Winter means snow, cuddly rom-coms…and brutal head colds. Nothing a little Z-Pak won’t fix…WRONG. That’s exactly what the superbugs want you to do. Our antibiotic misuse is contributing to the global rise of an unseen, deadly force: antibiotic-resistant superbugs. We hear from a mother and daughter with direct experience with these terrifying new strains of bacteria. Dr. Abdul El-Sayed then explains how the pharmaceutical industry’s broken incentives and the government’s failure to change them have left us without the new antibiotics we need to take them on—putting us behind in the arms-race against these highly-evolved killers.

___________________________

ABDUL VO: Think about the last time you got a cold. Your nose is stuffy, your sinuses ache, and you feel like you got hit by a truck. You go see your doctor to see if there’s something you can take for it… an antibiotic, maybe…

TAPE 1_ReisterRobin_0708: Reister: I would say most commonly when people are requesting antibiotics, but they don’t need them, it’s probably for an acute respiratory infection or illness. 

ABDUL VO: Dr. Robin Reister is a primary care physician in Texas. And she knows this scene all too well.

TAPE 2_ReisterRobin_0720: Reister [07:20] So in the wintertime, it is probably at least once a session, somebody will come in saying, you know, every year I get sick around the winter time and I just need to get my Z-Pak, and then I get better… 

TAPE 3_ReisterRobin_0805: [00:08:05] Reister: … I think that people like to use that word, I think it makes it sound more fun than a scary antibiotic like azithromycin. 

ABDUL VO: Z-Pak. It sounds like a little candy, like another name for Pez. And that’s part of the problem. People like to pop them like candy, any time they get one of those pesky colds or the flu. It feels like a little extra security–and besides, every time you’ve taken them, the cold definitely went away…

Except that’s what colds do. They go away–with or without your Z-pak. The common cold is caused by a class of viruses called rhinoviruses. 

Antibiotics are useless against viruses, like a cold or flu. Instead, they take on infections caused by bacteria, which are usually a lot more serious – like pneumonia, strep throat, or ear infections. 

And yet, primary care doctors face a ton of pressure from their patients to prescribe antibiotics for every little sniffle. And that has some serious consequences, as we’ll hear in today’s episode. Which is why responsible docs like Dr. Reister try to reason with their patients…

TAPE 4_ReisterRobin_0901: Reister [09:01] Well, like with anything, I’ll start by listening to them and then I’ll ask them questions to get more of a history and in my mind I start to go through the possible diagnoses that might actually require antibiotics and it’s usually pretty simple to actually eliminate those things… based on certain symptoms and then I would do an examination – so review their Vital Signs and then do a physical exam and then after all that I usually try to talk through my own thoughts with the patient so I would say, 

So I would say, “Look, you don’t have pneumonia because you don’t have a fever and your lungs sound normal and you’re not short of breath. You don’t have strep throat because your throat looks normal or we did this rapid test and it’s negative. You don’t have an ear infection because you don’t have symptoms, I looked at your ear…”

So I usually go through and … I tell them all the things I’ve eliminated in my mind… that would require antibiotics. And tell them you don’t have these things. I have good confidence that you don’t have those things. 

TAPE 5_ReisterRobin_1043: [10:43] Abdul: Have you ever had a patient who was just insistent?

Reister: Oh, yes, absolutely. 

Abdul: How does that play out?

Reister: So… if I do all that, and you know… some people… just aren’t listening to me and say listen, “This is what I need. I need this every year,” so then I usually would say, if I want to be dramatic, which I’ve done quite a few times, I would say, “I took an oath to ‘first do no harm,’ and it is my medical assessment that if I prescribe you antibiotics, I would be doing more harm than benefit – significantly more harm than benefit. So I cannot break my oath and I cannot give this to you.”

ABDUL VO: First do no harm. It’s the most memorable line in the Hippocratic Oath, the guiding ethical standard all doctors swear to. 

But antibiotics are supposed to help you. So what is Dr. Reister referring to? What’s the harm in a little bit of extra medication?

