Shortage Of Injections For Black Fungus, High Cost Of Treatment To Be Seriously Considered By State: Gujarat HC

What Is Black Fungus

When the person suffering from COVID-19, HIV/AIDS and other viral diseases, severe burns, cancers, and untreated or irregularly treated diabetes, congenital bone marrow disease having weak immune system inhales Mucor spores then mucormycosis develops. This is a rare, non-contagious disease but unbearable or deadly if not treated fast and timely. The frequency of these infections has augmented in the last decade. The major reason that can be seen for the increase in frequency is a greater number of organ transplants. It has been seen that people receiving transplanted organs depend on immunosuppressant drugs to keep their bodies away from the new organs, but in this state, it also inclined them to infection.

In the present situation, the covid-19 patients who have received steroids are mainly at risk because steroids overpower the immune system and for this reason, steroids should not be used.

How It Affects & Its Symptoms

When Mucor attacks or outbreaks the sinuses, it spreads to the lungs, the central nervous system, and the brain. Common symptoms of the developing mucormycosis include headache, fever, reddish and swollen skin near the nose or eyes, cough producing bloody or dark fluids, facial pain, and shortness of breath. Doctors can identify it through a tissue biopsy and an X-ray scan of the lungs.

Treatment Of Black Fungus Infection

The two drugs most efficient at treating mucormycosis are amphotericin B and posaconazole provided that the infection is found early. However, the latter is hard to do because there is no reliable and consistent diagnostic feature of mucormycosis.

Doctors provided with few simple steps that can be followed to lower the risk of contracting mucormycosis:

First, to educate society about the disease.

Second, we must periodically sample the air in hospitals, especially in the critical care wards, to check for spores.

Third, there is a need to ensure that the humidifiers used during oxygen therapy are sterile.

Fourth, the recovering patients should be advised to remain indoors until they regain their natural strength and immunity.

Last, patients engaged in farming or gardening should be advised to lie off from work until the storm has settled.

Gujarat High Court direction and Observation in Respect of shortage of injections for black fungus

Background Facts

The Gujarat High Court while taking the suo-moto action in lack of availability of RT¬PCR facilities and other infrastructural facilities in this second wave of the COVID Pandemic that is spreading fast in a rural area.

Directions by Court

The bench headed by Justice Bela Trivedi and Justice Bhargav D Trivedi

The court directed Central Government to place on record information about the vaccination policy adopted by it regarding the public at large.

It also took serious note of the new challenge faced by the State concerning the rapid increase of the cases of flesh-eating Black Fungal infection called Mucormycosis.

The Court also observed that there was nothing on data that suggests the future course of action that either the State or the Central Government would follow for the getting of the adequate quota of ‘Remdesivir’ injections.

The central government also did not place on record the policy decision relating to the distribution of the ‘Remdesivir’ injections to the States. The court called upon the State Government to cater details of the following on oath, on the next date of hearing:

1. How far the Community Health Centers and Primary Health Centers (PHCs) constituting the backbone of the State’s rural health infrastructure furnished with the facilities to treat the COVID¬19 patients?
2. What are the mechanism that the government is providing to PHCs and CHCs and other healthcare centers in the Districts and the Talukas for providing the RT¬PCR test kits, necessary medicines, ‘Remdesivir’ Injections, Oxygen supply, etc?
3. Whether there is the availability of doctors and trained nursing staff to carry out the RT¬PCR tests, administer the ‘Remdesivir’ injections and the oxygen, etc.?
4. If your answer is negative, what course of action planned in the above said regard? How many devoted COVID Health Centers, COVID Care Centers and hospitals have been set up at the District and Taluka level?
5. Specifically providing the details of each District and Taluka. How many persons have been fully vaccinated and how many have been partially vaccinated in each of the categories i.e., above 60 years, between 45¬60 years, and between 18¬44 years?
6. What is the predictable requirement of the vaccines for vaccinating all categories of people fully and what is the road¬map for accomplishing the said estimate?
7. Whether they have made any sort of special provision for vaccinating the staff members and inmates working at the special homes like lunatic asylums, Nari Samrakshan Gruh, juvenile homes, old age homes remand homes, correction homes, orphanages, etc.?

The court further asked the Government about the preparedness of the Health Department to combat the Mucormycosis disease. If any policy has been framed regarding the procurement and the distribution of the medicines and injections used to treat the Mucormycosis patients in private hospitals.

Conclusion

Many people recovering from COVID-19 have of late been afflicted by black fungus–or mucormycosis–disease. The fungus invades the sinus and makes its way into the intraorbital and intracranial regions. If its progression is not checked early, 50-80% of patients could die. Since this fungus is taking the lives of many people and is spreading quite fast, making it mandatory for the government to look into such issue and coming up with arrangements regarding proper availability of vaccines, medicines, well-specialized doctor, and well-equipped hospital for dealing with such issues. This also starts the responsibility of researchers and doctors to look into such disease and the fungus infection and how it can be cured. Last, there also lies a responsibility of us, i.e, the public, to follow whatever guideline or steps that doctors and the government are asking us to take to lower down the spread of such deadly virus.