Saving Antibiotics
It will take more than science to keep these life-saving drugs from becoming treatments of the past
By Sara Reardon
The Moonshot: Since Alexander Fleming’s discovery of penicillin in 1928, the health care community has had access to antibiotics for fighting many bacterial diseases and infections. One the most imortant tools in the history of public health, antibiotics have a pair of achilles heals: they become less effective over time as microbes evolve resistance to them and developing new antibiotics is a bad business proposition because patients generally only need to buy them for short periods of time. The prevalence of resistant bacteria has been rising and the public health sector fears we are approaching a “post-antibiotic era” in which diseases and infections previously treatable with antibiotics will again become debilitating and lethal. Although researchers have been identifying new and effective antibiotic compounds, the business-model failure of these agents has prevented them from becoming available in the clinic. To ensure effective antibiotics remain available, this business-model failure must be overcome.
The Philanthropic Opportunity: The profit motive is absent in antibiotic development. By decoupling development from expectations of financial return, philanthropic commitment to the often several-billion-dollar development and testing process that it takes to deliver clinically approved medicines could help prevent the arrival of a post-antibiotic era. Early in the innovation stage, such support could sustain innovative but financially precarious startups as they pursue promising medicinal leads. Further in the process, philanthropic funding could enable expensive clinical trials that would otherwise be too financially risky for small, let alone large, pharmaceutical stakeholders to embrace. Philanthropic money, perhaps in partnerships with government and nongovernmental incentive programs, also could help reduce risks for developers by, for example, guaranteeing initial, large-scale purchases of successfully-developed antibiotics.
When Tammy Heenan answers the phone, she is on her eighth lonely day in a Salem, Oregon hospital room. “I’ve really had my fill of hospital and I want to be home with family,” she says over the sound of a monitor beeping in the background. Her voice is raspy from pneumonia, respiratory infections, and multiple lung surgeries.
Heenan, who is 66, has spent the last 8 days on what she calls the “COVID floor” of the hospital. Although she does not have COVID-19, she is isolated from other patients and forbidden from receiving visitors — including her husband. With her medical preconditions, contracting the coronavirus could prove deadly.
Heenan has been worried about her lungs for 5 years, ever since surgery to remove cancer from her right lung left her with a chronic Mycobacterium avium infection that managed to persist despite multiple antibiotic treatments. In 2017, she also contracted chronic Pseudomonas aeruginosa, a bacterium that is prevalent in the environment but usually only dangerous to people with compromised lungs.
A P. aeruginosa flareup is what put Heenan in the hospital this time, causing severe pneumonia and resisting treatment with several standard antibiotics. She is supposed to have surgery soon to remove her right lung, which is atrophied, but she says her physicians are concerned the infection could have spread to her left lung as well. “I’m a little bit spooked,” she admits.
But Heenan hasn’t been idle: Over the past few months, she has become an advocate for research and development of new antibiotics that can treat infections like hers, even traveling to Washington D.C., earlier this year to talk with government officials about the problem. “You need to learn about whatever illness you have, because knowledge really is power,” she says. Although a new combination of drugs seems to be helping Heenan with her symptoms, there are no antibiotics that can cure drug-resistant P. aeruginosa. The last new drug to treat that category of bacteria was approved in 1962, and pharmaceutical companies have largely abandoned their efforts in the area.
Antibiotics — a seeming medical miracle when the first one, penicillin, was discovered in 1928 — are a victim of their own success. Their overuse in medicine and farm animals has accelerated the evolution of infectious bacteria that can resist the drugs and proliferate. Penicillin discoverer Alexander Fleming foresaw this danger: In his 1945 Nobel Prize acceptance speech, he warned that antibiotic misuse would elicit resistance in bacteria potentially rendering the medicine useless. What Fleming may not have known was how easily bacteria can share their antibiotic resistance genes with other bacterial species, or how well certain microorganisms can become resistant to multiple antibiotic drugs.
The toll is enormous. According to the latest global numbers from the World Health Organization (WHO), 700,000 people die each year from antibiotic- resistant infections — a number WHO expects to increase to 10 million by 2050. Millions more infections, like Heenan’s, turn out to be life-altering. “It’s a crisis that’s coming faster than climate change,” says Andrew Read, an evolutionary biologist at Pennsylvania State University.
