with chloroquine…) which today appear in all the infectious diseases textbooks in the world.
On February 26th, he published a resounding video on an online channel (including the word “tube”) saying: “Coronavirus, game over! »
The reason for his enthusiasm? The publication of a Chinese clinical trial on the prescription of chloroquine, showing suppression of viral carriage in a few days on patients infected with CoV-2-CoRSA. Studies had already shown the efficacy of this molecule against the virus in the laboratory (in vitro). The Chinese study confirmed this efficacy on a group of affected patients (in vivo). Following this study, the prescription of chloroquine was incorporated into the treatment recommendations for the coronavirus in China and Korea, the two countries that have been most successful in controlling the epidemic…
Chloroquine is a molecule put on the market in 1949, widely used as an antimalarial drug. All travellers to tropical countries will remember the nivaquine tablets (one of its trade names) that were prescribed to them as a preventive measure against malaria. This remedy was later replaced by others for certain geographical areas, remaining in use for some destinations.
Hydroxychloroquine (trade name: Plaquenil) was prepared in 1955 and has a hydroxylation on one of the two ethyl groups in the side chain.
So what ?!
Why are you talking about this ? Well because Professor Raoult and his teams are the best specialists in the world today in the use of chloroquine. In particular, he had the brilliant idea of testing it against intracellular bacteria (which penetrate cells like viruses), in particular Ricksettia. The Marseille IHU therefore has unparalleled clinical and pharmacological experience in the use of this molecule.
Chloroquine has also demonstrated a powerful therapeutic efficacy against most coronaviruses, including the dreaded SARS of sinister memory. Raoult therefore found confirmation in the Chinese clinical trial that chloroquine was also indicated against Covid-19.
However, he was greeted like a hair on the soup, his colleagues denigrating his proposal from the outset. The journalists of Le Monde even went so far as to describe his communication as “fake news”, an accusation that was repeated on the site of the Ministry of Health for a few hours before it was withdrawn.
Prof. Raoult was however immediately authorized to conduct a clinical trial on 24 patients in his department and was called to be part of the multidisciplinary committee of 11 experts formed in March by the French executive in order to “inform public decision-making in the management of the health situation related to the coronavirus”.
The results of the clinical trial were eagerly awaited, first and foremost by yours truly. We know the caution required when faced with promising substances and the importance of not advancing anything before research confirms or not a hypothesis Science is neither divination nor magic, it is observation, testing and then, if necessary, validation.
The results of his clinical study came out yesterday, confirming that spectacular therapeutic effects have been obtained. The methodology is robust, since the Marseille IHU was able to compare the negativation of viral carriage in patients who followed the protocol with patients in Avignon and Nice who did not receive treatment.
“Those who did not receive Plaquenil [a hydroxychloroquine drug] were still 90% carriers after six days, while those who received treatment were 25% positive,” explains Professor Raoult.
But it doesn’t stop there: the IHU Méditerrannée- Infection has long been advising (like others) to give concomitant antibiotics for respiratory viral infections “because they are mainly complicated by pneumopathies. So all people who had clinical signs that could develop into a bacterial complication of pneumopathy were given Azithromycin. It has been shown to decrease the risk in people with viral infections. The other reason is that Azithromycin has been shown in the laboratory to be effective against a large number of viruses, although it is an antibiotic. So even if we chose an antibiotic, we preferred to take an antibiotic that was effective against viruses. And when you compare the percentage of positives with the combination of hydroxychloroquine and Azithromycin, you have an absolutely dramatic decrease in the number of positives. “He adds.
Viral carriage?
A study published in the Lancet on March 11 revealed a new but essential fact: the viral carriage time (the time between the beginning and the end of the infection – and thus the possible contagiousness) is higher than previously thought, with an average duration of 20 days. With the hydroxychloroquine / azithromycin association, this duration is reduced to 4-6 days.
The drastic reduction in viral carriage time not only gives hope of treating critical cases, but also reduces the time it takes for an infected person to become no longer contagious. And thus offers enormous prospects for preventing the spread of the virus. This news is of course the best news that could be expected. The authorities and scientists have therefore welcomed it with joy, you may think…
Well, nay! The reactions that were heard were initially disputed from stupidity to wickedness.
