‘The Last of Us’ is right: we should be terrified of mutating fungi and superbugs

A fungal infection has gripped humanity, hacking nervous systems and turning victims into crazed, disfigured zombies whose single purpose is to gruesomely infect as many healthy humans as possible — or die trying.

It’s the premise of HBO’s latest slam-dunk TV series The Last of Us, in which bereft protagonists Joel and Ellie travel across a ruined US decades after the mutated fungus very nearly wiped out the human race.

The hit show is juicy post-apocalyptic narrative fodder reminiscent of Cormac McCarthy’s novel The Road, but the message is simple, the show’s co-creator Craig Mazin told Wired: “You don’t want to be too successful on planet earth.”

“I’m not an anti-progress, back-to-the-Stone-Age guy,” he said, “but we must regulate ourselves or something will come and regulate us against our will.”

Superbugs are coming

Mazin’s concern is shared by the CSIRO and the Australian Academy of Technological Sciences and Engineering, which have together sounded the alarm about a “looming global health crisis” for humanity: superbugs.

Superbugs are what happens when medicines are outsmarted by the very thing they’re trying to kill. It could be bacteria developing antibiotic resistance, or — as The Last of Us depicts in an extreme case scenario — fungus becoming immune to anti-fungal medicine.

Mushroom zombies aside, a new report has warned that if we don’t act on superbugs we can expect to enter into a “post-antibiotic world” in 2050 — an era of depleted life spans and dismal quality of life, where even just eating steak could risk lives.

“Loss of effective antimicrobial treatments would be catastrophic for [human and animal] health,” the report stated, forecasting an extra 10 million global deaths a year by 2050 and an eyewatering cost to the economy of more than $149 trillion.

Drug resistance is already killing about 1000 Australians a year, a 2022 CSIRO report found.

Is climate change to blame?

In the first few minutes of The Last of Us, a fungus expert in the 1960s explains that a pathogen — like the cordyceps fungus — could easily penetrate the immune systems of humankind and decimate humanity in a way that would far exceed a viral pandemic.

But he qualifies that it would require a fanciful circumstance where our planet was a few powerful degrees warmer. The series then fast-forwards to 2003, when it takes just 24 hours for the heated world’s population to descend into pathogen Armageddon.

It’s thought the overuse of antimicrobials in people, animals and food production is causing rising levels of drug resistance, but it’s being supercharged by another global crisis that is creating conditions for never-before-seen pathogens to emerge, mutate and wreak havoc: climate change.

“There is a lack of coordination in the efforts against the rise of antimicrobial resistance, significant data siloes across states and sectors, and a need to increase community understanding about the issues and impacts of antimicrobial resistance,” the CSIRO report found.

“Without this coordination it will be difficult … to tackle the impacts of climate change that can accelerate the emergence and spread of antimicrobial resistance.”

Earth will be hotter and sicker

In the simplest terms, the migration of displaced animals, whether from habitat destruction, changing temperatures, or heavier rainfall, leads to a cross-pollination of bacteria that hasn’t been seen before, as a 2022 study published in Nature explained.

It predicted more than 15,000 new cases of mammals transmitting new viruses to other mammals in the next 50 years thanks to climate change — the sort of zoonotic transmission that is believed to have caused a previously unknown strain of coronavirus to infiltrate humans in 2019.

“This work provides us with more incontrovertible evidence that the coming decades will not only be hotter, but sicker,” said Gregory Albery, a disease ecologist at Georgetown University in Washington DC and a co-author of Nature’s study.

Meanwhile, Branwen Morgan, CSIRO’s minimising antimicrobial resistance mission lead, said Australia’s turbo-charged extreme weather, like flooding and heavy rainfall, increasingly resulted in “sewage or stormwater overflows … They’re often hotspots for the evolution and dissemination of drug-resistant bacteria.”

Tech can beat superbugs at their own game

When it comes to stemming the flow of superbugs, Morgan said it wasn’t a matter of scientists simply creating new, better drugs to replace the failing ones.

“Discovering new antibiotics is a slow and expensive process [with] a high failure rate — most do not progress to the human clinical trial stage.”

Fellow of the Australian Academy of Technological Sciences and Engineering Sue MacLeman offered a glimpse of the future of medical technology in the race to beat superbugs.

She listed mitigating solutions: “Surface sprays that change colour when they come into contact with dangerous pathogens, neutralising technologies built into our sewerage systems which can detect and disarm harmful microbes before they are flushed out into our waterways, toothbrushes that provide data on our oral health and which self-sterilise after use.”

In the immediate future, however, we need better data to work out which drug-resistant infections are gripping the different regions of Australia so we have “a better picture of what is being given in the animal sector and also in [human medicine]”, Morgan said.

“The more we use antibiotics, the faster we lose them.”