Well, antibiotics–like all medications–have side-effects. Some of them can be really dangerous, like vision loss, liver or kidney failure, or seizures.

And overuse or misuse of antibiotics can lead to something even worse…

ARCHIVAL TAPE: Montage of news about superbugs/MRSA/antibiotic resistance

Abdul VO: You might think I’m going to tell you these news stories are overblown. But I’m not. This stuff is real. It’s deadly. It’s scary. And it’s getting worse. 

Superbugs – aka antibiotic resistant bacteria — are bacteria that one or more of the medicines we’ve used to treat them can no longer kill. They account for nearly two million infections in the US alone every year, killing 23,000 people.

ARCHIVAL TAPE: More news reports about superbugs, very panicky

The media is trying to panic you. But no one seems to be listening. Right now, they sound kinda like a fire alarm that’s been going off for a while.You hear the sound. You see the lights. You look around to see if anyone else is starting to run. But…everyone just keeps doing what they’re doing. And because no one else is freaking out, you go back to doing what you’re doing, even through the alarm is still screeching at you. But it’s time to pay attention.

I’m not trying to panic you. I’m trying to get real with you. Because we’re the reason this is happening. And we’ve got the power to stop it.

SOUND DESIGN TAPE: ALARM SOUND CRESCENDOS INTO THEME MUSIC

This is America Dissected with Abdul El-Sayed, I’m your host. 

• SERIES TITLE AND THEME

ACT 1 – Addie’s Story

While you’ve probably heard of antibiotic resistance, many of us don’t know how it works. So before we get into anything else, let me explain.

SOUND DESIGN / MUSIC IN

Bacteria are all around us and all over us. Literally everywhere. They’re usually harmless, unless they get into a part of the body they shouldn’t be, like in our muscles, or blood, or brain. That’s when they cause infections. 

Antibiotics are designed to kill different kinds of bacteria in case that happens. They all work in different ways, targeting different parts of different bacteria. 

Every time we use an antibiotic, we expect that — if we use the whole course, that is take all the pills our doctors told us to take — we’ll overwhelm all of the bacteria’s defenses, and kill it off completely. And that’s usually what happens. 

But sometimes, bacteria cells can mutate and evolve new defenses that make them resistant to our antibiotics. 

Every time we use antibiotics we don’t need, or – ALSO! – fail to use the full course of antibiotics we DO need, we increase the likelihood that resistant bacteria cells — superbugs — multiply and spread. 

That’s because we kill off all the usual bacteria that were there competing with the resistant ones. Without that competition, the resistant ones multiply and take their place. 

Now, over millions and millions of courses of antibiotics, we’re starting to see the evolution and spread of these superbugs. And when they get into parts of the body that they shouldn’t be–they’re causing serious infections that are difficult–or almost impossible–to treat.

And that has real human consequences. You don’t have to take my word for it. 

TAPE 6_RerecichTonya_0000: [00:00:00] Tonya: My name is Tanya Hotz I was Tanya Rerecich when my story became a thing and it’s not even really my story. It’s my daughter’s story.

[00:06:08] Tonya: I took her in to the hospital where she ended up in the ICU for five months. 

Abdul VO: Tonya Hotz lives in Tuscon, Arizona. She’s a nurse and a mom. Her daughter’s name is Addie. And we’re bringing you their story – a harrowing chain of events that – as implausible as it may seem – could happen to any one of us. It starts in 2011. 

TAPE 7_RerecichTonya_0240: [00:02:40] Tonya: She was pretty much like any other, you know, eleven year old girl. She played softball, she was on swim team. She played guitar. She played flute and piano. She was, oh she played volleyball, and she was active in the church groups. [00:02:57] We were just a normal family.

Abdul VO: This is Addie, her daughter.

TAPE 8_RerecichAddy_4256: [00:42:56] Addy: I was really excited because summer was coming up. I was going to start swim team. [00:43:00] I had plans for the summer to go to camp with a friend, and we were going to go to her house and swim, we were excited. We had these all these plans and then everything just got thrown up in it in the air.