Admittedly, neither the Chinese studies nor the clinical trial in Marseilles has valued as evidence (“evidence”) according to the criteria of scientific research. A replication of the results by other teams is required, not to mention a randomized double-blind study, the top of the pop of research methodologies.
But what the hell! We are in an emergency situation. Chloroquine is one of the best known and best controlled drugs (in particular by the IHU in Marseille). We can therefore count on a very solid experience on the subject of its prescription. Taking refuge behind procedural fundamentalism is ethically indefensible when we are talking about a drug that we know by heart, which has already demonstrated its efficacy on other coronaviruses, confirmed on this one by two clinical trials, and when lives are at stake day after day!
Raoult noted with irony that it was not impossible that the discovery of a new therapeutic utility for a drug that has long fallen into the public domain would be disappointing for all those hoping for a Nobel Prize thanks to the breakthrough discovery of a new molecule or vaccine… not to mention the prospect of tens of billions of dollars in revenue to be made, where chloroquine costs literally nothing.
Celebrating caregivers!
For the past few days, the confined population has been speaking out every day to pay tribute to the caregivers and support them in the trying circumstances they are experiencing. This is a beautiful expression of solidarity, obviously deserved by professionals – remarkable for their abnegation and commitment – in the face of this heavy suffering and this new danger.
Unfortunately, in the circles of leading experts, things are generally less brilliant. Medical research and authority are also often made up of petty, manipulative, dishonest or abusive practices of all kinds, as well as pitiful but violent ego battles.
On BFM TV, Dr. Alain Durcadonnet immediately broke sugar on Raoult’s back by reminding us that a scientific conclusion was published in scientific journals and not by video… This while, in his communication, Prof. Raoult (the French researcher who, let’s not forget, has published the most in scientific journals in his field) had obviously just specified that the article describing his clinical trial had been sent for publication to a peer-reviewed journal. This anecdote shows the level, like the following.
On March 1, well after the publication of the first Chinese clinical trial, the Director General of Assistance Publique – Hôpitaux de Paris, Martin Hirsch, said to the Europe 1 microphone: “Chloroquine works very well in a test tube, but has never worked in a living being”, which was already perfectly false!
In the feedback from the national press, the emphasis is heavily placed on the risk of overdosing with chloroquine, which is indeed toxic above 2 g/day in the absence of somatic comorbidity. The Chinese preferred doses of 2x 500 mg/day during their trial. Raoult and his team, finding this dosage excessive, preferred to opt for 600mg/day. The objection is therefore of a dismaying vacuity – let us recall that no clinical team knows this molecule better than that of Méditerranée-Infection. That would be like saying to a team of neurologists about Dafalgan: ooh there, careful, it can be toxic if misused, so it’s really not a good idea to consider treating headaches with this drug!
It was invoked (yes, yes, read the press!) the risks associated with prolonged use, where the proposed treatment lasts an average of 6 days. Furthermore, IHU has experience of exceptional long-term prescriptions (up to two years!) for the treatment of certain intracellular bacteria. We know that it is good to be charitable with our fellow man, but sometimes stupidity combined with dishonesty makes it difficult…
Others insisted (and still insist) that no definitive conclusions can be drawn on the basis of clinical trials. This is quite right in the absolute but does not apply to the present case, given the perfect knowledge of this molecule! Absurd situation summarized by Raoult: “There is a health emergency and we know how to cure the disease with a drug that we know perfectly well. We have to know where the priorities lie. “Faced with the reality of the epidemic, he recommends that we stop panicking and detect the sick without waiting for their case to get worse in order to treat them better.
