Didier Raoult’s résumé speaks for itself. He is among the most highly cited microbiologists in the world. His lab employs a small army of researchers who churn out several hundred papers a year. He has done pioneering work on so-called giant viruses and pathogenic bacteria. A French newspaper once called him “the archetype of the prolific scientist: imaginative, enterprising by nature, persevering, and a bit lucky.”
Other descriptions are less kind. In recent weeks, Raoult, who is a doctor and a professor of medicine at Aix-Marseille University, has been called “Trumpian” and “pathologically resistant to criticism,” while his studies have been dismissed as “misinformation” or simply “crap.”
Raoult and a couple of dozen co-authors have published two observational studies on hydroxychloroquine, an anti-malaria drug that’s already being used by some doctors, including Raoult himself, to treat Covid-19. In their most recent paper, released on March 27, they write that Covid-19 patients given the drug along with azithromycin, an antibiotic, had a reduction in detectable virus. They noted “clinical improvement” in nearly all of the 80 patients tested, with the exception, the researchers note, of a severely ill 86-year-old who died. They write that the results “confirm the efficacy” of the drug combination, and they implore fellow researchers to “urgently evaluate this therapeutic strategy both to avoid the spread of the disease and to treat patients.”
But other researchers are skeptical, and they wasted no time in pointing out why. For starters, the Raoult et al. study was not a randomized clinical trial, which is the gold standard in medical research. That means there was no control group. Other details seemed curious, like the fact that only 15 percent of the patients had fevers, a very common symptom of the disease. As one particularly thorough dissection of the study put it: “We just don’t know how good this treatment was or frankly if it was any good at all.”
You can roll your eyes, but he has done a lot for microbiology. He has discovered a lot of bacteria.
Raoult’s study is just one in a flood of Covid-19-related papers that have appeared in recent weeks, and will continue to be published in coming months as researchers race to understand the disease. Many will turn out to be flawed; some may provide important answers that will lead to treatments to combat the virus. What’s notable about Raoult’s study, and perhaps why it has received outsize attention, is that hydroxychloroquine is the drug that has been seized on by President Trump as a likely cure. Trump called it a “game changer.” Rudy Giuliani, the Trump ally and former New York City mayor, has been playing up hydroxychloroquine on TV and Twitter, and he posted Raoult’s most recent study on his own website, with key passages underlined and a scrawled, semi-legible summary of the findings.
Meanwhile, over the weekend, the Food and Drug Administration issued an emergency authorization that will allow the drug to be used on patients who aren’t in clinical trials. Whether that move was prompted by Trump’s enthusiasm or Raoult’s study, or some other factor, is unclear.
Raoult, who is 68, has been a well-known and respected, if somewhat controversial, figure among microbiologists for decades. A 2012 profile in Science portrays him as influential, cantankerous, and swift to offer a scathing opinion. He calls epidemiologists who model disease outbreaks “charlatans.” It also notes that other scientists complain that his papers, perhaps because they’re published at such a rapid clip, sometimes contain errors. “Raoult says he doesn’t really care what other people think,” the Science article concludes, “and he relishes the constant storm around him.”
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That’s consistent with his recent attitude toward those who doubt hydroxychloroquine. In late February, he scoffed in a Q&A at those who would question its effectiveness: “When we showed that a drug worked on a hundred people while everyone is having a nervous breakdown, and that there are noodles who say that we are not sure that it works, it does not interest me!” (Raoult did not respond to an email requesting comment for this article.) At the time, he was playing down the danger of what later became a pandemic. Somehow he’s already written a book about Covid-19, and epidemics generally, in which he asserts that “this panic is largely due to the exaggerations of the press, which knows that fear ‘sells.’”
I spoke with Elisabeth Bik about Raoult. Bik is a microbiologist who spends her days ferreting out research misconduct; before that, she spent 15 years working in a Stanford University laboratory. Among Bik and her colleagues, Raoult was considered a major figure in the field. “We didn’t really believe anyone could publish that much,” she says. “You can roll your eyes, but he has done a lot for microbiology. He has discovered a lot of bacteria.”
Another microbiologist, Jonathan A. Eisen, a professor at the University of California at Davis, knows Raoult fairly well — Eisen gave a talk not long ago at Raoult’s university, and Raoult introduced him. Eisen describes Raoult in a message as “smart and interesting but also iconoclastic and occasionally out to prove something rather than to study it.”
Bik wrote a post on her blog, Science Integrity Digest, raising questions about Raoult’s most recent hydroxychloroquine study, pointing out that “these were people who — at worst — were only mildly sick.” She emphasized the lack of a control group as the biggest cause for concern. Without that, it’s hard to know whether the drug made any difference at all, considering that the vast majority of patients with Covid-19 recover anyway. As Nick Brown, a researcher also known for exposing flawed and fraudulent research, wrote on Twitter: “They would have gotten the same results with chocolate pudding.”
None of that means hydroxychloroquine isn’t an effective treatment for the coronavirus. It might turn out to be. A new study by researchers based in Wuhan, China, where the outbreak began, showed promising results and, unlike Raoult’s study, included a control group. Meanwhile, researchers at the University of Minnesota-Twin Cities are conducting a clinical trial, also with a control group. Still, scientists who have taken a close look at Raoult’s results have yet to be persuaded that the drug is actually a game-changer.
