Superbugs ‘will make Covid-19 look minor’
The Covid-19 pandemic will “look minor” compared with what humanity faces from the growing number of superbugs resistant to drugs, Prof Dame Sally Davies, England’s former chief medical officer, has warned.
Davies, now the UK special envoy on antimicrobial resistance (AMR), lost her goddaughter two years ago to an infection that could not be treated.
She paints a bleak picture of what could happen if the world fails to tackle the problem within the next decade, saying the issue is “more acute” than climate change. Drugresistant infections already kill at least 1.2 million people a year.
“It looks like a lot of people with untreatable infections, and we would have to move to isolating people who were untreatable in order not to infect their families and communities. So it’s a really disastrous picture. It would make some of Covid look minor,” said Davies, who is also the first female master of Trinity College, Cambridge.
Some infections caused by bacteria, viruses, fungi and parasites can no longer be treated. Exposure to drugs allows the bugs to evolve the ability to resist them, and overuse of drugs such
as antibiotics accelerates that process. Widespread resistance would make much of modern medicine too risky, affecting treatments including caesarean sections, cancer interventions and organ transplantation.
“If we haven’t made good strides in the next 10 years, then I’m really scared,” Davies said. Without the development of new treatments “it’ll grind on for decades and it won’t burn out. We know that with viruses, they burn out, you generally develop herd immunity, but this isn’t like that.”
Last week the government announced a national action plan on AMR, with commitments to reduce use of antimicrobials in humans and animals, strengthen surveillance of drug resistant infections, and encourage the industry to develop new drugs and vaccines. Maria Caulfield, the health minister, said: “In a world recovering from the profound impact of the Covid-19 pandemic, international collaboration and preparedness for global health challenges have taken on an unprecedented level of importance.”
Davies has spent more than a decade warning about the problem, but said it truly hit home when her “beautiful” goddaughter, Emily Hoyle, died of a drug-resistant infection aged 38. Hoyle had cystic fibrosis and had undergone two lung transplants before she was infected by Mycobacteroides abscessus, which was resistant to treatment.
The team treating her “tried everything”, Davies said. “But she knew about six months before she died that this was not going to be treatable and that she would probably die of it.
“She had a very beautiful death – she was very dignified, laughing, joking, making light of it. She was very special. She gave me permission to use her story.”
Hoyle’s death reinforced her determination to turn the tide, Davies said, describing it as a question of intergenerational fairness. “My generation and older have used the antibiotics [and] we’re not replenishing them. We’re not making sure that our food is produced with as low usage as possible. And I owe it to my children and – if I have them – grandchildren and the next generations to do my best.”
There were also issues of fairness today, she said. One death in five caused by AMR was in a child aged under five, usually in sub-Saharan Africa, where the problem was “particularly prevalent and disastrous”.
Many of the countries were also being hit hard by the climate crisis, and the two problems were interlinked. “If we don’t control and mitigate AMR, then it will kill more people before climate change does,” she said. “Climate will play out in many ways, but think about flood water, think about sewage, think about displacement, think about storms and what they spread and the lack of clean water if you’ve got drought; infections do go up.”
There were global efforts to reduce inappropriate use of drugs such as antibiotics in medicine, though Covid stalled progress on many of those initiatives. Few new antibiotics had been created in recent years, and the issue was “made more complicated” because it involved sectors such as farming as well as human health.
More than two-thirds of antibiotics went into farm animals, Davies said, usually to promote growth or prevent infections in overcrowded, unsanitary conditions rather than to treat specific infections. “If you don’t have appropriate, careful use you’re risking it really getting out of control.”
Animals, including humans, excreted up to 80% of the antibiotics they consumed, contaminating the environment. Effluent from factories producing antibiotics could allow “dramatic amounts” to enter water systems, she said.
Despite her warnings, Davies insisted she was a “glass half-full” person. Breakthroughs such as genomics and AI were “reinvigorating” the science of new antibiotics. She was also hopeful programmes to give incentives to pharmaceutical firms to create new antibiotics would bear fruit.
Davies is part of the UN Global Leaders Group on AMR. In September, the UN will hold a high-level meeting on the issue.
A Department of Health spokes-person said: “Our five-year action plan outlines our commitment to lead the way in tackling antimicrobial resistance to protect people and animals from the risk of drug resistant infections.”