We can’t cure Covid-19 with a cheese sandwich
Covid-19 has reminded us all of the fragility of modern medicine. It’s 2020. Yet, in our fight against a worldwide pandemic, we’ve relied entirely on century-old techniques for controlling infectious disease, such as keeping our distance and frequent hand washing.
Only 70 years ago, a person could prick his finger on a rose bush in the garden and die of septicaemia five days later. It wasn’t unusual for influenza pandemics or outbreaks of measles or diphtheria to grip communities. Smallpox was feared.
Last year measles vaccination rates had fallen to such a point that New Zealand was faced with a deadly outbreak. This disease went on to have tragic consequences in the Pacific Islands.
Prior to last century we didn’t have vaccines or antibiotics, the mainstays of modern medicine. Yet, I hear from patients who have chosen not to vaccinate as if they can outrun measles or polio or have “natural immunity” to lifethreatening diseases (they don’t).
Last year’s epidemic taught us that diseases such as measles, whooping cough, diphtheria and polio still exist and can kill. We have become immune to the potential of harm from these diseases because we have forgotten about a world where these defences did not exist.
The tenets on which modern, firstworld medicine and health are built — vaccines, antibiotics, and for that matter sewerage systems — are fragile and need looking after.
While vaccination rates have fallen, it’s the opposite for antibiotics but with similar results. In New Zealand we consume an estimated 36 tonnes a year of common antibiotics. It’s not uncommon in east Porirua, where I work, to see resistance to antibiotics used to treat common infections in skin and urine.
Multi-resistant strains of bacteria that stalk our hospital corridors causing infection are becoming part of the everyday landscape of modern medicine. We are in crisis and there is a continual fight to counter these tricky organisms. We now see situations where patients have skin and lung infections that are resistant to all antibiotics and cannot be treated.
Alexander Fleming, who invented penicillin, the base for antibiotics, did so accidentally. Imagine a world where Fleming, notoriously messy, hadn’t been eating a sandwich over his petri dishes, scattering cheese fragments over them, then noticing only six weeks later when he returned from holiday in the Scottish Highlands that bacteria had not grown around the now-mouldy cheese.
The course of modern medicine wouldn’t have changed. It wasn’t until 10 years later when a policeman was dying in an Oxford hospital bed after stabbing his finger with a thorn that Fleming’s new discovery, penicillin, was used.
The policeman “miraculously” recovered, surviving certain death, and went on to live a long life. We are lucky indeed that Fleming was messy and had a fondness for cheese sandwiches.
Most infections — especially respiratory ones like Covid-19 — are viral, so antibiotics will never work. Yet patients often view antibiotics as they do paracetamol, a cure for all ills, not a precious, limited resource.
Covid-19 has reminded us a world did exist where viruses and bacteria were deadly and, although often hidden, are still deadly. They lurk beneath the surface of our awareness and, prepared to strike at us individually or on a global level.
Unlike spilling cheese, the search for a Covid-19 vaccine is complex and costly, with billions of dollars spent in investigation and trialling. More than 20 trials are under way around the world.
However, it will most likely be the middle of 2021 before a vaccine is ready and can be rolled out. Billions of doses will be required and an effective, wellmanaged delivery system will be needed.
A vaccination will prevent infection, not cure Covid-19. It will work in a similar way vaccines for polio and smallpox worked and will halt the pandemic, which is what we most need.
Vaccination, not overusing antibiotics, and respecting the advances we have made are the way forward. Vaccinations and antibiotics are there for a reason and need respect.