The future - a world of flying cars, hoverboards and of course no diseases. Or…a nightmare world of rampant infection and uncurable diseases? According to this BBC article the latter is more likely as bacteria become resistant to our antibiotics.
“…the apocalyptic scenario is that when I need a new hip in 20 years I’ll die from a routine infection because we’ve run out of antibiotics.”
(from the link)
MRSA is one such bug that has evolved its resistances, and anyone silly enough to end a course of antibiotics will have experience of the adaptability of bacteria first hand.
So, will a trip to the future be a case of love in the time of antibiotic-resistant supercholera? Has the history of antibiotics been a brief respite for humanity that the microbes will overcome?
Since humanity survived quite well before the discovery of antibiotics I expect the species and civilization will continue even if all of them cease to work. Yes, we’ll have more fatalities from infections. On the other hand, we know a lot more about preventing infection than we did a couple centuries ago, and a lot more about how to support the body’s efforts to fight infection.
They have been. The bugs have just been keeping up. The real problem is that as our lives become more sanitary and germ-free, we have a much lower tolerance for the germs that are there. One little mistake could leave you at the mercy of a deadly cellulitis infection you were not expecting to get from that little scratch.
Other than a perhaps misplaced faith in medicine and technology? No. As **ForYou **alludes to, we have become an overly sanitary society in some respects and I think I have read some reports from the medical world that indicate that we might be better off if our children played in the dirt a little more.
The thing is that bacteria have a billion year head start on developing their toolkit of adaptability.
Antibiotic drugs are not the only ways to kill bacteria. There is another. Leia. No. Sorry, wrong thread. It is possible that other treatments will further develop. Bacteriaphages, viruses that eat bacteria. Genetically engineered golden nano bullets. Who knows. But what we do know is that we will be charged for them.
Humanity survived—but about one third of all children died in the process.
So, yeah, civilization will continue…but not the Western civilization that we have now.
It’s worth mentioning that we haven’t exactly been asleep at the wheel either.
I think there is a general impression that our only type of immunity is the “acquired” kind that you get from being exposed to and hopefully surviving an infection. But we also have an older “innate” immune system that can mount a response to almost any microbial threat - assuming that we’re healthy. This includes a whole host of strategies from macrophage cells that use chemical warfare to literally dissolve the enemy in a bath of highly reactive chemicals to things like antimicrobial polypeptides such as cathelicidins (which you need vitamin D to produce btw and may be part of the reason flu is more common in winter when there is less sun).
This isn’t to say that multi-drug resistant bugs aren’t a problem, just that we’re far from defenseless if we do what we can to stay as healthy as we can.
CDC statistics from a century ago show a mortality rate for the first year of life of around 12%; fully one in five children could expect to not see their 10th birthday. Compared to today, where first year mortality is under 1% and does not even register a tenth of one percent for at least the next 20 years of life.
Western civilization as we know it is not hugely different from the early twentieth century.
Except for the minor fact that in the civilization we know today, every single kid we see is expected to live, but back then one in five was expected to die before age 10.
What period of history are you thinking of? 1930, when there was modern sanitation, the germ theory accepted and acted upon, and vaccines to some major killers had been developed, or 1930 BC when none of those things existed?
Modern sanitation, doctors (and others) washing their hands, knowledge of quarantine procedures, and vaccinations did more than antibiotics to drive down the infant/child mortality rate.
Our track record actually hasn’t been great on that so far. It’s been a while since my last medical micro class, so I may have a few details wrong, but IIRC, science has only invented one antibiotic that can actually be called “new” - vancomycin, I think. All the other antibiotics out there are chemical variations on chemicals that were originally isolated from nature, and that’s why resistance to them has been so common and easily adapted. Bacteria have already been fighting these chemicals, or close cousins to them, for millions of years.
A pretty huge chunk of those deaths were due to viruses we now have vaccines for. Even if our antibiotics completely cease working and we for some reason stop developing new ones or other ways to kill bacteria, we will still be way ahead of mortality rates of any other era.
One thing to note is that antibiotic-resistant bacteria aren’t necessarily more virulent; many people have MRSA infections but they usually no more serious than other staph infections (which are pretty common in the form of minor skin infections; pimples, boils and the like), it is only when an infection that needs treatment occurs when antibiotic resistance really matters:
(note that there do appear to be some strains that are more virulent, but more in the way that some influenza viruses are more virulent; presumably, over time they would become less so if things took their natural course; of course, treating infections means that people who would otherwise die live, thus defeating natural selection for disease resistance, pretty much the opposite problem of antibiotic resistance)
I don’t think it’ll be that bad. Public health initiatives and innovations to prevent the spread of bacteria like sanitation, water purification, trash removal, easily laundered clothes, easily available condoms, hand washing, quarantines, etc are more important to our survival than treating people after they get infected with antibiotics. A big part of why MRSA is so present in hospitals is that the people there don’t wash their hands as much as they are supposed to, so even if we didn’t have drugs for it, we can still slow/prevent its spread with public health efforts. But that doesn’t matter for situations like surgery if the bacteria are drug resistant.
Not only that but viruses are not undergoing this rapid evolution, I don’t think. Vaccines against viruses which have killed millions will still work.
Besides, not all bacteria are resistant to all drugs. Many aren’t really resistant to any. Some are resistant to one or two, a handful are resistant to many. So we will still, theoretically, be able to prevent minor cuts and scrapes from becoming life threatening infections.
We need more investment in antibiotic research though. But I don’t think it’ll be the end of civilization by any means. We have to take the issue more seriously though.
Is this part true? I was under the impression that nurses, doctors, etc wash their hands really frequently. Or use hand sanitizer a lot. There’s bottles of the stuff everywhere in doctor’s offices, clinics, hospitals, etc.
Some people get lazy. My hospital last year started spot-checking every department to confirm compliance, and is regularly sending out e-mails showing the rates of hand washing, to help keep up awareness. Oh, and definitions of “a lot” may vary - I’m pretty sure than in an inpatient setting, you’re supposed to wash or sanitize both as you enter and as you leave each patient room. (I work outpatient, so I forget what their standards are.)
That has been part of the problem to date. Antibiotics are just not where the money is in pharma development. Pharmas are looking for the blockbuster product and that means something people will take every day for the rest of their lives. A product that you take for three to ten days at a time, rarely, is not worth the R&D dollars.
Some details on policies aimed at responding to this circumstance here.
I see the final point as being the most critical: responsible antibiotic stewardship. Not every ear infection, sinus infection, or even community acquired pneumonia needs to be treated with an antibiotic, let alone with the newest one over the old fashioned one that still will work in most cases. Many will improve just as quickly with watchful waiting and when antibiotics are required use of the one with the narrowest spectrum that does the job is best.
We are getting better at using antibiotics more judiciously and with greater wisdom but we still have a long way to go. The quickest bang for the buck in the fight against superbugs in to be had on improving those behaviors.