The pandemic is over, officially. The lockdown has lapsed, the dashboards have gone dark and for much of the world, Covid-19 has receded into memory that nobody wants to ever look back on. Yet in families like the Bandgars, who live in the bird sanctuary town of Bhigwan 100 km from Pune, the virus has never really left. It lingers as its aftermath. The family continues to carry the burden of sickness, have never healed fully, stand in as caregivers for each other and are constantly losing their savings. Six years on, Covid is not just long, it is unresolved.Vishal Bandgar measures time differently now, squeezing a job between hospital visits, taking blood glucose readings of a bed-ridden father and providing some solace to his over-exhausted mother. “I could see my father deteriorate in front of my eyes,” he says of the time when both of them tested positive. Then in his early 30s, he had to forego one-and-a-half years of study but has recently cleared the MPSC – Group C examination for a Class III post as junior assistant at the Baramati Government Medical College.It all began in May 2021 when Vishal and his 60-year-old father, Namdeo, returned home after recovering from Covid at a government-run facility. Vishal had a brief bout of Covid and recovered quickly. Namdeo did not. In fact, his condition worsened and he required continuous oxygen support. Meanwhile, his blood sugar spiked to 400 mg/dL. When he was discharged, he continued to be fragile, dependent on oxygen while his blood sugar levels swung unpredictably.Although he had made it back alive, Namdeo just did not seem to recover. At first, he became very irritable, then his headaches got worse. Since post-Covid convalescents had a tough few months before feeling normal again, Vishal thought his father would probably need a longer time given his severe infection. But watching the news one evening, Vishal heard reports about a rare but increasingly discussed post-Covid complication — mucormycosis or “black fungus,” a rapid-acting infection in immune-compromised patients. His father, too, had a swelling beneath the eyes and black scaly tissue.Doctors referred them to Pune. “Private hospitals were full and we could not afford the cost. I took my father to Sassoon General Hospital where he was operated upon to remove the infected tissue from the nasal passage,” Vishal adds. A 21-day long stay, followed by tablets that cost Rs 1,500 per day, helped Namdeo recover.But lockdowns and long leaves meant Namdeo, a cab driver, lost out on work. The disappearance of a monthly income of around Rs 20,000 weighed heavily on the family. They could not afford the two-month course of medicines. However, Namdeo’s headache surfaced again. The family went to Sassoon General hospital yet again in July where doctors urged them to restart the medication. What followed were multiple MRIs, surgeries, consultations that stretched from allopathy to Ayurveda, and, eventually, a gradual but total loss of sight.Vishal had been preparing for the MPSC Group C examination, hoping for a government job. Instead, he became a caregiver.Story continues below this adWhen care-giving became the only priorityNamdeo became a pivot for a new routine in the house. Vishal’s mother, Ratnaprabha, tends to his daily needs with a constancy that has worn her down. “My father is alive mainly because of my mother but now her health is failing as a consequence,” says Vishal. She, too, is now frequently unwell.Vishal has learned to stay close. If his mother needs to step out and meet relatives, he remains at home. Sudden spikes in his father’s blood sugar still trigger alarm. But since facilities at the local district and sub-district hospitals have improved, the family does not have to travel all the way to Pune.After-shocks of the second waveThe second wave had overwhelmed India’s healthcare system, and Maharashtra, particularly Pune, emerged as a hotspot for Covid-associated mucormycosis. By late June 2021, the state had reported over 8,000 cases, with Pune among the highest. The infection often appeared weeks after moderate or severe Covid, especially in patients treated with steroids or oxygen, and those with uncontrolled diabetes.Then the administration started screening people who had recovered in rural areas as those with high blood sugar, ketoacidosis (a condition where the body breaks down fat too rapidly and makes the blood toxic), transplants, liver disease or low white blood cells faced a higher risk of getting the fungal infection.Story continues below this adAt the state’s largest government hospital in Pune, Dr Sameer Joshi, the then head of ENT at BJ Government Medical College and Sassoon General Hospital, and Dr Rahul Telang, the present HOD, had led the team handling the cases. In a report in the Emerging Infectious Diseases journal in 2022, the doctors noted how “mucormycosis was diagnosed approximately one month after diagnosis of moderate or severe Covid-19 requiring steroids and oxygenation support.”Dr Rahul Thakur, associate professor of ENT at B J Government Medical College and Sassoon General Hospital, explains that early diagnosis, timely antifungal treatment, strict diabetic control and surgical removal of the infected tissue was important to save lives. In fact, much of long Covid was exacerbated by this condition. “Both SARS-CoV-2 and mucormycosis cause significant damage to the lining of blood vessels and lungs. This damage is often persistent, contributing to long-term symptoms like fatigue and breathing difficulties. Because mucormycosis is a severe infection by itself, it prolonged the recovery period and resulted in permanent organ damage in many,” he says.Also Read | Supreme Court orders Centre to frame ‘no-fault’ compensation policy for serious COVID-19 vaccine side effectsA never-ending cost burdenTreatment was complex and unforgiving. Namdeo needed antifungal drugs, strict glucose control and an aggressive surgery to remove infected tissue. The drugs themselves were scarce and expensive. Posaconazole, an alternative to hospital-administered Amphotericin B, cost more than Rs 1,500 for a strip of ten tablets at the time.In August 2021, doctors recommended another surgery as the fungus spread toward the eye socket. But the risks were stark. Aggressive intervention could be fatal. The family hesitated, then declined. By then, the infection had taken Namdeo’s second eye.Story continues below this adAnd yet, life has edged forward. After clearing the MPSC Group C examination on his first attempt, Vishal got a job with his workplace being just 20 km away. “The years lost do feel significant,” he says. “But at least I am close to my parents, so I can reach them quickly in an emergency.” The pandemic may belong to the past but for Vishal, it is still present. Six years later, he has just learnt to cope better.