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Mankind can finally count on the truly catastrophic threat of climate change. But there is something else that threatens the human being and does not attract enough attention: the superbugs.
Since doctors and farmers have distributed antimicrobial drugs (such as antibiotics and antifungals) indiscriminately, the harmful bacteria and fungi that can thwart these drugs have multiplied. These superbugs threaten modern medicine, the safety of our food system – and ourselves. Experts warn that by 2050, the number of deaths from drug-resistant infections will increase to 10 million.
Yet many outbreaks of superbugs remain largely hidden from the public.
In a breathtaking news report from The New York Times, reporters Matt Richtel and Andrew Jacobs have highlighted one of those hidden epidemics: the spread of a drug-resistant fungus, Candida auris, around the world.
This pathogen, which usually strikes people with weakened immune systems, causing fever and chills, is so "invasive" that hospitals have been forced to acquire special equipment to eradicate it, even from remove the ceiling and floor tiles. And they also document the flagrant lack of transparency regarding the reporting of epidemics:
With bacteria and fungi, hospitals and local governments are reluctant to disclose outbreaks for fear of being considered as outbreaks of infection. Even the C.D.C., by virtue of its agreement with the States, is not authorized to make public the place or the name of the hospitals involved in epidemics. State governments have in many cases refused to publicly share information beyond simple case recognition.
This surprisingly means that the US states and the federal government have no public system to track and name current outbreaks. It also means that patients and their family members have no way of knowing if they are at risk of being exposed to superbugs in a hospital they are visiting.
Until now, we have done very little to stem the crisis of drug resistance
Around the world, we are already seeing a number of different insects – gonorrhea, CRF, TB strains, to name a few – that no longer respond to any of the drugs we have.
In the United States alone, we are seeing 23,000 deaths every year and 2 million diseases – a conservative estimate – of drug-resistant infections.
Experts warned that superbugs could become more common in the near future. And without effective antimicrobials, common medical procedures such as hip operations, caesareans or chemotherapy will become more dangerous and some medical procedures – organ transplants, chemotherapy – would be impossible to survive.
It's not just drugs: modern agricultural practices that provide us with our abundant food also depend on these drugs.
So far, we have done little to stem the global crisis of resistance, and the problem has been called a "tragedy of the commons" in the same way as climate change.
In low- and middle-income countries, such as India, the main factor of infections – and the need for antimicrobials – remains inadequate sanitation. Many people live in areas contaminated by human and animal waste. That is why it is essential to ensure safe drinking water and sanitation for all to prevent the use of antimicrobials. On the other hand, the uncontrolled use of antibiotics or the lack of access to drugs when people need them are also the drivers of the superbugs problem.
What would the public opinion look like outbreaks of superbugs?
Some health officials told The Times that it was extremely difficult to inform the public about outbreaks of superbugs, and they did not want to frighten patients who could not do anything about their exposure. At the same time, others pointed out that the public would not tolerate the secrecy of foodborne disease outbreaks, which raises the question of why outbreaks of superbugs should be different.
In any case, being transparent is not as simple as it sounds, Vox Jason Burnham, an infectious disease specialist at the University of Washington's St. Louis School of Medicine, told Vox. "First, when reporting is difficult. Should only one case require public reporting? In one case, it is possible that no other patient is affected. So are you waiting for two? Or three? If you report too early and it's not an epidemic, the public is scared for nothing.
Notifying the public could even be counterproductive, continued Burnham. "If people are too scared to go to the hospital, they can delay their care, getting sicker and sicker until their situation becomes an emergency." When health issues become emergencies, people are more likely to be hospitalized and die. added.
Burnham at least thinks that patients have the right to know about the health risks to which they are exposed. "We just need to know who to say what, when," said Burnham, "in order to avoid excessive panic while protecting patients."
With the spread of dangerous pathogens, like Candida auris, It is time for us to start thinking seriously about what such a system might look like and to determine if the potential risks of public reporting (fear of patients, delaying care) would outweigh the benefits (increased accountability, transparency and awareness of the problem).
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