09
Nov
Urgent Action Needed to Prevent Another Pandemic—This Time Due to Bacterial Resistance
(Beyond Pesticides, November 9, 2020) Now that we have learned what a pandemic looks and feels like, with the astounding levels of infection, hospitalization, and death from COVID-19, we must take serious steps to prevent another pandemic on the horizon—this one tied to bacterial resistance to antibiotics. An important article in The Lancet points to a “looming potential pandemic” resulting from a “rise in multidrug-resistant bacterial infections that are undetected, underdiagnosed, and increasingly untreatable, [which] threatens the health of people in the USA and globally.”
Two contributors to antimicrobial resistance (AMR) that are being highlighted are in agriculture and use of antibiotics in medicine when not warranted.
The misuse of antibiotics in agriculture includes antibiotics used to control certain bacterial diseases in plant agriculture (especially oxytetracycline and streptomycin). While crop uses are important contributors to breeding bacterial resistance, they are small compared to their uses in livestock production. Antibiotics are used largely as additives to animal feed to ward off any potential infections and to promote unnaturally rapid growth (the latter of which translates to higher profits), rather than being used to treat bacterial infections (although that does happen and products from treated animals can go to market with residues). Both of these objectives compensate for the overcrowded and unsanitary conditions of concentrated animal feeding operations (CAFOs), which scientists believe are contributing to the next pandemic. Use of antibiotics is prohibited in all certified organic production. Although the standards of the National Organic Program require that sick animals be treated, meat and other products from such animals cannot be sold with the imprimatur of the Certified Organic designation.
Another leading cause of AMR is the unnecessary use of antibiotics in human medicine. Antibiotics may be given prophylactically to prevent infection or during the course of a viral infection, which cannot be cured with antibiotics. A study from summer 2020 shows that a shocking 72% of COVID-19 patients received antibiotics even when they were not clinically indicated. The authors note: “AMR might worsen under COVID-19 due to the overuse of antibiotics in humans, continuing misuse in agriculture, and the dearth of antimicrobials in the development pipeline.”
The co-authors of The Lancet articles also discuss how the AMR phenomenon that underlies this rise can exacerbate COVID-19 risks. They observe that, across five countries, COVID-19 diagnoses are associated with bacterial infections (with 3.5% diagnosed concurrently and 14.3% post-COVID-19). The prevalence is higher in patients who require intensive care.
In 2015, the White House released a comprehensive action plan to curtail antibiotic misuse and accelerate new antimicrobials and vaccines—the National Action Plan for Combating Antibiotic-Resistant Bacteria. Implementation has been uneven and, at times, contradictory. In 2017, the U.S. Food and Drug Administration banned use of antibiotics as growth promoters in livestock, but the same year, the U.S. Department of Agriculture (USDA) rejected the World Health Organization’s guidance to limit antibiotic use in livestock feed. There have been unprecedented nationwide budget cuts to hospital-based AMR programs. Ignoring the looming pandemic, in 2019, the U.S. Environmental Protection Agency approved an expansion of medically important antibiotics such as streptomycin and oxytetracycline as pesticides to increase crop yields, and the USDA removed federal oversight of meat inspection at pork processing plants.
Failing to confront AMR undermines decades of advances in medicine and public health. The COVID-19 pandemic should serve as a wake-up call that progress on the national action plan is critical for public health.
Letter to Congress
I am writing to ask you to take urgent action to prevent the next pandemic related to bacterial resistance. Now that we have learned what a pandemic looks and feels like with the astounding levels of infection, hospitalization, and death from COVID-19, we must take serious steps to prevent another pandemic on the horizon. An important article in The Lancet points to a “looming potential pandemic” resulting from a “rise in multidrug-resistant bacterial infections that are undetected, underdiagnosed, and increasingly untreatable, [which] threatens the health of people in the USA and globally.”
Two contributors to antimicrobial resistance (AMR) that are being highlighted are in agriculture and use of antibiotics in medicine when not warranted.
The misuse of antibiotics in agriculture includes antibiotics used to control certain bacterial diseases in plant agriculture (especially oxytetracycline and streptomycin). While crop uses are important contributors to breeding bacterial resistance, they are small compared to their uses in livestock production. Antibiotics are used largely as additives to animal feed to ward off any potential infections and to promote unnaturally rapid growth, rather than being used to treat bacterial infections (although that does happen and products from treated animals can go to market with residues). Both of these objectives compensate for the overcrowded and unsanitary conditions of concentrated animal feeding operations (CAFOs), which scientists believe are contributing to the next pandemic.
Another leading cause of AMR is the unnecessary use of antibiotics in human medicine. Antibiotics may be given prophylactically to prevent infection or during the course of a viral infection, which cannot be cured with antibiotics. A study from summer 2020 shows that a shocking 72% of COVID-19 patients received antibiotics even when they were not clinically indicated. The authors note: “AMR might worsen under COVID-19 due to the overuse of antibiotics in humans, continuing misuse in agriculture, and the dearth of antimicrobials in the development pipeline.”
The co-authors of The Lancet articles also discuss how the AMR phenomenon that underlies this rise can exacerbate COVID-19 risks. They observe that, across five countries, COVID-19 diagnoses are associated with bacterial infections (with 3.5% diagnosed concurrently and 14.3% post-COVID-19). The prevalence is higher in patients who require intensive care.
In 2015, the White House released a comprehensive action plan to curtail antibiotic misuse and accelerate new antimicrobials and vaccines—the National Action Plan for Combating Antibiotic-Resistant Bacteria. Implementation has been uneven and, at times, contradictory. In 2017, the US Food and Drug Administration banned use of antibiotics as growth promoters in livestock, but the same year, the US Department of Agriculture (USDA) rejected WHO’s guidance to limit antibiotic use in livestock feed. There have been unprecedented nationwide budget cuts to hospital-based AMR programs. In 2019, the U.S. Environmental Protection Agency approved expansion of medically important antibiotics such as streptomycin and oxytetracycline as pesticides to increase crop yields, and the USDA removed federal oversight of meat inspection at pork processing plants.
Failing to confront AMR undermines decades of advances in medicine and public health. The COVID-19 pandemic should serve as a wake-up call that progress on the national action plan is critical for public health.
Please encourage federal agencies, including EPA, USDA, and FDA, to take urgent action to implement the National Action Plan for Combating Antibiotic-Resistant Bacteria.
Thank you.
