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Speaker 1: Welcome to Prognosis. I'm Francescaliti. Laura Carlson is out. It's

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Speaker 1: day since coronavirus was declared a global pandemic. Our main

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Speaker 1: story viruses like SARS COVID two, the one that causes

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Speaker 1: COVID nineteen, can't be treated by antibiotics. Even so, doctors

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Speaker 1: have used antibiotics on many COVID patients, and that has

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Speaker 1: scary implications for a whole other health crisis superbugs. But first,

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Speaker 1: here's what happened in virus news today. In Florida, COVID

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Speaker 1: nineteen cases sword to their highest weekly level yesterday. Governor

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Speaker 1: Rhonda Santis says the jump in numbers is partly an

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Speaker 1: illusion caused by this state ramping up testing, and he

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Speaker 1: says isolated outbreaks and prisons, long term care facilities, and

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Speaker 1: agriculture communities may be skewing the numbers higher, but a

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Speaker 1: Bloomberg News analysis of publicly available data suggests those factors

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Speaker 1: aren't the cause. The percentage of tests coming back positive

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Speaker 1: has jumped, undermining the idea that more testing is to blame.

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Speaker 1: And as for prisons, care facilities and agriculture workers, cases

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Speaker 1: are up dramatically even when you exclude those communities. In fact,

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Speaker 1: without those examples, the rate of increase would be even

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Speaker 1: more dramatic. In Beijing, a coronavirus outbreak that infected more

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Speaker 1: than one hundred fifty people has been contained, according to

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Speaker 1: Chinese disease experts. The Chinese Center for Disease Control and

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Speaker 1: Prevention said more cases will be confirmed in the coming days,

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Speaker 1: but that should only reflect people who are already infected.

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Speaker 1: And finally, American football fans who had been hoping for

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Speaker 1: good news were disappointed today. Anthony Fauci, the country's top

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Speaker 1: and actous disease expert, said National Football League and college

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Speaker 1: football seasons may have to be canceled if there is

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Speaker 1: a second wave of the virus. The NFL season is

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Speaker 1: scheduled to start September t. Fauci said players would have

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Speaker 1: to be in a bubble, isolated and tested daily for

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Speaker 1: him to imagine how the game could be played this fall.

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Speaker 1: And now for today's main story. Long before the COVID pandemic,

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Speaker 1: another global health disaster was brewing, threatening to kill millions

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Speaker 1: of people annually. Superbugs, germs even our most potent antibiotics

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Speaker 1: can't defeat, pose a massive challenge to human health and

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Speaker 1: well being. The coronavirus, of course, isn't stopped by antibiotics,

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Speaker 1: which target bacteria. Even so, antibiotics have been used liberally

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Speaker 1: for COVID nineteen patients. Bloomberg Senior editor Jason Gale reports

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Speaker 1: that could worsen the superbook crisis. In the first months

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Speaker 1: of the pandemic, studies from China showed that almost all

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Speaker 1: hospitalized COVID nineteen patients were being administered a cocktail of medicines,

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Speaker 1: including antibiotics. It's not that surprising. Studies of the Spanish

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Speaker 1: influenza pandemic showed that the vast majority of debts were

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Speaker 1: actually caused by a secondary bacterial infection. The flu virus

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Speaker 1: landed the first blow, but bacteria delivered the knockout punch.

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Speaker 1: So doctors caring for COVID patients have wanted to prevent

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Speaker 1: them suffering the same fate. I think it's safe to

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Speaker 1: say that many patients with COVID receive antibiotics, especially the

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Speaker 1: ones that are hospitalized, And I think part of that

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Speaker 1: is that the picture of COVID can look similar to

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Speaker 1: community acquired pneumonia. This is doctor Arnu Milani. He's an

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Speaker 1: infectious diseases physician, a medical director for the infection prevention

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Speaker 1: and antimicrobial stewardship programs at Saint Joseph's Mercy Health System

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Speaker 1: in Anna, but Michigan. Researchers in London analyzed more than

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Speaker 1: one thousand coronavirus studies and they found that seventy two

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Speaker 1: pc of COVID nineteen patients received antibiotics in the hospital.

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Speaker 1: I think many patients um are getting treated for pneumonia

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Speaker 1: or were being treated for pneumonia. But further researchers showing

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Speaker 1: that bacteria aren't a major threat. Fewer than eight percent

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Speaker 1: of COVID patients have a bacterial co infection. Two studies

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Speaker 1: published in the past month of showing another found that

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Speaker 1: using antibiotics to prevent infections and COVID patients has no

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Speaker 1: benefit that fits with the World Health Organization's guidance for

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Speaker 1: managing these cases. The agency recommends against using antibiotics unless

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Speaker 1: the patient is suspected of having a bacterial infection. But

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Speaker 1: one antibiotic was popularized, at least for a while, when

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Speaker 1: political leaders touted combinations of the malaria drugs chloroquin or

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Speaker 1: hydroxy chloric wine with the antibiotic zithromycin, and so early

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Speaker 1: on in the outbreak, at least in the United States,

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Speaker 1: there was quite a high degree of use of hydroxy

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Speaker 1: chloric win and zethromycin Um. You know, without a lot

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Speaker 1: of um you know, scientific evidence to support the use.

