WEBVTT - The New Superbug Threat

0:00:05.120 --> 0:00:10.559
<v Speaker 1>Welcome to Prognosis. I'm Francescaliti. Laura Carlson is out. It's

0:00:10.640 --> 0:00:15.280
<v Speaker 1>day since coronavirus was declared a global pandemic. Our main

0:00:15.360 --> 0:00:19.320
<v Speaker 1>story viruses like SARS COVID two, the one that causes

0:00:19.480 --> 0:00:24.480
<v Speaker 1>COVID nineteen, can't be treated by antibiotics. Even so, doctors

0:00:24.560 --> 0:00:28.560
<v Speaker 1>have used antibiotics on many COVID patients, and that has

0:00:28.600 --> 0:00:34.440
<v Speaker 1>scary implications for a whole other health crisis superbugs. But first,

0:00:34.840 --> 0:00:47.040
<v Speaker 1>here's what happened in virus news today. In Florida, COVID

0:00:47.120 --> 0:00:51.600
<v Speaker 1>nineteen cases sword to their highest weekly level yesterday. Governor

0:00:51.720 --> 0:00:54.520
<v Speaker 1>Rhonda Santis says the jump in numbers is partly an

0:00:54.560 --> 0:00:57.720
<v Speaker 1>illusion caused by this state ramping up testing, and he

0:00:57.800 --> 0:01:01.840
<v Speaker 1>says isolated outbreaks and prisons, long term care facilities, and

0:01:01.880 --> 0:01:07.040
<v Speaker 1>agriculture communities may be skewing the numbers higher, but a

0:01:07.080 --> 0:01:11.399
<v Speaker 1>Bloomberg News analysis of publicly available data suggests those factors

0:01:11.440 --> 0:01:14.800
<v Speaker 1>aren't the cause. The percentage of tests coming back positive

0:01:14.800 --> 0:01:18.160
<v Speaker 1>has jumped, undermining the idea that more testing is to blame.

0:01:18.840 --> 0:01:23.360
<v Speaker 1>And as for prisons, care facilities and agriculture workers, cases

0:01:23.360 --> 0:01:27.480
<v Speaker 1>are up dramatically even when you exclude those communities. In fact,

0:01:27.760 --> 0:01:30.720
<v Speaker 1>without those examples, the rate of increase would be even

0:01:30.800 --> 0:01:36.320
<v Speaker 1>more dramatic. In Beijing, a coronavirus outbreak that infected more

0:01:36.360 --> 0:01:39.760
<v Speaker 1>than one hundred fifty people has been contained, according to

0:01:39.880 --> 0:01:44.080
<v Speaker 1>Chinese disease experts. The Chinese Center for Disease Control and

0:01:44.120 --> 0:01:48.320
<v Speaker 1>Prevention said more cases will be confirmed in the coming days,

0:01:48.360 --> 0:01:51.200
<v Speaker 1>but that should only reflect people who are already infected.

0:01:52.600 --> 0:01:55.600
<v Speaker 1>And finally, American football fans who had been hoping for

0:01:55.640 --> 0:01:59.640
<v Speaker 1>good news were disappointed today. Anthony Fauci, the country's top

0:01:59.680 --> 0:02:04.600
<v Speaker 1>and actous disease expert, said National Football League and college

0:02:04.600 --> 0:02:08.040
<v Speaker 1>football seasons may have to be canceled if there is

0:02:08.080 --> 0:02:11.040
<v Speaker 1>a second wave of the virus. The NFL season is

0:02:11.080 --> 0:02:14.800
<v Speaker 1>scheduled to start September t. Fauci said players would have

0:02:14.840 --> 0:02:18.360
<v Speaker 1>to be in a bubble, isolated and tested daily for

0:02:18.440 --> 0:02:21.080
<v Speaker 1>him to imagine how the game could be played this fall.

0:02:27.200 --> 0:02:31.840
<v Speaker 1>And now for today's main story. Long before the COVID pandemic,

0:02:32.240 --> 0:02:36.720
<v Speaker 1>another global health disaster was brewing, threatening to kill millions

0:02:36.720 --> 0:02:41.800
<v Speaker 1>of people annually. Superbugs, germs even our most potent antibiotics

0:02:41.840 --> 0:02:45.160
<v Speaker 1>can't defeat, pose a massive challenge to human health and

0:02:45.160 --> 0:02:50.080
<v Speaker 1>well being. The coronavirus, of course, isn't stopped by antibiotics,

0:02:50.080 --> 0:02:55.160
<v Speaker 1>which target bacteria. Even so, antibiotics have been used liberally

