We have been told that our coronavirus lockdowns will not end until a vaccine has been successfully developed.

Meanwhile, in France, Professor Didier Raoult has been successfully using chloroquine, where suitable, on his COVID-19 patients at the IHU Méditerranée Infection facility, where he is the Director.

Professor Raoult is also a physician. A number of his fellow doctors oppose his use of an anti-malarial drug, which is cheap as chips, to treat this novel (new) coronavirus, said to have no known remedy, much less cure, at this time.

Raoult describes himself as a ‘renegade’ physician. Other doctors in France certainly agree. They doubt his claims. Now they want to suspend him from France’s national medical association, l’Ordre des Médecins (The Order of Physicians).

On Saturday, April 25, Geopolintel (French language, translated below) reported that the ANSM (French National Agency for Medicines and Health Products Safety), INSERM (French National Institute of Health and Medical Research) and the biopharmaceutical drug company Gilead are out to get Raoult.

The article is an open letter to Raoult’s critics:

The Covid-19 crisis shows the destructive ideology of your policies as well as that of the health institutions of our country.

Given the sums of money involved, it takes any and all costs to transfer the professor from Marseille for the generalized vaccination agreement between Macron and Bill Gates to be realized.

Censors, you have lost public opinion and you cannot regain it by threatening Professor Raoult with suspension by the Order of Physicians.

He makes fun of your stories of cash and corruption, unlike you, he treats and does not bear responsibility for death by organized shortage.

What displeases you in him is his indifference to lobbies and sirens of glory and as a professor, researcher and doctor; he cares while you polish your the seats of your trousers on the leather armchairs of the circles of initiates who have done nothing in their lives other than lying and earning dirty money.

There have been major pharmaceutical scandals in France in recent years, yet the establishment is going after Raoult, who has provided patient relief in an inexpensive prescription anti-malarial drug available at pharmacies. The medical establishment has accused the professor of employing ‘illegal medical research protocols’:

Regarding the “illegal clinical research protocols” which are attributed to Didier Raoult, what about the scandals of the Pick (Médiator), Depakin and other drugs approved in the so-called respect for randomized trial protocols?

As for his possible suspension by the Order of Physicians:

The Council of the Order of Physicians threatens Professor Raoult with immediate suspension of activity, because his clinical trials “do not comply with official procedures”, and he risks up to a year in prison and 15,000 euros in fines.

Yet, President Macron visited Raoult in Marseille recently to find out more about the doctor’s success with his COVID-19 patients. About this, the article says:

As a reminder, Professor Raoult presented Emmanuel Macron with the results of his work on 1,061 patients.

Almost 92% of patients cured in ten days,
Nearly 5% of patients cured “late”
Less than 5% of “patients with complications”.
Or 31 patients hospitalized for more than ten days,
10 transferred to intensive care,
and 5 deaths. On 1061: do your accounts and compare to the rest of France…

The abstract and summary table of the data in our article on the treatment of 1061 patients are online!
The abstract and the summary table of our paper on the treatment of 1061 patients are online! https: //t.co/mTWj6aGpTk https: //t.co … pic.twitter.com/PLdygNolxG
– Didier Raoult (@raoult_didier) April 10, 2020

These are the full results of Raoult’s study:

The article concludes:

The first reaction of the simple man that I am, in the delusional French context that I observe from afar, is this: Raoult heals while the profession flounders. It has no response, no treatment, adding the humiliation of the mandarins to the resentment of the rascals. In short, Raoult must be suspended. It is urgent: he risks treating even more people.

Now, it must be said that chloroquine doesn’t work on everyone. Nor does a similar drug, hydroxychloroquine, often combined with azithromycin (which contains zinc), in COVID-19 treatment. The latter is the treatment that President Trump has been championing for weeks.

Both should be used with caution and under medical supervision. They can harm patients with certain types of heart ailments. Never self-medicate!

As is true in France, the American medical establishment is eager to pour cold water on Trump’s claims.

