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India's Covid warriors: Doctor sets up helpline to save eyes of black fungus patients

Bengaluru - The initiative is the first-of-its-kind in Bengaluru, which is reeling under a deadlier wave of Covid-19.

Dr Gaurav S Medikeri had come across only eight cases of deadly mucormycosis or black fungus infection in his 11 years of experience in the profession.

However, his professional expertise has come full circle in the past fortnight, as the skull-base specialist has been operating on at least three cases daily of those infected with the deadly disease, which is taking patients who have recovered from Covid-19, back to the intensive care unit (ICU) with alarming regularity.

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The disturbing trend prompted Dr Medikeri to set up the first-of-its-kind helpline in Bengaluru that exclusively tracks and reports mucormycosis cases. The helpline (+91-9845571304) has not stopped buzzing since it was set up about 10 days ago.

"The speed at which this infection spreads is mind-boggling. So, it was imperative that people call the doctor the minute they get even the mildest symptoms of mucormycosis, which can cause blindness. If left untreated, the patient may either die or lose eye-sight because the fungus develops rapidly within four days. Our helpline attends to calls from hospital bed availability to plasma donation. So, why not for mucormycosis? At least patients can get immediate attention, thanks to the helpline,” said Dr Medikeri.

His 20-member dedicated team has been clocking up to 20 hours of work during the last fortnight at HCG hospital in Bengaluru, where the helpline has been set up.

Once patients reach the helpline and narrate their symptoms, the team of specialists swings into action to protect them from potentially losing their vision.

A video call is done to check the symptoms and from imaging to surgery is fast-tracked to save the patient's eyes and, in some cases, the life itself.

Typically, the infection starts with a common nasal congestion and graduates aggravates to numbness in the face, which then rapidly leads to blurred vision.

"Prior to the helpline’s launch, patients would call an eye doctor or an ear, nose, and throat (ENT) specialist. However, the onset of Covid-19 has changed the course of the deadly disease. It has been found that the progress of mucormycosis is rapid in the human body, as steroids may have been used to kill the virus during the treatment of the viral outbreak. Time is of the essence after symptoms point fingers to the fungal infection,” he said.

Studies have revealed that the mortality rate of mucormycosis is 96 per cent, if the brain is infected.

In most cases, a patient is likely to die if the infection reaches the optic nerve and affects the brain.

"We’ve operated cases where there was a day's delay in treatment and the patient had to lose an eye. It’s all about how quick the helpline responds after accurate diagnosis,” said Dr Medikeri, who operated on one such critical case of a 20-year-old last week.

In the first hour after the helpline opened, 48 calls were received. Now, it receives up to 15 calls daily.

The team is well-rounded — from an eye surgeon to an infectious disease specialist and an ENT, besides surgeons like Dr Medikeri, a skull-base specialist.

The counselling team members at the helpline desk have the most challenging job because they are assigned the responsibility to inform a patient’s family that it’s too late and the eye, perhaps, cannot be saved.

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Though the black fungus infection did appear in Covid-19 recovered patients even during the first wave of the contagion, patients complained of symptoms only a month after they recovered from the viral infection.

“But now we’re seeing patients within four days after recovery or, in some cases, while they’re being treated for Covid-19,” added Dr Medikeri, while attending another call on the helpline, which has emerged as the lifeline for the next-of-kin of patients afflicted with mucormycosis.

• India