Abstract
Before the coronavirus 2019 (COVID-19) pandemic began, antimicrobial resistance (AMR) was among the top priorities for global public health. Already a complex challenge, AMR now needs to be addressed in a changing healthcare landscape. Here, we analyse how changes due to COVID-19 in terms of antimicrobial usage, infection prevention, and health systems affect the emergence, transmission, and burden of AMR. Increased hand hygiene, decreased international travel, and decreased elective hospital procedures may reduce AMR pathogen selection and spread in the short term. However, the opposite effects may be seen if antibiotics are more widely used as standard healthcare pathways break down. Over 6 months into the COVID-19 pandemic, the dynamics of AMR remain uncertain. We call for the AMR community to keep a global perspective while designing finely tuned surveillance and research to continue to improve our preparedness and response to these intersecting public health challenges.
Highlights
The coronavirus disease 2019 (COVID-19) outbreak, caused by the SARS-CoV-2 virus, was declared a pandemic by the World Health Organization (WHO) on 11 March 2020 (Ghebreyesus, 2020) and has reshaped the world
As the Antimicrobial resistance (AMR) research community learns more about the mechanisms of SARS-CoV-2 transmission, its interaction with other diseases, the policy responses to COVID-19 around the globe, and the behaviours associated with COVID-19 interventions, the direct and indirect impacts of COVID-19 on AMR and vice versa are becoming increasingly clear
This review demonstrates that, through modifying the processes of emergence, transmission, and infection burden, COVID-19 is changing the landscape of AMR
Summary
The coronavirus disease 2019 (COVID-19) outbreak, caused by the SARS-CoV-2 virus, was declared a pandemic by the World Health Organization (WHO) on 11 March 2020 (Ghebreyesus, 2020) and has reshaped the world. Similar levels of impact are likely being seen across health systems affecting both infectious and non-communicable disease care such as sexual and reproductive health (Riley et al, 2020) This is motivated by a desire to minimise patient contact due to the potential risk of transmission in overburdened healthcare settings, as well as a repurposing of staff and diagnostic facilities for COVID-19 (Venkatesan, 2020). Provided that existing supply chains remain functional, increases in the sale of antibiotics as a workaround for multiple deficiencies in disrupted health systems can be expected In both hospital and community settings, COVID-19 disruptions have led to changes in health- and treatment-seeking behaviour, and potentially difficulties in physically accessing care. The AMR community needs to work to prevent such funds ever being needed for an ARO – primarily by the research outlined above, and by designing and supporting policy guidance and implementation research for AMR
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