Antimicrobials are already less useful than they were a few years back and they will become less useful as time goes by, but it’s very unlikely that we’d ever actually go back to the pre-antibiotic era.
I work on antimicrobial resistance as part of my day job and the reality is bad enough without having to overly-catastrophize. If ~10 million people die every year of antibiotic resistant infections, this is both (1) awful and (2) much better than the pre-antibiotic era.
“Deaths from antimicrobial resistance go above L” is a good one, although it is not trivial to measure (deaths are often multi-causal).
A related open question is to what extent a global moratorium on the use of a specific class of antibiotics could reset resistance. If there is a cost to the bug of being resistant, once the selection pressure of antibiotics is gone, it should revert to being sensitive. Some researchers say that now that the cat is out of the bag, it is too late, the reset would take too long (if it happened at all); others disagree and expect that within a few years, resistance would have gone down sufficiently to be meaningful. I have an opinion, but nobody actually has data on this.
Yes, that is a good crux. Maybe add an answer to “according to whom?” For example, “reported by WHO or in a top medical journal (such as the Lancet, BMJ)”
What would a clear criterion of us running out of effective microbials look like?
I want to write a prediction market here. What would be an unambiguous world state where it has happened?
Eg
The WHO releases some kind of statement
The US stops using XYZ drugs and no equivalent is found
Deaths from microbial resistance go above L
Could you link the prediction markets for this if you create them? Thanks in advance!
Antimicrobials are already less useful than they were a few years back and they will become less useful as time goes by, but it’s very unlikely that we’d ever actually go back to the pre-antibiotic era.
I work on antimicrobial resistance as part of my day job and the reality is bad enough without having to overly-catastrophize. If ~10 million people die every year of antibiotic resistant infections, this is both (1) awful and (2) much better than the pre-antibiotic era.
“Deaths from antimicrobial resistance go above L” is a good one, although it is not trivial to measure (deaths are often multi-causal).
A related open question is to what extent a global moratorium on the use of a specific class of antibiotics could reset resistance. If there is a cost to the bug of being resistant, once the selection pressure of antibiotics is gone, it should revert to being sensitive. Some researchers say that now that the cat is out of the bag, it is too late, the reset would take too long (if it happened at all); others disagree and expect that within a few years, resistance would have gone down sufficiently to be meaningful. I have an opinion, but nobody actually has data on this.
So “10 million people die in 2025 due to antibiotic resistant infectnions, worldwide” is that a good crux?
Yes, that is a good crux. Maybe add an answer to “according to whom?” For example, “reported by WHO or in a top medical journal (such as the Lancet, BMJ)”
I am thinking of a paper like this one: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext This was looking back at data from 10-15 years ago and gets to values just over 1 million deaths attributed to AMR.