Black fungus: Delhi hospitals can now refer patients to pvt health centres

The Delhi government has allowed its hospitals to refer patients of mucormycosis, popularly known as black fungus, to private hospitals for surgeries if the waiting period is more than seven days

The Delhi government has allowed its hospitals to refer patients of mucormycosis, popularly known as black fungus, to private hospitals for surgeries if the waiting period is more than seven days.

Surgery underway to remove black fungus (Mucormycosis) from a patient who recovered from the Covid-19 coronavirus at a hospital (AFP)

The measure has been taken under the government’s existing scheme of Delhi Arogya Kosh that allows state-run hospitals to refer patients in need of over 1,000 surgeries and procedures, which the Delhi government has identified that can be referred to private centres, if there is a long waiting period or the service is unavailable.

However, the waiting period at government hospitals for other procedures and surgeries has to be over a month for a patient to be referred out. Keeping in mind the urgent surgery that patients with mucormycosis need, the waiting period has been reduced to seven days.

“In view of the limited capacity for performing surgeries pertaining to mucormycosis in Delhi government hospitals … eligible patients (resident of Delhi identified on the basis of voter ID of Delhi) … may be referred to empaneled private hospitals under cashless scheme of Delhi Arogya Kosh if allotted date of surgery in the concerned Delhi government hospital is beyond seven days,” said the order signed by director general of health services Dr Nutan Mundeja.

This will help patients admitted to some state government hospitals where the ENT department, which handles cases of mucormycosis, are scheduled to do surgeries only on a few days of the week. The government designated three of its hospitals – Lok Nayak, Guru Teg Bahadur, and Rajiv Gandhi Superspeciality hospital – for dedicated treatment of patients with the fungal infection.

The decision of the Delhi government comes at a times when new cases of the fungal infection have already gone down in the city. A doctor from Lok Nayak hospital said, “Now, we are getting maybe one case a week. At its peak, we used to get five to six new mucormycosis patients each day”

The hospitals, however, are still running full with patients of the fungal infection needing hospitalisation for a month on average.

Data accessed by HT shows that Delhi has recorded at least 1,656 cases of mucormycosis so far, of which 952 are active cases.

Private hospitals are treating 402 cases in the city, which is the maximum among the three hospital categories in the city. The Delhi government hospitals are treating 302 cases, while Central government hospitals have 248 cases.

A senior doctor from Guru Teg Bahadur hospital said, “There is some waiting for the mucormycosis surgeries because the ENT department has only two OT (operation theatre) days.” A second doctor from Lok Nayak hospital, however, claimed they were able to bring down the waiting period by opening up the OTs on Sunday.

“With so many patients in need of surgery, the hospital had to increase hours for ENT and eye surgery. Now, we are performing surgeries even on Sundays to cut down on the waiting time, which has reduced from a week or ten days to maximum three days,” said the doctor from Lok Nayak hospital.

Mucormycosis is a rare fungal infection that started surging in the city after the second wave of Covid-19 wave in April-May. The infection is largely affecting those who recently contracted Covid-19, have uncontrolled blood sugar levels and were administered steroids during the treatment of the viral infection.

Mucormycosis has a fatality of over 50% and others face facial disfigurement as a result of surgeries to remove the dead tissues.

The total requirement of Amphotericin-B--the vital drug required for the treatment of mucormycosis-- in Delhi is about 150,000. “Delhi has been alloted a total of 39,680 vials of Amphotericin-B, of which 30,880 vials have been received and distributed to hospitals. At least 8,800 vials are awaited,” said the government document, which HT has seen.

To address the shortage of such medicines, the Delhi government is now procuring more injections. It is buying 6,700 vials of Liposomal Amphotericin-B and 25,000 vials of Amphotericin Lipid Complex, said a health official on the condition of anonymity.