This morning in the Daily Maverick – it’s been going downhill for a while – was this opinion piece:

Gosh. Really?

It’s 2026. Microbiologists have been watching this happen for 30 or more years already, and we’ve been telling you about it for almost as long.

Even on this blog, which isn’t a microbiology blog, we’ve covered all of this in some detail. Some repeated detail.

In 2012:

The time will come (soon), when we run out of antibiotics and we’ll be at the mercy of what are – at the moment, at least – minor infections. Advanced surgery like transplantation, will become impossible – immunosuppressed patients will simply not survive the inevitable infections without prophylactic (preventative) antibiotic treatment. Even “basic” surgery will be impossible for the same reasons. Anything around the abdomen – appendicitis, for example – will effectively mean game over.

In 2013:

Dame Sally Davies (the Chief Medical Officer in the UK) thinks that “…the threat from infections that are resistant to frontline antibiotics was so serious that the issue should be added to the government’s national risk register of civil emergencies.”
And that puts it alongside threats like “explosive volcanic eruptions” and “catastrophic terrorist acts”.

Twice, actually:

The Centers for Disease Control and Prevention (CDC) in the US revealed (just before the Federal Shutdown) that of the 2 million plus Americans affected by antibiotic resistant bugs each year, around 23,000 will die.

And then 2014:

“We risk going into a post-antibiotic era, and that could start any time in the next 10 or 20 years, when modern medicine becomes impossible. Routine surgical procedures – hip replacements, caesarean sections, modern cancer treatments – all are based on using antibiotics to prevent or treat infections. Without them, people will die.”

I was still banging the drum in 2015:

This is not a futuristic scenario … it is being played out right here, right now, in South Africa and other countries across the globe. Decisions to withhold surgery based purely on the patient being colonised by pan-resistant bacteria are being made, and people are dying of untreatable infections in our hospitals and communities. Quite simply, our abuse of antibiotics is destroying modern medicine as we know it. 

And then again six months later:

But it seems that a lot of people simply don’t understand what antibiotic resistance and superbugs are. Research has shown that there are two main categories of misunderstanding here. Both are bad, but you can completely understand the confusion of the 20% of people who have simply misheard the word and believe that it’s actually a “Superb Hug”. That wouldn’t be bad at all. It would be… well… superb. And a hug. Everyone loves hugs. Especially superb ones.

That’s not going to kill you.

Sadly, the other 80% of those who don’t get what antibiotic resistance is, think that it’s the patient who becomes resistant to the antibiotic:

2016. Ten whole years ago:

And again, just before 2017 as the UK Government announced their War on Superbugs:

It’s not a bad idea. It’s just a 15-years-too-late idea.

Apparently, I gave up on being a stuck record after that, because what’s the point in warning people if no-one is listening? It’s all too easy to become apathetic, and there are plenty of other things to be worried about since then, like Covid, like Trump, like numerous attempted World Wars and like the baggage retrieval system they’ve got at Heathrow.

Because there is no focus to this problem, because it is just a slow, ongoing, insidious issue, no-one is taking it seriously. Sure, there are a lot of words from scientists and doctors, but until the public get on board, there won’t be any action, because all too often, policy decisions are made on popular things, not on important things.

As Rowan Govender notes in the not-quite-as-good-as-it-used-to-be Daily Maverick (link way back up there):

Antimicrobial resistance does not trigger the same urgency as an explosive outbreak. It spreads across hospitals, farms, communities and borders without a single dramatic moment of recognition. Yet its cumulative impact could rival or surpass many traditional pandemics.

Yes, it’s happening now. It’s been happening for the last 30 years. But mostly, we’ve been able to avert the crisis by moving to a different drug when the first one didn’t work. And more recently, sometimes even to a third or fourth drug if the second or third didn’t work.

Sadly, this can’t continue, because we’re using up our drug options far faster than we can make new drug options. We’re running out of options. And so, increasingly, when a patient has an infection, there are times when none of the drugs that we can use are effective in treating that. And yes, we all have immune systems that might be able to help out, but we had those before we discovered antibiotics, and the data very clearly shows that they’re not able to do it all by themselves.

That’s why global deaths from infectious diseases decreased by over 70% after penicillin was first used in 1942.

The first outbreak of fully resistant bacterial disease is really not that far way, and ironically, the current world geopolitical situation might exacerbate the problem. Food shortages and inflation will lead to increased poverty, poor living conditions and malnutrition, and a larger number of people immediately vulnerable to infectious diseases.

Even after learning a lot through the Covid pandemic, we’re still hugely underprepared for this eventuality. And it will end in disaster.

You can’t say that you weren’t warned.