“What, me worry?”

Statistics are funny things. Done correctly, they have an unarguable standing, yet a clever person can use them to prove damn near anything. As Disraeli said, there are “lies, damn lies, and statistics.”

If I asked you to complete the sentence “the greatest threat to human life today is ________”, what would you say?

Based on the headlines, some might say gun violence. After all, there seems to be another mass shooting every thirteen days (a true statistic, depending on definitions) in the US. Despite the news coverage and the pathos of each of these attacks, the number of victims is still small (102 fatalities so far this year, another true statistic). Gun enthusiasts will remind all that the vast majority of guns are never used for a violent act (true), yet gun control proponents will counter that the most common use of a gun in your home (in the United States) is to kill yourself, a close friend, or family member, not a robber (also true).

Parents are buying bulletproof backpacks for fear of school shootings. These same parents blithely give their teenagers cars and smart phones, despite the fact that these two objects combine to kill ten teenagers every day (due to distracted driving).

Concerned for gun violence: quite valid. Worry? Maybe about the underlying causes.

People with a longer timeline might say climate change is the biggest threat. The violent weather and social disruption envisioned under most climate change scenarios is certainly a vivid threat, but sudden climate change remains a thing only in (bad) Hollywood movies. The imminent threat claim mouthed by politicians–you know, that we have only ten or twelve years left on the planet–has been rejected by the UN Intergovernmental Panel on Climate Change (IPCC).

What their report states is we have no time, since climate change is already here. If you live in New York or LA, you’re already experiencing the +2 degree centigrade average temperature increase that is the benchmark for climate disaster. But the IPCC states that dramatic efforts to reduce carbon emissions could (by 2030, hence the ten-to-twelve years stat) save us from even worse effects, when the rest of the world catches up to +2. No one knows exactly how bad things will get, or when or where the worst effects will hit. Threatening indeed, but the imminence is a call to action, not despair.

What I have in mind is a threat already lurking, with the possibility of sudden emergence. So let me give you something new to worry about (right, because that’s what we need, another existential threat!). I say new, but that is only true if you’re younger than ninety-one years old (That’s a hint).

Prior to 1928, the most common cause of death worldwide was . . . infectious disease. The most common cause of death among children, the most common cause of death among soldiers, the most common cause of death among any group of human beings. The average life expectancy in the industrialized world in the 1920’s was approaching forty-nine years. It had inched up due to cleaner water and public sanitation, but was still low by modern standards.

1928 was the year Alexander Fleming discovered penicillin, the first antibiotic medical treatment. The antibiotic qualities of some substances had been known for hundreds of years, but Fleming’s discovery was a mass-producible treatment which went widespread among the Allied armies in Wold War II and then everywhere else after the war. Prior to modern antibiotics, a cut or abrasion gave you a distinct possibility of dying. Gathering in large groups with poor sanitation risked the same. Your grandparents or great grandparents thought of hospitals as places where injured people went to get fixed up, but often got sick and died there. This wasn’t superstition: it was lived experience.

If you’re ninety-one or younger, you have lived entirely in the antibiotic era, which was different in type from previous human history. Life expectancy in the developed world shot up after 1928, gaining upwards of 30+ years in the next six decades! Antibiotics (and a better understanding of the bacteria they fight) was a major cause of this improvement. Proof lies in the fact that infectious disease remains the scourge of developing countries where antibiotics are unavailable.

The bad news is that evolution still holds, and bacteria, having countless numbers with which to experiment, are winning. Antibiotic resistant bacteria are popping up with increasing frequency, all around the world. Most of our antibiotics were developed in or before the 1970’s, the so-called “golden age of antibiotics.” But we misused them, using them to treat viral diseases (they don’t work against viruses), to fatten up farm animals, to mass spray and protect crops, in inadequate dosages or after they were expired, washing them down the drain where (other species and) bacteria were exposed. And survived. And evolved. And grew stronger.

There are new antibiotics in development, but of only a few new types. We have learned that bacteria are most vulnerable when hit with several different classes of antibiotic approaches at the same time: this complicates their natural selection, and buys us more time. So the new antibiotics are just a delaying action, and we don’t know how long before some truly deadly, easily transmitted disease beats the current set of “last-ditch” antibiotics.

What is a post-antibiotic world like? For a recent example, read about life during the Great Flu Pandemic of 1918. Granted, that was a virus, not a bacteria, but still it shows how an unchecked disease completely shuts down a modern society, and how social norms dissolve in the process. And that was just a 10-20% mortality rate. For a slightly more troubling scenario, read about the Black Death in Europe in the 14th century, where mortality exceeded 50% and the surviving remnant society was totally changed.

Unfortunately, there is not much an average person can do about the bacterial threat. Don’t ask for antibiotics when you probably have a virus, don’t use them when expired (or flush them down the drain), oppose policies of mass use for livestock or agriculture. Pretty small potatoes, what? That is what makes it such a threat, and why I choose to highlight it: individuals can’t do much about, it is massively deadly, and we have come to rely on antibiotics almost unconsciously.

Now that I have unburdened myself of this worry, I think I’ll take a good siesta. Sweet dreams!