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AIIMS director and member of the country’s Covid task force, Dr Randeep Guleria, said Saturday that several parts of the country are reporting a surge in a supplementary fungal infection known as Covid-Associated Mucormycosis (CAM), which is linked to the “irrational use of steroids” in treatment.
According to the Central government, ICMR has begun tracking CAM through its national registry, although the exact case burden is still not known.
Meanwhile, the task force’s head, Dr V K Paul, defended the Centre’s decision on Friday to extend the interval between Covishield doses to 12-16 weeks. Earlier Saturday, the UK government had reduced the gap between doses of the vaccine from 12 to eight weeks.
Paul said the UK’s data for a 12-week schedule showed that the vaccine was 60-85 per cent effective, and that an analysis by Indian scientists of the data showed signs of reduction in transmission.
On the Covid trajectory, the Centre said that while 24 states have a positivity rate of more than 15 per cent, 17 of them are showing early signs of a plateau in daily new cases.
Guleria, meanwhile, highlighted that hospitals need to focus on “infection control”. “Covid-associated mucormycosis (CAM) is a fungal infection. Earlier, mucormycosis was seen in those patients with uncontrolled diabetes. But the incidence was low. However, due to Covid-19 treatment, we are seeing a significant number of cases. Several parts of the country are reporting an increase in number of cases,” he said during a Health Ministry briefing.
Guleria said CAM has the potential to spread to the brain and “can also result in loss of vision; it also can affect the lungs”. “This time, we are seeing a rise in fungal infection due to two reasons: in many (Covid-19) patients who have diabetes which is uncontrollable, the risk of fungal infection is high; second is the misuse of steroids. Covid patients who are on steroids as well have diabetes have higher risk of fungal infection,” he said.
Guleria said doctors should ensure there is “no misuse of steroids” during Covid treatment. “Those with mild disease, and don’t need oxygen, should not be prescribed steroids. Second, we should ensure that people who have diabetes should keep monitoring their sugar levels. Third, we have to wear masks because it can be found in the air, especially places like construction sites,” he said.
Speaking separately at a clinical excellence programme to guide states and districts in clinical management protocol, Guleria pointed to a meeting he had with doctors from Gujarat where they reported more than 500 cases of the infection only from government hospitals.
On the new vaccination strategy, meanwhile, V K Paul said the National Technical Advisory Group on Immunisation’s decision was based on the WHO’s standard operating procedure.
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