I have always found it ironic that Alexander the Great likely died of a fever. With the benefits of modern medicine, it is hard for us to appreciate the threat that fevers have posed to people in the past. Before the 1920s, fevers were the leading cause of premature death. Fevers are an evolutionarily adaptive response to infections: The body creates a high-temperature environment in the form of a fever to fight foreign substances. However, the tradeoff is that the body is sometimes unable to regulate a fever, in which case it can become fatal. Today, we have antibiotics to fight bacterial infections, so we tend not to worry about the threat posed by fevers. But that threat may soon return.
We have all been rightly preoccupied with the coronavirus. However, this global pandemic has led me to reflect on the threat from another form of infectious disease: bacteria. Because we vastly overuse antibiotics, it is possible for bacteria to share antibiotic resistance with each other, creating a superbug that is impervious to preexisting drugs. This would suddenly make fevers fatal to many of us. As a society, we have to start using antibiotics responsibly to prevent the possibility of deadly superbugs.
Modern allopathic medicine depends entirely on the antibiotic, but our rampant misuse and abuse of this drug has probably put its efficacy at risk. Before the invention of antibiotics, people had to be much more cautious about cutting a finger or contracting an ear infection. Now, people tend not to worry about them because antibiotics alleviate the risk: They can simply procure a doctor’s note for simple prescription drugs, which are produced in the millions and sold in pharmacies worldwide. Today, the global antibiotic market is valued at $40 billion, with over 30 percent of prescribed antibiotics within the United States being used for infections that are not life-threatening. In fact, in many countries, pharmaceutical companies have bumped up their production of antibiotics and started the dirty business of collaborating with medical professionals to increase the demand. Thus, our overuse of antibiotics is partly the result of profit-driven efforts by these companies.
The real problem arises when we start to factor in the bacteria in the equation: Bacteria, like all other living organisms, are constantly evolving. When introduced to this novel environmental stress of the antibiotic, the bacteria start to mutate and develop resistance to it. Bacteria have a small plasmid feature, which allows for cross-strain mutations: That means different bacteria can share their antibiotic resistance with one another to form superbugs. Superbugs cannot be cured even by antibiotics, posing a real risk to us. A few months ago, I was in the hospital for a viral and bacterial infection in my tonsils. My doctors administered four different antibiotics over the course of 18 torturous days, since the bacterial infection I seemed to have harbored in my throat was immune to the most potent antibiotics that existed. It was only then that I realized that all the talk in my biology class, BIOL 0190F: “Darwinian Medicine,” about potential superbugs was much more relevant than I ever imagined.
The threat of a superbug does not just come from the irresponsible behaviors of the prescribers, producers and consumers of antibiotics in the medical sector. It can also come from agricultural practices. The next time you are savoring that piece of steak in front of you, remember that you in fact may be consuming an incomprehensible amount of antibiotics. Breeders and farmers heap antibiotics into animal fodder to ensure that the animals don’t catch any infections when held in cramped pens. This creates the risk of zoonosis, the process by which diseases travel between species. Zoonosis occurred with COVID-19, SARS, MERS, swine flu and Ebola. A statement like this is sometimes followed with a call to embrace and religiously practice veganism, but the vegans aren’t safe either. What do you think is used as manure to grow the vegetables which make up all your vegan salads? The excrement of these animals, of course, contains the same antibiotics that were present in the fodder in the first place.
During the COVID-19 pandemic, we should keep in mind a few things that will help us survive not only this ‘battle’ against microbes, but the larger war against an unsustainable reliance on antibiotics. First, when you fall sick, don’t instantly resort to an antibiotic course, but go to a trusted medical professional and get a diagnosis, which is the most important part of any treatment. Second, complete your entire antibiotic course — incomplete courses can result in the continued survival of bugs that have gained resistance. Bugs that have survived an antibacterial infection can easily spread, and worse, will be immune to treatment. Third, source antibiotic-free poultry for your homes, and support small organic farms that use antibiotic-free manure. I know this option is unavailable to many, but this not only provides business to small-scale eco-friendly practices, it also supports such local farmers and grocers, too.
The COVID-19 pandemic is so devastating because we do not yet have a cure for it. Very realistically, the next pandemic might well be from bacteria instead of a virus — bacteria that are immune to all antibiotics. That’s why we must plan ahead to prevent another medical disaster.
Yukti Agarwal '24 can be reached at yukti_agarwal@brown.edu. Please send responses to this opinion to letters@browndailyherald.com and op-eds to opinions@browndailyherald.com.
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