Do not listen to (some of) the French

As millions of other citizens and residents of the United States of America that have complied with the largely state-mandated “staying-at-home” guidelines, we have been glued to the television screens when the official daily news conference from the White House appears between 5 and 6 PM Eastern Standard Time. It usually involves the top administration officials and renowned public health and emergency officials that are dealing with the Coronavirus pandemic and the remedial measures.

One of the most mentioned and debated  issues is whether to use chloroquine, an anti-malarial drug, to treat the acute symptoms of the grave infection, which is based on some incidental reports from French physicians that treated patients with Coronavirus. Event though they do clarify that much more comprehensive clinical research studies, which are underway, are needed to give a seal of approval to this drug, the legend of its usefulness persists; it has been used “off-label” by some physicians with mixed results. However, it has produced serious cardiac arrhythmias in others.

In a recent correspondence to The Lancet, Dr. Joan Paul Moattti, a professor of the University of Aix-Marseille, questioned the responses of the French administration. He said : “Faced with criticisms, French authorities claim that their policy towards the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been evidence-based—they appointed an advisory board of 11 scientists to help manage the crisis. However, in situations where decision makers face radical uncertainty, sticking to conventional approaches might jeopardize the science-policy interface.”

First of all, he criticized the lack of massive testing of the first responders and possible cases in the beginning of the pandemic in March, unlike the authorities of South Korea that tackled the pandemic following the guidelines of the WHO:

  1. Massive tracing
  2. Contact tracing
  3. Social distancing

France did not implement a national lockdown until March 17, many days after the pandemic had been identified. Moreover, he claimed that the country was not prepared to carry out the critically needed massive testing as it only had 45 public health laboratories that could process the samples for a definitive diagnosis of cases. Rather than designing a rational plan to scale up the testing, the authorities argued that massive testing was not needed once the infection became generalized; they only changed course on March 28, after  a national uproar about their carelessness.

The widespread diffusion of the very preliminary—and inconclusive—results of treatment with Chloroquine fueled big speculation in the world media and an acrid controversy in the biomedical community; he claimed that there are alternative methods to evaluate the safety of some drugs without the need to wait months for the definitive opinion of the clinical researchers that conduct rials of the same. This dereliction of duty in a context of urgency: “has reduced the ability of authorities to mitigate the effects of irrational online rumors and regulate prescription practices of health professionals.”

The author has high hopes in a much smarter commission of 12 experts designated by the French authorities on March 28—they seemed to have done a radical public about-face that very day. It is chaired by Dr. Françoise Barré-Sinoussi, a renowned virologist and Nobel Laureate of Medicine in 2008.who, as a highly educated woman, might be endowed with a bigger dose of common sense in the public forum. He said: “the second commission seems an implicit recognition of the intrinsic difficulties of directly using science in political management of a health crisis.”

Stay distant. Stay safe. Stay beautiful.

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