Black fungus situation stabilises in Delhi

The mucormycosis peak came around 2-3 weeks after the height of the surge in Covid cases and steroids usage, said Sir Ganga Ram Hospital’s chairperson.

Hospitals across the city are reporting that the mucormycosis or black fungus situation is stabilising, with a slowdown in new cases, though doctors have cautioned that it is too early to tell the toll the fungal infection will have on patients.

Last week, Health Minister Satyendar Jain had stated that Delhi had recorded 1,044 cases of mucormycosis, an otherwise rare fungal infection. In numbers updated by the Delhi government on Monday, the number of black fungus cases in Delhi government and private hospitals was 638. This does not include the number of cases in central government hospitals.

Lok Nayak Hospital, which had been made a dedicated mucormycosis case facility by the Delhi government, has had the among the highest number of such cases and currently has 95 patients. The hospital’s medical director Dr Suresh Kumar said the overall numbers have now stabilised but it is too soon to talk about recoveries and mortality.

“Earlier we were seeing 8-9 cases every day. Now that has gone down to around three a day… Once patients are admitted to the hospital for mucormycosis, they have to be there for around four weeks since it’s a long treatment,” he said.

At Sir Ganga Ram Hospital, which has been one of the private hospitals with the highest number of mucormycosis cases, chairperson Dr D S Rana said most of the cases had occurred in a narrow window of time.

“We received almost all of our cases in about the span of a week… This mucormycosis peak came around 2-3 weeks after the height of the surge in Covid cases and steroids usage. So the Covid peak was around late April and the first week of May, and the third week of May is when the mucormycosis cases came in the most… At our peak, we had around 70 cases. Now we have 60. Some patients have been discharged. Hopefully the worst is over,” he said.

“The cases would have developed when there was an acute shortage of hospital beds, which is when a lot of steroids were used at home without required supervision. The monitoring of sugar levels of diabetic patients and the necessary titration of insulin also would not have been happening. Patients in hospitals too were given high amounts of steroids to keep down inflammation to avoid the need for ICU beds which were not there,” said head of critical care at Holy Family Hospital Dr Sumit Ray.

However, a senior administrator at a hospital said the supply of amphotericin B is still short, though hospitals are finding ways around it.

“In most hospitals, the administrations are sending across the number of suspected cases to the government because treatment needs to start even before the test results come in. At the moment, the Delhi government is distributing only two vials per patient, which is highly inadequate as 5-6 vials are required per patient per day. To meet this gap, we are not removing the numbers of those who have gone on to test negative for the infection, so that their supply can be used for the patients who require it,” the administrator said.

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