Like climate change, the erosion of antibiotic effectiveness is a catastrophe in slow motion, making it difficult to sustain public interest in the coming crisis that nonetheless has been in full view for decades. Researchers have struggled to find new antibiotics with new pharmaceutical mechanisms of killing multidrug resistant bacteria — the last truly new class to be approved was in 1980. Scientists know that any new drug will likely last only a decade or two before bacteria develop resistance to it, leading many experts to warn about a nightmarish “post-antibiotic era” in which medicine can no longer treat common infections.
A MISERABLE MARKET FAILURE
But the difficult medical science challenges pale next to those of the market, which renders antibiotics a singularly deep money drain for pharmaceutical companies. Compared to other drug categories, they are more expensive to manufacture and difficult to test in human subjects. They generally are prescribed for short periods, not for a lifetime like blood pressure and cholesterol-control medicines. Furthermore, the resistance crisis has taught conscientious physicians to use new antibiotics as rarely as possible and usually for a short period, lowering sales and minimizing profits.
“It doesn’t matter how quickly or how cheaply you get a drug to the market if it doesn’t get paid for,” says Peter Bak, vice president of the Boston-based consulting firm Back Bay Life Science Advisors. Over the past decade, most major pharmaceutical companies have left the antibiotic development space in order to pursue far more profitable fields like cancer or neurodegenerative disease.
Sales figures have spelled doom for many of the small companies that have tried to fill the gap left by the pharmaceutical giants. Although recent regulatory incentives and investment in basic research have led to a number of innovative new therapies, legal and insurance complications make it difficult for companies to actually sell their drugs. In recent years, multiple small companies went bankrupt well after their new antibiotics were approved by regulators, scaring private investors and driving industry scientists out of antibiotic development altogether.
Even as the post-antibiotic era looms, however, some signs indicate that antibiotic development could still turn around. In March, in a move analysts haven’t seen for years, pharma giant Roche Pharmaceuticals announced a partnership with a startup called Forge Therapeutics, agreeing to help the small biotech develop its antibiotic against drug-resistant lung infections like Heenan’s. Pilot programs in several countries are beginning to test whether financial incentives from the government can stimulate drug discovery and save innovative companies from bankruptcy. Meanwhile, some researchers are exploring whether nonprofit organizations funded by public monies and philanthropic donations can develop new antibiotics that might never generate financial returns.
But answers for all of these questions remain years away, even as dangerous bacteria continue spreading their antibiotic-resistant genes. “Right now we’re in this very fragile period while we’re waiting for evidence [for what solutions work], yet small companies are very vulnerable,” says Christine Årdal, an advisor for the Norwegian Institute of Public Health in Oslo.
In 2002, antibiotic development seemed like a good bet to Ryan Cirz, a microbiologist and entrepreneur living in Silicon Valley. “When [antibiotic resistance] gets bad it’s the worst thing there is,” he says. And with large companies losing interest, the competition seemed slim.
The company Cirz and his colleagues formed, Achaogen, decided to focus on a class of microorganism known as gram-negative bacteria, which has proven particularly difficult to target with antibiotics because of its penchant for simply pumping the drugs out of the cell. Gram-negative species, distinguished by their thin cell wall and double cell membrane, comprise seven of the nine drug-resistant species that WHO considers to be of most concern (P. aeruginosa is one of them).
The other two species on WHO’s list — methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) — are gram-positive bacteria, characterized by thick cell walls and a single membrane. Many antibiotics, including penicillin, interfere with microorganisms’ ability to build this cell wall, although pathogens like MRSA and VRE have evolved ways to disarm the antibiotics.
Over the 15 years following its inception, Achaogen received nearly $1 billion from private investors and from the US federal government, which was slowly waking up to the threat of antibiotic resistance. According to Cirz, about $4 million of this funding came from a public-private partnership called CARB-X, which launched in 2016 and was promoted by the Obama administration. The goal of CARB-X is to combine funding from the US Department of Health and Human Services and philanthropies like the Wellcome Trust to provide blue-sky financing for small companies like Achaogen to develop new, innovative antibiotics.
