Rising black fungus cases add to Bengaluru hospital woes

A survey of various hospitals has found over 250 cases of mucormycosis in Bengaluru, with doctors worried that the health infrastructure, stretched to the limit by Covid-19, will collapse by a further surge in cases of the fungal infection.

Numbers of the disease, which can be fatal, have been steadily increasing in recent days.

Some of the highest cases have been reported at the Bengaluru Medical Centre and Research Institute (BMCRI), especially Minto Eye Hospital, and St John’s Medical Hospital, with the latter having to suspend mucormycosis admissions on Saturday for 48 hours after medical personnel were overwhelmed.

Since May 10, when the first mucormycosis case was admitted at the BMCRI, the institute has seen about 80 cases, said Dr B L Sujatha Rathod, Director of Minto Eye Hospital.

“Some 30 cases were referred to Bowring & Lady Curzon Medical College & Research Institute which has been designated to handle non-Covid mucor cases," Dr Sujatha said.

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"About 56 cases, which are Covid-related, are being handled by us, of which 36 are currently in hospital care. There have been 14 deaths and seven cases where people have lost their vision.”

In total, some 267 cases have been reported among hospitals in the city. The total number of deaths is unclear.

No beds, no medication

The 'black fungus' cases are already overburdening the health infrastructure.

“Most patients require ICU support, but there are no ICU beds at all for them. We are reaching the stage where even private hospitals are running out of beds and are referring mucormycosis cases to us,” Dr Sujatha added.

On top of this, is an acute shortage of Amphotericin B Liposome, which costs between Rs 30 and 40,000 per ampule. Doctors said that this drug is more effective than the baseline Amphotericin B, which is also in short supply and costs between Rs 4 and 7,000 per ampule.

The situation has exasperated medical professionals. ENT expert Dr E V Raman of Manipal Hospital (Old Airport Road), where 38 cases have been detected, described the crisis as an “epidemic sandwiched between a pandemic”.

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At St John’s, Dr Sanjiv Lewin, Chief of Medical Services, said that his staff had become totally overwhelmed. “Pre-Covid, we saw about 30 cases per year. In the last five days, we have seen 55 cases, three of which were discharged. The rest are still with us. Some require ICU ventilator support, but there are no beds available,” Dr Lewin said.

“We have 35 vials of Amphotericin B Liposome and 55 patients. Each patient requires several vials per day for four weeks. How do we treat them?” he asked.

He suggested that ophthalmic centres, most of which are currently closed during the lockdown, be opened up to catch cases early.

Among Manipal's cases, 12 patients lost their vision and the deaths are less than two. “This is not unique to us. Every hospital in the city is overwhelmed,” Dr Raman said.