The problem goes further…
The loneliness of extreme competence?! Raoult explains how Emmanuel Macron came looking for him after his first public announcement on February 26th and the strange experience that has since been his in the circle of experts who advise the martial president. To the question asked by a journalist from Marianne: “Are you heard there? “he replied: “I say what I think, but it is not translated into action. We call this scientific advice, but it is political. I’m like an alien in it. »
This is his certainty, obviously uncomfortable for the authorities: with the measures currently being taken against the epidemic, we are walking on our heads. Our countries have given up (unlike the Chinese and Koreans) systematic screening in favour of a containment system that Professor Raoult stresses has never been an effective response to epidemics. It is an ancestral reflex of confinement (as in the times of cholera and the Hussar on the roof of Giono). Confining people who are not carriers of the virus to their homes is infectiologically absurd – the only effect of such a measure is to destroy the economy and social life. A bit like bombing a city to keep malaria-carrying mosquitoes away…
The only way that makes sense, he says, is to confine carriers of the virus only, and to treat them if necessary either to avoid terrible complications like the ones we see, or to reduce the time they are contagious.
In Switzerland as in France (and everywhere in the West), the decision taken is to confine people to their homes, sick or not. When they are sick, we wait for them to get better and then (because of the length of time they carry the virus), we let them out while they are still contagious! People at risk sometimes develop complications, especially acute respiratory distress that leads them to the emergency room. They then clog up the intensive care units and, for some patients, die there, whereas Raoult says they could have been treated before!
Confining the entire population without screening and without treatment is worthy of the treatment of epidemics of past centuries.
The only strategy that makes sense is to screen massively, then confine the positive cases and/or treat them, as well as high-risk cases, since it is possible, as we can see in China and Korea, which have integrated the combination of massive screening with the prescription of chloroquine in their treatment guidelines.
Neither Hong Kong nor Korea, two territories with the lowest mortality rates in relation to Covid-19, have imposed confinement on healthy people. They simply organized themselves differently.
The decadence of the West
It is unfortunately shouted and revealed here in all its crudeness… We have quality medicine, but medieval public health. Technological and scientific leadership has long since passed to the Far East, and our intellectual navel-gazing often makes us cling to the lanterns of the past rather than to the science of today.
Systematic testing would be easy to implement, provided that it is made a health priority and organized, which the Koreans have done in record time. In Europe, we have been completely overtaken, as if we were living in another time. The authorities now understand that this is an absolute priority – in line with the WHO’s insistent recommendations.
There is no difficulty in producing the tests: “It’s ordinary PCR [polymerase chain reaction] that anyone can do, it’s the organisation, not the technique, it’s not the diagnostic capability, we have it,” says Raoult. It’s a strategic choice that is not the one made by most technological countries, especially the Koreans, who, along with the Chinese, are among those who have mastered the epidemic by screening and treatment. In this country, like anywhere else, we are capable of doing thousands of tests and testing everyone. »
Of course, more disciplined or even authoritarian political regimes have a social compliance advantage, but that is not the point. The issue is us. France is sinking into endless polemics before anyone has even opened their mouth, while its Jupiterian president flies off into ancient perorasions about the “state of war” while contemplating himself in a mirror… In our country, the Federal Council reacted without agitation or malice, but giving the impression, as always, that he was being woken up unpleasantly from his nap.
In short, for our country, which prides itself on its innovation and biotech quality, it is still a bit of a village party…
Change is now?!
Luckily, we can expect the wind to change quickly and well. The French Ministry of Health has just commissioned the CHU of Lille for a trial to replicate the results obtained in Marseille. Let’s remember that convincing trials have already been conducted in China and Korea – but in France it is generally held that what comes from abroad is unworthy of French genius. Some hospital departments and their chief doctors are capable of considering that they have made a mistake, as is the case of Professor Alexandre Bleibtreu of the Hôpital de la Pitié-Salpêtrière, who recently tweeted with humour:
Interest in chloroquine is now worldwide with teams working all over the world. If the drug’s now highly probable effectiveness is confirmed, it will be a major game-changer.
Once people at risk of complications are diligently treated, the countless mild infections due to CoV-2-CoRSA, which many of us will experience, will provide the mass immunity that will make this “pandemic” a dirty misadventure.
Mass screening is now finally a health priority. By the time we organise laboratory analysis capacity, we will all gradually be entitled to it. The Sanofi laboratory has also just offered the French government to produce one million doses of chloroquine free of charge.
