Why India Is Dealing With a Deadly 'Black Fungus' Epidemic - The New York Times
Jun 20, 2021 1 min, 57 secs
The deadly disease has sickened former coronavirus patients across the country.

Doctors believe that hospitals desperate to keep Covid patients alive made choices that left them vulnerable.

Bela Prajapati, oversees treatment for nearly 400 patients with mucormycosis, a rare and often deadly fungal disease that has exploded across India on the coattails of the coronavirus pandemic.

The coronavirus pandemic has drawn stark lines between rich nations and poor, and the mucormycosis epidemic in India stands as the latest manifestation.

Many doctors in India think they know why.

Without enough oxygen to go around, doctors in many places injected patients with steroids, a standard treatment for doctors battling Covid globally.

Many doctors prescribed steroids in quantities and for durations that far exceed World Health Organization recommendations, said Arunaloke Chakrabarti, a microbiologist and the co-author of a study examining the causes of India’s mucormycosis outbreak.

Those steroids may have compromised patient immune systems and made Covid-19 patients more susceptible to fungal spores.

The steroids may have also dangerously increased blood sugar levels, leaving people with diabetes vulnerable to mucormycosis.

Desperate doctors may not have had the chance to ask patients about whether they had diabetes or other conditions before resorting to steroids.

According to the health ministry, about four out of five mucormycosis patients have had Covid-19.

After two weeks on oxygen support and steroids at a local hospital, he recovered from Covid-19 but developed an acute headache on the left side of his brain.

Centers for Disease Control and Prevention, said that heavy use of steroids, the correlation with diabetes and the unsanitary conditions at some hospitals had played a role.

Environmental conditions play a part, as does the incidence of diabetes — India has more than twice as many people with the condition as the United States does.

Usually in India, mucormycosis afflicts people with diabetes who are either unaware of their condition or who are not taking insulin properly.

But in the current outbreak, many patients had no history of diabetes.

Atul Patel, an infectious diseases specialist at the private Sterling Hospital in Ahmedabad who has treated dozens of mucormycosis patients in the outbreak.

Patel, another of the study’s authors, said that steroids, which in India are commonly prescribed for routine ailments such as diarrhea or fever, had been prescribed to Covid-19 patients with mild infections who didn’t need them.

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