The Gujarat government on Thursday declared mucormycosis (black fungus infection) reported among Covid-19 patients as an “epidemic” and made it a notifiable disease under the Epidemic Diseases Act.
The decision comes following a Union health ministry communication dated May 19 to all states and Union territories requesting all to declare it a “notifiable disease”.
As a notifiable disease, all government and private hospitals, and medical colleges will have to follow the guidelines issued by the ICMR and the Ministry of Health and Family Welfare with respect to the screening, diagnosis and management of the disease. It will be mandatory for these facilities to report all suspected and confirmed cases to state health department through district Chief Medical Officer and subsequently to Integrated Disease Surveillance Programme (IDSP) system.
In a communication dated May 19 by Union health ministry joint secretary Lav Agarwal to all states and principal health secretaries, a request was made to make mucormycosis a notifiable disease under the Epidemic Disease Act.
The decision by the Gujarat government was taken at a core committee meeting chaired by chief minister Vijay Rupani on Thursday. As of Thursday, across four government hospitals in three cities — Ahmedabad Civil Hospital, SSG Hospital and GMERS Gotri at Vadodara and PDU Hospital in Rajkot — a total of 980 mucormycosis patients were undergoing treatment.
The state health department also notified a state-controlled distribution policy of the anti-fungal drug Amphotericin-B, used to treat mucormycosis, for private hospitals after the issue of shortage of the drug was taken up by the Gujarat High Court that sought a response from the state.
In the communication addressed to municipal commissioners, district collectors, administrators of district and government hospitals and civil surgeons, it was stated that due to a shortage of liposomal Amphotericin-B injection in the market, which is causing distress to patients in private and government hospitals, a distribution policy was decided to ensure availability of the drug in private hospitals across the state at a regulated price.
As per the policy, private hospitals can requisition liposomal Amphotericin B for treatment of patients admitted to private hospitals from eight hospitals at Ahmedabad, Gandhinagar, Bhavnagar, Rajkot, Jamnagar and Surat at prices capped between Rs 4,792 and 6,247. These hospitals are SVP Hospital and Gujarat Medical Education and Research Society (GMERS) Sola in Ahmedabad, GMERS Gandhinagar, Sir T Hospital in Bhavnagar, PDU Hospital in Rajkot, GG Hospital in Jamnagar, SMIMER Hospital in Surat and SSG Hospital in Vadodara.
Private hospitals will have to submit details, including case history and doctor’s prescription, patient’s Aadhaar card copy, mucormycosis diagnosis copy and treating doctor’s recommendation letter. Supply and management of distribution of the drug to municipal corporation-run hospitals will be the responsibility of the respective health department.
The eight hospitals have been directed to form an expert committee and assess the patients’ need and verify the documents. Once documents are verified, the Gujarat Medical Services Corporation Limited (GMSCL) will provide the drug to the private hospital on payment of the amount. Civil hospitals have been directed to maintain a separate register of stock and distribution of liposomal Amphotericin B on the distribution.
At present, six manufacturers are supplying liposomal Amphotericin B — Bharat Serum and Vaccine Ltd, Lyka Labs, BDR Pharmaceuticals, Encure Pharmaceuticals, Sun Pharma Distributor and Mylan Pharmaceuticals. The lyophilised form is being provided by only Lyka Labs while the emulsion form is being provided by only Bharat Serum and Vaccine Ltd.
Gujarat Congress working president Hardik Patel wrote to Prime Minister Narendra Modi seeking that the Government of India declare mucormycosis as an “epidemic”. He also urged the government to “announce free injections and surgeries” for those infected as it is a “costly treatment”, adding that “most of the people in our country would not be able to afford it”.