TAPE 9_RerecichTonya_0308: [00:03:08] Abdul: And can you walk me through what happened? 

[00:03:13] Tonya: Sure. Yeah one day at a softball practice. She complained that her hip hurt, you know, not a big shock.

[00:03:22] She was athletic or what have you, and then a couple days later, her hip was still hurting, but she started to look more like she had the flu. I didn’t connect the two things, but I did take her to the doctor. And then throughout that week – this was like maybe Monday or Tuesday – by Friday, we’d seen a couple of different doctors

[00:03:44] we’ve been to the ER a couple of times. We’d had the paramedics to the house once and when I finally took her into the ER the the third time she was already going into septic shock.

Abdul VO: Addie had a Staph infection, a relatively common infection that happens when a kind of bacteria that’s common on the skin–Staphylococcus–gets into the tissue just under it. 

For Addie, the staph had entered her body, likely through an ingrown toenail or a scab, and found a home deep inside her hip muscle. Not where it’s ever supposed to be. 

It then made a break for her bloodstream, causing her body to go into septic shock–a potentially deadly response that happens when there’s enough bacteria in your blood to make your immune system freak out, like all the immune cells running around with their head’s cut off. 

TAPE 11_RereichTonya_0600: Abdul: When did you realize that this was going to be a little bit more than your run-of-the-mill infection?

[00:06:08] Tonya: I knew that morning, when she got out of bed that morning and I [00:07:00] helped her take a bath, but I [00:07:08] I knew right then. I knew that morning. I knew before I put her in the car. I knew that this was really really bad.

ABDUL VO: Tests revealed that Addie had an antibiotic resistant Staph infection – better known as MRSA. While MRSA, itself, is hard to treat–Addie’s was particularly challenging. And as doctors struggled to get a handle on how to treat it, she was put on and off a number of antibiotics–never a good thing when you’re trying to battle an antibiotic resistant infection in the first place.

In all that stopping and starting, Addie had indeed gotten a lot sicker. She was hooked up to all these machines – her body full of tubes and wires. These tubes and wires can save your life, but they can also carry bacteria.

And because hospitals are places with a lot of sick people on a lot of antibiotics–they’re a major breeding ground for superbugs.

And Addie’s battle with them was just beginning.

TAPE 12_RerecichTonya_1050: Tonya: so she started to kind of turn the corner. The fevers went away would you know she’s on a ventilator but [00:11:00] we’re all we’re all hopeful and then the fevers come back again. And I remember them telling me. We don’t know where the fever is coming from. We don’t know what the infection is.

[00:11:12] They were doing serial line draws. I assumed that included the Foley catheter. It does not it did not So it turns out the first infection that came after was an E. Coli infection of her bladder. And once they figured that out, they put her on, you know, appropriate antibiotics for that. It wasn’t helping once we got the cultures back.

[00:11:40] We found out that that was a resistant E.coli infection.

ABDUL VO: Another antibiotic resistant infection–this time E. coli. Requiring more heavy-duty antibiotics. More trial and error to kill it. 

TAPE 13_RerecichTonya_1140: I honestly don’t remember whether it was four or five different infections, but it was constant after that every time she started to spike a fever [00:12:00] they would search for the source of the infection find it treat it then get the final the final results back and find out that she was on the wrong antibiotic.

 ABDUL VO: Infection after infection, antibiotic after antibiotic. Every infection made Addie more susceptible to the next, knocking back her immune system–while the side-effects of each antibiotic were taking their toll.

Eventually, Addie had to be placed on a ventilator to help her breathe. She developed pneumonia — her lungs full of the most deadly superbug yet – enterobacter aerogenes.

Doctors determined that in order to save Addie’s life, they needed to do a double-lung transplant. In an 11-year old.

TAPE 14_RerecichTonya_1447: [00:14:47] Her lungs were ruined; they were never going to heal. 

ABDUL VO: But they didn’t want to do a lung transplant before clearing up all the superbugs running amok in her body. 

