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‘Black fungus’ new scare in India as second COVID wave ebbs | Coronavirus pandemic News



As a devastating second wave of COVID-19 ebbs with less than 100,000 new cases reported on Tuesday, India is now battling a new scare: Mucormycosis, commonly referred to as “black fungus”, is a rare fungal disease with a high mortality rate.

On Monday, Health Minister Harsh Vardhan said the country had more than 28,000 cases of the fungal infection.

“From 28 states, we have some 28,252 cases of mucormycosis till now. Out of this, 86 percent, or 24,370 cases, have a history of COVID-19 and 62.3 percent, or 17,601, have a history of diabetes,” Vardhan said in a meeting with a group of federal ministers.

“The highest number of cases – 6,329 – have been recorded in Maharashtra, followed by Gujarat with 5,486, and then Madhya Pradesh, Uttar Pradesh, Rajasthan, Haryana, Karnataka, Delhi, and Andhra Pradesh,” he said.

What is black fungus?

Mucormycosis causes blackening or discolouration over the nose, blurred or double vision, chest pain, breathing difficulties and coughing of blood. Coronavirus patients with diabetes and a weakened immune system are particularly prone to attack.

Pain and redness around the eyes or nose, fever, headache, coughing, shortness of breath, bloody vomit and altered mental status are some of its symptoms.

Patients infected with black fungus at a government hospital in Hyderabad [File: Mahesh Kumar A/AP]

Health experts say India’s poor air quality and excessive dust in cities, like Mumbai, make it easier for the fungi to thrive, terming the recent spike in cases a matter of “serious concern”.

“We and most mainstream hospitals have seen more mucormycosis cases in the past month than in the previous five years,” Dr Arvinder Soin, chairman of the Medanta Liver Transplant Institute at Gurugram, told Al Jazeera.

While black fungus has been found in India before, the current spike in infections is among people infected with COVID-19 and those who have recovered from the disease.

Dr Sumit Mrig, who heads the ENT department at Max Smart Super Speciality Hospital in New Delhi, told Al Jazeera they used to see one or two such cases in a week before the second wave of the pandemic.

“The numbers have drastically increased this time and at present, we are seeing five to six such patients on a daily basis,” Mrig said.

He said the outbreak has “put tremendous pressure on the health infrastructure”, especially on the availability of Liposomal Amphotericin-B, the last-line drug being used to treat black fungus and which he said is “suddenly in short supply in the country”.

“Apart from the high mortality associated with disease which rapidly spreads from nose and sinuses to the eye and brain in a span of 24 to 48 hours, if treatment is not initiated on time, the patient can lose his eyesight. Once it involves the brain, the mortality is approximately 80 percent,” Mrig added.

How is the infection treated?

Liposomal Amphotericin-B is allocated to the states by the federal government based on the number of cases reported by them.

Several states have reported a shortage of the vital drug as Indian missions across the world scramble to secure supplies. India last week imposed curbs on the export of Amphotericin-B injections.

Opposition parties, including the Congress party, have questioned Prime Minister Narendra Modi over the handling of the black fungus scare.

“What is being done for Amphotericin B drug shortage? What is the procedure for getting this medicine to the patient?” Congress leader Rahul Gandhi asked in a tweet last week.

“Instead of giving treatment, why is the public getting bogged down in formalities by the government?” he posted.

A doctor performs endoscopic sinus surgery on a patient suffering from mucormycosis at a private hospital in Ghaziabad on the outskirts of New Delhi [Adnan Abidi/Reuters]

Also last week, the Delhi High Court directed the federal government to form a policy on the distribution of Liposomal Amphotericin B drug.

The court also said the administration of the drug must be “prioritised” for those “with better chances of survival as also the younger generation, having promise of future over the older ones who have lived their lives”.

‘Steroids make things worse’

Medanta hospital’s Dr Soin said that during the second wave of COVID, the fungal infection is affecting coronavirus patients three to six weeks after recovery, most commonly those who have uncontrolled diabetes or were treated with steroids.