On April 16, 2020, MedRxiv published an abstract of one such study: ‘Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19’, which ends as follows:

CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.

Yet, nearly half of America’s 50 states are stockpiling the drug, as Axios reported on April 25 (emphases in the original):

At least 22 states and Washington, D.C., are building up stores of the anti-malarial drug President Trump previously touted as a possible solution for the novel coronavirus, AP reports.

Why it matters: The Food and Drug Administration advised doctors Friday against prescribing hydroxychloroquine or the related drug chloroquine to coronavirus patients as it appears to be causing some serious and potentially life-threatening side effects.

    • ‘The warning comes as doctors at a New York hospital published a report that heart rhythm abnormalities developed in most of 84 coronavirus patients treated with hydroxychloroquine and the antibiotic azithromycin, a combo Trump has promoted,” AP notes.

What they’re saying: “While clinical trials are ongoing to determine the safety and effectiveness of these drugs for COVID-19, there are known side effects of these medications that should be considered,” FDA Commissioner Stephen Hahn said.

The state of play: Some health experts worry the public could misuse the drug if it is made more widely available.

The FDA has authorised use of hydroxychloroquine under the following conditions, summarised on page 4 of their guidelines:

The hydroxychloroquine sulfate may only be used to treat adult and adolescent patients who weigh 50 kg or more hospitalized with COVID-19 for whom a clinical trial is not available, or participation is not feasible.9

South Dakota is the first state to participate in a trial of the drug:

https://twitter.com/niro60487270/status/1255271493560303616

Kudos to their governor, Kristi Noem, who ignored calls for lockdown. South Dakotans rewarded her with a parade:

https://twitter.com/niro60487270/status/1255270014518779905

https://twitter.com/notjumpingship/status/1255305573945487360

But I digress.

Health Feedback is a site that debunks current coronavirus remedies or possible cures. Another is Poynter. Both must be busy.

There has been much talk of using ventilators on ICU patients with COVID-19. However, in some cases, ventilators do not always work and, in some instances, have worsened patients’ outcomes.

On March 20, Cleveland Clinic published an explanation of the damage that COVID-19 can do to the lungs, leading to the need for intensive care and, likely, a ventilator. Excerpts follow (emphases mine):

Although many people with COVID-19 have no symptoms or only mild symptoms, a subset of patients develop severe respiratory illness and may need to be admitted for intensive care.

In a new video, lung pathologist Sanjay Mukhopadhyay, MD, lays out in detail how the lungs are affected in these severe cases. The 15-minute video walks through how COVID-19 causes a “dangerous and potentially fatal” condition known as acute respiratory distress syndrome (ARDS) while providing stark images that underscore the severity of the damage that condition can cause to your lungs.

As Dr. Mukhopadhyay explains, Chinese researchers have linked COVID-19 to ARDS. Their study examined risk factors for 191 confirmed coronavirus patients who died while being treated in two hospitals in Wuhan, China.

The researchers found 50 of the 54 patients who died had developed ARDS while only nine of the 137 survivors had ARDS …

If you have ARDS, you’ll have symptoms like sudden breathlessness, rapid breathing, dizziness, rapid heart rate and excessive sweating.

But the four main things doctors will look for are:

    • If you have an acute condition, symptoms that started within one week of what they call a “known clinical insult,” or new or worsening symptoms.
    • If your shortness of breath isn’t explained by heart failure or fluid overload.
    • Having low oxygen levels in your blood (severe hypoxia).
    • Both lungs appearing white and opaque (versus black) on chest X-rays (called bilateral lung opacities on chest imaging) …

There might have been other articles like this circulating recently, ones that mention hypoxia.

Hypoxia has been mentioned often in online discourse and in some online articles, such as one from April 5, posted on Medium, ‘Covid-19 had us all fooled, but now we might have finally found its secret’, written by a non-medic whose Medium account has since been deleted.

That article has appeared all over various fora over the past few weeks.

It does sound really plausible, even though Poynter and Health Feedback have both debunked it, which I’ll get to below.

