AMR Voices Series: Do We Really Want Another “New Normal”?
Stories from the frontlines of antimicrobial resistance during Covid-19
Between July and November 2020, the Longitude Prize reached out to contacts around the world to connect with people living with – or who have experienced – drug-resistant infections, to better understand how the Covid-19 pandemic is shaping their lives. The team also spoke to medical professionals, doctors and pharmacists, to capture their perspectives. Combined, the stories shared in this report provide the reader with a first-hand look at how the antimicrobial resistance (AMR) and Covid-19 agendas meet and what people living with resistant infections or have overcome them think needs to be done. The readable PDF is below, but we will also be sharing each story as a separate piece throughout the next few months to highlight it’s importance.
In just a matter of months, the Covid-19 pandemic has turned the world on its head, laying bare the vulnerability of human health, the potential of global contagion, and the fragility of our public health infrastructure. We have also seen the disruption of everyday life and things we took for granted. National governments have implemented sweeping social restrictions to contain the spread of the disease, introducing radical measures to shore up jobs and markets.
For many, this was unimaginable just 12 months ago. Yet, the threat of the global spread of a highly infectious disease — “Disease X” — had been anticipated and forewarned by the World Health Organization (WHO) for some time. Covid-19 carries all the hallmarks of the “Disease X”.
What can we learn from this in regards to the battle against antimicrobial resistance (AMR)?
At Nesta Challenges – home to the Longitude Prize, an £8m prize to accelerate the development of a point-of-care diagnostic test that will conserve antibiotics for future generations – we’ve been asking ourselves this question.
Accelerated by the misuse and overuse of antibiotics, drug-resistant bacteria – or “superbugs” – are multiplying rapidly. Common bacteria, like Escherichia coli and Enterobacter which cause urinary tract infections (UTIs), are developing resistance to drugs and are deemed critical on the WHO’s priority pathogens list. Today, too few new antibacterial treatments are in development, rapid diagnostics are still not funded at an effective scale and pace, and antibiotic stewardship is faltering as a result.
Superbugs claim the lives of 700,000 people worldwide every year. As more drugs stop working, more lives will be put in danger. By 2050, an anticipated 10 million lives will be lost as a result of a resistant infection if we do not act now. That’s greater than the current population of New York City, London or Paris.
The Covid-19 experience has taught us that the general public responds well to accurate data about serious health threats. Numbers matter – but so does the first-person experience. For many of us, Covid-19 became real when journalists started reporting and sharing footage from the hospital wards where patients were being treated. Action on AMR doesn’t need to be a polarised “either or” discussion of what evidence matters, numbers vs stories — it needs both.
Stories from around the globe
Human stories from around the world
AMR Voices gives a platform for people living with drug-resistant infections, those that have survived them and to the clinicians contending with them, and captures their views on the pandemic. The stories included in this report shine a light on the deep interconnections between AMR and Covid-19.
With stories from around the world, delivered first-hand or as narrated interviews, we aim to create a space where patient and medical professionals’ hopes and concerns for the future treatment of superbugs can be heard.
In the UK, Dr. Ranj Singh, an Emergency Paediatrician in the National Health Service (NHS) and TV presenter, shares his fears for the future. He imagines the day when he will have to tell the parents of an extremely sick child with an AMR infection that they’ve run out of options, and why Covid-19 must be a lesson for us all on the value of public health. Ronda Windsor, who lives with a drug-resistant UTI, speaks candidly about the toll the pandemic has taken on her mental health and limited her access to her doctor and essential medicines – an experience that will resonate with anyone living with a chronic illness.
In India, AMR campaigner, Dr. Abdul Ghafur tells us of his turn of fate, hospitalised as a Covid-19 patient, and of his fears of being ventilated because of the increased exposure to a hospital-acquired infection. Meanwhile, patient-turned-entrepreneur Pranav Johri’s experience of travelling abroad to get treatment for his resistant infection is a stark reminder that national lockdowns threaten people with other diseases than Covid-19.
Mary Millard in the US and Vanessa Carter in South Africa both call for better public education and awareness as a result of the pandemic and lament that their respective governments have not treated AMR as the public health emergency that it is. Mary highlights that sepsis already kills 99,000 people per year in the US and that, at the time of writing, more than 240,000 Americans have died as a result of the Covid-19 pandemic.
As the accounts in this report will attest, all levers of change need to be pulled in order to inspire and to mobilise communities to act on AMR. There is no silver bullet solution. It requires a concerted effort on multiple fronts, including better strategies for developing new antibiotics, new and innovative treatment techniques, continued improvement in hospital hygiene and investment in new rapid diagnostics. Better testing will be key to the sustainable stewardship of the drugs we have and those that, we hope, will come.
There’s still much to learn from the Covid-19 pandemic, but it is clear that the experience has focused minds on the devastating impact of infectious diseases that are hard to manage and trace, and the challenges of developing vaccines and cures. It has equally elevated global awareness of the value of rapid diagnostics and testing as part of community responses.
Without action and new antibiotics, a simple wound or cut could be fatal and routine operations like hip replacement surgery and life-saving treatments like chemotherapy may become impossible. Just as patients have had to think twice about visiting a hospital this year to avoid the risk of contracting Covid-19, the same calculations are already having to be made in some cities in India to avoid drug-resistant infections.
AMR is a universal issue and has the potential to affect the full spectrum of the population, whereas Covid-19 hits the elderly and those with pre-existing conditions hardest. Without action on AMR, it is a calculation that many more of us may be forced to make.
Antibiotic and antimicrobial resistance cannot be allowed to become the next “new normal”.
Our heartfelt thanks to all the people who have kindly contributed their experiences to this report, especially to those battling and recovering from Covid-19. Our thanks to all the committed charities, foundations and agencies that have helped us along the way. Special mention to: Antibiotic Research UK, Superheroes Against Superbugs, as well as to those doing great work in the field, including BSAC, ReAct, Wellcome Trust, CARB-X, GARDP and BIRAC, who kindly provided their consultative support.