Telangana stares at shortage of black fungus drug

HYDERABAD: Even as Covid-associated mucormycosis or black fungus cases are rising, Telangana requires at least 54,000 liposomal amphotericin B injections while the number of amphotericin B vials allotted to Telangana by the Centre is insufficient to treat the number of patients, health experts said.
In a data collected from both private and government hospitals where the patients are undergoing treatment, health activists said the number of patients suffering from black fungus is over 900 whereas the number of vials required would be around 54,000 at the rate of 60 injections per patient. However, director of public health Dr G Srinivasa Rao tried to downplay the growing worries over black fungus cases in the state.
Ch Sai Mani Varun Reddy, a health activist who filed PILs in Telangana High Court on Covid-19 treatment and other issues, told TOI, “We have collected data from the private hospitals. There are around 400 active cases of black fungus in private hospitals alone.”
An independent check by TOI found that AIG Hospitals has 55 patients, Apollo has 75 cases in which 50 have been operated, Yashoda has 17 cases, Medicover has 16 cases, Care has 10 patients and KIMS has 26 cases of mucormycosis. If black fungus cases in two government hospitals — Gandhi and ENT Koti — are added, the number would easily cross 900, health activists said.
Varun Reddy said the state government has constituted a committee to allocate the drug based on reports from the hospitals. “There are more than 900 applications from private hospitals in the last four days requesting for the anti-fungal medicine, which has emerged as a lifesaver for many,” he said. Experts, however, said there is a big mismatch between supply and demand of the drug. “The Telangana government instead of trying to hide the numbers should inform the Centre about the total number of black fungus cases from the private sector, from the districts and demand allotment of the vials from the Centre,” a health expert said. The vials cost anywhere between Rs 6,000 and Rs 8,000 each.
According to health officials, a total of 400 black fungus patients are undergoing treatment on 150 beds in Gandhi and 250 beds in ENT Hospital. But, not sounding alarmist, Dr Srinivasa Rao told TOI, “When compared to the number of Covid-19 cases, black fungus cases are negligble. We need not panic about mucormycosis. We have to provide courage to the patients instead of exaggerating the issue.”
On the other hand, doctors treating the black fungus cases warned against any complacency. Dr T Krishna Kishore, HoD, Rangaraya Medical College, Kakinada, said amphotericin B has to be given before surgery. “Otherwise, a surgery alone with amphotericin will not help. The mortality rate may increase by 90 per cent,” he said.
Echoing the concerns, Dr Laxmi Narayana Buddharaju of University of Nebraska said: “Unfortunately, there are no other medicines for black fungus other than the three prescribed. There is lack of evidence on other agents. In case of non-availability of liposomal amphotericin B, one could consider amphotericin deoxycholate and monitor renal function closely.”