“Don’t expect a miracle drug that will change everything”, estimated Mathieu Molimard, professor of pharmacology, president of the CHU Pellegrin, in Bordeaux (Gironde), Wednesday October 27 on franceinfo, while France has ordered 50,000 doses of molnupiravir, the anti-Covid 19 pill from the American laboratory Merck.
franceinfo: This would be the first oral treatment against Covid-19, what do we know about its effectiveness?
Mathieu Molimard: This medicine is a bogus component of RNA. This false component makes us manufacture a false RNA, and this virus can no longer reproduce. It is an interesting mechanism which has shown its interest in animals, and which now shows an interest in humans. With five days of treatment, two doses per day, this would prevent 50% of hospitalizations and deaths. But we must be careful, this study was carried out with approximately 400 patients treated, it was stopped halfway because the results were satisfactory. It’s like judging the trifecta halfway through because your horse is in front. We would like to know if the horse held up over time, and what the risks were in terms of adverse effects. These 50% must be reduced to an absolute value, and around 25 hospitalizations are avoided for 400 patients treated. That’s good, but it’s not the revolution either.
So this is not the miracle drug?
Don’t expect a miracle drug that will change everything. These are small advances that are added to each other, which must be combined with barrier measures, masks, hydroalcoholic gel, the fact of being tested, being vaccinated. I am desperate when I still see patients arriving in intensive care at the hospital, saturating our hospitals while they are not vaccinated. Get vaccinated, 90% works, and that’s for sure.
Is France right to order this drug today?
We are in choices that are political, in an international competition. So you have to have doses and give yourself every chance. 50,000 doses, it takes 10 doses to do a treatment, that makes 5,000 patients. VSit will be useful for patients who do not respond to vaccines, who are on immunosuppressants and who have a good chance of going to the hospital. It is not for everyone.
There are other treatments, corticosteroids, there are also synthetic antibodies. Are we making progress on this issue today?
Corticosteroids have been a breakthrough for patients in intensive care, on the inflammatory phase of the disease. For the early, viral phase, monoclonal antibodies can be used. It’s best to have an oral form like molnupiravir, but an antiviral probably won’t suffice. We have effective treatments when we act on several levels of reproduction of the virus. The virus is not a bacterium, it enters our cells, and to block it, if we act too hard, we kill our cells, so we have to block it in several places. Several drugs are needed, often in combination.
In his latest study, Professor Jean-François Delfraissy, who chairs the Scientific Council, estimates that 20% of the beds in the public hospital are closed for lack of personnel. Is this the case with you at the Bordeaux University Hospital?
The current situation is dramatic, we are close to the white plan. There are sectors where there is a 20% shortage of personnel. We have operating theaters that are closed, waiting lists that are growing. Patients who are in the emergency room, for whom we cannot find beds. We must certainly upgrade these careers, upgrade night work, and help these personnel. We must stop the bleeding, we must help the hospital. It is to be vaccinated against the flu, to be vaccinated against the Covid-19 so that one does not have to deprogram operations and not to treat the other diseases which are accumulating at the door of the hospital.
Olivier Véran speaks this morning in Liberation of an increase in absenteeism of around one point. Said like that, it does not make much, but on the scale of all the hospitals in France, it makes hundreds and hundreds of caregivers who no longer come to work. Do you see this around you?
There is great fatigue, we have been on the bridge for 20 months. The caregivers are exhausted and replace each other. This is why we cannot accept having unvaccinated caregivers in the hospital. To protect patients, but also to protect colleagues. We now have very few caregivers who are not vaccinated. More than 99.9% of caregivers at Bordeaux hospital are vaccinated. There are a few refractories who are victims of disinformation.