Novel viral pathogens are causing diseases to emerge
in humans,
a challenge to which society has responded with technological innovations
such as antiviral therapies. Antivirals can be rapidly deployed to
mitigate severe disease, and with vaccines, they can save human lives
and provide a long-term safety net against new viral diseases. Yet
with these advances come unforeseen consequences when antivirals are
inevitably released to the environment. Using SARS-CoV-2 as a case
study, we identify global patterns of overlap between bats and elevated
pharmaceutical concentrations in surface waters. We model how freshwater
contamination by antivirals could result in exposure to insectivorous
bats via consumption of emergent insects with aquatic larvae, ultimately
risking the evolution of antiviral-resistant viruses in bats. The
consequences of widespread antiviral usage for both human and ecosystem
health underscore urgent frontiers in scientific research, antiviral
development, and use.