New Report Details Rise in Deaths Caused by Superbugs During the COVID-19 Pandemic

Resistance to antibiotics and antifungals rose dramatically during the COVID-19 pandemic, causing an estimated 29,400 deaths in the first year of the pandemic. It’s estimated that 40 percent of those were due to hospital-acquired infections, with the remainder occurring in nursing homes and other healthcare facilities.

The surge erased much of the progress made in the last decade in the fight to contain these superbugs, according to a new report from the Centers for Disease Control and Prevention (CDC), issued on July 12.

Antimicrobial resistance (AMR) was one of the country’s greatest public health concerns prior to the COVID-19 pandemic, and it remains so, said CDC director Rochelle Walensky, MD, MPH, in a statement accompanying the report. “These setbacks can and must be temporary,” she said.

Bacterial and Fungal Infections Resistant to Antibiotics Rose by 15 Percent in 2020

Deaths caused by superbugs — bacterial or fungal infections that are resistant to antibiotics — rose overall by 15 percent in 2020, the first year of the pandemic, compared with 2019, according to federal health officials. The actual number of deaths may be even higher; because many public health labs were overwhelmed during the pandemic, data is missing for many of the most dangerous pathogens, according to the report.

The report detailed the rise of many dangerous superbugs, including a 78 percent increase of carbapenem-resistant acinetobacter infections. “This kind of bacteria is really what’s driving antibiotic resistance around the world,” said Maria Valeria Fabre, MD, an assistant professor of medicine and infectious disease expert at Johns Hopkins University School of Medicine in Baltimore, in an earlier interview with Everyday Health.

“These infections are typically associated with exposure to healthcare. It’s very commonly seen in patients who require respiratory support in the hospital. The term ‘carbapenem-resistance’ is a red flag,” said Dr. Fabre. Carbapenems are a class of highly effective broad-category antibiotic, she noted: “We usually reserve these medicines for the most resistant infections, so we are talking about an infection that is resistant to this ‘big gun’ antibiotic.” Patients who get this kind of infection have a very high risk of death, added Fabre.

The agency also reported increases in resistance to antifungals, including a 60 percent increase in cases involving the fungus Candida auris. This fungus causes invasive and serious infections, such as bloodstream infections, said Fabre. “Candida auris is typically associated with healthcare settings, including long-term care facilities. Elderly people can be at high risk of getting this infection,” she said.

These pathogens have been on the CDC radar of late: In a prepandemic 2019 CDC report that named 18 germs considered antibiotic-resistant threats, both drug-resistant Candida auris and carbapenem-resistant acinetobacter were deemed to be new “urgent threats,” a category reserved for the most concerning pathogens.

Why the Increase in Drug-Resistant Infections?

AMR occurs when certain bacteria, fungi, and parasites change over time until they no longer respond to the medicines designed to fight them. As the antibiotics and antimicrobial medicines become ineffective, it leads to more difficult to treat infections and death, according to the World Health Organization (WHO).

Although this resistance occurs naturally over time, it can be accelerated by poor infection and disease prevention in healthcare facilities and the misuse and overuse of antibiotics. The staff shortages and overflowing hospitals that occurred during COVID-19 surges often led to all-hands-on-deck situations in which infection control specialists on the staff were reassigned to direct patient care — rather than ensuring that the health facility followed appropriate protocols regarding antibiotic use, handwashing, and other safety measures, according to the report.

Other key factors that may have contributed to the rise of pathogens and hospital-acquired infections include the following:

• Larger numbers of sicker patients came into the hospital during the pandemic and required more frequent and longer use of catheters and ventilators. At the same time, many hospitals experienced shortages of personal protective equipment, lab supplies, and staff.
• Antibiotics were commonly prescribed to patients with COVID-19, even though antibiotics are not effective against viruses like the one that causes COVID-19. Almost 80 percent of patients hospitalized with COVID-19 received an antibiotic from March to October 2020.

“With so many hospitalizations for COVID, so many individuals on ventilators, it is not surprising to see drug resistance rise as a high proportion of these patients were treated with antibiotics,” says Amesh Adalja MD, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore.

AMR Projected to Cause 10 Million Deaths Worldwide by 2050

A comprehensive analysis published in The Lancet earlier this year estimated that in 2019 AMR caused 1.27 million deaths around the globe and played a role in 4.95 million deaths. If actions aren’t taken to combat the threat, antimicrobial resistance could cause 10 million deaths annually by 2050, according a WHO report.

Before the pandemic, the United States had made progress in slowing antimicrobial-resistant infections. Between 2012 and 2017, deaths from AMR were down by 18 percent overall and 30 percent in hospitals, and those reductions continued until COVID-19 struck, said the agency.

Drug resistance among bacteria is one of the most pressing challenges society faces, says Dr. Adalja. “It is critical that we address the challenge of antimicrobial resistance with new drugs, vaccines, and diagnostics, coupled with more judicious use of antibiotics,” he says.

In the 44-page statement that accompanied the report, the CDC outlined tactics to do just that, including leveraging the National Wastewater Surveillance System (NWSS) that was introduced in September 2020 as a response to COVID-19. Scientists can use the NWSS to combat AMR by analyzing wastewater to identify antimicrobial resistance and be alerted to new threats.

How to Help Reduce the Spread of Antibiotic-Resistant Bugs and Minimize Your Risk of Infection

Although this health crisis needs to be addressed on a global and national level, there are simple steps you can take to combat antibiotic resistance, according to the Cedars-Sinai healthcare organization.

First, reduce your own risk of getting an infection.

• Get vaccinated, which could help prevent you from getting an infection in the first place.
• Practice good hygiene and keep your hands clean at home, at work, and anytime you visit a healthcare setting.
• Follow safe food prep.
• If you’re sexually active, use safe sex practices.

Using antibiotics correctly can also help reduce the spread of superbugs.

• Don’t take an antibiotic for a virus.
• Only take an antibiotic exactly as prescribed, don’t skip doses, and complete the full course of treatment, even if you are feeling better.
• Never take an antibiotic that was prescribed to someone else.