Not being a medic or have anyone in the family who is, I’m just going to throw these excerpts out there.

As such, I wonder if this is accurate, i.e. something that front line physicians will mention a year from now. Anyone with a medical background reading this should feel free to leave a comment below.

The author explains why ventilators don’t always work on COVID-19 patients. This is what caught my eye:

There is no ‘pneumonia’ nor ARDS. At least not the ARDS with established treatment protocols and procedures we’re familiar with. Ventilators are not only the wrong solution, but high pressure intubation can actually wind up causing more damage than without, not to mention complications from tracheal scarring and ulcers given the duration of intubation often required… They may still have a use in the immediate future for patients too far to bring back with this newfound knowledge, but moving forward a new treatment protocol needs to be established so we stop treating patients for the wrong disease.

Then the author quotes someone in the medical profession who published a paper that seems to have gone nowhere (see below). Unfortunately, there is no reference to what or whom he quotes, which is this:

The past 48 hours or so have seen a huge revelation: COVID-19 causes prolonged and progressive hypoxia (starving your body of oxygen) by binding to the heme groups in hemoglobin in your red blood cells. People are simply desaturating (losing o2 in their blood), and that’s what eventually leads to organ failures that kill them, not any form of ARDS or pneumonia. All the damage to the lungs you see in CT scans are from the release of oxidative iron from the hemes, this overwhelms the natural defenses against pulmonary oxidative stress and causes that nice, always-bilateral ground glass opacity in the lungs. Patients returning for re-hospitalization days or weeks after recovery suffering from apparent delayed post-hypoxic leukoencephalopathy strengthen the notion COVID-19 patients are suffering from hypoxia despite no signs of respiratory ‘tire out’ or fatigue.

I only found the Medium article last week, but I have many COVID-19 links bookmarked, including this one from April 10:

The article is behind a paywall, but you can read it here in its entirety. The doctors the Telegraph interviewed seem to be saying the same as the Medium author does: no ARDS, no pneumonia, therefore, no ventilator, which can do more harm than good:

British and American intensive care doctors at the front line of the coronavirus crisis are starting to question the aggressive use of ventilators for the treatment of patients.

In many cases they say the machines, which are highly invasive and require the patient to be rendered unconscious, are being used too early and may cause more harm than good. Instead they are finding that less invasive forms of oxygen treatment through face masks or nasal cannulas work better for patients, even those with very low blood oxygen readings.

Dr Ron Daniels, a consultant in critical care at University Hospitals Birmingham NHS Foundation Trust, on Thursday confirmed reports from US medics that he and other NHS doctors were revising their view of when ventilators should be used.

At the heart of the issue was the “bizarre” and “frankly baffling” phenomenon of Covid-19 patients presenting with catastrophically low blood oxygen levels but few other ill effects.

The Telegraph says that this new protocol goes against prior received wisdom on the unknown COVID-19. Prime Minister Boris Johnson had been in intensive care that week, released back to a general ward on the evening of Maundy Thursday, April 9:

The initial recommendations from doctors in China and Italy were to ventilate Covid patients early and aggressively, with the so-called “PEEP” pressure on the machines turned up high so their lungs did not contract when they exhaled.

“The initial message was treat as if you were treating for acute respiratory distress syndrome (ARDS) with a high PEEP,” said Daniels. “But now we are becoming braver. We are tolerating much lower blood oxygen levels and using lower pressures. We are learning as we go along”.

The alternative to mechanical ventilation is oxygen treatment delivered via a mask or a nasal cannula or via a non-invasive high flow device. This is the sort of treatment the Prime Minister Boris Johnson is said to be receiving in an intensive care unit at St Thomas’s hospital London. His blood oxygen levels are not known.

Increasingly doctors in the UK, America and Europe are using these less invasive measures and holding back on the use of mechanical ventilation for as long as possible …

Doctors in Italy and Germany wrote to the American Journal of Respiratory and Critical Care Medicine last week making a similar point. They urged other doctors to be “patient” with Covid patients, arguing for “gentle ventilation” wherever possible …

It is not known why Covid-19 allows some patients to tolerate such low blood oxygen readings without air hunger or obvious confusion. One clue may be that patients are still able to exhale carbon dioxide – a toxin – through their lungs even if they are having difficulty absorbing oxygen.

