Lack of beds: Around 50 black fungus patients turned away daily at Koti ENT hospital

Hyderabad: The Government ENT Hospital in Koti, the designated nodal centre for Telangana state for treating cases of mucormycosis, or black fungus, is running on fumes. In a grim tale, the staff at the hospital says they are turning away around 50 such patients every day over the past three days.

All of its 150 beds are full with patients suffering from the disease, and another 50 patients are crammed into the facility.

“We do not have space anymore,” a doctor at the hospital told Deccan Chronicle on Sunday. “The Covid-19 vaccination centre here is being converted for treatment of black fungus cases, and we can add another 30 beds there,” the doctor said.

Packed with patients suffering from varying degrees of mucormycosis, the hospital has requested, via the official online request system, for 700 vials of liposomal amphoterecin-B injections. “We need these 700 to start with and need more supplies every day.”

“Gandhi Hospital needs another 100 vials urgently, while private hospitals are waiting for 200 more to keep the treatment going,” a doctor said.

Gandhi Hospital is the nodal centre in Telangana for treating Covid-19 patients. But, it has been designated as a treatment facility for black fungus cases when the patients are Covid-19 positive.

The ENT Hospital, with three surgical beds, was never meant to cope with such an influx of emergency cases. The primary and first line of defence treatment for black fungus is debridement -- the cleaning of the sinuses. This takes anywhere up to two to three hours for a patient.

“Since we have only three beds, we are not able to do more than 10 debridements a day. Ideally, we should be doing around 50 a day so we can repeat the procedures on all patients who need it, within two or three days of the first cleaning. But that requires more surgical beds, and more teams of specialists,” the doctor said.

The faster the cleaning, the better the chances of healing. The procedure removes the growing mucor from the sinuses, prevents it from eating into the bones, reaching the eyes, or the brain. Once the fungus takes hold of the eyes, and if the treatment is delayed, the infected eye, or both eyes must be removed. This is to prevent the infection from reaching the brain.

And if it reaches the brain, then the chances of the patient’s survival get slimmer by the hour.

“It is not just the eyes that need to be removed. Sometimes, even the bones around it, sometimes up to the cheek, need to be removed; leaving gaping holes that need complicated reconstruction surgeries’ something we are not just able to provide the patient,” a doctor said.

Wait for black fungus patient for a bed could last 10 days

The wait for a bed for a black fungus patient at the ENT Hospital here could last 10 days. The 150-bed facility is now treating 200 patients, a hospital staffer said.

With the hospital turning away around 50 patients a day, the staff is maintaining a register of those who are on the wait-list.

“Whenever a bed becomes available, we call as per the list, informing the patient or the family that they can come in,” a staffer told Deccan Chronicle.

When a patient is asked to return home and wait, he or she is given prescriptions of oral antifungal medications.

Families of such patients are desperately seeking admission for the infected at the premier eye-care facility. Many are falling at the feet of doctors, or nurses, or anyone who is willing to lend them an ear. They are so desperate.

Surgeons in various private and government hospitals, since Saturday, were forced to remove at least 71 eyeballs from patients in whom the black fungus infection reached the eye and threatened to enter the brain.

The state government does not release data on the fatalities from the black fungus infections.

“It is hard to tell a patient’s family that we have no bed. They are desperate, they know that the infection can be disastrous and can result in losing the eyes, if not life itself. There is little we can do,” a doctor said.

“We came from Manthani, 300 km from the city. Kindly admit him (a patient),” a young man implored even as a doctor tried to explain to him that there was no bed availability.

Meanwhile, a young woman, who was handed a prescription with oral antifungals listed on it, edged closer. Despite the advice to take her patient back home and an assurance that the disease is not contagious, she fell at the doctor’s feet. Fighting back tears, she pleaded with the doctor one more time to admit her ailing man and find a bed for him.