Achaogen, whose drug plazomicin deploys a novel molecular mechanism to kill bacteria, was hailed as a success story when the drug was approved in 2018. The antibiotic field needed some good news. Pharma giant AstraZeneca had sold off its antibiotics division in 2016, as did Sanofi, Novartis, and Allergan in 2018. All of them found antibiotics to be a drag on their income. “Honestly, the pharma companies that stayed in until recently were doing everyone a favor,” Cirz says. “They were losing money for a decade.” Now, in 2020, only four major companies maintain active antibiotic discovery portfolios.
The reasons for the market failures are manifold. One is what amounts to a price cap on antibiotics, which keeps them cheap. While Medicare and private insurance companies reimburse hospitals for the actual cost of most drugs, these payers consider antibiotics as a commodity like gloves or syringes. Insurers pay hospitals the same amount whether they use an old, cheap antibiotic or a new, expensive one. That leaves hospitals with little incentive to purchase newer drugs that could eat into their own budgets.
Antibiotic developers often struggle to convince hospitals that their pricy new drugs are worth using in the first place. Despite the growing prevalence of antibiotic resistance overall, infections with any given antibiotic-resistant bacterial species are too rare for a new drug to be tested against existing ones in a proper clinical trial. So the Food and Drug Administration (FDA) requires only that companies prove the drug is not less effective than existing drugs at treating infections before approving it. This double-negative — “noninferior” in regulatory-speak — proves to be insufficient in countries such as France, where public insurance will not cover new, expensive antibiotics unless they are actually superior to existing drugs. That’s a hard thing to prove, especially since most new antibiotics are slight variations on existing drugs and bacteria resistant to the old drugs can retool their defenses against these variations on familiar medicinal themes.
The largest cost, by far, comes after the drug has made it through the gauntlet of at least three increasingly demanding phases of clinical trials and has been approved. “Approval was not an end, it was a beginning,” Cirz says. Antibiotics, particularly those administered intravenously, are extraordinarily expensive to manufacture because of the strict sterility requirements. The FDA also requires that companies continue to monitor the health of patients taking approved drugs, assessing safety and efficacy in so-called phase IV trials. For noninferior antibiotics, this is particularly important because the initial trials for these agents tend to be so small. Regulatory approval comes with a raft of other requirements, such as mandatory post-approval clinical trials in children, which can cost millions of dollars to perform.
Those costs quickly tend to outpace companies’ income from the new drugs’ usually negligible sales. “There’s no other product that, once it’s approved by the FDA, we immediately put on the shelf and hope no one uses,” says Kevin Outterson, a lawyer at Boston University and director of CARB-X.
Large companies like Roche, which is still developing antibiotics, also have plenty of profitable products that keep them afloat while they bet that sales of their antibiotics eventually will grow. Perhaps more importantly, the giants have infrastructure like manufacturing plants and clinical trial networks in developing countries, allowing them to test their new drugs in places with higher rates of antibiotic resistance than the United States.
Achaogen had none of those things. In 2019, the company filed for bankruptcy and sold off its assets in a fire sale for $16 million. It was only one in a recent string of high-profile failures. The largest company solely producing antibiotics, Melinta Therapeutics, is in the midst of financial restructuring after declaring bankruptcy in December 2019 as a result of failing to recoup costs on its four recently approved drugs. And Tetraphase, a startup that invested $600 million to get its antibiotic against abdominal infections approved in 2018, was acquired in a bankruptcy sale in March for a mere $14 million.
A VENTURIST’S MINEFIELD
Cirz has given up on antibiotics for the time being. “I cannot tell venture capitalists with any certainty they will get any money back,” he says. “It’s gotten so dire you could have 90% of your funding from the federal government and still can’t get the remaining 10%.”
That’s something that Kim Lewis, a biologist at Northeastern University, is quickly learning. In 2015, his lab discovered teixobactin, a natural compound produced by soil bacteria that kills gram-positive bacteria like MRSA. Its bactericidal mechanism and structure are completely novel — the first such discovery in decades. And try as they might, Lewis’ team and others have failed to coax any bacteria into developing teixobactin resistance, likely because the antibiotic targets multiple cell components at once. “In a field dominated by doom and gloom, [the] work offers hope that innovation and creativity can combine to solve the antibiotics crisis,” enthused a commentary article in Nature, which published the study.
Lewis cofounded a startup called NovoBiotic and went looking for funding to start testing teixobactin in human patients. But no venture capitalists have bitten, even when Lewis suggests the new drug could be the first treatment patients receive rather than the one to use after others have failed. “Here you’ll have an opportunity to give an antibiotic that will work for everybody,” he tells potential investors. But the argument hasn’t proven convincing enough.