What if the molecule does not keep its promises? This is of course a possible hypothesis, even if it is unlikely at this stage. Other drugs are currently under review, including known antivirals (such as Favipiravir) also being tested in China with encouraging initial clinical results. According to news reports this morning:
“China has completed clinical research on Favipiravir, an antiviral drug with good clinical efficacy against the new coronavirus (COVID-19).
Favipiravir, an anti-influenza drug approved for clinical use in Japan in 2014, did not cause any obvious adverse reactions in the clinical trial, Zhang Xinmin, director of China’s National Biotechnology Development Center under the Ministry of Science and Technology, told a press conference.
Favipiravir has been recommended to the medical treatment teams and should be included as soon as possible in the diagnostic and treatment plan for VIDOC-19, he said.”
What is striking about chloroquine is the religiousness of the debate that this option provokes – a classic, however, in science. Raoult is described as a kind of guru (despite his remarkable record of scientific service) and the “belief” in the drug is described as the expectation of a “miracle cure” that would mislead people with “impossible hopes”.
Fortunately, there is still a process called science that aims to move from opinions (everyone sees the world in their own way) to knowledge (what has been tested, verified and validated independently of personal opinions).
If the results obtained in Marseilles and China are contradicted, then the collective hallucination in which we are engulfed will continue, with very serious consequences for our society, our way of life, our psychological and social health. If, on the other hand, they are confirmed, we will have taken a giant step to get out of this heavy swelling, and then it will be well and truly “Game over! for the Covid”. We’ll have learnt a lot in the process.
Tribute to the authorities
It is not my custom to be complacent with the authorities. I have too often seen the ravages of flattery and vexation (such as gratuitous criticism or trial by intent) to fall into the trap. Here, one hears many criticisms that seem unfair to me. Yes, our health care system is not really a health care system, we have a disease industry – which is not the same thing. Yes, our health responses are incredibly dusty and even outdated. Yes, the Federal Council has lead shoes – and sometimes that has its advantages too.
But I would like to express my feeling that the response of the federal and cantonal authorities has been proportionate to what we knew and did not know. It is easy to say that the borders should have been closed a month ago in a world where the threat was still not very visible and where we would have been the only ones to do so.
Closing everything inevitably leads to economic and social disaster. In the absence of the means to apply the best strategy (screening – containment – treatment), resorting to a “lock-down” is an archaic and ineffective measure, but the only one that could be taken.
In Geneva in particular, the Council of State (with Mr Mauro Poggia and Mr Antonio Hodgers in the front line) was solid, humane, reassuring and clear, acting calmly and with an undeniable sense of proportionality.
Once the emergency is over, however, health and political leaders will have to be held to account for the way in which they proved to be totally caught unawares by a perfectly identified health risk, with a situation in this case very little worse than what a real killer pandemic would be.
It should be remembered that the risk of a pandemic has been feared for more than 30 years, both from the Far East and now from the sub-Arctic tundra, at the risk of releasing countless varieties of viruses that were previously frozen under the permafrost .
As if in an earthquake-prone region there were no earthquake-proof building standards or procedures for protecting the population! This while cohorts of high-ranking civil servants and academics were generously paid to anticipate these risks?
The inability to respond quickly and well (as other nations do) will also have to be met with a compelling demand for industrial and scientific capacity to do what should have been done. As one reader tells me, France is nevertheless the world leader in the production of respiratory assistance machines and its pharmaceutical capacity is powerful.
Finally, one last piece of information, which I hope will encourage us all to be cautious: the latest infectiological data would tend to confirm that children are only very rarely carriers and/or contaminants of SARS-CoV-2. If this hypothesis is confirmed, school closures would in fact not be a necessary measure. The data I am relaying here came in this week. At the time the closure was decided, they were not known-as I mentioned in my previous blog, so it was a precautionary measure, and that indication could be refuted if the data in question is confirmed.
So let us be patient and diligent. Once this collective hallucination has passed, it will then be time to do a rigorous “post-mortem” of health decisions and to try to understand what happened so that we can generate this incredible societal mess…
Jean-Dominique Michel.
