A doctor checks the medical reports as she examines the patients who recovered from COVID-19 and now infected with Black Fungus, a deadly fungal infection at a ward of a government hospital in Hyderabad on May 21, 2021. (PHOTO / AFP)
As India continues to battle a deadly second wave of the COVID-19 pandemic, the emergence of mucormycosis, a rare life-threatening infection commonly known as “black fungus”, has become a fresh cause of worry.
With thousands of cases of the fungal disease being reported, especially with the victims mostly comprising of recovering or recovered COVID-19 patients, several state governments have labeled black fungus as an epidemic.
Sadananda Gowda, a member of Prime Minister Narendra Modi’s federal cabinet, said on May 25 that 11,700 cases of mucormycosis have been identified in India. Experts, however, believe the actual number of cases could be far greater.
Most of the cases are occurring in the western states of Maharashtra and Gujarat, and in India's national capital, New Delhi, according to the union health ministry. At least 15 more states have reported between 800 and 900 cases. On May 28, with 153 cases in a day, black fungus was declared an epidemic in the national capital.
Sadananda Gowda, a member of Prime Minister Narendra Modi’s federal cabinet, said on May 25 that 11,700 cases of mucormycosis have been identified in India. Experts, however, believe the actual number of cases could be far greater
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Several states are reeling under severe shortage of drugs to treat the infection. Local governments have expressed serious concern over the rising number of infections, and have been pressing for supply of injections needed for treating the black fungus.
Delhi Chief Minister Arvind Kejriwal said on May 27 that the capital has hundreds of cases of mucormycosis but Amphortericin B needed for the treatment is not easily available.
Randeep Guleria, director of the All India Institute of Medical Sciences, said earlier in May that many parts of India were reporting an increase in the number of cases of a supplementary fungal infection called COVID-associated mucormycosis. On May 20, Guleria said the COVID-19-linked infections have claimed more than 7,000 lives in the country.
Experts suggested that an overuse of certain drugs during the COVID-19 pandemic could be causing the surge.
“Mucormycosis is not a communicable disease and 90-95 percent of patients that we have with us currently are diabetics who were on steroids. We are also seeing the fungus early on in COVID patients which is proving to be a challenge,” Guleria said recently.
Experts surmise that other factors may have also contributed to the surge in cases. With hospitals overwhelmed in the second wave of the pandemic, many families have been self-medicating and applying oxygen therapy at home without proper hygiene, public health experts noted.
The infection can infest the sinuses and bones of the face and invade the brain or cause patients to lose an eye, said Raj Kamal Agarwal, a senior doctor who works at Delhi’s Sir Ganga Ram Hospital.
"The black fungus infection has now become more challenging than COVID-19. The cost of treatment is expensive. If patients are not treated in time and properly, the mortality rate can go up to 94 per cent," Agarwal said.
At the hospital where he works, around 100 cases of black fungus were reported over the past few weeks, the doctor revealed.
Doctors said they are surprised by the severity and the frequency of this fungal infection during the second wave.
Most of the patients arrive late, when they are already losing vision. In some cases, doctors had to surgically remove an eye to stop the infection from reaching the brain. In rare cases, doctors have to surgically remove the jaw bone in order to stop the disease from spreading, medical experts said.
Data from the United States Centers for Disease Control and Prevention shows that mucormycosis has a mortality rate of 54 percent, which can vary depending on the condition of the patients and the body part affected.
Low blood-oxygen, diabetes, high iron levels, and immuno-suppression, coupled with several other factors including prolonged hospitalization with mechanical ventilators, creates an ideal environment for contracting mucormycosis, researchers have written in the Indian journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews.
Lack of facilities to treat the mucormycosis patients at most of the government hospitals in the national capital region, or NCR, has aggravated the situation.
“In the last one week we have had around ten patients diagnosed with black fungus. All of them were referred to private hospitals, said Anurag Bhargava, chief medical superintendent of MMG District Hospital in Ghaziabad, in NCR.
The alarm over black fungus comes even as India has been witnessing a downswing in daily COVID-19 cases over the past few weeks.
On May 31, the nation reported 152,734 new COVID-19 infections over a 24-hour period, the lowest daily increase since April 11.
The total case tally now stands at 28 million, while the number of fatalities has passed the 329,000 mark.
The decline in daily case numbers has offered a glimmer of hope that the pandemic’s devastating second wave may be ebbing.
Experts, however, warned that in order to prevent possible a third wave people should follow COVID-19 appropriate behavior for next one year and also get themselves vaccinated.
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According to the India’s health ministry, more than 221 million COVID-19 vaccine doses have been administered in the country so far. That still leaves a huge chunk of the nation’s 1.3 billion population yet to be inoculated.
Prime Minister Modi, in a radio address, claimed that production of liquid medical oxygen, a key component in treatment of COVID-19 patients, has been increased tenfold.
In the past two months, many patients died as hospitals struggled to get oxygen supplies.
Right now, apart from staying vigilant to curb the spread of the coronavirus, authorities are facing the added challenge of getting the so-called black fungus infections under control.
Aparajit Chakraborty is a freelance journalist for China Daily.