• Infectious diseases may evolve to escape the preventative or therapeutic measures such as vaccines and antimicrobials. Reduced efficacy of vaccines and potentially increased severity of infections caused by these variants may contribute to the demand for patient management and further use of antimicrobial agents. Recent data indicate a significant use of antimicrobial agents for COVID-19 patients, even in the absence of secondary infections, sparking concerns over exacerbation of antimicrobial resistance (AMR). However, cancellations of elective and non-critical surgeries, and the implementation of non-pharmaceutical interventions that has led to the near disappearance of various seasonal infections (e.g., influenza), have collectively reduced the use of antimicrobial agents. The effect of these tradeoffs on the rate of antimicrobial use in different population settings remains unclear. We aim to quantify this effect by considering the role of new variants in the vaccine era of COVID-19 and the potential for altered rates of AMR post-pandemic. By the inclusion of an evolutionary framework into population models of AMR, we will aim to take advantage of linking genetic and epidemiological data, and investigate the effect of various exogenous factors on the secular trend.

Leads: Seyed Moghadas (York University) and Jianhong Wu (York University)

Team members: Nathaniel Osgood, Cheryl Waldner