Horrible sanitation failure of the hospital, not COVID, responsible for Mucormycosis?

 

Our medical fraternity has recently reported the new threat called Mucormycosis in some COVID patients where different specialities of doctors starting from pulmonologist, cardiologist, diabetologist, opthamologist, mycologist, dentist, general physician, surgeon etc., are required to treat the COVID patient with mucormycosis? 

It is quite interesting to credit and crown COVID for mucormycosis because it is already been declared that COVID causes severe immune problem; some say induces hyper immunity while some claim due to poor immunity only people become susceptible to the new virus.  To support the observation of mucormycosis, steroid use has been implicated which is bound to suppress the immunity although such therapy may be required at times to save the patient.

The fundamental question is why Mucor alone infect the COVID patients and not any other most common and ubiquitously prevalent other fungi like species of Aspergillus?  If immune suppression due to steroid and prolonged hospitalization of COVID patient is the cause for Mucormycosis means, why many other patients who are also in the hospital for prolonged treatment and are on steroid like organ transplant patients, cancer patients, patients with severe Psoriasis, arthritis etc., have not developed Mucormycosis and not even Aspergillolis?

The recent medical observation of mycormycosis clearly points towards the possibility of the treating hospital / clinic / ward of the COVID patients being highly contaminated by Mucor than COVID, responsible for Mucormycosis. 

The members of Zygomycetes fungi like Mucor and Rhizopus and Ascomycetes fungi like Aspergillus are prevalent everywhere.  Only when the premise is quite damp and unhygienic, Mucor can grow.  The sporulation nature of Mucor is different from Aspergillus, where the sporangia head must dehisce and only then the spores are released whereas Aspergillus puffs up its spores easily.  Further the spore size of Mucor is much larger than that of Aspergillus.    Therefore to infect a person by these fungi, the inoculum load or spore volume needs to be damn too high and the spores that floats normally in the air is unlikely to infect people even if the immunity of a person is too low.  

Even in HIV patients with almost very low CD4/CD8 count are not that commonly infected by Mucor.  Another big question is how the most common normal fungi in our body, Candida did not get amused by the opportunity and infects the COVID patients? 

Candida is the first fungi to notice and get the advantage of COVID to infect people with immune suppression.  In several cases, the presence of candida infection in buccal cavity otherwise called as oral thrush is been indicated with immune suppression either due to drug or due to HIV or severe diabetes mellitus and accordingly the clinician would recommend further diagnostic tests to the confirm the underlying condition such as diabetes or HIV etc.

When the country is already under severe distress and is going hopeless, how our medical fraternity can hype Mucormycosis and can link it with COVID?  The COVID ward contamination by Mucor as the cause, can we dismiss completely?  If the COVID ward contamination by Mucor is the real reason for Mucormycosis, then whom to be blamed first?

Can our medical fraternity ascertain that only Mucor alone can cause infection in severe COVID patients and not the other opportunistic pathogenic fungi if the patient is sufficiently exposed to such fungi? 

If the sufficient exposure is the cause means, should we also not detect the possible source for the above?  Other than the treating ward of COVID patient, what else can be the principal source of Mucor?  Does that not mean COVID ward was not sufficiently sanitized and asepsis measures were not followed?  It is quite natural that when the sudden inflow of large number of patients due to COVID is bound to cripple the system of any hospital and the hospital cannot follow sufficient sanitization measures.  Then why the medical fraternity over shout Mucormycosis and associate the same with COVID and declare COVID as the predisposing factor? 

Just to score some brownie point in medical science can our medical fraternity over cry Mucormycosis and COVID association instead of ordering for proper sanitation measures to be followed in the COVID ward?

Was the COVID patient came to hospital with Mucor or after prolonged stay in the hospital got Mucormycosis?  If after sufficient stay in the COVID ward or hospital only the patient had developed Mucormycos means then who served the fungi to the patient other than the COVID ward?

Need of the hour is confidence to the people.  We need ‘doctor’ as described in the book of RK Narayanan “Doctors word” to give confidence to people but our medicos are hyping the situation. 

COVID crisis is not real; it is partly created by media and partly by our opposition.  COVID is small time flu and India has lots to worry about many other things than COVID.