We are almost in the third wave of the COVID 19 pandemic. The testing and genome sequencing results in India in January 2022 indicate that there is mixed infections of delta and omicron continuing. In city of Pune the daily counts as of now are 12000 cases per day and continue to rise until next month. The number of infections is rising exponentially but the cases requiring the need for hospitalization still manageable. This although is a good indication but there is lot more undercover stored for all of us to fear. More than 2 years in the pandemic there is a notion amongst the experts that we are nearing the end of the pandemic. But having witnessed the change in the behavior of the virus and the continued evolution and mutations in the virus the use of antibiotics to combat the secondary infections is out of control.
Are we heading towards the another pandemic of bacterial diseases as medical practitioners and laws are not enforcing the prudent usage of antibiotics? World Health organization has clearly defined in the COVID 19 treatment protocol to avoid usage of antibiotics in mild cases and restrict in moderate to severe cases only. During the first wave of the pandemic the clinicians had meagre information about the virus behavior and disease etiology which made them use antibiotics carelessly. This caused secondary infections more severe during the third wave when the hospitalization time increased. The easy availability of antibiotics, confusion amongst patients and clinicians caused rampant usage that too without medical prescription is accelerated bacterial mutations and superbugs evolution. Closely evaluating the changes in the behavior of the virus helps us unravel the coevolution of bacterial superbugs along with the virus. Although we are focusing on the mutations through sequencing of viruses but we are overlooking the coevolution of bacterial superbugs that are arising out of the increased dosage of antibiotics used to curb the secondary infections rising out of viral mutants.
The nightmare of bacterial superbugs was witnessed before pandemic but the rate at which the superbugs are evolving has increased. During the second wave of pandemic the hospital stay increased as most patients were facing severe serious hospital acquired bacterial infections. The fungal infections like the mucormycosis was causative for mortality. These superbugs will be a threat to comorbid population as well as low immune young population without comorbidities. Even minor infection can lead to potential complications and mortality.
In order to combat bacteria many researchers are now focusing on using phages which are natural killers of bacteria to be used in the treatment protocol. But the question of again handling the phages which are viruses is like developing a treatment that can prove to be threat. Evolution is reality and microbes are way smarter than us and they would continue to mutate. They are capable of evading all the drug and vaccine blockages that humans would ever create. The rational solution to this strive for survival is to use the available drugs judiciously.