A laboratory at Sainte-Camille hospital in Bry-sur-Marne. – Lionel GUERICOLAS
- Every Friday, “20 Minutes” offers a personality to comment on a social phenomenon, in his meeting “20 Minutes …”
- Dominique Martin, the director of the Medicines Agency, has been on the front lines to fight the coronavirus since its appearance in France.
- He is delighted with the many attempts underway to find a cure, but calls for caution and requires a little patience.
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Like all of us, Dominique Martin no longer differentiates between the days of the week and the weekend. No not because
containment. But because he works tirelessly. Director of
the National Agency for the Safety of Medicines and Health Products (ANSM), it is the guarantor of the many researches currently being carried out to try to find a remedy
with coronavirus.
Between two calls to the Minister of Health to keep him informed of the progress of the work, he agreed to answer questions from 20 minutes. The opportunity to comment on the hopes born from different researches and to come back to
the enthusiasm for chloroquine despite the risks.
First there was chloroquine. Then nicotine. Recently, there has been talk about the hopes of ivermectin and tocilizumab. Finally, on Wednesday, the United States announced that remdesivir could be an effective product to fight against the coronavirus. Is there reason to be enthusiastic with each new search?
The period is more to reason than to enthusiasm. Let’s talk about remdesivir, for example.
The Gilead laboratory has announced that it is producing interesting effects.
But a few hours later, another study claimed the opposite … We are in a difficult period.
There is a very important activity in research. We’ve never been so fast. This is why so much information circulates. At the Agency, we received 75 requests for clinical trials. Much of it has been authorized. All this in two months. We had never seen this on a single pathology. There is an effervescence in research. Obviously, the industrialist or the academic team who finds the remedy will have a serious advantage over the others.
So we are sure that the research will lead to an effective treatment?
Are we sure? The answer is no. Is there any hope that the research will be successful? The answer is rather yes. With the mobilization of the best researchers on the planet, we can think that this will succeed. But you have to be careful.
We must not imagine that we will find a drug that will annihilate all the effects of Covid-19 for 100% of positive cases. Watch out for science fiction! To the illusion! On the other hand,
we can hope for a drug that saves patients from being in intensive care. Or that prevents their health from deteriorating.
A final report shows 257 patients suffering from serious adverse effects after taking drugs during the testing phase. Of which a large half took chloroquine. Where are we on this product?
Each report of adverse reaction is the subject of a clinical investigation, not a statistical analysis. It’s more interesting to analyze each case to identify a safety signal. The risk of heart attack from taking chloroquine was known. This has not stopped some from taking self-medication. This did not prevent some doctors from self-prescribing … Between March 15 and 25, there was a fourfold increase in sales of
Plaquenil (the drug containing hydroxychloroquine) in town. This concerned us a lot, which is why we have issued a warning.
[Info @20Minutes] #Coronavirus #chloroquine
A 42-year-old man in critical condition after trying to treat himself with chloroquine (self-medication …) He is in intensive care at the Jacques Cartier hospital in Massy.https: //t.co/Ba1DyaLjWq– Vincent Vantighem (@vvantighem) April 10, 2020
Today, the sales curve has dropped. Even in the hospital – the only place where it is licensed – there has been a drop in the use of chloroquine. Probably because there are questions about its effectiveness, and especially about the risks.
Looking back, do you understand how public opinion reacted to chloroquine?
It was incredible. I was able to observe it myself by dealing with people personally. Or caring for friends of friends … And then it had an effect on research. I have colleagues who have had trouble launching trials on other products. Because the patients only wanted to test chloroquine. And nothing else…
It is not worrying that people have intuitions like Professor Didier Raoult. This is also what medicine is: the essential place of the empirical dimension. But once you have had an empirical approach, you have to have the scientific approach. Compliant clinical trials are required. It is this approach that must govern us. This is what avoids illusions …
What about research on a possible vaccine?
Worldwide, several teams are working on it. There is a real question about the quality of the immune response of the host that is Man.
On his antibody production. Tests have already been done on animals in the laboratory. We can hope. Some say there is hope for the end of the year.
Fingers crossed! But it would never be seen. Next year ? I prefer to think about it.
Making a vaccine is almost the most difficult thing to do. To get it right, look at the flu. We have a vaccine but no treatment. And look at HIV, we have treatment but no vaccine.
Do you think that some French people will be resistant to the vaccine? And what will you tell them if any?
If there is a vaccine, we will probably have the criticisms in good standing of the opposing people and the conspiratorial remarks that we know well. Nothing very new on this. To prevent a resurgence of the coronavirus epidemic, it may be necessary to create a vaccine requirement. Given what we’re going through today, I would be pretty much in agreement on that.
Some have a relationship with rationality that questions. When I hear them, I always share what I experienced in the refugee camps when I was a humanitarian doctor. We had measles epidemics. And we had 50% to 80% of the children in a camp dying. 50 to 80%! Can you imagine 50 to 80% of a sacrificed generation? I say that to people. I say it’s easy to criticize vaccines when you’re protected. Protected by treatments. Protected by others who get vaccinated!
How has this health crisis changed your life?
I keep coming to the office every day. It lengthened my work days a little. I no longer have the notion of the weekend. Like many, there is a loss of the usual benchmarks. Especially since Sunday afternoon, I can’t leave my house …
Precisely, what will you do once the containment is lifted?
One of the great pleasures of Paris is its café terraces. I live in the 13th arrondissement. It’s nice. I completely identify with these Parisians who stop for coffee or beer on the terrace while shopping. To be there. To look at life. To chat with your neighbor. This is one of the elements of the sweetness of this city. I missed it.
And then I’ll go find my family members that I can’t see. My children, in particular, who are far apart due to confinement.