“While steroids are life-saving for many patients with COVID, many cases could have been prevented if their diabetes was better controlled and steroid use was restricted,” he told Al Jazeera.

Dr Jayaprakash Muliyil, an epidemiologist at the Christian Medical College in the southern state of Tamil Nadu, said irregularity in attending diabetic patients is a likely cause of mucormycosis.

“When a patient is diabetic and is admitted to a ward, usually repeated blood sugar checking is done and doses of whatever required drug are adjusted to control it. But during COVID, these protocols are not fully followed in many hospitals. That could be one of the reasons,” he said.

“When blood sugar goes out of control and they [patients] are on steroids, that makes things worse.”

Experts suggest high-risk diabetics who have recovered from COVID-19 should be careful and any red flags should be immediately reported to an ENT surgeon.

“If we keep the sugar level of COVID-19 patients in control, I believe you won’t have this problem and we can do that.” Dr Muliyil said.

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New Zealand’s Hubbard selected as first transgender Olympian | LGBTQ News




Laurel Hubbard, 43, will compete in the super-heavyweight women’s event in Tokyo.

Weightlifter Laurel Hubbard will become the first transgender athlete to compete at the Olympics after being selected by New Zealand for the women’s event at the Tokyo Games, a decision set to test the ideal of fair competition in sport.

New Zealand Olympic Committee chief Kereyn Smith said 43-year-old Hubbard – who was assigned male at birth but transitioned to female in 2013 – had met all the qualification criteria for transgender athletes.

“We acknowledge that gender identity in sport is a highly sensitive and complex issue requiring a balance between human rights and fairness on the field of play,” Smith said in a statement.

Hubbard will compete in the super-heavyweight 87-kg category after showing testosterone levels below the threshold required by the International Olympic Committee (IOC).

The 43-year-old had competed in men’s weightlifting competitions before transitioning.

“I am grateful and humbled by the kindness and support that has been given to me by so many New Zealanders,” Hubbard, an intensely private person who rarely speaks to the media, said in a statement issued by the New Zealand Olympic Committee (NZOC) on Monday.

Hubbard has been eligible to compete at Olympics since 2015, when the IOC issued guidelines allowing any transgender athlete to compete as a woman provided their testosterone levels are below 10 nanomoles per litre for at least 12 months before their first competition.

Some scientists have said the guidelines do little to mitigate the biological advantages of people who have gone through puberty as males, including bone and muscle density.

Advocates for transgender inclusion argue the process of transition decreases that advantage considerably and that physical differences between athletes mean there is never a truly level playing field.

Save Women’s Sport Australasia, an advocacy group for women athletes, criticised Hubbard’s selection.

“It is flawed policy from the IOC that has allowed the selection of a 43-year-old biological male who identifies as a woman to compete in the female category,” the group said in a statement.

Weightlifting has been at the centre of the debate about the fairness of transgender athletes competing against women, and Hubbard’s presence in Tokyo could prove divisive.

Her gold medal wins at the 2019 Pacific Games in Samoa, where she topped the podium ahead of Samoa’s Commonwealth Games champion Feagaiga Stowers, triggered outrage in the host nation.

Samoa’s weightlifting boss said Hubbard’s selection for Tokyo would be like letting athletes “dope” and feared it could cost the small Pacific nation a medal.

Belgian weightlifter Anna Vanbellinghen said last month allowing Hubbard to compete at Tokyo was unfair for women and “like a bad joke”.

Australia’s weightlifting federation sought to block Hubbard from competing at the 2018 Commonwealth Games on the Gold Coast but organisers rejected the move.

Hubbard was forced to withdraw after injuring herself during competition, and thought her career was over.

“When I broke my arm at the Commonwealth Games three years ago, I was advised that my sporting career had likely reached its end,” Hubbard said on Monday, thanking New Zealanders.

“But your support, your encouragement, and your aroha (love) carried me through the darkness.”

Olympic Weightlifting New Zealand President Richie Patterson said Hubbard had worked hard to come back from the potentially career-ending injury.