[00:12:18] Tonya: No, no, I don’t know how many different ones but I can tell you that she had every class of antibiotic and that we ended up with Colistin, and yeah, Colisitin is scary stuff. 

ABDUL VO: Scary is an understatement. Colisitin is the nuclear option of antibiotics–what we call call an antibiotic of last resort.  It’s extremely deadly for bacteria–but unfortunately, it’s extremely dangerous for people, too. It’s got all kinds of side effects, like seizures and severe kidney damage, to name a few.

For Addie, there was no other option. So they went for it – they dropped the Colistin bomb. And fortunately, it worked. It nuked the bugs.

TAPE 14_RerecichTonya_1447: [00:14:47] Her lungs were ruined; they were never going to heal. The fact that she was able to even survive that lung transplant was huge. Her surgeon later told someone that he would have given her maybe a one percent chance of surviving that lung transplant, but for her the choice was transplant or death and we had a kid who was hooked to a ventilator and an ECMO machine but was still awake and alert communicating with us.

TAPE 14_RerecichTonya_1447: [00:14:47] Tonya: Lung transplant patients are… with any transplant, you’re trading one set of problems for another.

ABDUL VO: And for Addie, that was what happened. After five months in the hospital, she had lost 30 pounds. Her immune system was compromised because of the medications she had to take to keep her body from attacking her new lungs. She had suffered a stroke on the right side of her brain, costing her the use of her left arm and leaving only limited mobility in her left leg. And because of the all treatments, she’d also lost vision in her left eye, and had only limited vision in her right eye.

TAPE 15_RerecichTonya_1600: Tonya: and yet she was still communicating with us. And she survived that transplant and she’s been living her life for almost eight years, but her life is not. it’s not what I’d hoped. You know, I wanted her to I used to tell her Addie. You [00:16:00] can have it all back.

[00:16:02] She never got it all back. And she never will. 

ABDUL VO: What starts out as a pretty mundane infection leads to sepsis which leads to hospitalization which leads to several different superbug infections which leads to a double-lung transplant and a stroke. An 11 year-old softball player becomes an 11 year-old with severe limitations she’ll never fully heal from.

Tonya, Addie’s mom, suffers from PTSD from the whole experience. Though a nurse, she stays home with Addie. She can’t go back to work in a hospital. Addie, now 20, despite her harrowing experience–maintains hope. 

TAPE 16_RerecichAddy_4447: [00:44:47] Addy: My mother and I our relationship got stronger, I think. I’ve lost a couple friends due to getting sick. It was just hard for them to lose somebody for five months and then have me come back [00:45:00] in the middle of their lives with my family. It’s changed, but I feel like some of it’s gotten better. I have a stronger relationship with my mother and my stepdad my sister and my brother. I have some really good friends who stuck with me throughout it and our relationship is great, but it is definitely different than what it was before I got sick. 

ABDUL VO: Today, Addie’s getting by… But the lungs she got when she was 11? Her body is now rejecting them. And that’s forced this young woman, who should be thinking about where to go to college, or that cute date she’s got coming up, to think about far more serious choices.

TAPE 29_RerecichAddy_3939: [00:39:39] Rerecich_ABDUL: I hear you and I know that you’ve got some some some big decisions coming up right now about whether or not you wanted to go through another. Transplant, how are you thinking about that right now? 

[00:39:53] Rerecich_ADDIE: I’m on a page on Facebook with other [00:40:00] people who are waiting for transplants and I see all these stories of them hoping and waiting and then getting dry runs where the lungs weren’t good or they weren’t there on time and I don’t want to live like that. I had eight good years and I think that it would just it’s I’ve got what I’ve had and I’m good.

[BEAT]

ABDUL VO: Addie–no 20 year old– should have to contemplate their future this way. She offers a powerful reminder for us that our choices–as individuals, as a society–matter for other people, sometimes in ways we can’t even imagine. 

Addie’s spirit is nothing short of inspiring, though. And the fact that she’s telling her story, putting herself out there, makes her an activist in her own right. 

