The Delhi High Court on Tuesday asked the Centre to prioritise treatment of the younger population and frame a policy on the distribution of Liposomal Amphotericin B, an anti-fungal drug used to treat mucormycosis or “black fungus”, reported ANI.

Mucormycosis is a fungal infection that has been reported among hundreds of recovered Covid-19 patients. It is caused by a fungus named mucor, which is found on wet surfaces. The symptoms of the infection include headache, fever, pain under the eyes, nasal or sinus congestion, and partial loss of vision, among others.

“If we have to choose, the young will have to be chosen,” the court said. “They are the future. Eighty year olds are not going to carry this country forward. They have lived their lives.”

The court also clarified its statement, saying that it was not “discounting the emotional support” that the elderly generation provides to families that are closely bonded. But added that difficult choices had to be made amid the pandemic.

A division bench of Justices Vipin Sanghi and Jasmeet Singh asked the Centre to file a status report on the policies related to mucormycosis. The court will take up the matter on Friday.

The High Court asked the Centre to take a policy decision on manner in which anti-fungal drug Amphotericin B is distributed. The decision should be taken with inputs from the medical fraternity, the court said.

“We may also observe that there may be a category of persons who are serving the nation at high positions and whose safety and security may have to be kept in mind due to the pivotal role that they play, the policy may provide for such cases,” it added, according to ANI.

The court said that the allocation for treatment of black fungus cases should be made once the policy is in place. The government policy on mucormycosis should, however, make exceptions for older people “who are serving the nation in high positions”, the bench said, according to the Hindustan Times.

The Centre said that it was considering the matter and that a decision would be taken.

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  1. ‘Black fungus’: Rahul Gandhi asks Centre three questions about India’s policy on mucormycosis

‘Black fungus’ or mucormycosis cases in India

On May 20, the Centre had asked the states and Union Territories to declare mucormycosis a notifiable disease under the Epidemic Diseases Act 1897.

On May 22, Union minister Sadananda Gowda said there are 8,848 cases of mucormycosis or “black fungus” in India. The minister added that 23,680 additional vials of Amphotericin-B, the drug used to treat the infection, have been allocated to the states.

According to the break-up provided by Gowda, Gujarat has been allotted 5,800 vials of the drug. The state has reported 2,281 cases of the fungal infection, the maximum in the country.

Maharashtra, with 2,000 cases of “black fungus”, was allotted 5,090 vials of Amphotericin-B. Andhra Pradesh, which has recorded 910 cases of the infection, got 2,310 vials. Madhya Pradesh received 1,830 vials of the medicine, while Rajasthan got 1,780.

One of the potential causes of the fungal infection is reportedly the use of steroids for Covid-19 treatment, which increases blood sugar levels.

On May 22, the Centre had urged health professionals to stop the irrational use of steroids for treating coronavirus patients and said it was contributing to the increase in “black fungus” cases.

Steroids reduce inflammation in the lungs for Covid-19 and the body’s immune system goes into overdrive to fight off the virus. However, they also may reduce immunity and push up blood sugar levels in both diabetic and non-diabetic Covid-19 patients, according to doctors quoted by the BBC. The drop in immunity might then exacerbate the “black fungus”.