Here’s the scariest paper that I read during a month at Harvard Medical School…
“Microbial Genomics and Infectious Diseases” (Relman 2011, NEJM):
Nearly 40,000 strains of influenza virus and more than 300,000 strains of human immunodeficiency virus (HIV) type 1 have been partially sequenced
The folks who get paid to tinker with biology keep telling us that a cure is around the corner (just send more barrels of cash!), but why can’t viruses evolve faster than we can spend money on anti-virus research? The Harvard folks seem to think that we’re losing the battle on the antibiotic front. There haven’t been any good new drugs since the 1990s, but there are plenty of pathogens that have evolved immunity to the 20th century antibiotics.
As the U.S. population trends higher (on track to more than double during my lifetime) and more urban, will germaphobes move to dry mountain towns and try to avoid physical contact with anyone who has recently come in from a big city? Lean more heavily on the (clean) Internet for work and social life?
“germaphobes move to dry mountain towns” this explains the popularity of Colorado.
” The Harvard folks seem to think that we’re losing the battle on the antibiotic front”
Could use of antibiotic in livestock (especially preventive use) have something to do with it:
https://en.wikipedia.org/wiki/Antibiotic_use_in_livestock
Philip,
I once read an article in the New Yorker which seemed to imply that the holy grail in virus research, one which is supposed to supplant antibiotics, is the development of bacteriophages.
The cavalry is coming. The infectious disease problem will be solved once and for all. The future worry will be how to exercise your immune system, to preserve some form of natural resistance. Anybody who still looking to solve this in the “traditional way” is doomed to fail sooner or later.
Not even the mountains are safe these days
“Using platform sites high in Spain’s Sierra Nevada Mountains, the researchers found billions of viruses and tens of millions of bacteria are being deposited per square metre per day. The deposition rates for viruses were nine to 461 times greater than the rates for bacteria.”
https://www.sciencedaily.com/releases/2018/02/180206090650.htm
http://www.newsweek.com/viruses-atmosphere-falling-800694
Antibiotics and vaccines are the crowning triumph of modern medicine and biomedical science. It’s really hard to think of many technologies that had such an unambiguously positive impact.
That said, resistance was foreseen as a problem from the start of the antibiotic era. Like many coordination problems, resistance could have been dramatically postponed in some ideal world, but instead we have burnt through much of our head start. The lack of new antibiotics is both from all the low hanging fruit being gone (thus new drugs require increasing investment) and market failure (new drugs would not be front-line therapy; this is being partly addressed by policies committing to large orders to hold in reserve). New therapy is not an easy nut to crack, but I wouldn’t be as pessimistic: since the 90s, HIV has been reduced to chronic and Hep C cured completely.
Resistance will always an issue, but pathogens have evolutionary constraints as well — for example, a major development in vaccine development for AIDS and flu involves channeling immune response to parts of viral proteins that can not easily be changed without compromising the virus itself. Combination therapy is the other main recourse, as in cancer: treating with drugs against multiple independent mechanisms dramatically decreases the possibility of resistance.
Pandemic is one of the biggest threats I see to our present comfortable experience. Analogous to earthquakes on the west coast after the 1904 San Francisco quake (which led to a lull in seismic activity through the 70s just as California’s population and infrastructure exploded), we’re probably on borrowed time. While possible future vaccines, etc. will probably help, it seems to me the biggest useful investment is in surveillance (i.e., sampling known hotspots for emerging threats) and communication. Politicians would need pretty clear predictions to justify an efficacious quarantine, which could make the difference between local outbreak and black plague or spanish flu level casualties.