Black fungus outbreak in India
During the second wave of Covid-19, patients being treated for covid in India faced an extremely peculiar threat that was beyond that of the virus. Patients were faced with Mucormycosis or as the general public and news outlets called it, ‘The Black Fungus’. Although this nickname for the fungus comes from its appearance and not to do with the black death of Europe caused by the plague, the death rate of the fungus is approximately 50% (Soutik Biswas, bbc.com), similar to the percentage of Europeans that died in the black death. However, it is still unclear why India’s Mucormycosis cases reached over 45000 cases with over 4300 deaths. This raises the question of why were Indian Covid-19 patients hit so much worse with this fungal infection during their recovery process than patients in any other country?
Mucormycosis is a fungus that infects the nose and eyes and if severe can attack the brain. This fungus can be extremely deadly to immunocompromised people such as those suffering from Cancer and HIV. This fungus attacked people being treated for severe covid in India and often those people would also fall into the above category. With a 50% mortality rate and with many of the survivors having to get body parts such as an eye removed, this disease further devastated India during its second wave of Covid.
One of the main hypothesised reasons for this outbreak specifically in India is due to the high rate of diabetes in India and the over prescription of steroids. With approximately every eighth adult over 30 in India suffering from Diabetes, many of those suffering from covid were highly at risk. Therefore, it became a common practice in India during the second wave to inject high amounts of steroids into those suffering from severe symptoms or those infected who do not yet have such symptoms but suffer from underlying health conditions such as diabetes. These steroids were used to dampen the inflammation of the lungs for covid patients suffering from such symptoms or underlying health conditions.
However, although these steroids help the body combat inflammation of the lungs, they also significantly reduced the immunity of the patients. If the average person came into contact with black fungus, it would not result in any infection or medical issue in most cases. However, with people suffering from reduced immunity due to covid, and then having this reduction further amplified due to the steroids, the level of immunity in such patients was not at the normal level (Maryn Mckenna, scientificamerican.com)
Therefore, with the exposure of these patients to bacteria and fungi in the hospital, infections, especially those of black fungus were amplified significantly. Furthermore, as claimed by doctor Nishant Kumar of Hinduja Hospital in Mumbai “There is a lot of contamination in oxygen cylinders and pipes that are being used to treat patients”. He further goes on to say that the longer you are exposed to such pipes, the higher the chance of being exposed to such infections. Therefore it is safe for one to say that the use of steroids, underlying health issues as well as unsanitary oxygen cylinders could all have played a part in India’s devastating spread of Mucromycosis, a disease that is not transferable between humans or animals.
However, With China having a diabetes rate of almost double that of India’s and the US with a diabetes rate per capita approximately equal to that of India’s (Statista.com) these countries have almost no reporting of black fungus due to Covid-19. This leads to the possibility that the prescription of steroids in patients in Indian could have been too extreme or wrongly prescribed. One can say this as by looking at these statistics, the explanation that the extreme number of cases of Mucormycosis in India is due to the large rate of diabetes can be seen as dissatisfying as if this was the case, Countries such as China and the US would have experienced an extreme volume of cases of this infection as India did: However, this was not the case.
