By Jamie Doggett 
In a recent CREATION Pinpoint® study published in PMLiVE, of the social media conversations of healthcare professionals (HCPs) in Europe, it was discovered that since the COVID-19 pandemic the overall level of interest in antimicrobial resistance (AMR) has waned.
After an initial explosion of online conversation among HCPs about COVID-19 in spring 2020, the level has been slowly declining. Despite this, the volume of AMR posts does not seem to show any signs of returning to pre-pandemic levels at this stage.
Why antimicrobial resistance is a problem
When bacteria, viruses, fungi and parasites cease responding to medicines there is a higher risk of disease spreading and treating infections becomes harder. This is antimicrobial resistance (AMR) and why it is such a problem for humanity at this time.
The main reason drug-resistant pathogens develop is the misuse and overuse of antimicrobials. The World Health Organization announced AMR as one of the “top 10 global public health threats facing humanity” requiring “urgent multisectoral action”.
Not only does AMR present health risks for all global populations there are also economic challenges for nations as their health systems spend more on care and productivity is reduced through hospital stays for patients.
HCP use social media to spread AMR awareness
The issue matters to HCPs and there are strong emotions online: as one haematologist shared his experience of a blood culture with sensitivities to ‘no drugs’, one respiratory consultant in London responded “Antimicrobial Resistance is the nightmare none of us are ready for”.
Sharing The Times columnist David Aaronovitch’s article Next time there won’t be a vaccine to save us, a microbiologist in Liverpool who is specifically investigating AMR said it was an important piece about preparing for the next health disaster “which is, of course, AMR”.
A number of HCPs in the UK are driving forward the online conversation for the continent making their voices heard. Hashtags being used by leading pharmacists Philip Howard OBE and Diane Ashiru PhD include #Antibioticguardian and #sustainability while Alicia Demirjian, a paediatric infections doctor, often posts using hashtags #AntimicrobialStewardship and #AntimicrobialResistance.
The ‘silent pandemic’
AMR has sometimes been labelled the ‘silent pandemic’ and while there has been an awareness of its potentially catastrophic effects, there is increasingly the weight of data behind its importance. In January 2022 when Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis was published in the Lancet there was a positive response from HCPs to use this to press on with tackling AMR. Professor Dame Sally Davies was widely shared as she linked to the article claiming “The ‘silent pandemic’ is not silent anymore” and that “We must use these data as a warning signal to spur on action at every level.” Also sharing the Lancet article Rita Issa referred to her training including the potential threat level of AMR and that it is still a “quiet killer”.
As well as the HCPs across Europe using social media to raise awareness for ‘the silent pandemic’, there are also a number of HCP individuals who are using their platform to point to the under-recognised aspect of AMR. Former Chief Medical Officer for England, Dame Sally Davies is one of these individuals as she now serves as UK Special Envoy on Antimicrobial Resistance and actively uses her online presence. Two other doctors who are looking to make a difference in the space and affect policy are Eduardo García-Toledano in Spain and Haileyesus Getahun in Switzerland, both of whom discussed the ‘silent-nature’ of the AMR pandemic.
García-Toledano was active online seeking to get engagement around a Council Recommendation on AMR to strengthen coordination between EU Member States by retweeting a number of posts from the EU Health account. Getahun shared various campaigns and actions taking place to tackle or raise the profile of the AMR pandemic, particularly from the UN.
COVID-19 has taken focus from AMR
In some therapy areas we have seen a shift in focus to simply COVID-19 in the context of that therapy area. In the AMR space, for example, Stephen Griffin, a Leeds-based virologist, suggested financial loss during COVID-19 shines a light on the need for government long term investment in AMR, calling for “a fraction of the losses invested to empower research in [AMR]”.
However, it is not that HCPs are just talking about AMR in the context of COVID-19. At the start of the European pandemic there was a brief window when the majority of the AMR chat was in the context of COVID-19, but since then there have been very few posts about both.
A real challenge in the comparison between the two areas is that they are just a chasm apart. Still in 2022, the number of AMR posts from HCPs in Europe pales in comparison to those of COVID-19, even as the pandemic in Europe turns two.
Ensuring AMR returns to the fore
While COVID-19 has taken some of the focus of the online conversation away, HCPs feel it may not have been entirely bad for AMR. It has highlighted some opportunities such as the speed of the COVID-19 vaccine development being translated into the search for vaccines to address AMR, as highlighted by Kate O’Brien, a paediatrician and World Health Organization Immunization, Vaccines and Biologicals Director.
Of late there have also been groups gathering to share these learning and to prepare for “The Silent Tsunami” which HCPs in Europe have responded to well, even when those groups are further afield such as the Colloquium on State Action Plans on AMR in India.
Despite the changes in volume there is no sense of despair in the tone of posts of HCPs; the sentiment of the conversation is filled with a mixture of hope, urgency and drive to tackle the problem head on with research, investment and awareness.