“The patients in front of me are unlike any I’ve ever seen,” one American doctor working in a Brooklyn hospital told the specialist health publication STAT this week. “They looked a lot more like they had altitude sickness than pneumonia.”

Dr Daniels agreed that there were similarities with altitude sickness, itself a potentially fatal condition. “We’ve seen a lot of headache and dizziness”, he noted …

You might have heard of Drs Dan Erickson and Artin Massihi, whose two-part press briefing in California was removed last week from YouTube. The two went against the received wisdom of the WHO. I watched both videos when they came out at the beginning of April. In the second video, they warned against the aggressive use of ventilators when treating COVID-19.

Therefore, the Medium article might not be either wrong or fake news with regard to ventilators.

It has an explanation of what might be happening whereby blood gets starved of oxygen through COVID-19, and it is this which has proven to be controversial with physicians:

Your red blood cells carry oxygen from your lungs to all your organs and the rest of your body. Red blood cells can do this thanks to hemoglobin, which is a protein consisting of four “hemes”. Hemes have a special kind of iron ion, which is normally quite toxic in its free form, locked away in its center with a porphyrin acting as it’s ‘container’. In this way, the iron ion can be ‘caged’ and carried around safely by the hemoglobin, but used to bind to oxygen when it gets to your lungs.

When the red blood cell gets to the alveoli, or the little sacs in your lungs where all the gas exchange happens, that special little iron ion can flip between FE2+ and FE3+ states with electron exchange and bond to some oxygen, then it goes off on its little merry way to deliver o2 elsewhere.

Here’s where COVID-19 comes in. Its glycoproteins bond to the heme, and in doing so that special and toxic oxidative iron ion is “disassociated” (released). It’s basically let out of the cage and now freely roaming around on its own. This is bad for two reasons:

1) Without the iron ion, hemoglobin can no longer bind to oxygen. Once all the hemoglobin is impaired, the red blood cell is essentially turned into a Freightliner truck cab with no trailer and no ability to store its cargo. It is useless and just running around with COVID-19 virus attached to its porphyrin. All these useless trucks running around not delivering oxygen is what starts to lead to desaturation, or watching the patient’s spo2 levels drop. It is INCORRECT to assume traditional ARDS and in doing so, you’re treating the WRONG DISEASE. Think of it a lot like carbon monoxide poisoning, in which CO is bound to the hemoglobin, making it unable to carry oxygen. In those cases, ventilators aren’t treating the root cause; the patient’s lungs aren’t ‘tiring out’, they’re pumping just fine. The red blood cells just can’t carry o2, end of story. Only in this case, unlike CO poisoning in which eventually the CO can break off, the affected hemoglobin is permanently stripped of its ability to carry o2 because it has lost its iron ion. The body compensates for this lack of o2 carrying capacity and deliveries by having your kidneys release hormones like erythropoietin, which tell your bone marrow factories to ramp up production on new red blood cells with freshly made and fully functioning hemoglobin. This is the reason you find elevated hemoglobin and decreased blood oxygen saturation as one of the 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not.

2) That little iron ion, along with millions of its friends released from other hemes, are now floating through your blood freely. As I mentioned before, this type of iron ion is highly reactive and causes oxidative damage. It turns out that this happens to a limited extent naturally in our bodies and we have cleanup & defense mechanisms to keep the balance. The lungs, in particular, have 3 primary defenses to maintain “iron homeostasis”, 2 of which are in the alveoli, those little sacs in your lungs we talked about earlier. The first of the two are little macrophages that roam around and scavenge up any free radicals like this oxidative iron. The second is a lining on the walls (called the epithelial surface) which has a thin layer of fluid packed with high levels of antioxidant molecules… things like ascorbic acid (AKA Vitamin C) among others. Well, this is usually good enough for naturally occurring rogue iron ions but with COVID-19 running rampant your body is now basically like a progressive state letting out all the prisoners out of the prisons… it’s just too much iron and it begins to overwhelm your lungs’ countermeasures, and thus begins the process of pulmonary oxidative stress. This leads to damage and inflammation, which leads to all that nasty stuff and damage you see in CT scans of COVID-19 patient lungs. Ever noticed how it’s always bilateral? (both lungs at the same time) Pneumonia rarely ever does that, but COVID-19 does… EVERY. SINGLE. TIME.