0:02:55.200 --> 0:02:59.680
<v Speaker 1>for COVID nineteen patients. Bloomberg Senior editor Jason Gale reports

0:03:00.240 --> 0:03:12.520
<v Speaker 1>that could worsen the superbook crisis. In the first months

0:03:12.520 --> 0:03:15.600
<v Speaker 1>of the pandemic, studies from China showed that almost all

0:03:15.720 --> 0:03:20.120
<v Speaker 1>hospitalized COVID nineteen patients were being administered a cocktail of medicines,

0:03:20.520 --> 0:03:26.480
<v Speaker 1>including antibiotics. It's not that surprising. Studies of the Spanish

0:03:26.480 --> 0:03:30.320
<v Speaker 1>influenza pandemic showed that the vast majority of debts were

0:03:30.400 --> 0:03:34.760
<v Speaker 1>actually caused by a secondary bacterial infection. The flu virus

0:03:34.960 --> 0:03:39.200
<v Speaker 1>landed the first blow, but bacteria delivered the knockout punch.

0:03:39.840 --> 0:03:43.360
<v Speaker 1>So doctors caring for COVID patients have wanted to prevent

0:03:43.400 --> 0:03:46.400
<v Speaker 1>them suffering the same fate. I think it's safe to

0:03:46.480 --> 0:03:51.120
<v Speaker 1>say that many patients with COVID receive antibiotics, especially the

0:03:51.160 --> 0:03:54.160
<v Speaker 1>ones that are hospitalized, And I think part of that

0:03:54.280 --> 0:03:57.280
<v Speaker 1>is that the picture of COVID can look similar to

0:03:58.120 --> 0:04:02.600
<v Speaker 1>community acquired pneumonia. This is doctor Arnu Milani. He's an

0:04:02.640 --> 0:04:06.560
<v Speaker 1>infectious diseases physician, a medical director for the infection prevention

0:04:06.600 --> 0:04:10.760
<v Speaker 1>and antimicrobial stewardship programs at Saint Joseph's Mercy Health System

0:04:11.040 --> 0:04:15.160
<v Speaker 1>in Anna, but Michigan. Researchers in London analyzed more than

0:04:15.240 --> 0:04:18.720
<v Speaker 1>one thousand coronavirus studies and they found that seventy two

0:04:18.720 --> 0:04:22.560
<v Speaker 1>pc of COVID nineteen patients received antibiotics in the hospital.

0:04:23.160 --> 0:04:27.600
<v Speaker 1>I think many patients um are getting treated for pneumonia

0:04:27.680 --> 0:04:32.640
<v Speaker 1>or were being treated for pneumonia. But further researchers showing

0:04:32.680 --> 0:04:36.800
<v Speaker 1>that bacteria aren't a major threat. Fewer than eight percent

0:04:36.880 --> 0:04:40.240
<v Speaker 1>of COVID patients have a bacterial co infection. Two studies

0:04:40.279 --> 0:04:43.280
<v Speaker 1>published in the past month of showing another found that

0:04:43.480 --> 0:04:47.480
<v Speaker 1>using antibiotics to prevent infections and COVID patients has no

0:04:47.640 --> 0:04:51.160
<v Speaker 1>benefit that fits with the World Health Organization's guidance for

0:04:51.240 --> 0:04:56.760
<v Speaker 1>managing these cases. The agency recommends against using antibiotics unless

0:04:56.760 --> 0:05:00.400
<v Speaker 1>the patient is suspected of having a bacterial infection. But

0:05:00.880 --> 0:05:04.640
<v Speaker 1>one antibiotic was popularized, at least for a while, when

0:05:04.800 --> 0:05:08.839
<v Speaker 1>political leaders touted combinations of the malaria drugs chloroquin or

0:05:08.920 --> 0:05:14.240
<v Speaker 1>hydroxy chloric wine with the antibiotic zithromycin, and so early

0:05:14.320 --> 0:05:17.039
<v Speaker 1>on in the outbreak, at least in the United States,

0:05:17.120 --> 0:05:21.240
<v Speaker 1>there was quite a high degree of use of hydroxy

0:05:21.320 --> 0:05:25.599
<v Speaker 1>chloric win and zethromycin Um. You know, without a lot

0:05:25.720 --> 0:05:29.640
<v Speaker 1>of um you know, scientific evidence to support the use.

