‘Who’ll bear cost of treating black fungus?’

State declares COVID-19 Associated Mucormycosis as a notifiable disease, but is silent on treatment cost

The State government on Wednesday declared COVID-19 Associated Mucormycosis (CAM) as a notifiable disease and mandated all private hospitals to report cases to the Department of Health and Family Welfare. The order also stated that no hospital that has the facilities for treatment should refuse admission to any patient.

Health and Family Welfare Minister K. Sudhakar had said on Monday that the treatment for CAM should be given for seven consecutive weeks and costs ₹2-3 lakh

While the order lists six government medical colleges across the State [BMCRI in Bengaluru, and medical colleges in Mysuru, Shivamogga and Kalaburagi, Wenlock Hospital, Mangaluru, and KIMS, Hubballi] as centres for CAM treatment, it is silent on expenses incurred on treatment in private hospitals. On who will bear the cost, Dr. Sudhakar said he would discuss with the Chief Minister the possibility of the State government providing free treatment.

With private hospitals charging anywhere between ₹4 – 6 lakh as a package for treatment of CAM, many patients, unable to find beds in government facilities, are left high and dry.

“A private hospital said they will admit only if we agree for a package of ₹5 lakh and make a hefty advance, which we are unable to afford. But we are also unable to find a bed in a government hospital,” said Ravi G., whose brother Murali Krishna is suffering from CAM. He demanded that the State augment facilities or allot government quota beds in private hospitals bearing treatment expenses in private hospitals, like for COVID-19.

Gaurav Gupta, Chief Commissioner, Bruhat Bengaluru Mahanagara Palike (BBMP), said a decision on this has to be taken by the Department of Health and Family Welfare and Suvarna Arogya Suraksha Trust (SAST), which pays for COVID-19 treatment of patients in the government quota.

Treatment plan

The treatment protocol notified by the government on Wednesday, based on a report by an expert committee, puts patients on antifungal therapy with either Liposomal Amphotericin-B or Amphotericin-B injections administered for a 14- 21-day period in a hospital. One injection dose of Amphotericin-B costs anywhere in the range of ₹6,000-₹9,000, which is driving the cost of treatment for the infection northwards, sources said. The SOP includes strict control of diabetes, reducing steroids, stopping immunomodulating drugs and surgical debridement of all necrotic material.

The guidelines asked patients under home isolation to look for warning symptoms: facial/cheek pain, bloody and foul smelling nasal discharge, nasal stuffiness, and eye symptoms like eyelid edema, redness in the eye, and any visual disturbance.

Those who have recently recovered from COVID-19 are also directed to look for these symptoms, control diabetes mellitus levels, and exercise judicious use of steroids, strictly based on doctor’s advice.

Those on home oxygen therapy have been instructed to use clean and sterile water for humidifiers during home oxygen therapy.

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