Issue No. 7: Antibiotic Resistance Exacerbates Public Health Emergencies

 COVID-19 has now claimed almost 119,000 lives across 185 countries. These figures continue to jump each day.
While most who succumb to the disease perish from respiratory distress, a subset of patients are dying from secondary bacterial infections that attack their weakened immune systems. Some of these infections don’t respond to our existing arsenal of antibiotics.
COVID-19 thus offers a stark warning to public health leaders and policymakers across the globe. Unless we get serious about fighting antimicrobial resistance, we’ll remain distressingly unprepared for pandemics.

Mounting drug resistance against today’s antibiotics
Modern antibiotics are quickly losing their effectiveness. Every time a person uses antibiotics, some bacteria survive. Over time, these surviving microbes evolve, reproduce, and develop resistance to our leading medicines, a phenomenon known as antimicrobial resistance or AMR.
According to a new report from the Centers for Disease Control and Prevention (CDC), such drug-resistant bacteria, or superbugs, infect one American every 11 seconds — and kill one every 15 minutes. Globally, AMR claims 700,000 lives each year, according to the World Health Organization. Many public health experts believe these figures underestimate the true death toll.

AMR’s burgeoning role in public health emergencies
AMR is an urgent public health crisis on its own. But superbugs often exacerbate other public health crises, because they’re more likely to attack patients with compromised immune systems and those in overcrowded spaces that are difficult to disinfect. In other words, public health emergencies are the perfect breeding ground for superbugs.  

Already, 99,000 Americans die from infections acquired in healthcare settings like hospitals, clinics, and physicians’ offices annually. Many of the bacteria that cause these infections are resistant to multiple first-line antibiotics. Antibiotic resistant bacteria accounts for at least 2.8 million infections and 35,000 deaths each year, according to the Centers for Disease Control and Prevention.

But imagine the death toll when hospitals are filled with survivors of mass casualty events like pandemics or natural disasters, or wars.

For instance, one hospital in Jordan found multi-drug resistant pathogens in half of all Syrian, Iraqi, and Yemeni patients who had survived mass casualty events. And after Hurricane Katrina, an evacuee facility in Dallas found a drug-resistant staph infection in 30 patients.

Those figures could skyrocket as resistance increases. Before antibiotics were invented in the 1920s, infectious diseases killed 797 out of every 100,000 Americans each year, on average. That’s roughly 2.6 million U.S. deaths annually in today’s population — equal to roughly all existing causes of death combined.

Alarmingly, a post-antibiotic era is right around the corner. Pneumonia, once effectively treated by penicillin, now often requires second and third-line antibiotics. Many urinary tract infections, once easily eradicated by ampicillin or bactrim, lead to multiple rounds of intravenous therapies and even hospitalization.

As more microbes become resistant to antibiotics, relatively common bacterial infections like these could mean near-certain death.

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