Understanding the black mold is more important than succumbing to its fear. The plight of patients desperately trying to find oxygen to save their loved ones has caused this new edition of the black fungus to take off. The cause of this is unclean water and oxygen.
Indians who practice the yoga Jalneti (purification of nasal water) with unclean water have also succumbed to black mold in the passt. If we are to combat the fear of black mold, we must let science speak for itself.
What is black mold?
It is a rare infection called mucormycosis that is fatal for patients suffering from or recovering from Covid-19. If progression is not checked early, 50-80 percent of patients may die. Mucormycosis is a fungal infection that mainly affects people who use drugs for other health problems that reduce their ability to fight environmental pathogens. Sinuses or lungs of such individuals are affected after airborne fungal spores are inhaled.
The symptoms depend on which part of the body is affected, although it often affects the sinuses, lungs and brain. Common symptoms include a stuffy or stuffy nose, blackish or bloody runny nose, blackish discoloration of the bridge of the nose or palate. If the eyes are involved, it can lead to blurred or double vision with pain. If the lungs are affected, pre-existing Covid lung symptoms such as shortness of breath, coughing, chest pain, and water buildup in the lungs can worsen. Other symptoms include fever, headache, cough, vomiting blood, and altered mental status.
The use of steroids in the treatment of Covid-19 must be timely. Steroids are only effective in fighting the effects of Covid, not the virus directly. (Photo: Getty)
The disease spreads quickly. It is usually diagnosed by ENT examination and MRI. Rarely, it also affects people who practice ‘Jalneti’ without using boiled or sterile water.
The fungus has been all around us for thousands of years. Millions of patients with diabetes, steroids, or immunosuppressants have been admitted to hospitals across the country for years, with only a handful of cases reported in the past 10 years. There are very few cases of black yeast infection among Covid patients in the US, Europe or elsewhere. Then why is there a sudden surge in India, also during the second wave?
The most important reason: is prolonged unsanitary delivery of oxygen to patients, combined with indiscriminate use of steroids. Patients who are particularly vulnerable include those with uncontrolled diabetes mellitus, steroid immunosuppression, prolonged ICU stay and co-morbidities such as post-transplant complications, cancer, etc. However, India never reported a high incidence of black mold until mid-May when thousands of cases of black mold have been reported in patients suffering from or recovering from Covid.
The main reason is prolonged unsanitary delivery of oxygen to patients, combined with indiscriminate use of steroids. (Photo: Getty)
Black mold is found in our homes and is caused by exposure to slime molds, which are commonly found in soil, animal manure, decaying wood, plant matter, manure, and rotting fruits and vegetables. However, the increase we are seeing during the second phase of Covid is because of the completely unsanitary way of oxygenating patients in many places in India, combined with indiscriminate and ill-considered use of steroids in the treatment of Covid.
There is a big difference between medical oxygen (MO) and industrial oxygen. MO is a highly purified version that is more than 99.5% pure and is prepared by repeated steps of compression, filtration and purification. The cylinders in which the liquid oxygen is stored, transported and used are thoroughly cleaned and disinfected. This oxygen requires humidification before it is administered to patients; so it is passed through a container filled with sterile water. The water itself should be sterilized according to protocol and replaced regularly. If the water is not sterile, it may be a source of black fungal infection. Imagine what this can do to diabetics and non-diabetic Covid-19 patients! No wonder our overburdened public health system is further taxed.
Also read: Assam reports first black mold fungus death
On the other hand, if oxygen is given without humidification, it dries out the mucous membrane and damages the inner lining of the lungs. It will also make the sputum or discharge very thick to remove.
Common symptoms include a stuffy or stuffy nose, blackish or bloody runny nose, blackish discoloration of the bridge of the nose or palate. (Photo: Getty)
The use of steroids in the treatment of Covid-19 must be timely. Steroids are only effective in fighting the effects of Covid, not the virus directly. It is dangerous and harmful if administered early, when the virus is multiplying. This will lower the body’s immunity and facilitate further replication of viruses. Administering steroids unnecessarily or prematurely to a diabetic will raise their sugar levels too high, making them more susceptible to a further risk of increasing the severity of Covid and to the ill effects of black mold.
The real solution is to ensure that the oxygen supply container where water for humidification is placed is regularly sterilized and that distilled water is used. All disposable parts should be replaced regularly. There is also a need to stop the indiscriminate use of steroids to minimize this new enemy. An important precaution is to continue monitoring sugar levels after Covid patients are discharged.
The second is to recognize that we experience mold in our kitchens when fruit starts to rot or bread becomes moldy. Fungi evolved 400 million years ago and play an important role on Earth.
The great Irish famine of 1845 that killed more than 10 lakh people was due to the fungus Phytophthora Infestans, which wiped out an entire potato crop in the country. We should not make the mistake of taking the black mold lightly.
(The author is a leading cardiovascular thoracic surgeon and VC&MD, Asian Heart Institute, Mumbai)