Deadly fungi: The world's most dangerous emerging microbe threat?

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  Quantumrun Foresight
• March 4, 2022

Insight summary

After the global health crisis posed by SARS-CoV-2, medical professionals are sounding the alarm about a different potential pandemic: the rise of deadly fungal infections. These infections can prove fatal and are often resistant to current treatments. This looming threat could lead to considerable changes in healthcare practices, hospital design, and pharmaceutical research.

Deadly fungi context

In the wake of COVID-19, doctors have witnessed an unprecedented increase in a variety of dangerous fungal diseases. In India, an outbreak of mucormycosis, or black fungus, (a rare but serious infection that attacks the eyes, nose, and, in some cases, the brain) has caused thousands of deaths. An increase in other fungal infections is also being detected in patients with COVID-19, mostly after a week in the intensive care unit (ICU). 

Aspergillus and Candida are just two of more than five million varieties of fungi that are responsible for thousands of deaths worldwide. Candida auris (C. auris) can be found on a variety of surfaces and is known to cause bloodstream infections, but can also infect the respiratory system, central nervous system, internal organs, and the skin. 

At least 5 percent of COVID-19 patients become critically ill and require intensive care, sometimes for an extended length of time. Aided by the coronavirus' destruction to the epidermis, blood vessel walls, and other linings of the airway, the fungus makes its way to the respiratory system of COVID-19 patients. Approximately 20 to 30 percent of mechanically ventilated COVID-19 patients contracted this infection. When the fungus enters the bloodstream, blood pressure drops, and the patient may experience fevers, abdominal pain, and urinary tract infections. Seriously ill patients are often ventilated, have several intravenous lines, and are given drugs to suppress infection and inflammation. 

Interventions that may save patients from the coronavirus can dampen the body's innate defense mechanisms and eliminate beneficial bacteria, making COVID-19 patients in critical care more susceptible to infection. Reduced infection control in crowded ICUs, greater use of major fluid tubes, decreased handwashing compliance, and changes in cleaning and disinfection techniques are all significant contributors to the surge in fungal infections.

Disruptive impact

C.auris thrives on cold, hard surfaces and often resists cleaning agents. In healthy people, fungal infections are far less of a concern, but it can be difficult to eliminate the fungus from surfaces and equipment where it can colonize in hospital environments. According to one widely accepted estimate, fungal illnesses affect 300 million people worldwide each year, resulting in 1.6 million fatalities. The CDC estimates that more than 75,000 people are hospitalized each year in the United States for fungal infections. 

The majority of C. auris infections are treated with a class of antifungal drugs called echinocandins. Some C. auris infections, however, have shown resistance to all three major classes of antifungal drugs, making treatment more challenging. However, the best antidote against the ravages of fungi is prevention. There is currently no vaccine available for any fungal illness. Yet the difficulties of treating patients for lengthy periods with toxic drugs, along with an increasing number of cases, makes developing one imperative. 

A rethinking of hospital design and layout may be required with isolation rooms incorporating design interventions that minimize touchpoints, remove hard-to-clean places and prevent any splash or cross-contamination. The CDC recommends that patients on contact precautions be housed in a negative pressure, single-occupancy room with a closed door and dedicated bathroom to limit transmission during acute outbreaks. When single rooms are unavailable, it is advisable to cohort C. auris patients in the same wing or unit. The rise of infectious fungi organisms may necessitate a redesign of a hospital’s layout since effective space planning can mitigate the opportunities for pathogen growth and transmission.

Implications of deadly fungi

Wider implications of deadly fungi may include:

• Increased investments in pharmaceutical research to develop new antifungal drugs and possibly vaccines.


• A potential shift in hospital design and protocols to prevent the spread of fungal infections.


• More stringent cleaning procedures in healthcare facilities due to the hardiness of certain fungi.


• The need for ongoing training for healthcare professionals to detect and treat fungal infections promptly.


• Enhanced public awareness campaigns about the risks of fungal infections, especially for individuals with compromised immune systems.


• A potential rise in healthcare costs due to the increased need for isolation facilities and specialized treatments.


• The necessity for global collaboration in monitoring and responding to the spread of dangerous fungi.


• Changes in legislation and regulatory frameworks to accommodate the growing threat of fungal infections.


• A potential increase in telemedicine and remote patient monitoring to minimize the risk of hospital-acquired infections.

Questions to consider

• Besides stringent hand hygiene protocols, what other measures do you think hospitals could implement to prevent deadly fungus infections from spreading?


• Do you think that the rise of antifungal resistance is a problem that requires more widespread attention?