Comment by mherdeg | Hacker News Reader

Comment by mherdeg | Hacker News Reader

Johanna Rhodes, an infectious disease specialist at Imperial College London, told the New York Times: "We are driving [the spread of antifungal-resistant organisms] with the use of fungicides on crops." The Times also cited a theory from Tom Chiller, head of the CDC's fungal branch, that C. auris has become increasingly prevalent as the widespread use of azole fungicides has killed off other fungi on crops.

So ... let's suppose I care about slowing the development of drug-resistant fungi. As an individual, what can I do?

I basically buy into the claim that widespread overuse of antibiotic drugs in humans has caused an increase of multi-drug-resistant bacteria and I'm generally on board with limiting my own use of antibiotics (e.g. not asking a physician for an antibiotic prescription for a minor illness that is most likely viral). I'm not so sure I understand the literature on antibiotic use in livestock and I happily eat meat without thinking about what drugs the animals were given.

What should I do with respect to azole fungicides and my grocery-shopping decisions? I don't currently see strong evidence that buying food marked "organic" is better for health or the environment, but should this new-to-the-public-consciousness information about azole fungicide use in crops change my mind? Should I be trying to buy crops which were not made with the use of azole fungicides? What kind IS that -- are those fungicides on the permitted/proscribed list for things that carry the marketing label "organic" in the grocery store, and do certain farming practices end up using a lot more of this apparently irresponsible pesticide versus certain other practices?

I took a cursory look at this for about half an hour and could not figure it out, even after trying to understand primary-source literature from the past few years about C. auris and USDA rules. I also can't even tell if individual consumer-level actions make a difference, or if it's not worth trying.

Admittedly science reporting is really tough but it's a little surprising that nothing in the literature I could readily find clearly suggests what researchers think consumers should do differently (if anything).

> What should I do with respect to azole fungicides and my grocery-shopping decisions?

I would avoid using non-organic citrus for zest. Conventional lemons and limes get covered in antifungal drugs before getting covered again in wax. So you probably don’t want to be eating the outside.

> I'm not so sure I understand the literature on antibiotic use in livestock and I happily eat meat without thinking about what drugs the animals were given.

It's the same principle. Feed the livestock with antibiotics, be it for treating a disease or making them grow faster, and you'll eventually end up with multidrug resistant bacteria like salmonella and e coli in your food.

let's suppose I care about slowing the development of drug-resistant fungi. As an individual, what can I do?

Grow some of your own food so you can control what goes on it.

Reduce your use of harsh chemicals generally in life/at home.

Skip particle board furnishings. Stick to glass, metal, hard plastic and real wood.

Eat right and exercise as your first line of defense for your own health.

/2 cents

> Grow some of your own food so you can control what goes on it.

This is laughable. Growing your own food is a cute hobby, but if it was actually adopted at scale, the resource, energy and land costs associated with food production would go up by somewhere between 10-100x.

The current population of this planet could not and can not exist without modern agriculture.

Not everyone sees it that way.

https://www.treehugger.com/lawn-garden/who-knew-vegetable-ga...

https://www.washingtonpost.com/lifestyle/home_garden/victory...

I don't think you have any grasp of the efficiency gains brought by modern agriculture and its scale.

I actually grew up on an old school farm and it took the land area equivalent of an apartment complex to feed our one family all year round. Tending to it was almost a full time job for 6 of the 12 months of each year. This is how people have been living for hundreds of years, the math is pretty well understood.

If you have anything better than a pair of op-eds to show that home gardening can be made 10-100x more efficient than it was a generation ago, I would love to see. My fruit+veg garden is a fun hobby and is quite large and healthy, but there is no way it could feed me for a year, never mind my family.

What part of "Grow some of your own food" are you interpreting to mean "grow all of your own food"?

I'm well aware that the efficiencies of modern agriculture has allowed us to have more than half the global population living in cities for the first time in human history. This not only become true within my own lifetime, it became true within the lifetimes of my children.

None of which is really pertinent to the idea that there is value in having some food supplies outside the chain of industrial agriculture as a protective measure.

Last I heard, American gardens provided about 10 percent of America food. I didn't bother to mention that earlier because I couldn't find a source.

Ten percent of a nation's food is not insubstantial, even if is less efficient than industrial agriculture.

I really doubt american home gardens are providing 10% of america's food.

But I think a large home garden like mine could ostensibly provide 10% of my family's fruit/veg intake. It takes a nontrivial mount of work to maintain, it takes a lot of water and energy, and it takes ownership of a large piece of land, and I could have also subdivided the land and built a second house instead of that garden. Oh did I mention one fuckup with extreme weather pests or birds means you lose everything? Guess who was enjoying my first ever harvest of peaches? It wasn't me, it was the fucking cockatoos that raided it in less than an hour.

All of those opportunity costs to reduce my intake of harmful chemicals by 10%? That's laughable. No one is doing home gardening unless they enjoy it. The health benefits are a minor bonus that comes way down the list after real benefits like proper flavour.

No one is doing home gardening unless they enjoy it. The health benefits are a minor bonus that comes way down the list after real benefits like proper flavour.

I've spent time on an email list where the owner was growing food for their ill spouse in order to have control over everything that went into that food.

Not everyone does things for the same reasons you do them.

If you thought there were enough people who thought similarly, wouldn't the right move be to sponsor a farm together? Don't people already do things like that? IMO a community funded farm with a highly accessible interface and transparent operations would be amenable to a lot of health-concerned people.

It makes a lot sense to me that like-minded individuals who don't like how how their food is handled should prefer a scalable method that doesn't break your back and takes advantage of modern efficiencies, and a way to handle excess supply so you're not wasteful. I can't see a vehicle going from house to house collecting tiny and disorganized surplus.

