Fighting the COVID-19 pandemic could herald a rise in superbugs

Copious use of hand sanitizer and disinfectant is crucial in the fight against COVID-19, but it could be setting Canada back in the battle against superbugs.

Microbiologists say antimicrobial resistant organisms, or superbugs, are a pandemic on the same scale as COVID-19, though it will play out on a much longer timeline.

Antimicrobial resistance was directly responsible for 5,400 deaths in 2018, according to a recent report by the Council of Canadian Academies.

If nothing is done, by 2050 there could be as many as 140,000 preventable deaths, and Canada's health-care costs associated with antimicrobial resistance could grow to $8 billion per year.

That's why some of the images of the COVID-19 pandemic have been so disturbing for Dr. Lori Burrows, a professor of biochemical science at McMaster University.

"I was a little freaked out by watching tanker trucks full of disinfectant being sprayed all over the street in some countries," she said. "It seems a little excessive to me."

Some experts worry even strictly necessary efforts to destroy the novel coronavirus linked to COVID-19 could actually drive some bacteria to become more resistant.

The government was set to release its pan-Canadian action plan to tackle antimicrobial resistance this year.

Health Minister Patty Hajdu was questioned about the plan at the House of Commons health committee in early March, before the COVID-19 pandemic struck Canada full force.

"We've been committing to using antimicrobials responsibly," she told the committee. "As you know, though, right now there is a surge on hand sanitizer, which is not helpful in terms of the work that we're doing to reduce the use of things that contribute to the growth of antimicrobials."

Though washing hands with soap or alcohol-based sanitizers has no known effect on superbugs, other types of sanitizers and disinfectants can contribute to bacteria that resist antimicrobials.

Few pharma companies invest in new antibiotics because they're lessprofitable

The use of drugs during the pandemic could also have an effect, said Dr. Gerry Wright, director of the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University.

"Any time that we're facing a rise in infections of the kind that we're seeing with COVID-19 ... we run the risk of bacterial infections at the same time," Wright said.

Secondary bacterial infections are common in patients with severe upper respiratory symptoms, he said, which lead doctors to prescribe antibiotics. And increased use of antibiotics leads to an increase in antimicrobial resistance.

It's not clear if antibiotic use in the general public has gone up or down during the pandemic because Canada doesn't gather real-time data.

It could be that people are less likely to seek out medical care of any kind, but a rise in virtual doctor visits could also lead physicians to prescribe antibiotics without testing for bacterial infections first, said Dr. Andrew Morris, medical director of the Sinai Health System-University Health Network Antimicrobial Stewardship Program.

We won't know either way until after the pandemic passes, he said.

It does seem that more people are taking unproven medications to fight COVID-19 though, particularly south of the border where President Donald Trump has advocated for the preventative use of some drugs.

"We actually have physicians and patients clamouring for the drug, when we actually have no idea if the drug even helps," Morris said.

"It's really set us back, because we've been saying for a very long time that antimicrobials should be used when we know that they help. It should not be widely and indiscriminately used."

Like the novel coronavirus, superbugs know no borders and can travel the globe at incredible speed, leaving Canada vulnerable to the actions of people elsewhere in the world.

To make matters worse, few pharmaceutical companies are investing in new antibiotics because they're not as profitable as drugs people are prescribed on an ongoing basis.

The experts said Canada's new plan to fight the problem will need to come with money for increased surveillance, data collection and research if it's going to make any difference in this second, but potentially just as deadly pandemic.