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BLACK FUNGUS DRUG SHORTAGE ADDS MORE MISERY TO COVID BLUES

Over 7,250 mucormycosis cases reported across the country; PM Modi calls it a new challenge.

Black Fungus
Black Fungus

Amid the current rise in cases of mucormycosis, a rare fungal disease affecting Covid-19 patients after recovery, the Union government said on Friday that it is working to tackle the new infection and the shortage of the medicine used to treat it.

At least 7,250 cases of mucormycosis, or “black fungus”, have been reported in several states across the country as of 19 May. Rajasthan, Telangana, Gujarat, Haryana, and Assam have declared it as an epidemic. It is a potentially serious condition that affects vision and the respiratory system.

“In our ongoing fight against Covid-19, a new challenge of black fungus has surfaced. We must focus on precaution and preparation to deal with it,” Prime Minister Modi said on Friday. His remarks came at an interaction with the doctors, paramedical staff and other frontline health workers of Varanasi over the challenges posed by the pandemic.

Union Health and Family Welfare Minister Harsh Vardhan also held a meeting on Friday where he expressed his concern over the spread of black fungus. “Rising number of black fungus cases is a concern. Now we are ramping up the production of the drug used for the treatment of the disease. Every state has been asked to put black fungus in the notified list,” he said.

The Union Health Ministry on Thursday had urged the states to make it a notified disease under the Epidemic Diseases Act, 1897. Under the Act, all states will have to report all confirmed or suspected cases of this condition, seen in recovering Covid patients, to the Health Ministry.

The Centre has said that the Health Ministry along with the Department of Pharmaceuticals and the Ministry of External Affairs (MEA) are making efforts to significantly ramp up the domestic production of the antifungal drug amphotericin-B and also increase imports. This would lead to a nearly 250% increase in supply, taking it to around 570,000 vials in June, the Health Ministry said on Friday.

Union Minister of State for Chemical and Fertilizers Mansukh Mandaviya had informed on Thursday that five more manufacturers have been given licenses to manufacture the drug within the country and the production by the existing five manufacturers is being ramped up.

Some states like Delhi and Maharashtra have reported that they are running low on the drug, leading to families running pillar to post and posting on social media platforms in search of it.

Each vial of amphotericin B costs Rs 7,800 and patients are prescribed more than one a day, families in Delhi reported.

“One patient needs 60 to 100 injections (of amphotericin B) depending on the severity of the illness. With the current caseload, we need more than 150,000 injections,” said Maharashtra Health Minister Rajesh Tope to reporters. Maharashtra has reported 1,500 cases of mucormycosis so far and 850 patients are undergoing treatment.

AIIMS director Randeep Guleria stressed on the increasing trend in the fungal infection among Covid patients and informed that use of excessive steroids and uncontrolled diabetes with Covid can contribute to the development of mucormycosis. “Steroid use has become much more in this Covid wave and steroids given when not indicated in mild or early disease can cause a secondary infection. Those given high doses of steroids when not indicated can lead to high blood sugar levels and a high chance of mucormycosis,” Dr Guleria told ANI.

Taking a note of the secondary and opportunistic fungal infections which are getting amplified due to the present surge in Covid cases and mucormycosis becoming a cause of concern, the Union Health Secretary in his letter to the Chief Secretaries and Administrators of all states and UTs advising them to review their preparedness for infection prevention and control, as well as hygiene and sanitation in hospitals.

In the letter, the Health Ministry listed certain activities and urged states and UTs to undertake those to ensure “robust infection prevention and control practices in Covid hospitals and other healthcare facilities”.

All states and UTs have also been directed to establish or activate the Hospital Infection Control Committee with the head of the institution or an administrator as the chairperson, as well as designate an infection prevention and control nodal officer, preferably a microbiologist or senior infection control nurse.

The government has also instructed the states and UTs to prepare and implement the Infection Prevention Control (IPC) Programme in hospitals/health facilities, as per the guidance given in National Guidelines for Infection and Control in Healthcare Facilities, train all hospital staff to develop their skills in IPC.

The Health Secretary also directed the states and UTs to establish surveillance of healthcare associated infections. In due course, with focus on ventilator associated pneumonia, catheter-associated blood stream infection, catheter-associated urinary tract infection, surgical site infections, gastro-intestinal outbreaks.

AIIMS has also released new guidelines for detection and care in cases of black fungus. Meanwhile, India reported 259,591 new Covid-19 cases and 4,209 deaths in the last 24 hours. As many as 3,57,295 people also recovered from the disease across the country in the 24-hour period. At least 2,91,331 people have succumbed to Covid-19 in India, while the recovery tally has mounted to 2,27,12,735.

“The cumulative caseload in India now stands at 2,60,31,991. There are 30,27,925 active Covid cases in the country,” the Health Ministry said.

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