Mucormycosis in COVID – Ecosystem shift from ‘abundance’ to ‘scarce’ looks ridiculous, is COVID going orphan?

 

The growing fear of mucormycosis, whether posed actually by Mucor (and or other species of Zygosporomycetes fungi) or due to poor sanitation and patient handling in most hospitals that treat COVID or the severe immune suppression by COVID is a million dollar question. 

No one would admit the origin of mucormycosis is nosocomial infection and would instead argue and document only in favour of proving mucor as an emerging new pathogen of man.   The admission of mucormycosis as nosocomial or hospital acquired infection would put both the hospitals management and government in a daisy situation.   But when mucor is accused or penalized, mucor is not going to challenge or question the charge in any court of law in India.

Any species of life form on earth shifting its ecosystem from abundance to scarce is quite ludicrous possibility both from common sense point of view, as well from the definition of evolution and natural selection. 

COVID virus itself defeats the above possibility.  The COVID virus whether it had emerged from Wuhan Laboratory in China or from Pangolin or from bat, the virus has only invaded man the most abundant and easy to reach target or destination to spread and populate.  For a virus choosing man is always advantageous because the virus can transmit from one to another so easily in human population.  

Imagine, if the virus has chosen any other animal than man means, the chance of the virus succeeding in the chosen niche is poor and such niche may either eliminate the virus or the virus may get eliminated along with host or the virus may find itself in an isolated island in the given species of host and have to live with limited adaptation scope and of course, have to face limited challenges to adapt or modify frequently.   No species of life on earth would like to be lazy like man from the biological or evolutionary stand point.

Evolution will always favour every species of life to choose only the ecosystem where the resource is abundant not only to survive but also to reproduce fast and not the ecosystem which provides scarce resources for the species. 

Mucor is obviously a saprophyte, a commensal fungus in plants and also is an occasional plant pathogen.  Mucor is also a very successful saprophyte and has established its abundance and dominance in most habitats either through its faster growth rate or through spore formation.  The filth, the organic decomposed materials, decayed plant debris, wet soil, the phylloplane etc., are richly available in nature for the fungus to live and reproduce and hence why should such fungus navigate man and infect? 

Is it so easy for a saprophyte to become parasite, that too in a mammalian system? 

Occasional surprises cannot be generalized and made as a taboo by our medical science.   The cost incurred by the fungus transforming from saprophytic life to parasitic life in mammalian system can come only with ‘utter selfishness’ for own survival in the host cell or tissue and then totally and or partially loose the reproductive ability and also such tendency and finally die.   Which species of life on earth has evolved only for own survival and it does not want to leave its genetic finger print for the future? 

Food gathering and procreation are the only tenets on which all life has evolved and nothing beyond that.  Desire to become an engineer or doctor or IAS officer etc., rests only with man and no other species of life on earth other than man ever harbinger such desires or objective.    

Once mucor invades human cell or tissue, further invasion is necessary for the fungus to survive and otherwise the fungus would get eliminated by our immune system.  Therefore the only vegetative invasion is possible for the fungus in the host tissue or cell and not asexual or sexual form of invasion.  This may the reason why mucormycosis causes about 50% mortality.  Which organism on earth with such a high mortality has high infectivity?  Why an organism should choose a habitat that would give the organism only 50% survival chances.

Shouldn’t the scientific world ask why mucor must take such headless, senseless option or the choice of choosing man, infect and then earn the title of a notorious pathogen, finally gain nothing for itself? 

Our great ‘doctor community in India’ (CUT, COPY AND PASTE EXPERTS OF WESTERN MEDICAL SCIENCE) may argue that they are every day encountering more and more mucormycosis cases and does that not mean mucor is becoming a threat to COVID patients?

The debate is not about mucor but we must anchor our logic and argument towards the source of the fungus.  COVID patients even with limited symptoms are rushing to the hospital for treatment due to massive fear created in the beginning. 

Unlike the wards of cardiac patients or other patients, the wards and beds created for COVID patients were on war footing basis.  The sanitization measures, hygiene practices, bio-waste disposal mechanism, treatment discipline etc., are unlikely to be of good standard in most COVID treatment centres.   

When mucor get trapped in such habitat, the mucor has very limited option and that is to infect the victim.  When the immune status of the victim is poor and weak, the fungus naturally explores such possibility as the fungus is a saprophyte to ensure own survival and that can be achieved in the given circumstances only by invading the human host.   It means most of the mucormycosis reported so far are likely to be nosocomial or hospital or treatment centre based infections and not necessarily due to mucor becoming pathogenic or COVID predilecting the same.  

But our medical fraternity has hijacked the debate towards mucor than the abysmally horrible sanitation measures in COVID wards and treatment centres.  No one questions mucormycosis and deaths due to mucormycosis but the moot question is from where else mucor has come and infected the COVID patients?  If the use of steroids, diabetes mellitus, immune suppression were the cause, such population is always there in India in abundance since time immemorial but why most of them had not infected by mucormycosis in the past?  The possible answer would be that most of them had not got admitted to any of the horribly managed, unhygienic hospital wards like some of our COVID centres before.     

Who would show mirror to our medical fraternity?  Can we afford to bury the medical negligence and nosocomial origin of mucormycosis and debate more about mucor and scare people?

If the source identification is not addressed and corrective measures are not taken on war footing, more and more mucormycosis cases will emerge and our media debate will shift from COVID to mucormyosis and nothing else.  If suddenly any other saprophytic fungi gets a chance to peep into the visceral system of COVID patients then the debate would turn towards the new fungus, naturally mucor becomes an orphan like how mucor has stolen the thunder away from COVID.