India’s federal health ministry raised an alarm on Thursday, asking state governments to immediately report all cases of a potentially deadly fungal infection that appears to be spreading quickly among Covid-19 patients.
The rare condition, mucormycosis, commonly known as black fungus, was present in India before the pandemic, but it is affecting those with Covid or those who have recently recovered.
Many health experts blame the spread on a central coronavirus treatment, steroids. These drugs can limit inflammation of the lungs, but they also dull the response of the immune system, which can allow infections like the black fungus to take hold.
More broadly, Covid patients with weakened immune systems and underlying conditions, particularly diabetes, are especially vulnerable to black fungus, which has a high mortality rate.
Making matters worse, a shortage of antifungal drugs, like amphotericin B, has made it hard to fight the infection once it attacks. Relatives of the sick have been desperately sending messages over social media seeking the drug.
Courts are pressuring local governments to make antifungal drugs available and pushing for stepped up investigations to stop black-market drugs from being distributed.
Before the pandemic, a vial of amphotericin B would cost around $80, but some relatives of sick people say they have paid as much as $500 on the black market.
Video of a woman saying she would jump off the roof of a hospital if it failed to arrange injections of the medication for her husband spread widely on social media early this week.
The woman, in the central Indian state of Madhya Pradesh, said, “If I don’t get the injection today, then I will jump off the roof of the hospital and commit suicide. I have no other option left.” She added that the hospital had none of the medication and said of her husband, “Where should I take him in this condition?”
In the western state of Maharashtra, which includes the commercial hub of Mumbai, the authorities said at least 90 people had died of fungal infections and more than 1,500 patients were being treated in hospitals.
Rajesh Topai, the health minister of Maharashtra, told reporters on Wednesday that the state was desperate for more supplies of the medicine and begged the federal government, “do anything, but give more vials to Maharashtra.”
In Delhi, the capital, badly hit by the pandemic, hospitals have recorded 185 fungal infection cases and the local government is setting up three dedicated centers inside government-run hospitals to treat the condition.
M.V. Padma Srivastava, a professor and head of neurology department at All India Institute of Medical Sciences, New Delhi, said the number of black fungus cases was increasing every day and the condition was appearing across the country like never before.
She said hospitals received few cases during the first wave of the pandemic but certainly not the numbers they are registering now, amid a virulent second wave.
Of the medication for the disease she said: “It is not one of the common over-the-counter medications. This is a toxic medication by itself. It can’t be given by all and sundry. It is not something which you can take at home. It needs strict monitoring of body parameters because it is a toxic drug.”
The federal government directive requiring state governments to immediately disclose cases follows those of many Indian states that had already required hospitals to report cases of mucormycosis.