The fact that markets are stifling antibiotic development is frustrating to patients like Mary Millard, a former nurse living in Louisiana. She says she was perfectly healthy when, at age 56, she had heart surgery to remove an aneurysm. Five days later, when she was leaving the hospital, she went into septic shock. The cause, she later learned, was a P. aeruginosa infection that likely entered through the life support system that oxygenated her blood during the heart surgery. The doctor prescribed oral ciprofloxacin for the rest of her life. “I said, ‘Excuse me?’” Millard recalls.
Ciprofloxacin doesn’t kill P. aeruginosa; it only prevents it from forming permanent films in the body. That protection has cost Millard heavily in side effects from the drug: kidney problems, ringing in her ears, and skin cancer from light sensitivity. She has been hospitalized 9 times in the last 6 years. “I felt sorry for myself the first couple months, then I got angry,” she says.
Millard went to Washington in February, along with Heenan, to accompany the Pew Charitable Trusts, which was lobbying the federal government to reform the antibiotic pipeline. “It’s something that just gets forgotten,” she says. “I want to raise that awareness that I’m the everyman and one day you’ll know someone.”
Among other initiatives, Pew supports a bill currently in Congress called the DISARM act. DISARM would allow US hospitals to bill Medicare and private insurers for antibiotics just like any other drug, which would greatly drive up the cost of antibiotics. To some, that is a desirable outcome. “If you want meaningful new antibiotics, you’ve got to be willing to stump $1 to 4 billion globally,” says John Rex, chief medical officer at F2G Limited and former head of antibiotic development at AstraZeneca. His analyses have found that companies need to recoup at least $350 million to break even over the course of 10 years once their drug hits the market, before even repaying their investors.
But it could be tough to convince the public to pay more for drugs that have always been taken for granted. “For antibiotics, we want to have them available and already completed, FDA-approved and mass-produced and in the hospital waiting, but don’t want to pay until the patient needs it,” Outterson says. He likens antibiotics to fire engines — you need to have them built and paid for before the fire occurs. “We don’t want to be paying on a per fire base,” he says.
PUSHING AND PULLING
In recent years, a number of expert groups have proposed solutions to this economic morass. One influential 2016 report, by UK economist Jim O’Neill, recommended countries develop a “market entry award” approach– a one-time $1 billion payment for companies that get an antibiotic approved. It would allow companies to recoup some of the development costs and carry out the necessary manufacturing, distribution and drug testing without going bankrupt.
An international working group called DRIVE-AB, which included Årdal and Rex, released another report in 2018 recommending similar incentives. Providing buyers for the new antibiotics, the authors believe, will embolden both those who “push” antibiotic innovation and development, and those who “pull” those drugs across the finish line.
The “push” — investment in early stage research — is the easier of the two. CARB-X, for instance, has funded nearly 40 companies with new antibiotics in their pipelines, covering research and development costs until their respective drug either fails or completes safety trials. “Our portfolio is probably bigger than the preclinical research of all the large pharmaceuticals combined,” Outterson says. The NIH and organizations like the Gates Foundation also contribute heavily to early-stage development. And while it can be a tough sell, private donors and philanthropists might be convinced to fund drug development as well, says Sue Merrilees, senior advisor at the Science Philanthropy Alliance.
Push incentives have perhaps been too successful by convincing people to develop new variations of drugs for the same types of infections — many of which then never make it to market. “Ten to 15 years ago we were in desperate need” of new drugs for MRSA, says Brad Spellberg, chief medical officer at the Los Angeles County and University of Southern California Medical Center. Since 2004, a dozen such drugs have become available, but “in 10 to 15 years, we’ll be in desperate need again.” The whole system, he says, needs a redesign to determine how drugs are developed from beginning to end, “not a feeding frenzy that pushes many drugs to market.”
“If you want meaningful new antibiotics, you’ve got to be willing to stump $1 to 4 billion globally,” — John Rex, antibiotic developer and analyst
There is little advantage to developing so many drugs anyway. A 2019 analysis found that the total annual market for antibiotics against gram-negative bacteria is only $289 million. That’s a far cry from the cost of developing even one such drug, and would require a monopoly that no company could actually secure. The market could not support multiple drugs with this revenue profile, and a string of bankruptcies from the dozens of companies that Pew indicates are currently developing antibiotics would further drive both investors and researchers from the field.
