Mucormycosis, COVID-19 Pandemic and the Lessons Learnt: A Review

Anila Varghese, A. Upadhyay, R. Daniel, Twinkle Sharma, Vivek Mohan, Balaji Susindran, Priyanka Singh, C. Lahariya
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Abstract

Mucormycosis emerged as a major public health challenge during the second wave of the COVID-19 pandemic in India in mid-2021. The disease, colloquially known as the Black fungus, was declared epidemic by the government. This review describes the epidemiological pattern and the determinants of mucormycosis. The review also proposes evidence based public health strategies for the prevention and control of mucormycosis. The rationale use of steroids in clinical management, formulation of evidence-based standard treatment guidelines and adherence to those guidelines by physicians, the strengthening of primary healthcare services to facilitate early care; compliance with infection prevention and control measures at all the health facilities; and early diagnosis and case management are the key strategies to prevent future emergence of mucormycosis. The article concludes that it is not enough that we tackle a health challenge at hand, in crisis mode. It is equally important that we derive learnings and take measures prevent any future. Effective control of mucormycosis and prevention of future outbreaks of disease is possible through coordinated actions of health policy makers, public health experts and clinicians. The entire episode is also a reminder for strengthening India's health systems at all levels – primary, secondary and tertiary – as well as in both public and private sector.
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毛霉病、COVID-19大流行及经验教训综述
在2021年年中印度发生的第二波COVID-19大流行期间,毛霉病成为一项重大公共卫生挑战。这种俗称黑木耳的疾病被政府宣布为流行病。本文综述了毛霉病的流行病学模式和决定因素。本综述还提出了预防和控制毛霉病的循证公共卫生战略。在临床管理中使用类固醇的理由,制定循证标准治疗准则并使医生遵守这些准则,加强初级保健服务以促进早期护理;遵守所有卫生设施的感染预防和控制措施;早期诊断和病例管理是预防毛霉病未来发生的关键策略。这篇文章的结论是,我们在危机模式下解决手头的健康挑战是不够的。同样重要的是,我们吸取教训并采取措施防止任何未来。通过卫生决策者、公共卫生专家和临床医生的协调行动,就有可能有效控制毛霉病并预防今后的疾病暴发。整个事件也提醒人们加强印度各级卫生系统——初级、二级和三级——以及公共和私营部门。
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