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"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 contact
by 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 agoThanks, I really enjoy and respect your perspective and facts.
- candiodari 8y agoI 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 agoI 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 agoThat describes the steady-state situation, but about once a generation you can expect at least an epidemic, maybe a pandemic.
- Fomite 8y agoNot for endemic pathogens. You get small, stochastic outbreaks in specific populations, and you can have a global rise in infection rates, but many of the diseases we are talking about don't work anything like influenza. There's no once a generation, massive mortality pandemic of Acinetobacter.