0:05:29.720 --> 0:05:32.600
<v Speaker 1>But I think you know with COVID, because so many

0:05:32.680 --> 0:05:37.640
<v Speaker 1>patients are quite ill um providers, there's there's a tendency

0:05:37.680 --> 0:05:40.800
<v Speaker 1>to try to want to do something the who says

0:05:40.880 --> 0:05:44.960
<v Speaker 1>COVID has bolsted the use of antibiotics. Hospitals naturally have

0:05:45.040 --> 0:05:48.400
<v Speaker 1>a lot of sick people with infections or receiving treatments

0:05:48.480 --> 0:05:52.480
<v Speaker 1>like intravenous infusions, catholis and ventilators that put patients at

0:05:52.600 --> 0:05:56.800
<v Speaker 1>risk of an infection, so antibiotics are commonly administered. But

0:05:57.000 --> 0:06:00.160
<v Speaker 1>when these medicines are overused, he gives rise to the

0:06:00.200 --> 0:06:05.320
<v Speaker 1>emergence and transmission of multi drug resistant bacteria, and infections

0:06:05.320 --> 0:06:08.680
<v Speaker 1>with these superbugs are more difficult and costly to treat,

0:06:09.240 --> 0:06:12.279
<v Speaker 1>and they're more likely to lead to prolonged illness and death.

0:06:13.080 --> 0:06:17.440
<v Speaker 1>Ni says it's important that healthcare workers prevent spreading infections

0:06:17.440 --> 0:06:21.120
<v Speaker 1>through careful hand hygiene and sterilization practices, and that they

0:06:21.200 --> 0:06:25.400
<v Speaker 1>use antibiotics only when they're needed, and I think we

0:06:25.440 --> 0:06:27.600
<v Speaker 1>want to make sure we don't take any steps backwards

0:06:27.600 --> 0:06:32.880
<v Speaker 1>with respecting animalcuobial stewardship. Prudent management of these precious miracle

0:06:32.960 --> 0:06:36.520
<v Speaker 1>cures has come under serious threat because of COVID nineteen.

0:06:36.600 --> 0:06:40.200
<v Speaker 1>According to Marion McKenna, she's an Atlanta based science journalist

0:06:40.200 --> 0:06:44.040
<v Speaker 1>who has written books about antibiotic resistance, some tests needed

0:06:44.080 --> 0:06:47.200
<v Speaker 1>to determine whether a COVID patient has a bacterial infection

0:06:47.600 --> 0:06:50.799
<v Speaker 1>might not get done because collecting specimens from patients lower

0:06:50.839 --> 0:06:54.400
<v Speaker 1>respiratory tracks puts health workers at increased risk of catching

0:06:54.400 --> 0:06:58.719
<v Speaker 1>the coronavirus. Marine says in those cases, antibiotics might be

0:06:58.760 --> 0:07:02.840
<v Speaker 1>administered as a rec ocean um and many more people

0:07:03.480 --> 0:07:08.400
<v Speaker 1>being treated prospectively against the fear that they're going to

0:07:08.480 --> 0:07:11.880
<v Speaker 1>develop bacterial infections. Those things kind of fly in the

0:07:11.880 --> 0:07:15.760
<v Speaker 1>face of stewardship. You've just violated a couple of the

0:07:15.800 --> 0:07:19.160
<v Speaker 1>precepts of stewardship, which is you might not have exactly

0:07:19.160 --> 0:07:20.880
<v Speaker 1>the right drug for the organism because you don't know

0:07:20.880 --> 0:07:24.240
<v Speaker 1>what the organism is and you're not sure you're gonna

0:07:24.240 --> 0:07:25.840
<v Speaker 1>be using it for the right amount of time. Because

0:07:25.880 --> 0:07:29.440
<v Speaker 1>COVID makes people sicker for so much longer. So this

0:07:29.640 --> 0:07:35.760
<v Speaker 1>whole effort to try to suppress antibiotic resistance around the

0:07:35.760 --> 0:07:39.800
<v Speaker 1>world by making sure we use antibiotics as conservatively as possible,

0:07:40.680 --> 0:07:43.920
<v Speaker 1>is that particular effort is under threat because of the

0:07:43.920 --> 0:07:49.800
<v Speaker 1>conditions created by COVID. Worldwide, at least seven thousand people

0:07:49.920 --> 0:07:53.920
<v Speaker 1>die annually from drug resistant infections. That number will balloon

0:07:54.000 --> 0:07:56.920
<v Speaker 1>to ten millions. That's a year by twenty fifty, and

0:07:56.960 --> 0:08:00.640
<v Speaker 1>will cost more than one and lost economic put without

0:08:00.680 --> 0:08:04.400
<v Speaker 1>corrective actions. That's according to research for the UK government

0:08:04.600 --> 0:08:07.640
<v Speaker 1>by former Goldman SAX economist Jim O'Neil four years ago.

