AILSA CHANG, HOST:
India has been battling the world's biggest and deadliest COVID-19 outbreak. On top of that, another health crisis is unfolding. Thousands of Indians have come down with a rare fungal infection just as they are recovering from COVID-19. It's being called the black fungus, and it's been killing up to half of the people it infects. NPR's Lauren Frayer reports from Mumbai.
LAUREN FRAYER, BYLINE: Pushkar Saran lives in a suburb of India's capital, and he's one of millions of Indians who recently caught the coronavirus. He got ill, but his prognosis was good. He's 42, he has diabetes and was prescribed steroids for treatment. But as he recovered from COVID-19, Saran came down with something else. He described his symptoms on local TV.
(SOUNDBITE OF ARCHIVED RECORDING)
PUSHKAR SARAN: (Unintelligible) Left face numbness on my cheek (ph).
FRAYER: The left side of my face went numb, and my eye turned red, he says. I couldn't feel my teeth or jaw.
(SOUNDBITE OF ARCHIVED RECORDING)
SARAN: (Speaking Hindi). And I was also very scared.
FRAYER: He was scared because he'd heard all the news about a deadly fungus preying on people as they recuperate from COVID-19.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED REPORTER: Well, if the coronavirus crisis wasn't enough, black fungus is wreaking havoc in the country.
FRAYER: They call it black fungus because it often discolors human tissue as it kills it. The scientific name for this infection is mucormycosis. It's from a fungus called mucor, which is ubiquitous in the soil in the tropics. And it's usually harmless, except when someone's immunity is very low, like Saran's was from COVID-19 on top of diabetes.
ARUNALOKE CHAKRABARTI: Somehow, uncontrolled diabetes makes a very fertile ground for the mucor to enter.
FRAYER: Dr. Arunaloke Chakrabarti is a microbiologist in the northern city of Chandigarh and one of India's top experts on mucormycosis. He used to diagnose about 50 cases a year, mostly in people weakened by organ transplants or chemotherapy. But he's diagnosed 55 cases this week alone, all of them diabetics with COVID. And...
CHAKRABARTI: Around two-thirds of the patients have been inappropriately given steroid, or they have given extra dose of steroid.
FRAYER: Some doctors have overprescribed steroids for COVID, Chakrabarti says, and that may have made certain patients even more vulnerable to fungal infections. The mucor fungus grows in the respiratory tract and then spreads to the jaw, eyes and eventually the brain. Dr. Raghuraj Hegde is an eye surgeon in the southern city of Bengaluru who's been forced to make tough decisions for his mucormycosis patients.
RAGHURAJ HEGDE: Yeah, it has been very challenging. To save the patient, we had to remove many eyes over the last one month.
FRAYER: He's had to remove their eyes to save them. As if that's not bad enough, lately he's run out of antifungal drugs to help these patients recover. They typically need seven doses per day, and he's only able to give them one or two. The drugs are on backorder with the government. Some desperate patients are turning to the black market amid shortages nationwide.
HEGDE: So this has been very tough to explain to the patients. And they are frustrated, and we are frustrated as well. Because of the speed of this fungal infection, it gives us very little time.
FRAYER: In the best of times, mucormycosis has a 10 to 15% fatality rate. But in India right now, with COVID already collapsing the health system and shortages of antifungal medications, mucormycosis is killing about half of the people it infects. Lauren Frayer, NPR News, Mumbai. Transcript provided by NPR, Copyright NPR.
