As the novel coronavirus wreaks havoc, more sinister Superbugs continue to evolve.
My last article was written about the impacts of the ongoing pandemic on global politics; indeed, there are countless articles on this and other websites to remind us of precisely how different our world is from just a few short months ago. There is, however, something that has not changed – the growing problem of resistant bacteria, and the continuing failure of Western Medicine to explore the solutions. Half medicinal, half political – welcome to the world of resistant microbes.
Coronavirus has shown us all how vulnerable we can be to infections. As a novel virus, we lack any kind of immunity to it and as a result it will infect such a huge proportion of the global population that, despite the low fatality rate, millions of lives will be lost to the virus. However, once the virus has infected most people it will enter the seasonal flu cycle as another strain of flu-causing coronavirus. This will contribute a low number of deaths every year to our annual flu totals. Coronavirus is so disruptive to us because it has only this year evolved. After this, it will become progressively weaker, with its symptoms gradually weakening over time. This is called attenuation, and while it is not fully understood in nature it is the backbone of modern vaccine research.
So, what about Bacteria? Bacteria are very different to Virions. They are a hugely diverse group of organisms which includes many healthy or benign microbes – the probiotics in your morning Yoghurt, for instance, can add to the variety of healthy bacteria in your gut – these little guys are key to gut health, and bacteria have similar positive effects throughout the body.
While viruses are little more than a shell containing genetic material (a sort of ‘Bio-torpedo’), Bacteria are their very own cells. They can survive and replicate outside of human cells and, as a result, they can be a far larger problem for our immune systems. Even in Covid-19 cases, it is often not the virus itself that kills you but a co-infection by opportunistic bacteria, which infect the cells in the lungs after the virus has eaten away the protective lining around them. Bacteria replicate outside of your cells and in the case of Covid-19 they do so in the tiniest airways of your lungs. They can also replicate in your blood vessels, your body cavities, and your mouth for example.
This is bad for us because the infection is not contained within your cells. Your immune system must use a more ‘broad-spectrum’ set of defences. Take pneumonia for example, which can be caused by either type of microbe and is much more dangerous when it is bacterial. This is due to something called Inflammation. Inflammation is its own topic, but it is best characterised as the kind of soreness you experience with a cut or an infection. Bacteria cause more of this throughout the cavities of the body, which stresses your immune system far more.
We all know how antibiotics work, and we all know they only kill bacteria. Many of them kill bacteria so well in fact that they cause serious collateral damage to the healthy bacteria in your body as well. They’re so powerful that full courses of well prescribed antibiotics have effectively eliminated bacterial disease and significantly lengthened our lifespans. They have been used – and misused – so widely, so loosely, and so excessively however that we may well lose them altogether. How is this possible?
Bacteria evolve around our antibiotics when they are given enough exposure to do so – the stragglers which remain when a patient skips half of their course, or the exposure in patients who are given antibiotics they do not need. Agriculture in particular is a huge contributor to the problem. Livestock around the world – particularly in the US and China – are pumped full of antibiotics, creating huge pools of resistant bacteria. We know that bacterial resistance rises with more antibiotics, and it falls with less. Yet, usage of the drugs continues to increase and the costs of treating resistant infections like MRSA continue to rise, already costing us billions of pounds in healthcare. On top of all of this, no new antibiotics have been developed in over 30 years. However, there is a solution. And this is where the politics comes in.
Bacteriophage are viruses which only infect bacteria. They are incredibly specific to their target, with most phage only infecting one species of bacteria. They have been shown to co-evolve with the bacteria they kill even inside our bodies, which would permanently solve the problem of resistance. Phage could be cheaper than antibiotics once established as a treatment and it can act alongside antibiotics to kill resistant strains such as MRSA. The list of benefits from phage therapy is long and exciting, and yet the Western Literature has only recently begun to look into them. Why is this? Why don’t we use them?
Well, Phage therapies have been used in Poland for decades. As far back as the 1920s, in fact. Phage therapies developed in the Soviet Union in the early twentieth century as Western countries developed antibiotics. The two sides did not share much research and focussed on their respective techniques. Indeed, in the 1940s the Soviets produced a litany of research on phage in various fields of medicine. This research is not perfect, but it is surely enough to warrant attention. The West, misguided by the mindset of the new Cold War, chose to abandon phage.
Even Now, the FDA is hesitant to approve phage therapies. Phage are specific, and cocktails of different phage must be used to treat most infections. Hesitation to adopt Soviet technology and a longstanding FDA opposition to cocktail therapies continues to frustrate attempts to invite American healthcare dollars into phage research. Though, this will not be the case forever, with novel technologies being looked at and a few FDA Approvals of phage therapy (though few and far between).
In the times of the pandemic, it is important not to forget the other invisible enemy and, perhaps even more importantly, how politics can influence how we look at science, sometimes to our detriment.
By David Haigh
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