COVID-19 Has Amplified the Superbug Crisis. Hospitals Must Respond Part 2

COVID-19 Has Amplified the Superbug Crisis. Hospitals Must Respond Part 2

read part 1 of this blog post here.

TB patients have rationed medication, yet another practice known to spur antibiotic resistance. During the pandemic, most countries have reported sharp drops in tuberculosis cases, which means huge numbers of patients are going undiagnosed. In 2020, an estimated 500,000 more people than usual may have died of TB, and the number receiving TB treatment dropped by over 1 million.

“The more [patients] you leave undiagnosed and untreated, the more you will have next year and the year after,” warns Lucica Ditiu, M.D., of Stop TB Partnership.

Before COVID, tuberculosis ranked as the world’s leading infectious disease killer; it’s now number two. Drug-resistant forms of the disease account for about 29% of all deaths worldwide caused by bacterial infections. Treatment can last over 2 years and is both highly toxic and often ineffective.

Far worse is XDR-TB, extensively drug-resistant tuberculosis. Now found in 127 countries, this strain is resistant to four anti-TB drugs and represents 6% of all multidrug-resistant tuberculosis cases.

The TB Alliance calls XDR-TB “an extremely deadly and costly global health threat that the world must mobilize rapidly to tackle.”

Instead, understandably, the world is mobilizing against COVID-19.

Before the pandemic, the pipeline for antibiotic development had slowed to a trickle. Now, it’s essentially dry. When COVID emerged, the United States launched Operation Warp Speed to develop a vaccine; no such urgency has been mustered to fight TB or MRSA.

That’s because no incentive exists for drug companies to invest. Antibiotics, after all, must be used sparingly. In the United States, the development of a single antibiotic can cost $985 million, for an annual sales return of perhaps $50 million.

The global economic crisis, driven by COVID, has further dimmed investor enthusiasm. With all hands on deck to fight the pandemic, antimicrobial trials have been delayed. Reagents and researchers alike have been redeployed.

“Very few new innovative anti-bacterial treatments will come to the patients’ bedside in the coming years, and even fewer are targeting the most dangerous resistant bacteria,” warns Peter Beyer, Ph.D., a senior adviser to WHO on antibiotic resistance.

The Silver Lining: COVID Shines Spotlight on Airborne Pathogens

Yet, all is not bleak in the fight against superbugs.

While COVID-19 has suppressed antimicrobial research, the pandemic also has sparked awareness of airborne pathogens. 

Hospitals now know: It’s not just door handles, bed rails, and scalpels that can be teeming with lethal microbes. The air we all share — in the emergency department, the operating theatre, the ICU — may be contaminated, too.

Of course, airborne superbugs have long been implicated in the transmission of hospital-acquired infection. As Iranian scientists observed well before the pandemic, “Antibiotic-resistant airborne bacteria can survive in the various hospital environments and remain suspended in the air for long periods of time.”

In fact, airborne superbugs posed such a danger that these scientists urged hospitals to deploy stand-alone air cleaning devices: “Use of advanced air purification and ventilation equipment, their constant monitoring, as well as a continuous microbial sampling of the hospital air are strongly recommended for preventing nosocomial infection.”

The COVID-19 pandemic has strengthened the case, prompting hospitals worldwide to install air dis-infection technology, such as NanoStrikeTechnology by Novaerus.

After all, the same devices that remove SARS-CoV aerosols also inactivate airborne superbugs.

MRSA, C. difficile, Acinetobacter species, and tuberculosis are among the bacteria shown by independent testing to be obliterated by Novaerus’ ultra-low energy NanoStrikeTechnology. Common viruses such as influenza and norovirus are removed by the same process.

NanoStrike Technology harnesses a range of physical concurrent pathogen inactivation processes to safely disinfect the air. NanoStrike coils provide a powerful strike that works to burst airborne pathogen cells, rapidly inactivating them, ensuring they are no longer a threat of infection.

Mounted above ICU beds, or wheeled into operating theatres, installed in wards and emergency rooms, Novaerus units safely operate 24/7 proximity to even the most vulnerable patients and protect medical staff as well.

It’s clear that both antibiotic stewardship and infection prevention are critical to slowing the rise of antibiotic resistance. Some experts argue that of the two approaches, infection prevention is the more urgent.

“Antimicrobial resistance is affected by many factors, but too much of our focus has been on antimicrobial usage,” two Australian physicians have asserted in JAC-Antimicrobial Resistance.  “The major factor that drives resistance rates globally is spread.”

The countries most burdened by antimicrobial resistance, these doctors note, are those in which pathogen spread, rather than antibiotic overuse, is the dominant factor.

One of the most effective, most accessible, and least expensive, weapons against transmission is air disinfection.

Right now, all attention is focused on taming COVID-19, but the world cannot wait for the pandemic to subside before tackling the rise of superbugs. As a Harvard University scientist notes, “The antibiotic resistance crisis will continue well beyond the resolution of the COVID-19 pandemic.”