An electron micrograph skin showing sporangia of the Mucorales fungi, which cause mucormycosis. Photo: Ran Yuping et al/Wikimedia Commons, CC BY 3.0
Bengaluru: A new set of government regulations in Delhi has some unusual wording. The regulations relate to mucormycosis, a deadly fungal infection that has been spreading among COVID-19 patients.
Under the powers vested in him by the Epidemic Diseases Act 1897, the Lt. Governor of Delhi issued the Delhi Epidemic Diseases (Mycormycosis) Regulations 2021.
The regulations have 10 points. The first four stipulate that all healthcare facilities will follow the Union health ministry’s screening, diagnosis and management guidelines for mucormycosis and that they will report all cases of the disease to the city-government’s health department.
The wording appears in points 5 and 6. Quoted verbatim:
5. No person/institution or organisation will spread any information or material for management of mucormycosis without prior permission from Department of Health and Family Welfare, Government of NCT of Delhi.
6. No person/institution or organisation will use any print-electronic or any other form of media for mucormycosis without prior permission from Department of Health and Family Welfare, Government of NCT of Delhi
The way the points are currently phrased, even healthcare workers, medical researchers and other experts won’t be able to disseminate information about managing mucormycosis without permission from the local government. This can be a serious impediment to timely advice.
In previous instances, the Indian government has threatened to penalise people who spread misinformation about COVID-19. It drew flak because it didn’t properly define ‘misinformation’, especially since the government itself has made questionable claims about unproven drugs and therapies.
In January this year, home secretary Ajay Bhalla “urged” the states’ chief secretaries to “check” the spread of “unfounded and misleading rumours … creating doubt about the safety and efficacy” of the vaccines, to penalise those “found to have indulged in such activities” under the Disaster Management Act 2005 and the IPC, and to “promptly disseminate factual messages”.
More recently, Union health minister Harsh Vardhan let yoga guru Baba Ramdev off the hook after the latter’s offensive comments about allopathic medicine.
However, without using the word ‘misinformation’, the new regulations potentially extend to all kinds of information related to managing mucormycosis – including that intended to push back against false or misleading claims.
The regulations go on to say that a district-level committee chaired by the chief district medical officer, and populated by internal-medicine, ophthalmology, ENT and epidemiology specialists, will review each report of offence. If they agree an offence has been committed, the district collector will issue a notice to the offender, wait for the reply, and then determine a final course of action (under Section 3 of the Epidemic Diseases Act).
It’s not clear why this level of expertise is necessary to consider if an offence has been committed – considering the regulations define an offence as any message about managing mucormycosis that has been shared without the government’s okay.
An alternative possibility is that points 5 and 6 really pertain to misinformation, not “information”, and that the experts will be the arbiters.
It’s important for the Delhi government to justify its choice of words, especially since point 10 is also broad: “No suit or legal proceedings shall lie against any person for anything done or intended to be done in good faith under these regulations.”
While the exact reasons for the surge in mucormycosis infections remain unknown, experts already believe that the infection could be the product of the irrational use of steroids and/or antibiotics. Mucormycosis is opportunistic – it attacks the body when the immune system is weakened or suppressed.
As scientists study the disease further, they should be able to disseminate their results and people should be able to discuss them freely.