THIRUVANANTHAPURAM: Rampant self-medication by Covid patients at home without any expert supervision has become a major concern as they become vulnerable to black fungus. Though the government has advised home care for Covid patients with mild to moderate symptoms, it has been found that several patients have gone past the brief and started treating themselves with drugs without knowing their complications.
According to health experts, the commonly used drugs such as Tocilizumab and steroids and will lower the immunity of patients and use of such drugs without the supervision of a doctor will make the patient vulnerable to Covid-associated mucormycosis (CAM), loosely described as black fungal infection. It is associated with high morbidity and treatment costs.
“A lot of people are using drugs without any prescription. Some of them start using steroids on their own for three to four days after detecting Covid. It is a dangerous trend,” said Dr R C Sreekumar, chairman of research cell, Indian Medical Association (IMA).
These drugs can be easily purchased from a medical store as the prescriptions are not often demanded. Steroids are widely used to treat patients with moderate to severe Covid infection. However, the doctors said the steroids would affect the blood sugar level of the patient, weaken the immune system and pose the risk of catching black fungus.
“Steroids are life saving. But these have to be used at the right time and in the right dose for the right patient and right duration. Blood sugar control is the key factor to watch out for,” said a member of the state medical board. According to Dr Sreekumar, the people abusing steroids are not aware of the blood sugar level and they risk their lives. “Steroids should be started for specific reasons and stopped in a tapered manner to enable the recovery of the immune system. The blood sugar level of diabetic and non-diabetic patients should be monitored throughout,” he said.
Dr Padmanabha Shenoy, an immunologist and a public health expert, a lot more investigations needed to be done to understand the spurt in black fungus cases. “We have been giving steroids to a lot of patients. But mucormycosis had not been that common all these years. The sudden surge also points to other factors. It could be linked to the hygiene,” he said. Dr Amar Fettle, state nodal officer for Covid-19, said a lot of people try self-treatment with unverified information available on social media. “I would advise them to call DISHA helpline (1056) to check the treatment regimen,” he said.
STATE ON ALERT AFTER FIRST DEATH, SAFETY OF ICUS COMES INTO FOCUS
The state has been on alert as more cases of black fungus infection are being reported across the state. The infection claimed its first victim, a schoolteacher hailing from Mallappally in Pathanamthitta, on Wednesday. “She was under treatment for Covid in Kanyakumari where she worked. The 32-year-old was a diabetic and was shifted here in a bad condition,” said Superintendent of Thiruvananthapuram Government Medical College Hospital Dr Sharmad M S. The instances of black fungus infection have put the spotlight on safety of ICUs as well. The health department has directed hospitals to assess the presence of fungal spores in all ICUs. It recommended the use of masks to reduce exposure to mucorales.
“The high demand for ICU admissions gives little time gap for replacing one patient with another. Earlier, the beds were properly sterilised and kept vacant for some time before allowing in the next patient. Once fungal infection appears in an ICU, it can’t be easily removed,” said Dr R C Sreekumar, chairman of IMA research cell. He also said that it was difficult and costly to conduct fungal culture. The hospitals have been directed to inform the state medical board about black fungus cases.
Status now
20 cases detected in state
Covid patients with uncontrolled and undetected diabetes vulnerable
Four states have declared it as epidemic
WHAT IS BLACK FUNGUS?
It is a group of molds, called mucormycetes found commonly in soil, air or in decaying fruits. It affects immunity-compromised people when they inhale fungal spores. It affects the sinuses, brain and lungs, and it is especially life threatening in people suffering from diabetes, cancer and HIV/AIDS. The drugs used for treating it is costly and is in short supply due to its wide use now.