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What's a Safe Way to Handle Mortal Remains of a COVID-19 Victim?

What's a Safe Way to Handle Mortal Remains of a COVID-19 Victim?

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As of Friday, 27 March, the total death toll from COVID-19 in India was 17, out of a total active 724 cases.

In all the noise about the coronavirus, one heartbreaking detail often missed out is how to safely part with your loved one.

Before the numbers become a statistic, it is crucial to think of those 17 patients who passed away and to think of their families. How exactly does one go about the funeral procession and last rites of a family member lost to COVID-19?

Now, the Ministry of Health and Family Welfare has issued detailed guidelines on the precautions to be taken by healthcare workers during disposal, cleaning and an autopsy if required.

Dr Khetarpal knows a little something about handling dead bodies - he has more than 33 years of experience in the practice and teaching of Pathology & Transfusion Medicine in various private and military hospitals and has served as an army doctor as well.

He tells FIT, “I was a pathologist with the armed forces, and as a policy there, if any patient dies we have to conduct an autopsy. I must have done hundreds of such autopsies there, which includes positive cases with infectious diseases”

On COVID-19 fatalities, he says, “The rules are the same, with any kind of infection.”

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Precautions For Healthcare Workers

The main source of COVID-19 transmission is through infected droplets. “There is unlikely to be an increased risk of COVID-19 infection from a dead body to health workers or family members who follow standard precautions while handling the body,” reads the health ministry's guidelines.

According to the ministry, these include:

  1. Hand hygiene.

  2. Use of personal protective equipment (e.g., water-resistant apron, gloves, masks, eyewear).

  3. Safe handling of sharps.

  4. Disinfect bag housing the body; instruments and devices used on the patient.

  5. Disinfect linen.

  6. Clean and disinfect environmental surfaces.

“We have to use hand hygiene before touching the body, personal protective equipment by way of a water-resistant apron, putting on gloves, the eyewear, use of gumboots and N95 masks,” adds Dr Khetarpal. The body and the area must be cleaned and disinfected thoroughly and once done, the equipment used needs to cleaned too and “any biomedical waste or infected material should be wrapped in plastic and disposed.”

Dr Khetarpal says that it is imperative to go about this carefully.

One of the key points is that the lungs of the patient need special attention as they still may be infected. COVID-19 is an infectious respiratory disease, and Dr Khetarpal explains,

He adds, “Oropharyngeal secretions or secretions through the mouth, or from the tube if the patient has been incubated, or from the neck if an airway has been put. Any lung secretion basically through the various passages, that is trachea and bronchi to the oral cavity (the mouth) could be infected.”

Extra care needs to be taken during an autopsy when handling the lungs as well.

Dr Khetarpal adds that so far “there are adequate stocks for this process..” This could also be because there have not been that many recorded COVID-19 deaths in India.

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‘Social Distancing Must be Maintained at the Funeral’

Once the body is cleaned and ready for the last rites, there are a few more steps for healthcare workers to keep in mind.

Staff in the isolation area, mortuary, ambulance and those workers in the crematorium/burial ground should be trained in the infection prevention control practices, and read the government guidelines.

Special care needs to be taken in transporting the body says Dr Khetarpal.

“We have to keep the body in a plastic body bag, and the exterior of this bag should be disinfected with 1 per cent sodium hypochlorite. One could put a sheet over the body bag so it is not directly exposed for an extra layer of protection.”

All orifices should be plugged so there is no leakage of body fluids. “The body can throw up secretions during this time as well,” he adds.

In such cases, the family members are given guidance on handling the body so that they don't get infected.

At the cremation ground, or at the burial site, there should be minimal crowds present. “Social distancing should be followed, with at least 1 -2 meters of distance.”

Religious rituals like reading from religious scripts, sprinkling holy water or any other last rites that don’t involve touching the body are allowed as per government guidelines.

Hand hygiene and standard precautions need to be taken by the family, “and no one should take this lightly,” advises Dr Khetarpal. After the funeral procession, the loved ones present should thoroughly wash their hands and disinfect.

Another important thing to keep in mind is that the ash of such patients is not harmful or infectious and it can safely be used for the last rites.

(At The Quint, we are answerable only to our audience. Play an active role in shaping our journalism by becoming a member. Because the truth is worth it.)

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