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New Delhi: There is still some time left for the Covid pandemic to spread in India, but one epidemic that seems to be definitely under control is mucormycosis or black fungus.
The jury is still out on why the black fungus was widespread – was it simply steroid overuse, as the Modi government admits, or were there other factors such as unhealthy conditions in hospitals or the use of less sterile industrial oxygen? But doctors, in general, agree that while there are still cases of covid cases, the dreaded black fungus has started to retreat.
“The cases of mucormycosis occurred at the peak of the second wave of COVID in patients who had high blood sugar and were immunized. Now, the Covid cases have come down and we are not seeing mucormycosis,” Dr. s. Chatterjee, Consultant Medicine, Indraprastha Apollo Hospitals said.
“The compromised immunity was both due to Covid and due to the use of steroids. Post-Covid we saw the same reduction in T-cells as seen in patients with HIV etc,” he said. “What else could have been added to the problem was when the oxygen used was not pure or the oxygen was not dehumidized.”
But several other doctors ThePrint spoke to highlighted the role played by industrial oxygen at the peak of the COVID-19 crisis.
“The black fungal spore has to enter the system from somewhere. This simplistic explanation is ignoring the aspect that steroid overuse causes mucormycosis,” said a senior doctor on condition of anonymity.
“In addition, many large hospitals treat fungal infections; The question is how many patients got infected there and how many came from outside.
“At the peak of the second wave, oxygen was used in homes and small establishments without experience of sanitary precautions.”
He is not the only one underscoring the role of industrial oxygen.
one in statement issued During the second wave, the Indian Medical Association had also taken precautions.
“While industrial oxygen is being pushed towards hospitals, it is important to bridge the gap between medical oxygen and industrial oxygen. Medical oxygen is a type of oxygen produced and used specifically for medical purposes,” the statement said.
“Medical oxygen can only be generated by medical air compressors. Medical oxygen generators or compressors are usually in oil-free or oil-free varieties. Transport and storage cylinders, but also the entire supply chain, strictly control the presence of water inside the cylinders to prevent rusting.”
National President of IMA, Dr JA Jayalal was also among those who signed the statement.
In fact, “The first point in a correspondence by researchers from PGIMER Chandigarh was the cleaning and operation of oxygen gas cylinders published In british medical journal Soon after, the epidemic spread in the country.
Read also: Slow-growing second-dose virus delays Sputnik V’s entry into India’s government vaccination campaign
Overuse of steroids, says government
Modi government in July told the Rajya Sabha that as of the 15th of that month, a total of 45,432 cases of mucormycosis were reported, leading to 4,252 deaths.
The most common presentations of mucormycosis were rhinoceros (77.6 percent), cutaneous (4.3 percent) and pulmonary (3 percent) – nose and brain, skin and lung, respectively.
The government said a large number of mucormycosis patients (84.4 per cent) had reported a history of COVID-19.
ThePrint reached out to the health ministry over email for the latest mucormycosis numbers. This report will be updated upon receipt of feedback.
However, a senior government official told ThePrint that the latest numbers are “not available”.
The government also emphasizes that the black fungus epidemic was caused by overuse of steroids.
“There are several underlying factors in mucormycosis. First is steroid use, then diabetes mellitus and hospitalization due to Covid,” Dr VK Paul, member (health), NITI Aayog, and head of several committees on Covid, told ThePrint .
“In addition, patients were often hospitalized two weeks or so before developing this problem. Generally, this is a medium-term complication,” he said. “With increased awareness, Steroid use has become more rational and restricted. And doctors are more alert to better control of diabetes and hygienic practices.”
Dr Paul dismissed industrial oxygen as one of the causes of the pandemic.
“You have to understand that the number of active COVID cases has come down from 35 lakh to 3 lakh now. Industrial oxygen should not be blamed,” he said. “If that was the case, why would hospitals that never use industrial oxygen report such cases. Mucormycosis also occurred in people who did not require oxygen therapy. I believe this was largely due to the freedom we had with steroids. “
Some experts like Dr KS Reddy, President of Public Health Foundation of India and The assistant professor of epidemiology at Harvard believes it’s hard to pinpoint the reason.
“It is difficult to say without clear numbers what was the incidence of mucormycosis before and what is now. But there are two things that are essential – one is an immune-compromised individual and the other is a source of introducing fungi into the body, ” They said. “That steroid overuse playing a role in making patients immunocompromised is generally well accepted. As for the source, there are several theories – it may be poor hygiene precautions in oxygen administration.
“Many people also blame the use of industrial oxygen that is not as sterile as medical oxygen. Even the overuse of antibiotics could have played a role,” he said. “Whatever it was, Many of those things would have been fixed now. We are probably being more careful in both the administration of steroids and the use of oxygen.”
(Edited by Arun Prashant)
Read also: Fatigue, hair loss, depression – long Covid study reveals what Wuhan patients suffer in a year
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