“Laurel has shown grit and perseverance in her return from a significant injury and overcoming the challenges in building back confidence on the competition platform,” he said.

Hubbard is currently ranked 16th in the world in the super heavyweight category.

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Apple Daily could shut ‘in days’ after Hong Kong asset freeze | Freedom of the Press News




Company adviser says action under security law means it cannot access some $50 million in funds to pay staff and vendors.

Hong Kong pro-democracy newspaper Apple Daily will be forced to shut “in a matter of days” after authorities used the national security law imposed by China to freeze the company’s assets as it arrested the paper’s editor and four other directors, an adviser to jailed tycoon Jimmy Lai told Reuters on Monday.

Mark Simon, speaking by phone from the United States, said the company was no longer able to access its funds and would be holding a board meeting on Monday to discuss how to move forward.

“We thought we’d be able to make it to the end of the month,” Simon told the news agency. “It’s just getting harder and harder. It’s essentially a matter of days.”

His comments signal closure is imminent even after Apple Daily said on Sunday the freezing of its assets had left the newspaper with cash for “a few weeks” for normal operations.”

The news comes two days after editor Ryan Law, 47, and chief executive Cheung Kim-hung, 59, were denied bail after being charged under the security law with collusion with foreign forces.

Apple Daily’s editor-in-chief Ryan Law arrives back at the detention centre after he was remanded in custody on Saturday [Lam Yik/Reuters]

Three other senior executives were also arrested last Thursday when 500 police officers raided the newspaper’s offices in a case that has drawn condemnation from Western nations, human rights groups and the chief United Nations spokesperson for human rights.

The three have been released on bail.

Simon told Reuters it had become impossible to conduct banking operations.

“Vendors tried to put money into our accounts and were rejected. We can’t bank. Some vendors tried to do that as a favour. We just wanted to find out and it was rejected,” he said.

Speaking earlier to US news channel CNN, Simon said the company had about $50 million available, but was unable to access the funds.

The publisher has come under increasing pressure since its owner Jimmy Lai was arrested under the national security law last August, which marked the first time the company’s headquarters was raided. Lai, 73, is now jailed and facing trial under the national security law. In May, the authorities also froze some assets belonging to the longtime critic of Beijing has also had some of his assets frozen.

Three companies related to Apple Daily are also being prosecuted for collusion with a foreign country and authorities have frozen HK$18 million ($2.3 million) of their assets.

China imposed the national security law on Hong Kong last June saying it was necessary to restore “stability” to a territory that had been rocked by mass protests in 2019, some of which turned violent.

The broadly-worded law criminalises acts such as subversion, sedition, collusion with foreign forces and secession with possible life imprisonment, but critics have said it is being used to suppress legitimate political debate with dozens of pro-democracy politicians and activists among the more than 100 arrested since it was brought into force.

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Birmingham Classic: Ons Jabeur beats Daria Kasatkina to win first title




Tunisian second seed Ons Jabeur defeated Russia’s Daria Kasatkina in straight sets to win her first singles title at the Birmingham Classic.

World number 24 Jabeur triumphed 7-5 6-4 against the fourth seed to become the first Arab woman to win a WTA title.

In Berlin, Russian qualifier Liudmila Samsonova stunned Swiss fifth seed Belinda Bencic to win her first title.

The 22-year-old world number 106 battled back from a set down to win 1-6 6-1 6-3 in her first final.

Victories for Jabeur and Samsonova mean there have now been 10 first-time singles winners on the women’s Tour this year.

Jabeur broke Kasatkina’s serve three times to prevail in the first set, before successive breaks at the start of the second put the 26-year-old in control at 4-0.

Two-time Grand Slam quarter-finalist Kasatkina recovered to 4-3, but Jabeur held on to win a singles final at the third attempt.

It was a breakthrough week for Samsonova in Germany, during which she also defeated seventh seed Victoria Azarenka of Belaurus in the semi-final.

World number 12 Bencic won the first five games as she dominated the opening set, but Samsonova matched that feat in the second before completing her comeback with breaks in the first and ninth games in the deciding set.

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