TAPE 17_RerecichAddy_4059: [00:40:59] [00:41:00] Abdul: Can you tell me a little bit about what you would say to folks about why they should be using these medicines more responsibly. 

[00:41:10] Addy: Well you don’t want what happened to me to happen to your child or your friend or yourself? What happened to me sucks and my life isn’t easy at all, all because antibiotics are used inappropriately.

TAPE 18_RerecichTonya_2959: [00:29:59] Tonya: I don’t I don’t know [00:30:00] what you would say other than don’t don’t abuse the antibiotics and don’t overuse the antibiotics. Everybody just needs better education. We need to understand that these things are not bottomless that just so they’d have it on hand and they wouldn’t have to ask the doctor. 

ABDUL VO: That’s our part–we have to understand that every time we press our doctors for antibiotics we don’t need–every time our doctors give them to us, we’re creating the environment where an innocent kid like Addie can have her life devastated. 

See the MRSA that kicked this whole thing off – and all the superbugs that afflicted Addie after that one – they exist because of our constant overuse and misuse of antibiotics. We all helped to create the environment where resistant bacteria thrive. 

It’s on us–all of us–to be more conscientious. But as a society–there’s far more that needs to be done, too.

We’ll dig in, after the break.

AD BREAK – MIDROLL

ACT TWO: HOW WE GOT HERE, HOW TO GET OUT

Abdul VO: Horrific infections like Addie’s are happening more and more often. Even infections that used to be easy to treat with antibiotics – like urinary tract infections or sexaully transmitted infections like gonorrhea – they’re simply not any more. Instead of a course of pills, sometimes patients now need IV antibiotics. 

We all have a hand in this…but it’s also much bigger than individual doctors and patients, or the day-to-day practice of medicine. If superbugs are evolving, that means that we’ve got to discover new medications to treat them. This used to be a priority for us, but somehow that priority has fallen by the wayside.

TAPE 20_TalkingtonKathy_1920: [00:19:20] We had the sort of the Golden Age after penicillin of developing new therapies, and we stayed ahead of the problem. We are no longer ahead of the problem. And therefore we need to put more attention and resources into creating new antibiotics and new therapies to address this issue. 

Abdul VO: Kathy Talkington is the director of The Antibiotic Resistance Project at Pew Charitable Trust. 

TAPE 20_TalkingtonKathy_2700: Talkington: We want to build on the gains that we’ve made from scientific advances and the concern we’re looking at right here Is that if we these if we don’t keep pace, if we don’t keep making new antibiotics that are that are [00:27:00] effective and only use our antibiotics when we absolutely need them, we could be looking at a pre-antibiotic era and that’s frightening both from this country, but around the world as well. 

ABDUL VO: Antibiotics haven’t been around for that long. The first one, penicillin, wasn’t used on patients until 1942! And it was revolutionary. 

But our misuse is now threatening the strength of these crucial tools. And, guess what, innovation isn’t keeping pace. 

TAPE 21_TalkingtonKathy_1830: [00:18:30] Talkington: The current pipeline that we have is not adequate. It’s not we don’t have enough of the antibiotics that we need to address. Both current and emerging infection potential resistant bacteria. Currently, we have 42 drugs in our antibiotic Pipeline and if you compare that to cancer, for example, there are about a thousand in that pipeline.

[00:18:57] And then you can start sort of to slice and dice [00:19:00] the pipeline for antibiotics and it gets less and less encouraging in terms of what we have now available what we need and what we need to have coming in the future and I think that’s part of the story here is we have been fairly successful in developing new antibiotics.

ABDUL VO: I asked Kathy why the development of new antibiotics is lagging.

[00:19:47] Talkington: I think there are a couple of reasons why that’s happening. I think we may have gotten a little bit complacent and it takes [00:20:00] 10 to 15 years to develop new therapies. And the science has gotten harder. At first we were sort of tweaking around the edges of antibiotic new antibiotics and were able to find new therapies and and again stay ahead. What we need now is sort of whole new classes of antibiotics and the science around that is hard some as you mentioned earlier 

ABDUL VO: The superbugs we have now, for example, are often what’s called gram-negative bacteria. They have extra defenses–two cell walls for example — which makes it harder for antibiotics to penetrate. Working out the science of how to defeat these difficult bacteria is not easy. 

