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Black Fungus cases rise, but Delhi’s bigger task is stocking enough medicine to treat patients

Delhi hospitals are seeing a rise in cases of mucormycosis, or Black Fungus infection, & are struggling with ensuring medicine stock, says govt needs to speed up supply.

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New Delhi: At least 12 people have died of the fungal infection mucormycosis in the national capital over the past one week, according to information collected by ThePrint from hospitals in Delhi. The casualties occurred at AIIMS, Ganga Ram, Moolchand and Aakash hospitals.

Further, the number of patients coming in with mucormycosis, also known as the ‘Black Fungus’ infection, has seen a rise in hospitals across the city. As of Friday morning, nearly 275 patients suffering from Black Fungus infection were admitted to different hospitals across the city, according to sources in the Delhi government.

The problem of increased instances of the infection is compounded by a shortage of medicines to treat the disease. The Delhi High Court Thursday had directed the Centre to “get black fungus drug from wherever in the world”. The shortage of medicines in Delhi was also cited by Delhi counsel Rahul Mehra at the same hearing. Mehra said that while 2,150 doses had been received from the Union government, an order for 600 more was placed with pharmaceutical manufacturer Cipla Ltd.

Health Minister Satyender Jain, in a statement to the media Friday morning, maintained that only 197 cases of the infection had been reported in Delhi. Allaying fears of a widespread infection, the health minister also said that Black Fungus usually affects those whose body immunity is reduced owing to intake of steroids, which are being extensively used to treat critical Covid-19 patients. Many of the cases of Black Fungus infections are being seen among recovered or under-treatment Covid patients. Those with diabetes are also at risk, said doctors.

Black Fungus is a rare infection, caused by mucormycetes, a group of fungi. Symptoms include numbness of face, nose obstruction, swelling in the eyes or cheeks, and the formation of black dry crusts in the nose.

Also read: Days after PM’s ‘baal mitra’ call, CBSE invites students to join awareness programme on Covid

Can’t tell patients to go die because we don’t have medicine’

On Thursday, Delhi Chief Minister Arvind Kejriwal announced that three hospitals — LNJP, Guru Teg Bahadur (GTB) and Rajiv Gandhi Super Speciality hospital — will soon have dedicated centres to deal with the increasing cases of Black Fungus infections.

However, what is making attending to patients difficult is the shortage of medicines needed to treat these patients, said Ganga Ram Medical Superintendent, Dr D.S. Rana.

The hospital received some vials of Amphotericin B (being used to treat mucormycosis) Thursday night, but Rana said they are far short of the amount needed.

“Bu the government [Centre] needs to speed up the supply and since they decide who will get the medicine, it makes the situation difficult for us. We can’t tell patients to go die because we don’t have enough medicine,” he said, adding that the hospital will take this up with government authorities Friday.

According to a senior state health department official, Delhi received approximately 2,500 vials of the drug to be used till 31 May. “However, the number of patients infected are rising, so we are trying to figure out what to do after that,” added the official, requesting anonymity.

The official also pointed out that the drug is rather expensive. The Amphotericin B costs at least Rs 6,000 per vial, he said.

The Delhi government had earlier this week appointed a three-member technical  committee to address issues about procurement and supply of the drug and ensure proper distribution of Amphotericin B.

Each patient of Black Fungus requires six to eight vials of the drug per day for treatment, which means 42 to 56 such vials for seven days, the prescribed minimum duration for which one has to take the medicine, according to doctors.

Ganga Ram received 153 vials Thursday, which means they are short of many doses even for their existing 59.

Also read: How Varanasi cut Covid cases from 1,000+ to under 300 — thanks to Modi’s man, an ex-IAS officer

‘Infection need not mean immediate death’

Of the 12 Black Fungus deaths reported from hospitals in Delhi in the past one week, eight were in AIIMS, two at Ganga Ram hospital and one each at Moolchand and Aakash hospitals, ThePrint found.

On Friday morning, 59 patients were being treated for the disease at Ganga Ram hospital. The hospital had 51 Black Fungus patients till Thursday, but two died and two others were discharged. However, 12 admissions happened overnight, Medical Superintendent Dr  Rana told ThePrint.

Of the 59 currently being treated, 35 are diabetic, while 13 others were on steroids. Sixteen of the 59 patients had received one dose of Covid-19 vaccine, while three had got both shots. Dr Rana added that 25 of the 59 patients were also Covid positive.

“This shows that deaths don’t necessarily occur late [after recovery from Covid], but may occur in those suffering from Covid,” said Dr Rana.

At Moolchand Hospital, Medical Superintendent Dr Madhu Handa, said that in addition to the patient who succumbed to Black Fungus infection at the hospital, another is currently being treated for the disease.

“No Covid patient treated at Aakash Healthcare developed the serious post-Covid complication known as Black Fungus infection,” said Dr Aashish Chaudhry, Managing Director, Aakash Healthcare, where one person had succumbed to the infection.

Clarifying the death, Dr Chaudhry added, “we received two referral cases from Haryana and Uttar Pradesh, where these Covid patients were being treated in small nursing homes … Three-four weeks after recovery, they reported loss of vision, drooping eyes and severe pain in one side of the face.”

Both patients were critical and needed surgery, and “one of them passed away after the surgery,” he said.

Chaudhry added that Aakash Healthcare has so far treated five cases of mucormycosis successfully and one more patient was being evaluated for treatment.

Meanwhile, other hospitals in the city are preparing to provide dedicated care to patients of Black Fungus infection.

While Rajiv Gandhi Super Speciality Hospital has not had instances of the infection among its patients yet, the hospital is in the process of setting up a centre dedicated to mucormycosis patients. Media spokesperson Dr Chhavi Agarwal said, “It will take another day or two for the centre to be set up, post which we will be in a position to take in patients.” An entire floor is being set aside for the treatment of Black Fungus patients, she added.

At Lok Nayak Jai Prakash Narayan (LNJP) Hospital, where three-four patients are currently being treated for the infection, a committee of experts has been created to monitor treatment. “There have been many enquiries, but the ward [dedicated for mucormycosis patients] is still being set up. Once it is ready, we will be in a better position to understand the severity here,” a senior hospital spokesperson told ThePrint.

At Lady Hardinge Medical College and Hospital, four patients are being treated for the infection.

“Infection doesn’t always mean immediate death. Patients may survive with treatment. We haven’t had any deaths yet,” said Dr N.N. Mathur, professor of Excellence ENT and additional Director General Health Services at the hospital.

(Edited by Poulomi Banerjee)

Also read: Dinesh Mohan, IIT professor & leading road safety expert behind Delhi’s BRT, dies of Covid


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