What If Antibiotics Stopped Working?

What If Antibiotics Stopped Working?

Right now, we are living in the most medically-advanced and safest period of human history. And it’s all thanks to antibiotics.

An antibiotic is an antimicrobial substance that’s used to fight bacterial infections, and it’s what keeps injuries and sickness from becoming life-threatening catastrophes. Unsurprisingly, they were one of the most revolutionary and important creations of the 20th century – with an early pioneer, Paul Ehrlich, winning the Nobel Prize in 1908, Alexander Fleming making arguably the biggest breakthrough with his discovery of penicillin in 1928, and antibiotics rolled out for general use worldwide by 1945. As a group of medicines and treatments, antibiotics have proven to be immensely successful against various types of bacterial infection.

Before them, deadly disease was rampant, and the slightest injury could result in prolonged illness, amputation or even death. So, if antibiotics stopped working today, we’d be thrown back at least 100 years. Infection would again become life-threatening, and old diseases like syphilis and tuberculosis could (and probably would) make a devastating return. Even relatively simple and treatable conditions like pneumonia would once again spread, killing thousands if not millions.

In fact, should antibiotics suddenly disappear or stop working today, conditions could actually be even worse because of the contemporary world. Earth’s population has skyrocketed in recent decades, and cities are more densely packed than ever before. Even as recently as the mid-1900s, urban, built-up areas were relatively small – at least compared to today’s sprawling metropolises – and rural towns still thrived. But, the crowded cities of the twenty-first century are potentially a hotbed for disease – with illnesses passed from person to person at an alarming rate. With antibiotics we can control the spread. Without them, we’d have lost our first line of defence.

It’s easy to see how society could change as a result. Rather than being places for friendliness, inclusion and socialising, cities and their citizens could become much more reserved, cautious and suspicious. Typical, everyday niceties like hugs, handshakes and air-kisses would fall well out of fashion – becoming relic behaviours as they’re just too risky. Facemasks would be worn with more than just air pollution in mind, and gloves could become an indispensable accessory. But, even then, the willingness of people to mix with each other would likely fade, various forms of segregation could set in, and once-bustling communities could begin to close themselves off – all as a knock-on effect of not having access to antibiotics. In the darkest versions of this alternate reality, powerful people could even begin to remove anyone who’s sick from society altogether, as a ruthless dystopia unfolds.

In general, there wouldn’t be much to smile about – but even the act of smiling would be affected. Because safe, reliable dentistry is a relatively modern concept, too. Before the late 1800s – when dentistry was finally considered a serious, worthwhile profession – we used excruciatingly crude methods to fix teeth – with barbers typically doubling up as heavy-handed ‘tooth doctors’. It’s a specific case in point, but without antibiotics, teeth extraction would once again be a very risky prospect… and while we’d retain our acquired knowledge on how to pull teeth, we wouldn’t be able to protect against the inevitable infections or the pain. If even low-level antibacterial products like mouthwash were to disappear, then cavity rates would rise, gingivitis and bleeding gums would be common, and everyone would have bad breath.

Modern forms of transportation like subways and airplanes would also carry incredible risk. Not just because of the bad breath issue, but because they’re contained spaces where the now-untreatable germs can spread. A post-antibiotic world could even see stricter travel regulations as a direct effect of the decline in medicine and treatment. Domestically, public transport could be phased out. Internationally, passports would also list a traveller’s medical history – and getting through national borders would be much more difficult.

It’s more than just the increased threat of illness, though. Without antibiotics, we’d also be at risk of losing many more ‘modern miracles’ – developed thanks to the advent of safe medicine and treatments. Things like organ transplants could no longer be performed without incredible risk. Modern surgery would be nearly impossible. Most cancer treatments could no longer be practised, as patients are often much more susceptible to disease and infection. Heart disease would become virtually untreatable, as infected heart valves would be inoperable and by-pass surgery also requires antibiotics to curb serious infection. It’s estimated that one in four people in the United States die from some form of heart disease, in fact it’s the leading cause of death in the US... But those already concerning statistics would rise and rise without the miracle aid of various drugs. In general, and though estimates do vary, our life expectancy could drop by as much as 20 years without the use of antibiotics.

The miracle of birth would be another source of major anxiety. Mortality rates could skyrocket for mothers, and C-sections would probably no longer be practised – unless as an absolute last resort. While there are records of caesarean births being performed for hundreds of years throughout history, the relative safety of the procedure is a fairly new thing. In 1865, the mortality rate during C-sections in the United Kingdom was an astounding 85% – and similar figures were a grim reality the world over. Giving birth, in general, throws up all manner of possible complications, both long and short-term. Today, there’s often antibiotics to aid a mother’s recovery. But, take those away, and the whole experience becomes that much more life-threatening.

But perhaps the problem we’d most struggle with doesn’t surround such massive medical milestones like birth or major surgery. Perhaps the most troubling aspect of losing antibiotics would be that even minor wounds could lead to certain death. Today, whenever we’re wounded, even with a minor cut or graze, we’re often treated with an antibiotic of some form. Tablets, gels, creams; something to relieve the pain, and repair the injury. But, back before antibiotics, even simple wounds like a shaving nick or an accidental scratch while cutting vegetables could result in deadly serious infection. Of course, there were other methods of dealing with such problems – including bloodletting, herbal remedies, instant amputation or the administration of very questionable chemical compounds, usually laced with mercury. Those were your options back in the medical dark ages. But, should antibiotics stop working, we’d be in the same fix – with an urgent need to develop something to keep us all healthy.

So, this one’s a pretty bleak future. But is it really something we should worry about? Well, actually, it really could be – as scientists have continually warned us that our antibiotics are beginning to lose effectiveness. The thing with bacteria is that it develops a resistance over time, evolving to outrun the antibiotics built to stop it. So, after decades of antibiotic use (and in some cases over-use), the fear is that some harmful germs are becoming more and more difficult to overcome. In fact, ‘antimicrobial resistance’ is now considered a significant health risk by the World Health Organization. In one 2016 report commissioned by the UK government, it’s predicted that the spread of so-called ‘superbugs’ could cost us $100 trillion and kill upwards of 10 million people a year by 2050. By then, bacterial infections could have become deadlier than cancer.

If there’s ever an indicator of how much we rely on antibiotics, then it’s that. But, it’s a never-ending race, with medicine developers trying to outrun and outthink the rapidly evolving bacteria. Let’s hope that we can keep ahead of the game, or else we might wind up losing the very essence of modern life.