In 16 districts, mortality rate due to black fungus higher than the state average

In 16 districts, mortality rate due to black fungus higher than the state average

Sixteen districts in Maharashtra had a Covid-associated case fatality rate (CFR) mucormycosis either black fungus substantially higher than the state average of 13.4 percent recorded during the second wave of the pandemic in 2021, according to government data. Experts said the high CFR recorded in these districts was largely due to the “broken” health care system, as well as the unavailability of expensive life-saving drugs and the absence of specialist doctors.

Some districts, including mumbai, had a CFR greater than 20 percent. These include Palghar (45.45%), Washim (26.67%), Ratnagiri (25%), Satara (23.88%), Raigad (22.73%), Kolhapur (21.75%) and Jalgaon ( 20.86%). . Experts attributed Mumbai’s CFR (20 percent) to the volume of patients referred from other districts.

As of November 2021, a total of 9,961 COVID-19 the patients contracted mucormycosis. Of these, 1,300 succumbed to infection. Most of these cases came from rural districts where accessibility to health care was restricted.

One such victim was Amrita Salvi, 52, who contracted the fungal infection after being discharged from the Beed civil hospital after being treated for a novel illness. coronavirus. “Soon, we noticed the blackening of the skin inside his mouth,” said Ramesh, his son.

Salvi was admitted to a private hospital in Beed, but by then the infection had gone up his nose. She underwent two surgeries. The doctors prescribed 100 vials of amphotericin B liposomal injection. But by then, the number of patients suffering from mucormycosis had risen to 5,644 in the state, leading to a shortage of the drug.

On May 22, Salvi succumbed to the infection and the family had to pay Rs 5 lakh to the hospital for his treatment.

Dr Mangala Gomare, Executive Health Officer of the Brihanmumbai Municipal Corporation, said: “Nearly 80 per cent of the cases we recorded in Mumbai were patients referred from other cities. Due to the lack of health facilities and ENT specialists, patients from distant districts also came to us.”

Mucormycosis is a rare infection caused by a group of molds called mucormycetes. Doctors in rural districts blamed the government for ignoring their parts of the state when Maharashtra was facing shortages of liposomal amphotericin B and simple amphotericin B.

A Raigad doctor said that according to the treatment protocol, when the black fungus infects the nose, sinuses or palate, doctors are supposed to administer a dose of 5 mg for every kilogram (kg) of body weight. But when the infection reaches the brain, doctors have to give 8-10 mg of the drug for every kg of body weight. “But how

the district did not have the supply, we had to use the reasonably available vials on the patients. Their

relatives would travel to other districts to purchase the medicines,” said a doctor who was involved in treating covid-19 patients at the district hospital. An official, previously associated with the health department, said that in the second wave, the demand suddenly increased from seven people who contracted the black fungus in December 2020 to more than 600 in April 2021. “The Center had provided only 18,000 injections in May…Later, the state had to purchase directly from manufacturers at a higher rate,” the officer said.

Dr. Gautam Bhansali of Mumbai Hospital, who was in charge of Covid beds in private hospitals, said that as doctors stationed in primary health centers and rural hospitals were not qualified to identify mucormycosis, they would ignore it as a simple rash. “Rural centers often lack CT or MRI facilities or specialists to collect samples for mushroom culture,” he added.

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