The coronavirus infects and kills more Americans each day. The number of confirmed cases just eclipsed 1.2 million and the death toll now exceeds 70,000.

While the standard advice is to never take an antibiotic for a virus, most patients hospitalized with covid-19 are receiving antibiotics to prevent or to presumptively treat secondary bacterial or fungal pneumonia.

In fact, some patients, especially those on lifesaving ventilators, aren’t dying from the virus itself but from other infections they contract in the hospital. According to one study published in the Lancet, a prestigious medical journal, these secondary infections were present in half of those who died from coronavirus. A separate study found that many “severely ill [patients] had co-infections of bacteria and fungi.”

Unfortunately, bacterial infections are growing resistant to our most powerful antibiotics. In a study published in Lancet Respiratory Medicine, most of the bacteria and fungi causing secondary infections in patients with covid-19 were antibiotic-resistant “superbugs.” Some patients won’t win their fight against coronavirus — or other, future pandemics — until we add new and improved antibiotics to our drug arsenal.

Every time people take antibiotics, some bacteria may survive, multiply and evolve to become resistant to existing treatments. Today, common bacterial infections like strep throat and urinary tract infections no longer respond to run-of-the-mill antibiotics.

Superbugs are on track to kill 10 million people annually by 2050, according to the World Health Organization. Already, these antibiotic resistant microbes account for 700,000 global deaths each year.

Unfortunately, drug companies aren’t developing enough new antibiotics. Not because they don’t want to, but because they can’t. It just doesn’t make financial sense.

It costs over a billion dollars and 10 to 15 years to develop a new drug. Normally, pharmaceutical firms recoup this massive investment by selling large quantities of their drugs to a large consumer base.

But new antibiotics have to be used as sparingly as possible. The sales model that enables companies to recoup their research and development dollars on most drugs simply doesn’t work for antibiotics.

That’s why firms are increasingly shutting down their antibiotic departments and shifting investments to less risky disease areas. In fact, it’s been over three decades since a new class of antibiotics hit the market.

Without antibiotics to treat secondary infections, viral pandemics become far more deadly. Consider the 1918 Spanish flu, which killed up to 50 million people worldwide and took place before antibiotics were invented.

Most of these deaths can be traced back to secondary bacterial pneumonia, according to a National Institute of Allergy and Infectious Diseases study that examined lung tissue from 58 autopsies. The study notes that if it weren’t for secondary infections “most patients would have recovered” and concludes that “… treatment of secondary bacterial pneumonia, as well as stockpiling of antibiotics” should “be high priorities for pandemic planning.”

A separate study in the journal Infection and Immunity found that bacterial pneumonia — not the virus itself — accounted for 85% to 90% of Spanish flu deaths. In a 2008 article, National Institute of Allergy and Infectious Disease Director Dr. Anthony Fauci confirmed that most of the millions of Spanish flu deaths were from bacteria, not the virus itself.

We’re on track to repeat history.

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