That’s where “pull” mechanisms come in, and far less is known about how these could work. “Push is an immediate reward,” says Kathy Talkington, director of Pew’s antibiotic resistance programs. “On pull incentives, you have to have something that’s consistent and predictable into the future so companies starting a 10-year process know [a market] will be there.”
The DRIVE-AB report provided a number of potential solutions, none of them ideal. One is the market entry award, which the pharmaceutical industry tends to support. A similar idea would guarantee that companies would earn a certain amount per year on a new antibiotic, with the government filling in whatever the company didn’t make in sales. The idea, Bak says, is that after the company hits that threshold, it would sell the drug at cost rather than continuing to make a profit beyond what they already gleaned from sales.
But David Shlaes, a microbiologist and author who blogs about antibiotic development, says that such a move would be politically impossible and seen by lawmakers as a gift to big corporations. “Everyone who wants to give money to the pharma industry, raise their hands,” he quips. Private donors are unlikely to support the idea either. “Giving money to multibillion-dollar industries to get them to take on these things is not going to appeal to practically any person I can think of,” Merrilees says.
There are practical challenges as well. Governments would need to choose carefully which drug to back — giving money to every new antibiotic would eat heavily into healthcare budgets. That choice could be both politically and practically difficult, especially since the drugs have not yet been widely tested for efficacy. And, of course, it would only be a matter of time before antibiotic resistance would develop.
Another approach proposed by the pharmaceutical industry is a transferrable voucher system. Under this system, the government would extend the amount of time a large company has the exclusive right to sell another unrelated drug in its portfolio before generics are allowed on the market. Under this system, a company like AbbVie could receive a voucher for a drug like Humira: a $40,000-per-year therapy for arthritis and other immune disorders whose US patent runs out in 2023. AbbVie earns nearly $20 billion per year in Humira sales, so extending the drug’s exclusivity period by just a few months could easily cover the loss incurred by developing and marketing a new antibiotic.
Although Shlaes says this model would likely draw big pharma back into antibiotic development, the companies would simply transfer the cost of drugs from patients with antibiotic-resistant infections to patients with other diseases and, ultimately, to taxpayers who pay into Medicare.
A final idea for saving the antibiotic pipeline is known as the subscription or “Netflix” model, in which states or hospitals pay companies a flat fee for access to antibiotics whenever they need them. The model was originally developed to stabilize prices for necessary but expensive drugs. In 2019, Louisiana used this model to buy Gilead’s hepatitis C drug Sovaldi, which infamously cost $1,000 per pill. The state, which wants to eliminate hepatitis C by 2030, expects that the subscription will pay for itself through mass use of the drug.
Antibiotic developers hope the opposite is true — that a subscription will raise the price of a little-used drug. Later this year, Sweden will launch the first trial of a system in which the government will choose new antibiotics and compensate their manufacturers — up to a minimum revenue figure — for whatever they don’t make in sales. Scandinavia has very low rates of antibiotic resistance and rarely uses new drugs, Årdal says, “but that doesn’t mean we don’t want access.”
“Giving money to multibillion-dollar industries to get them to take on these things is not going to appeal to practically any person I can think of.” — Sue Merrilees, The Science Philanthropy Alliance
The UK government plans to launch a similar experiment in 2022, guaranteeing £10 million per year to the makers of two antibiotics — one old and one new — for up to 10 years. The government is looking at a variety of factors to choose the drugs, including their novelty, the importance of the antibiotic-resistant species they target, and whether they can be used in a way that prevents resistance. Årdal expects that within two to three years, Sweden’s program will indicate whether this model is a viable solution to the antibiotic development crisis, with the UK a few years behind.
But Sweden and the UK make up a very small slice of the global antibiotic market — hardly enough to excite drug developers. The US makes up 50% of the GDP of advanced economies and, according to Rex’s calculations, would need to contribute $200 million per year to a single market entry award. Low-income countries with high rates of antibiotic resistance couldn’t be expected to contribute much to the award. And coordinating different countries’ policies could prove a logistical nightmare. “The calculus would get awfully complicated if the EU has agreed on one model and the US on another model,” Bak says.