Plus, it’s super expensive. And guess who we need to spend the money and take the time to research and develop these new antibiotics? You guessed it. Big Pharma. Last week, we talked about their absurd pricing practices and incentive structure. And Dr. Elizabeth Rosenthal asked a question that’s worth remembering right now:

INTV – ROSENTHAL: [21.34]  Would you want to spend a whole lot of money developing an antibiotic where someone’s going to take it for, you know, five days and get better? 

ABDUL VO: If you’re a pharma Exec, the answer is no. If you’re society–the answer is a big fucking YES. And that’s the problem. Pharma is incentivized to invest in research and development for medications that a lot of people need to take for a long time. Things like blood pressure medication, cholesterol pills, diabetes drugs. Not curative meds like antibiotics.

INTV – TALKINGTON: [24:56] If the market is not there it dampens the amount of time and money and energy that goes into it for antibiotics. And that’s the challenge. We’re trying to address here. 

ABDUL VO: On top of that, Kathy laid out another problem.

TAPE 23_TalkingtonKathy_2148: [00:22:00] scenarios and there are a couple reasons why. Antibiotics, once they make it to Market if you develop a successful antibiotic, we are going to say, ‘don’t use it. Put it on the Shelf until we absolutely need it.’ As I mentioned before, the science is hard and it’s expensive, so you’re going to need to put the same amount of sort of time and energy into developing this therapy and then we don’t want that drug to be used very often as we’ve talked about before we need to make sure we only use these when absolutely necessary and so we’ll want to limit the sale of that in a sense.

ABDUL VO: That’s a really important point. Responsible use of antibiotics would require us to use these new drugs as little as possible–to avoid creating bacteria that are resistant to them. If you’re big pharma, you really don’t want to make a new drug to watch it get used AS LITTLE AS POSSIBLE. 

Put that all together, and you see we’ve got a big fucking problem. Pharma, who we rely on to research and develop the medications that we need, as a society, basically has no incentive to make meds that only a few people, no matter how sick they are–like Addie–need, for a short period of time. And so they don’t. 

I asked Tonya, Addie’s mom what she thought about that. 

TAPE 24_RerecichTonya_3157: Tonya: [00:31:57] I get needing to make money [00:32:00] I get that corporations owe owe their stockholders. But at some point are these people not people. Do they not have kids and grandkids and people they love do they not understand that even for themselves. I mean, even if you’re that selfish. You could be the one in the hospital with something.

ABDUL VO: There’s the human cost–which should be enough. But there’s also the financial cost for the entire health care system. 

TAPE 25_RerecichTonya_2322 [00:23:22] Tonya: Her first hospital bill for the five months in the ICU was almost 8 million dollars. I know the insurance company didn’t pay that. They probably paid closer to 3 million, you know, once they had done all the math the way insurance companies do with hospitals but still. 

ABDUL VO: So how do we fix this? 

TAPE 26_TalkingtonKathy_2322: [00:20:58] We now know we [00:21:00] don’t, so we’re behind the curve and it’s going to take a multitude of approaches. It’s going to take we need resources. We need probably government leadership in this. We need probably government leadership in this. The market has failed at this point in helping to stay ahead of the antibiotic. So we need to be creative and thinking about how how to approach this problem.

TAPE 27_TalkingtonKathy_3149: Talkington: [00:31:49] So I think you know, we’ve got to look at this both from stewardship and from Innovation and there’s work to be done across the board. I think [01:02:28] continuing the the support from Congress on Appropriations for all of these agencies that need to take a role and have been taking a role and inantibiotic stewardship and antibiotic development. So it’s going to take the administration that’s going to take Congress. It’s going to take private sector pharmaceutical company. So I think all of those efforts would help move the needle. 

