5 ms·

You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacte

by delbel 8y ago

You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacted? Instead, they focus on farm animals. Somehow regular family doctors read this -- fear the most, and hesitant to prescribe basic antibiotics for conditions that could turn serious, where these people later on could end up in your care because of these mistakes. The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts and therefore, kill itself rendering no vector to transfer between hosts. This is why I think ebola outbreaks always die down.

buvanshak 8y ago
>The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts.. That is not what a super bug means. It just means that it is resistant to antibiotics. Not that it has a MR of 100. It is possible for people to survive infections without antibiotics. I am surprised that I have to say this aloud. It seems that we are living in a time where people are born convinced that human beings cannot survive without medicines...
Fomite 8y ago
"You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacted?" - Yep. "Instead, they focus on farm animals." - While the focus on farm animals occasionally irritates me because it lets doctors off the hook by pretending they're not part of the problem, ESBLs - as an example - are relatively common in livestock. "...hesitant to prescribe basic antibiotics for conditions that could turn serious, where these people later on could end up in your care because of these mistakes." Of the problems we have, the inappropriate non-use of antibiotics pales in comparison to the inappropriate use of antibiotics, either using an overly broad spectrum agent (like penicillin or ampicillin...), the wrong agent, or treating a viral infection with antibiotics. Antibiotic stewardship, in both the inpatient and outpatient settings, is not pretty much the standard of care, and supported by major medical societies like the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. "The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts and therefore, kill itself rendering no vector to transfer between hosts. This is why I think ebola outbreaks always die down." Relying on the concept of susceptible depletion is a really bad idea. It's one of those "just so" stories that seems to make sense, but doesn't work in practice (Ebola doesn't actually die down due to susceptible depletion either...) The issue is not "OH MY GOD IT WILL KILL EVERYONE" but that there are activities today that are relatively risk free because if you do get an infection it's treatable. Things like surgery and childbirth. Absent effective treatments, the concern is that the mortality rate from infections will rise. Not to 100%, but it also doesn't need to be 100% to be a major public health problem.
- delbel 8y ago
  Thanks, I really enjoy and respect your perspective and facts.
- candiodari 8y ago
  I think if one looks at relatively recent incidents of diseases spreading, and take the Spanish flu as precedent, that provides a good framework for what one can expect once we fully lose antibiotics. Suddenly losing 10, 20, probably up to 60% of certain popluation groups (usually age based, but definitely not race-blind) is to be expected, with some groups more likely than others to be affected. The poor obviously, but beyond that children and elderly, sometimes with a large preference for one sex over another, or one race over another ... I'm pretty sure that's pretty accurately described as "OH MY GOD EVERYBODY DIES", because ... that's certainly what it'll feel like for at least 6 months.
  - Fomite 8y ago
    I mean, that's based on a particularly aggressive route of transmission. I think the much more useful examples are to read old historical accounts of every day life. People died of things we now simply assume to be safe - shaving, for example. There are all manner of modern interactions we have with the world and especially the medical system where the expectation is "I won't die during this" - and much of that relies on access to effective antibiotics. Antibiotic resistance is unlikely to cause an epidemic in the same way as flu. What it's much more likely to do is make people have worse outcomes forever. You won't get gonorrhea any more than you do right now - but if you do it's not a quick course of antibiotics. It's a painful infection followed by the distinct possibility of sterility.
    - candiodari 8y ago
      That describes the steady-state situation, but about once a generation you can expect at least an epidemic, maybe a pandemic.
      - Fomite 8y ago
maxxxxx 8y ago
The black death didn't kill all of its hosts but wiping out a third of the population is still pretty bad in my book.
- jryan49 8y ago
  But it increased the quality of life for those who did survive, and has had many positive effects on all humans born afterwards [0]. So it's not all bad :D 0: https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the_Italian_Renaissance_possible%3F https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the...
  - maxxxxx 8y ago
    In Britain peasants also suddenly had bargaining power when land owners need workers and there were not many workers left.
  - saiya-jin 8y ago
    so called Thanos argument
hexane360 8y ago
You've likely played too much Pandemic. Take a step back and wonder whether it's likelier that all the scientists are wrong or that you don't know as much about epidemiology (or, looking at your post history: geology, chemistry, climate science, GMOs) as you may about programming. https://xkcd.com/675/ https://xkcd.com/675/
TeMPOraL 8y ago
To reiterate the point brought by others so that it stands in the clear: the problem with superbugs isn't the imagined risk of creating a super-pathogen that will wipe out large parts of the population. The problem is that the routine procedures you don't think about as unsafe - like childbirth, patching up cuts, minor surgeries - could suddenly become life-threatening conditions.
- Fomite 8y ago
  The one I often pick is battlefield medicine. Soldiers don't die of gangrene and sepsis in field hospitals anymore.

by delbel 8y ago

buvanshak 8y ago

>The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts.. That is not what a super bug means. It just means that it is resistant to antibiotics. Not that it has a MR of 100. It is possible for people to survive infections without antibiotics. I am surprised that I have to say this aloud. It seems that we are living in a time where people are born convinced that human beings cannot survive without medicines...