0:08:08.200 --> 0:08:11.119
<v Speaker 1>He recommended spending forty two billion dollars over ten years

0:08:11.160 --> 0:08:14.640
<v Speaker 1>to boost the supply of new medicines, vaccines and diagnostic

0:08:14.680 --> 0:08:18.480
<v Speaker 1>tools and introduce mechanisms to reduce the demand for antibiotics.

0:08:18.840 --> 0:08:21.920
<v Speaker 1>Yet few governments have been willing to make the necessary

0:08:21.960 --> 0:08:27.040
<v Speaker 1>investment needed to mitigate the global antimicrobial resistance crisis. Marin

0:08:27.080 --> 0:08:31.280
<v Speaker 1>says COVID hasn't lessened the likelihood of those grim predictions.

0:08:31.320 --> 0:08:35.439
<v Speaker 1>You know. One of the things that makes antibiotic resistance

0:08:35.840 --> 0:08:39.760
<v Speaker 1>so challenging is that as the bugs get worse and worse,

0:08:40.360 --> 0:08:43.680
<v Speaker 1>we don't have the drugs to combat them, to take

0:08:43.720 --> 0:08:45.920
<v Speaker 1>the next jump in that game of leap drug between

0:08:45.960 --> 0:08:50.360
<v Speaker 1>bug and drug because making antibiotics has become so profoundly

0:08:50.400 --> 0:08:55.960
<v Speaker 1>unsatisfying for pharmaceutical manufacturers. That is also not going to

0:08:56.040 --> 0:09:01.360
<v Speaker 1>change in the setting of COVID right because manufacturers or

0:09:01.440 --> 0:09:05.520
<v Speaker 1>let's say, drug developers, discoverers and developers all over the

0:09:05.520 --> 0:09:11.040
<v Speaker 1>world are now turning to looking for anti virals. Marins's

0:09:11.080 --> 0:09:14.280
<v Speaker 1>antibiotic developers have told her they're going through their drug

0:09:14.360 --> 0:09:19.360
<v Speaker 1>libraries looking for potential anti virals instead of antibiotics because

0:09:19.520 --> 0:09:23.920
<v Speaker 1>that's what's needed now. So between the economic disincentives to

0:09:24.160 --> 0:09:29.360
<v Speaker 1>develop antibiotics right now and the potential incentives to spend

0:09:29.400 --> 0:09:32.600
<v Speaker 1>your time looking for anti virals instead, we're just going

0:09:32.679 --> 0:09:35.800
<v Speaker 1>to be further behind in that bug drug game of

0:09:35.880 --> 0:09:39.080
<v Speaker 1>leap frog. We're not going to get new drugs any faster.

0:09:40.120 --> 0:09:43.200
<v Speaker 1>The pandemic has, however, sent a stark warning to world

0:09:43.320 --> 0:09:46.319
<v Speaker 1>leaders and policy maker is that global threats to human

0:09:46.360 --> 0:09:51.280
<v Speaker 1>health a devastatingly costly No person and no country is immune.

0:09:51.840 --> 0:09:55.800
<v Speaker 1>Investing in ways to prevent and mitigate infectious risks isn't

0:09:55.840 --> 0:10:10.480
<v Speaker 1>just smart, it's a necessity. That was Jason Gale in

0:10:10.520 --> 0:10:14.040
<v Speaker 1>Melbourne and that's our show today. For coverage of the

0:10:14.040 --> 0:10:17.720
<v Speaker 1>outbreak from one bureaus around the world, visit Bloomberg dot

0:10:17.760 --> 0:10:21.880
<v Speaker 1>com slash Coronavirus and if you like the show, please

0:10:21.960 --> 0:10:24.559
<v Speaker 1>leave us a review and a rating on Apple Podcasts

0:10:24.600 --> 0:10:27.480
<v Speaker 1>or Spotify. It's the best way to help more listeners

0:10:27.520 --> 0:10:32.840
<v Speaker 1>find our global reporting. The Prognosis Daily edition is produced

0:10:32.840 --> 0:10:37.360
<v Speaker 1>by Tover foreheads Jordan Gospore, Magnus Hendrickson and Laura Carlson.

0:10:37.840 --> 0:10:41.920
<v Speaker 1>Today's main story was reported by Jason Gibb. Original music

0:10:42.000 --> 0:10:45.599
<v Speaker 1>by Leo Sidron. Our editors are Rick Shine and me

0:10:45.920 --> 0:10:50.200
<v Speaker 1>Francesca Leave. Bloomberg's head of podcasts is also Lea