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Speaker 1: But I think you know with COVID, because so many

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Speaker 1: patients are quite ill um providers, there's there's a tendency

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Speaker 1: to try to want to do something the who says

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Speaker 1: COVID has bolsted the use of antibiotics. Hospitals naturally have

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Speaker 1: a lot of sick people with infections or receiving treatments

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Speaker 1: like intravenous infusions, catholis and ventilators that put patients at

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Speaker 1: risk of an infection, so antibiotics are commonly administered. But

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Speaker 1: when these medicines are overused, he gives rise to the

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Speaker 1: emergence and transmission of multi drug resistant bacteria, and infections

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Speaker 1: with these superbugs are more difficult and costly to treat,

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Speaker 1: and they're more likely to lead to prolonged illness and death.

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Speaker 1: Ni says it's important that healthcare workers prevent spreading infections

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Speaker 1: through careful hand hygiene and sterilization practices, and that they

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Speaker 1: use antibiotics only when they're needed, and I think we

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Speaker 1: want to make sure we don't take any steps backwards

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Speaker 1: with respecting animalcuobial stewardship. Prudent management of these precious miracle

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Speaker 1: cures has come under serious threat because of COVID nineteen.

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Speaker 1: According to Marion McKenna, she's an Atlanta based science journalist

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Speaker 1: who has written books about antibiotic resistance, some tests needed

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Speaker 1: to determine whether a COVID patient has a bacterial infection

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Speaker 1: might not get done because collecting specimens from patients lower

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Speaker 1: respiratory tracks puts health workers at increased risk of catching

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Speaker 1: the coronavirus. Marine says in those cases, antibiotics might be

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Speaker 1: administered as a rec ocean um and many more people

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Speaker 1: being treated prospectively against the fear that they're going to

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Speaker 1: develop bacterial infections. Those things kind of fly in the

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Speaker 1: face of stewardship. You've just violated a couple of the

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Speaker 1: precepts of stewardship, which is you might not have exactly

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Speaker 1: the right drug for the organism because you don't know

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Speaker 1: what the organism is and you're not sure you're gonna

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Speaker 1: be using it for the right amount of time. Because

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Speaker 1: COVID makes people sicker for so much longer. So this

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Speaker 1: whole effort to try to suppress antibiotic resistance around the

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Speaker 1: world by making sure we use antibiotics as conservatively as possible,

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Speaker 1: is that particular effort is under threat because of the

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Speaker 1: conditions created by COVID. Worldwide, at least seven thousand people

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Speaker 1: die annually from drug resistant infections. That number will balloon

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Speaker 1: to ten millions. That's a year by twenty fifty, and

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Speaker 1: will cost more than one and lost economic put without

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Speaker 1: corrective actions. That's according to research for the UK government

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Speaker 1: by former Goldman SAX economist Jim O'Neil four years ago.

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Speaker 1: He recommended spending forty two billion dollars over ten years

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Speaker 1: to boost the supply of new medicines, vaccines and diagnostic

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Speaker 1: tools and introduce mechanisms to reduce the demand for antibiotics.

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Speaker 1: Yet few governments have been willing to make the necessary

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Speaker 1: investment needed to mitigate the global antimicrobial resistance crisis. Marin

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Speaker 1: says COVID hasn't lessened the likelihood of those grim predictions.

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Speaker 1: You know. One of the things that makes antibiotic resistance

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Speaker 1: so challenging is that as the bugs get worse and worse,

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Speaker 1: we don't have the drugs to combat them, to take

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Speaker 1: the next jump in that game of leap drug between

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Speaker 1: bug and drug because making antibiotics has become so profoundly

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Speaker 1: unsatisfying for pharmaceutical manufacturers. That is also not going to

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Speaker 1: change in the setting of COVID right because manufacturers or

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Speaker 1: let's say, drug developers, discoverers and developers all over the

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Speaker 1: world are now turning to looking for anti virals. Marins's

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Speaker 1: antibiotic developers have told her they're going through their drug

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Speaker 1: libraries looking for potential anti virals instead of antibiotics because

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Speaker 1: that's what's needed now. So between the economic disincentives to

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Speaker 1: develop antibiotics right now and the potential incentives to spend

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Speaker 1: your time looking for anti virals instead, we're just going

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Speaker 1: to be further behind in that bug drug game of

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Speaker 1: leap frog. We're not going to get new drugs any faster.

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Speaker 1: The pandemic has, however, sent a stark warning to world

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Speaker 1: leaders and policy maker is that global threats to human

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Speaker 1: health a devastatingly costly No person and no country is immune.

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Speaker 1: Investing in ways to prevent and mitigate infectious risks isn't

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Speaker 1: just smart, it's a necessity. That was Jason Gale in

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Speaker 1: Melbourne and that's our show today. For coverage of the

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Speaker 1: outbreak from one bureaus around the world, visit Bloomberg dot

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Speaker 1: com slash Coronavirus and if you like the show, please

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Speaker 1: leave us a review and a rating on Apple Podcasts

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Speaker 1: or Spotify. It's the best way to help more listeners

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Speaker 1: find our global reporting. The Prognosis Daily edition is produced

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Speaker 1: by Tover foreheads Jordan Gospore, Magnus Hendrickson and Laura Carlson.

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Speaker 1: Today's main story was reported by Jason Gibb. Original music

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Speaker 1: by Leo Sidron. Our editors are Rick Shine and me

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Speaker 1: Francesca Leave. Bloomberg's head of podcasts is also Lea