Fomite 8y ago

"You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacted?" - Yep. "Instead, they focus on farm animals." - While the focus on farm animals occasionally irritates me because it lets doctors off the hook by pretending they're not part of the problem, ESBLs - as an example - are relatively common in livestock. "...hesitant to prescribe basic antibiotics for conditions that could turn serious, where these people later on could end up in your care because of these mistakes." Of the problems we have, the inappropriate non-use of antibiotics pales in comparison to the inappropriate use of antibiotics, either using an overly broad spectrum agent (like penicillin or ampicillin...), the wrong agent, or treating a viral infection with antibiotics. Antibiotic stewardship, in both the inpatient and outpatient settings, is not pretty much the standard of care, and supported by major medical societies like the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. "The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts and therefore, kill itself rendering no vector to transfer between hosts. This is why I think ebola outbreaks always die down." Relying on the concept of susceptible depletion is a really bad idea. It's one of those "just so" stories that seems to make sense, but doesn't work in practice (Ebola doesn't actually die down due to susceptible depletion either...) The issue is not "OH MY GOD IT WILL KILL EVERYONE" but that there are activities today that are relatively risk free because if you do get an infection it's treatable. Things like surgery and childbirth. Absent effective treatments, the concern is that the mortality rate from infections will rise. Not to 100%, but it also doesn't need to be 100% to be a major public health problem.

delbel 8y ago
Thanks, I really enjoy and respect your perspective and facts.
candiodari 8y ago
I think if one looks at relatively recent incidents of diseases spreading, and take the Spanish flu as precedent, that provides a good framework for what one can expect once we fully lose antibiotics. Suddenly losing 10, 20, probably up to 60% of certain popluation groups (usually age based, but definitely not race-blind) is to be expected, with some groups more likely than others to be affected. The poor obviously, but beyond that children and elderly, sometimes with a large preference for one sex over another, or one race over another ... I'm pretty sure that's pretty accurately described as "OH MY GOD EVERYBODY DIES", because ... that's certainly what it'll feel like for at least 6 months.
- Fomite 8y ago
  I mean, that's based on a particularly aggressive route of transmission. I think the much more useful examples are to read old historical accounts of every day life. People died of things we now simply assume to be safe - shaving, for example. There are all manner of modern interactions we have with the world and especially the medical system where the expectation is "I won't die during this" - and much of that relies on access to effective antibiotics. Antibiotic resistance is unlikely to cause an epidemic in the same way as flu. What it's much more likely to do is make people have worse outcomes forever. You won't get gonorrhea any more than you do right now - but if you do it's not a quick course of antibiotics. It's a painful infection followed by the distinct possibility of sterility.
  - candiodari 8y ago
    That describes the steady-state situation, but about once a generation you can expect at least an epidemic, maybe a pandemic.
    - Fomite 8y ago

maxxxxx 8y ago

The black death didn't kill all of its hosts but wiping out a third of the population is still pretty bad in my book.

jryan49 8y ago
But it increased the quality of life for those who did survive, and has had many positive effects on all humans born afterwards [0]. So it's not all bad :D 0: https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the_Italian_Renaissance_possible%3F https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the...
- maxxxxx 8y ago
  In Britain peasants also suddenly had bargaining power when land owners need workers and there were not many workers left.
- saiya-jin 8y ago
  so called Thanos argument

hexane360 8y ago

You've likely played too much Pandemic. Take a step back and wonder whether it's likelier that all the scientists are wrong or that you don't know as much about epidemiology (or, looking at your post history: geology, chemistry, climate science, GMOs) as you may about programming. https://xkcd.com/675/ https://xkcd.com/675/

TeMPOraL 8y ago

To reiterate the point brought by others so that it stands in the clear: the problem with superbugs isn't the imagined risk of creating a super-pathogen that will wipe out large parts of the population. The problem is that the routine procedures you don't think about as unsafe - like childbirth, patching up cuts, minor surgeries - could suddenly become life-threatening conditions.

Fomite 8y ago
The one I often pick is battlefield medicine. Soldiers don't die of gangrene and sepsis in field hospitals anymore.