Poynter says this is clearly wrong:

The claim that COVID-19 causes hypoxia because the causative virus binds to hemoglobin in red blood cells is unsupported. For starters, no scientific evidence demonstrates that SARS-CoV-2 can enter red blood cells. The claim that the virus binds to hemoglobin is founded on the conclusions of a single pre-print, which solely involves computational analysis, without experimental verification or peer-review. The mechanism proposed is also inconsistent with clinical evidence from COVID-19 patients.

Health Feedback posted their refutation on Wednesday, April 15. It is lengthy and thorough. Excerpts follow:

Scientists told Health Feedback that the claim was not supported by experimental and clinical evidence. “There is no direct biological evidence that SARS-CoV-2 proteins interact with hemoglobin. The claim is based on a single study performed purely in silico without proper wet lab validation,” explained Victor Tseng, pulmonologist and assistant professor of medicine at Emory University. Eva Nozik-Grayck, clinician-scientist and critical care specialist at the Children’s Hospital Colorado, stated that “without any experimental evidence, it is dangerous and misleading to make these claims.”

David Irwin, associate professor at the University of Colorado Denver, who studies hemoglobin and hypoxia, questioned the conclusions of the ChemRxiv pre-print that served as the basis for the claim. “The authors show no convincing data to suggest that the [viral] proteins of interest, such as Orf8, etc., actually bind heme other than in modeling theories. Most troubling is that there is no way that we know of to suggest that the virus accesses hemoglobin in red blood cells to attack the heme as described in the manuscript,” he said.

A Medium article authored by Matthew Amdahl, a clinician-scientist and hemoglobin researcher at the University of Pittsburgh, details the numerous problems with [Medium author] Gaiziunas’ hypothesis. Notably, he pointed out that SARS-CoV-2 is larger than the entire hemoglobin protein, but according to Gaiziunas’ hypothesis, would somehow manage to fit into “a space barely large enough for two-atom molecules like oxygen (O2)” in order to eject iron from hemoglobin and bind to porphyrin:

“To put it charitably, this would be an entirely novel and seemingly impossible sort of chemistry, and there is absolutely no scientific evidence that supports such a possibility. It’s this seemingly impossible interaction that forms the foundation of the blog post’s entire argument, and so the remainder of the conclusions drawn by the blogger simply don’t carry any weight.”

Furthermore, clinical evidence from COVID-19 patients contradict Gaiziunas’ hypothesis. Firstly, supposing that the virus did bind to hemoglobin and ejected iron from red blood cells, this would have produced a modified form of hemoglobin that has an altered ability to bind to oxygen, which can be detected by measuring the oxyhemoglobin dissociation constant …

In summary, while scientists have not ruled out a potential link between changes in red blood cell physiology and hypoxia observed in COVID-19 patients, the mechanisms proposed by Gaiziunas are founded on little to no scientific evidence, are highly implausible given what we already know of hemoglobin and the virus, and are contradicted by clinical evidence in COVID-19 patients.

We might find out more about hypoxia in COVID-19 patients in a year’s time.

For now, I can’t help but wonder if this type of hypoxia explains why hospitals have been refusing more ventilators for COVID-19 patients.

In the meantime, returning to Prof Didier Raoult, it seems that renegades are never in vogue with the establishment.

More power to him for successfully trialling on his coronavirus patients an inexpensive, prescription anti-malarial that has been on the market for decades. Well done. Millions of us support him in his work.