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The scourge of drug-resistant infections is on course to exact a heavy toll on the Canadian economy and affect the quality of life of millions of citizens, a government-commissioned report has warned.

The report was released on Tuesday by the Council of Canadian Academies, a federally funded organization that convenes experts to assess scientific evidence for policy makers. It represents the most comprehensive attempt yet to frame the global threat of antimicrobial resistance in national terms with Canadian data. And while the authors say they have been cautious not to overstate their findings, the report paints a stark picture of what is in store if “superbugs” that are immune to first line antibiotics continue to outpace existing treatments.

Today, drug resistant strains account for 26 per cent of treated infections and cause an average of 14 deaths a day across Canada – a rate that health-care professionals say is already cause for alarm. If present trends continue, that rate will grow to 40 per cent by 2050, more than doubling the daily death toll. By then, the report estimates, the accumulated cost to hospitals due to infections will have reached an additional $120-billion over current levels.

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But the real impact to society could run much deeper as growing fears over infections that can’t be treated take their toll on a wide swath of businesses and alter the way people live their lives.

“We need to get a handle on this,” said Brett Finlay, a microbiologist at the University of British Columbia who led the report. He noted that the scale of the threat in terms of human and economic cost might be second only to climate change.

HOW ANTIBIOTIC RESISTANCE OCCURS

1. There are bacteria everywhere. Some are drug resistant

Drug-resistant bacteria

2. Antibiotics kill bacteria causing the illness, as well as good bacteria protecting the body from infection

Dead bacteria

3. The drug-resistant bacteria are now allowed to multiply and take over

4. Some bacteria give their drug-resistance to other bacteria, causing more problems

THE GLOBE AND MAIL, SOURCE: CDC.GOV

HOW ANTIBIOTIC RESISTANCE OCCURS

1. There are bacteria everywhere. Some are drug resistant

Drug-resistant bacteria

2. Antibiotics kill bacteria causing the illness, as well as good bacteria protecting the body from infection

Dead bacteria

3. The drug-resistant bacteria are now allowed to multiply and take over

4. Some bacteria give their drug-resistance to other bacteria, causing more problems

THE GLOBE AND MAIL, SOURCE: CDC.GOV

HOW ANTIBIOTIC RESISTANCE OCCURS

1. There are bacteria everywhere. Some are drug resistant

2. Antibiotics kill bacteria causing the illness, as well as good bacteria protecting the body from infection

Drug-resistant bacteria

Dead bacteria

3. The drug-resistant bacteria are now allowed to multiply and take over

4. Some bacteria give their drug-resistance to other bacteria, causing more problems

THE GLOBE AND MAIL, SOURCE: CDC.GOV

The report underscores the fragile underpinnings of the medical revolution sparked by the 1928 discovery of penicillin, an antibacterial compound derived from mould. More antibiotics soon followed, making short work of a host of once-deadly diseases. The average life expectancy for Canadians grew from about 60 years to 80.

Now those gains are at risk as the persistent overuse of antibacterials in routine health care, veterinary treatment, livestock management and consumer products has battered the microbial environment and created ample opportunities for the emergence and spread of variant strains of bacteria that are not affected by antibiotics.

In developing their report Dr. Finlay and a panel of experts gathered data on the current state and costs of antimicrobial resistance from across Canada and then projected those numbers forward for different infection rate scenarios. For example, in the most optimistic scenario, where infection rates remain at 26 per cent, the national gross domestic product would lose $13-billion a year by 2050. That number grows to $21-billion a year in the more realistic 40 per cent scenario.

The effects look especially pronounced in the service sector, where personal interactions are a key part of doing business. But they also extend to other areas of the economy because of the effect of protracted illnesses on workers and caregivers.

Amélie Quesnel-Vallée, a panel member and medical sociologist at McGill University in Montreal, said the group looked to the 2003 SARS outbreak as an example of how public behaviour changed and people reduced their interactions in response to an increased risk of being exposed to a dangerous pathogen. She added that there would be additional impacts from people foregoing routine surgeries such as hip and knee replacements because of the growing risk of contracting a drug resistant infection while in hospital.

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John Conly, a University of Calgary professor and physician with Alberta Health Services who also served on the panel said that the report’s findings square with what he and his colleagues encounter daily, when patients who received an antibiotic from a doctor and were expected to recover quickly can end up in the emergency room and – if they survive – incapacitated for days or weeks.

Costs Associated with Antimicrobial

Resistance (amr)

Annual hospital costs in Canada, 2020–2050,

in billions of dollars

$15

AMR accounts for

0.9 to 1.6% of

health spending

Resistance rate

(three scenarios)

26% (Status quo)

40%

10

100%

5

AMR accounts for

0.6% of health

spending

0

2020

2030

2040

2050

THE GLOBE AND MAIL, SOURCE: Council of

Canadian Academies

Costs Associated with Antimicrobial Resistance (amr)

Annual hospital costs in Canada, 2020–2050, in billions of dollars

$15

AMR accounts for

0.9 to 1.6% of

health spending

Resistance rate

(three scenarios)

26% (Status quo)

40%

10

100%

5

AMR accounts for

0.6% of health

spending

0

2020

2030

2040

2050

THE GLOBE AND MAIL, SOURCE: Council of

Canadian Academies

Costs Associated with Antimicrobial Resistance (amr)

Annual hospital costs in Canada, 2020–2050, in billions of dollars

$15

AMR accounts for

0.9 to 1.6% of

health spending

Resistance rate

(three scenarios)

26% (Status quo)

40%

10

100%

5

AMR accounts for

0.6% of health

spending

0

2020

2030

2040

2050

THE GLOBE AND MAIL, SOURCE: Council of Canadian Academies

“You start looking at the human cost, the lost productivity, the impact on families and then multiply that out,” he said.

Jerome Leis, medical director of infection control at Sunnybrook Health Centre in Toronto and a clinical lead with Choosing Wisely Canada, a health advocacy group that promotes the more careful use of antibiotics, called the report a wake up call.

“This may be a bit of a turning point that helps Canadians really understand how antibiotic resistance has the potential to affect them," added Dr. Leis, who was not a panel member.

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