One recent Lancet study found that 10 percent of coronavirus patients had secondary infections. Of those, more than one-third were admitted to the ICU. Another NCBI study found that the majority of deaths from the 1918 Spanish flu—which killed 50 million people worldwide—are attributable to secondary bacterial pneumonia.
Greg Frank, Ph.D., director of Working to Fight AMR and an infectious disease scholar and policy expert at the Biotechnology Innovation Organization, wants readers to know that most people who die during viral disease outbreaks actually die from secondary drug-resistant bacterial infections—or superbugs. So, as the industry races to find a vaccine for COVID-19, it's crucial that it also research new antibiotics. –KB
CP: What is the potential scope of the COVID-19 public health crisis and how can policymakers respond to aid in efforts?
Greg Frank: I believe this is the most serious pandemic our world has faced since the 1918 influenza pandemic. I can say that policymakers have been playing and continue to play a major role in helping to marshal the government response to the pandemic. This includes rapidly developing public-private partnerships to ensure new diagnostics, treatments, and vaccines are developed to help identify, treat, and prevent the spread of the coronavirus pandemic.
CP: What antibiotics are currently used for infections related to pandemics such as this, and where do they fall short?
GF: Patients suffering from pandemic viruses such as COVID-19 are more susceptible to secondary bacterial and fungal infections. The vast majority of the 50 million deaths from the 1918 influenza pandemic were attributed to bacterial infections – in a time before we had access to antibiotics. A more recent example is the 2009 H1N1 pandemic where 29-55% of deaths were also attributed to secondary infections. While data are still rolling in, we are seeing similar signs with COVID-19. A recent study found that 50% of patients that died from COVID-19 had secondary infections.
Current reports indicate that the vast majority of hospitalized patients in China received broad spectrum antibiotics – this was empiric therapy to help prevent secondary infections. Antimicrobial resistance – where microbes develop mechanisms to render our antimicrobial arsenal ineffective – greatly complicates the treatment of these patients. Multi-drug resistant infections are an ever-growing threat and we simply do not have the arsenal of new antimicrobials to keep up with drug-resistant superbugs. With a pandemic on the scale of COVID-19, it is likely that a sizable number of patients with secondary infections will suffer from resistant infections that are difficult to treat. I anticipate these drug-resistant secondary infections will contribute to the mortality of the COVID-19 pandemic.
CP: Do you anticipate a shortage of antibiotics or supply chain issues?
GF: So far, I haven’t noted any major disruption to the antibiotic supply chain but we continue to monitor it closely.
Greg Frank, Ph.D., is the director of Working to Fight AMR and the director of infectious disease policy at BIO, where he is responsible for BIO’s antimicrobial resistance, vaccine regulatory, and vaccine reimbursement policy. His role includes leading a group of almost 50 BIO member companies to develop policy solutions that address AMR. Prior to joining BIO, Dr. Frank served as the program officer for science and research policy at the Infectious Diseases Society of America (IDSA). Dr. Frank received his doctorate in immunology at the University of Pittsburgh and pursued his postdoctoral training at the Laboratory of Viral Diseases at the National Institute of Allergy & Infectious Diseases. He has published multiple scientific articles in the field of infectious disease.