ABDUL VO: Kathy’s saying it more nicely than I would. Pharma isn’t going to get off their asses on this until government makes them–Either by rewarding new innovation, or punishing the failure to invest in it. 

But let’s not forget–we–all of us–have been part of the problem, too. I asked Kathy about how we could be a part of the solution: 

[00:32:25] Abdul: And if everyday folks want to do something about this problem, what is it that they can be doing and should be doing? 

[00:32:33] Talkington: They can do a number of things they may, you know, heightening their awareness and their knowledge of this problem and communicating that to their friends their family to their policy makers. Part of the challenge we face is getting attention about this problem.

[00:32:52] And the more people we can have aware of it and recognizing the importance of it in the severity of it the better [01:03:28] off we’ll be so I think you know having those conversations with their their Physicians. They should ask the question, do I need this? Is this really what I should be doing? Are there some negative consequences to this and and and having those conversations?

[01:04:28] both stewardship and new innovation to address this issue. I think the other important point is this is a solvable problem in the sense that we have stayed ahead of the problem before we can do it again, but it’s going to take an ongoing commitment.

ABDUL VO: We’ve been here before. In fact, this arms race between humanity and the superbugs tends to flow in cycles. After bacteria developed resistance to penicillin–the first antibiotic–there was a massive effort in the 1950s to research and develop new antibiotics. By the early 1960s, there were several new antibiotics on the market. Overconfident, pharmaceuticals turned their attention elsewhere. Once again, the bacteria caught up, prompting another round of antibiotic stockpiling between the late 60s and early 80s. And again…we got overconfident. Leaving us where we are now. At a crossroads.

[00:34:19] It’s not something that we will have a one Silver Bullet solution to because of the nature of the problem of resistance. It’s going to take an ongoing commitment. For from years to come.

[24:42] when we put our mind in our energy and our resources into solving some of these critical public health problems we can do it and I think that’s the case here, too.

ABDUL VO: We’ve done it before–we can do it again. 

Now there are some new experimental treatments on the horizon, but they carry some real risk. You might have heard a little bit about crispr technology…

ARCHIVAL – reports about CRISPR

ABDUL VO: Scientists are now experimenting with using crispr to reprogram bacterial DNA so that those bacteria in effect go into self-destruct mode. But DNA engineering is new and–let’s face it– it’s kind of scary. We don’t really know what the side-effects might be. After all, this means re-engineering the DNA of really harmful bacteria.

And, there has been some movement on reducing unnecessary antibiotic use. One place where unnecessary use was quite common in the past was in livestock feed. Farmers used to put it into animal feed because it helped livestock grow–but it also contributed to antibiotic resistance. So in 2017, the Food & Drug Administration made it illegal. 

That’s a great step in the right direction – but we’ve still got a long way to go before the battle against superbugs is won.

The alarm bells are ringing. We need to pay attention. We need to act.

Next time on Healthy Skepticism, more on Big Pharma: we’ll talk about what happens when drugmakers – the companies that won’t invest in new life-saving antibiotics – instead pump harmful medications into communities that don’t need them. We’re talking about the opioid epidemic–and why we were so unprepared for it.

America Dissected is a production of Crooked Media. Our producers are Austin Fisher, Cary Junior II, and Katie Long. Andrea B. Scott is our story editor. Our sound designer is Daniel Ramirez. Production support from Alison Falzetta (Fall-ZET-ta), Elisa (AY-lisa) Gutierrez, Kara (CARE-ah) Hart, Daniel Porcerelli (PORE-sir-el-ee), and Tara Terpstra. Fact-checking by Dr. Nicole Aiello (aye-YELL-low). The theme song is by Taka Yasuzawa (TAAK-ah Yaas-oo-ZAH-wah) and Alex Sugiura (SOO-ghee-er-ah). Our executive producers are Sarah Geismer (GUISE-mer) and Mukta Mohan (MO-haan). Special thanks to Jon Favreau, Jon Lovett, Tanya Somanader (SOW-men-ay-der) and Tommy Vietor. And I’m your host Dr Abdul El-Sayed. Thanks for listening.