Plus, I'd rather see what a community plot could do rather than vs small home plots good for only growing mint tea, if even that.

No. Monocultures are a large part of the problem.

If you want a human world that is resistant to drug resistant infections, you want a bunch of individual efforts to grow things in the kitchen window of their city apartment and in small container gardens on the balcony and in square foot gardens in the back yard. That's the correct antidote to the monoculture of indistrial agriculture.

Biological and genetic diversity is how you foster a world where one genetic variation of one infection cannot simply run like wildfire through the global population.

You want an intentionally inefficient system. The efficiencies of industrial agriculture are the problem. They are how we are creating these super bugs.

But there's nothing stopping your community-run farm from engaging in ecologically aware practices... the right move seems to be to take control of industry, not to decentralise it into home plots. I feel you're losing levers and knobs with which to operate your ecological concerns, and one ends up hoping the decentralised winds blows in their favor.

It doesn't have to be like solar power.

When they began creating tree farms, they came up with some German word that means "forest death" (or something like that) to describe the sickly trees you get from planting nothing but a single species of tree. It strips the land of the same nutrients over and over. You combat that with commercial fertilizer and commercial pesticides.

It is fundamentally not possible to simultaneously pursue both goals you espouse. You decry the variability in quality/quantity of hardest while claiming we can solve this on industrial farms. The consistency of yield that you seem to feel is the most important detail is the root cause of drug resistant infections developing.

If you want to stop crating ever more efficient super bugs that perform excellently well at eating people, then you need to intentionally inject more inefficiency and diversity into our food chain.

It still sounds like transparent governance of community-funded farms would enable you to address the biodiversity of your region. Having an efficient farm doesn't mean you have to crank the efficiency dial to the maximum. But inefficiencies are paid with the fact that fewer people can access the ecological lifestyle we're talking about, whereas a community farm will allow someone who doesn't have a garden to pursue an ecological lifestyle.

Furthermore, a community governing a farm can centrally plan out for ecological concerns, and they can actually measure and study their progress. A decentralised community is hoping the winds of fortune will coordinate them. A lot of this comes down to whether you trust the ability of a community to maintain control.

Also I know people who have a well-sized garden meant to actually make produce, but nobody would say it could remotely alleviate their food or lifestyle burdens. The time-sink is huge; they do it for the gratification of home gardening, not as a mitigation of food burden.

You realize that most people in the world don't have a garden of their own. Right?

Yes.

I assume you know some city people grow herbs and veggies in their kitchen window or in a container on the patio.

It also wasn't a suggestion that everyone on the planet must do this.

> and I'm generally on board with limiting my own use of antibiotics (e.g. not asking a physician for an antibiotic prescription for a minor illness that is most likely viral).

I, on the other hand, have an illegal supply of powerful antibiotics and antifungals sitting in my medicine cabinet. They're technically for fish, but do the math: there are only a handful of factories making these pills in the world, and the pills are indistinguishable. I don't feel guilty about it in the slightest.

There has been a fundamental change in the role of doctors and healthcare professionals in the past 30 years, and I don't like it. You can go to a doctor, and you can both agree that you have a certain infection, and the doctor will refuse to prescribe a drug which all parties know will cure the infection. I think that's a new development in medical practice.

So that's why I have fish medicine. Because when I'm sick for 3 weeks and still getting worse, fuck the greater good, I'm getting mine. And that's why you should take fish medicine, too: because as long as there are people like me, you're fighting a lost cause.

But you in your home are unlikely to be able to diagnose whether an illness is bacterial or viral, and so sometimes you will be exposing yourself to anti-biotics for no reason. That's not a risk-free option. You might be happy with the amount of risk, but I doubt you know what the level of risk actually is.

> doctor will refuse to prescribe a drug which all parties know will cure the infection

Mostly it's doctors saying "we don't know if this is viral or bacterial, and by the time the tests come back it will have cleared up", or they're saying "this is a self limiting condition with no long lasting effects and taking antibiotics will shorten the duration by only half a day".

You can go to a doctor, and you can both agree that you have a certain infection, and the doctor will refuse to prescribe a drug which all parties know will cure the infection

That’s really not a thing that’s happening. You might find a doctor reticent to throw antibiotics at minor infections, but that’s because of their side effects rather than anything to do with antibiotic resistance.

In any case, even if there are a small number of people misusing antibiotics, it’s likely that the effect of their use in farming is far more harmful in the whole.

indeed, it's mostly that they know which antibiotics and other drugs work on which infections, and when they will not work at all. So many people demand drugs for colds and flu, and it is only the incompetent doctor that will give you antibiotics for viruses. Patients generally aren't good at diagnosis or choosing correct treatment, even with their apparent certainties from google.

> when I'm sick for 3 weeks and still getting worse

You must have a super weak immune system if that happens often. Which is a symptom of taking too much antibiotics / medicine.

> fuck the greater good

Individualism is the cancer of humanity, do your part.

https://newatlas.com/antibiotics-counteract-immune-system/52...

http://microbeminded.com/2018/03/31/antibiotics-immunosuppre...

None of what you said even makes sense. Doctors aren't withholding medicine when it is needed, they are withholding it when it isn't needed. The point is to ensure your fish medicine will still work. By encouraging others to do the same as you it just makes it more likely you will end up with MRSA or whatever, and if that happens you won't be beating the system with your illegal fish drugs. They won't be able to help you.

Meanwhile in the more likely scenario where you don't catch MRSA, as others have said all you are doing is damaging your health.

I wonder when they start adding to fish pills additional substances which are OK for fish but harmful to humans.

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