Shlaes doubts any of these solutions will work. “The problem with that whole approach is that it takes 10 to 15 years to get an antibiotic onto the market,” he says. “I think what’s going to happen is we’re going to wait until there’s enough resistance and enough small companies have gone bankrupt and enough investors have fled the area.” At that point, large pharmaceutical companies might come back to address what is, by that point, causing millions of deaths that had not been occurring in the earlier portions of the antibiotic era. “I think, for now, we’re screwed.”
Spellberg is less pessimistic. “What you have witnessed is capital markets doing exactly what capital markets are supposed to do,” he says — eliminating similar drugs that overlap with one another. “There’s more than 90 antibiotics on the market already, and each new one competes with all those others.”
In a 2019 paper, Spellberg proposed a new model based around a nonprofit organization that develops unique drugs that target unmet needs — gram-negative Pseudomonas, for instance. The organization would take drugs from the research and development stage all the way through approval and distribution without ambitions of making a profit. Funding could come from public sources like CARB-X, the US Department of Defense, and private philanthropies. “It recreates an old-style pharmaceutical team in a nonprofit environment,” he says.
There is precedent for this model. The nonprofit TB Alliance, which is funded by governments and charities, developed an anti-tuberculosis medication called pretomanid without help from large pharmaceutical companies. In 2019, it became only the third TB drug approved in the US in 40 years, and the organization then partnered with the pharmaceutical company Mylan to distribute it as part of a multi-drug TB therapy designed to prevent resistance. The WHO’s Drugs for Neglected Diseases Initiative (DNDi) similarly amasses money and expertise from private donors, governments, industry, and academia to develop drugs for diseases like malaria and sleeping sickness.
At least one organization is already trying something like this with antibiotics. In 2016, DNDi and the WHO created a nonprofit called Global Antibiotic Research and Development Partnership (GARDP), which is funded by governments and private foundations. GARDP, which aims to develop five new treatments by 2025, also helps antibiotic developers bridge the gap between R&D and ensuring that new treatments become accesible to all people who need them, wherever they live. “No one can do this alone,” says Laura Piddock, GARDP’s director of scientific affairs. The organization fills a variety of roles: running its own clinical trials, screening collections of chemical compounds for antibiotic properties, assessing whether old drugs can be used in new ways, and expanding access to antibiotics, among others. GARDP’s goal is not to compete with pharma, Piddock says, but to partner and organize with those traditional players.
But none of the therapies in GARDP’s pipeline have yet reached the crucial phase IV period, which has proven so deadly for new antibiotics. Piddock isn’t sure how GARDP will navigate that space, but says they are discussing various solutions like those outlined in DRIVE-AB. “The reality is that until a drug is launched from a nonprofit, we’re not going to know what the reimbursement model is or even the cost of marketing and distribution,” she says.
Rex and others are skeptical that nonprofits are the future of antibiotic development. “The one thing a little market pressure does is it forces you to confront the reality,” he says, and abandon early stage drugs that are failing. “You end up paying a couple billion either way, and a little profit motive really drives clarity.”
But he’s open to all ideas, and is particularly enthusiastic about Roche’s recent partnership with Forge Therapeutics — an indication, he says, that pharmaceutical companies are at least still watching the space. Forge is developing a drug for antibiotic-resistant lung infections, going after a protein component of gram-negative bacterial cells’ membrane. Many other companies have tried to target this protein and failed. “We’re all crossing our fingers they’ll be successful,” Rex says, which could herald a new phase of antibiotic development by big companies.
No matter who develops the drugs, they will not be cheap. Convincing governments, industry, donors, and taxpayers to pay will be crucial. “There has to be a strong public perception that paying this amount has given them some level of insurance, and that will depend on how effective these antibiotics are,” Årdal says.
And having that insurance will be much cheaper than paying for the effects of not having it, Rex adds. According to a 2017 report from the World Bank, the economic fallout of uncontrolled antibiotic resistance could rival the 2008–2009 financial crisis, and drive some 24 million people into extreme poverty by 2050. Says Rex, “A silver lining to the COVID-19 crisis is it’s teaching everyone how expensive it is when you don’t have the right fire extinguisher.”
Sara Reardon is a freelance science reporter and filmmaker based in Bozeman, Montana.
[This article has been slightly modified since its original posting on June 23, 2020.]
