“Respiratory viral infections such as influenza and SARS-CoV-2 have proven themselves to be a precursor to secondary bacterial infections—infections that can often be the real cause of mortality, as was the case during the Spanish influenza of 1918. A significant proportion of hospitalised COVID-19 patients to date have been treated with antibiotics. Between 30 to 90% of all antibiotics are excreted in its active form. There will be a sustained release of antibiotics into the wastewater from COVID-19 infected patients on top of tons of antibiotics already in use in the UK, as was seen during the 2009 influenza pandemic. The biofilms that line the sewage pipes, flocs and biofilms within wastewater treatment plants and the bacteria that are ubiquitous within our rivers are all at increased risk of growth inhibition, death or acquisition of antibiotic resistance from this surge in antibiotic use.

The quantity of antibiotic used during the COVID-19 pandemic will likely far exceed the amount used during the 2009 influenza pandemic given the severity and length of the pandemic. The lasting environmental effect of this medical response will be in a potential reduction in wastewater treatment efficiency due to growth inhibition or death of keystone species within the wastewater treatment plants, and changes in community structure within environmental compartments (i.e., biofilms, microbiomes). The longer-term implications could be a further increase in the prevalence of antibiotic resistance genes in the environment and future lives lost as a result of the interconnectedness of environmental AMR and human health (i.e., One Health).

The rationale for supporting scientific efforts that preclude or greatly diminish the effects of catastrophic pandemics include vaccination, surveillance, and support for the infrastructure needed to respond to a pandemic. This critical infrastructure comprises scientists, vaccine development, and antibiotic and antiviral research and development. These keys to future success are perhaps, now, abundantly clear to citizens and governments alike. There is a need to keep this focus to build capacity, embrace new ways of innovation, and invest in science for the long-term. This pandemic will end, but as we found with influenza, the next pandemic might only be ten years away.”

Andrew Singer, Senior Scientist, UK Centre for Ecology and Hydrology

@Oxonandrew

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