A little-reported side effect of surging COVID-19 cases is the likelihood that there will be an increasing number of people exposed to antibiotic-resistant bacteria.
At least 15 percent to 20 percent of people infected with SARS-CoV-2, the coronavirus that causes COVID-19, develop a secondary bacterial infection, requiring the use of antibiotics. As a result, most hospitals are prescribing antibiotics pre-emptively to hospitalized COVID-19 patients, heightening the likelihood that more bacteria are adapting and developing resistance to these antibiotics.
“We are dealing with a viral pandemic right now, but it’s highly likely that the next pandemic will be bacterial,” Ted Schroeder, chief executive officer of Nabriva Therapeutics, said during a antibiotic resistance briefing in June that was hosted by the World Antibiotic Resistance Congress. Nabriva is a Dublin, Ireland-based biotechnology company that is researching and developing new antibiotics.
The potential for a pandemic from a resistant microbe has been growing for decades, as most major drug companies have stopped developing new antibiotics. Antimicrobial resistance is manageable in the long-term, as long as scientists keep up the development of new antibiotics, but the research pipeline is drying up.
Forty years ago, 18 of the world’s largest drug companies invested in antimicrobial development. Now there are just three. Companies dropped out of the antibiotic market because they are less lucrative. Drugs made for chronic illnesses like diabetes and heart disease can be taken for years, while antibiotics cure people within days.
Around 95 percent of new antimicrobial drugs currently are being developed by small drug companies, like Nabriva. Costs of developing a new drug average around $1 billion, and many are struggling to attract enough financing to make it from idea to the regulatory and marketing stage.
Before the COVID-19 pandemic, around 2.8 million Americans were infected annually with a resistant microbe and 35,000 died from them, according to the Centers for Disease Control and Prevention. There is no data yet about how many people in the US have developed resistant infections in connection with COVID-19. Still, a few early reports from China indicate that superbugs may have played a role in patient deaths in Wuhan, according to Cornelius (Neil) Clancy, an infectious disease physician at the University of Pittsburgh.
“I’m very concerned about the number of people who are going to lose their lives, not because of coronavirus, but because of these deadly superinfections,” Julie Gerberding, a former CDC director, told CNBC.
Organizations like the Pew Charitable Trusts have been pushing Congress to consider legislation that would provide economic incentives for antimicrobial development, but there is disagreement about how the incentives would work.
For reporters looking for under-covered COVID-19 stories, take a look at the topic of antimicrobial resistance.
See our AHCJ tip sheet for covering antibiotic resistance, which includes many resources for journalists.
Resources & recent coverage
- World Antibiotic Resistance Congress webinar: Keeping Antimicrobial Resistance top-of-mind for policymakers and the public during COVID-19
- Pew Charitable Trust: The U.S. is not prepared to combat existential threat of antibiotic-resistant superbugs
- Wired: COVID-19 may worsen the antibiotic resistance crisis
- CIDRAP: Analysis highlights troubles in the antibiotic pipeline
- Medium: Antibiotic-resistant superbugs could be worse than COVID-19
- Science Speaks: COVID-19: The role of superinfections in novel coronavirus deaths highlights urgent need for sustainable development of new antibiotics
- CTV News: Fighting the COVID-19 pandemic could herald a rise in superbugs
- PBS Newshour: How a crumbling antibiotics infrastructure could yield ‘catastrophe’