On 24 March 2020, the World Health Organization (WHO) has issued an interim guidance on the safe management of a dead body in the context of Covid-19. According to the WHO, the interim guidance is applicable for all those, including managers of health care facilities and mortuaries, religious and public health authorities, and families, who tend to the bodies of persons who have died of suspected or confirmed COVID-19.
As the WHO continues its investigation, to date there is no evidence of persons having become infected from exposure to the bodies of persons who died from COVID-19. However, people may obviously die of COVID-19 in the health care facilities, home or in other locations. That is why, the safety and well-being of everyone who tends to bodies should be the first priority. Before attending to a body, people should ensure that the necessary hand hygiene and personal protective equipment (PPE) supplies are available. The dignity of the dead, their cultural and religious traditions, and their families should also be respected and protected throughout. The WHO discourages hasty disposal of a dead from COVID-19. Authorities should manage each situation on a case-by-case basis, balancing the rights of the family, the need to investigate the cause of death, and the risks of exposure to infection.
Preparing and packing the body for transfer to a burial site
It is to ensure that personnel who interact with the body (health care or mortuary staff, or the burial team) apply standard precautions including hand hygiene before and after interaction with the body, and the environment; and use appropriate PPE according to the level of interaction with the body, including a gown and gloves. If there is a risk of splashes from the body fluids or secretions, personnel should use facial protection, including the use of face shield or goggles and medical mask.
The preparation of dead body for transfer requires the removal of all lines, catheters and other tubes. It also requires that any body fluids leaking from orifices are contained. Keeping both the movement and handling of the body to a minimum is essential. The body needs to be wrapped in cloth and transferred as soon as possible to the mortuary area/burial site.
There is no need to disinfect the body before transfer to the mortuary area. Body bags are not necessary, although they may be used for other reasons (e.g. excessive body fluid leakage). No special transport equipment or vehicle is required.
Functions in funeral home/mortuary care
Health care workers or mortuary staff preparing the body (e.g. washing the body, tidying hair, trimming nails, or shaving) should wear appropriate PPE according to standard precautions (gloves, impermeable disposable gown [or disposable gown with impermeable apron], medical mask, eye protection). If the family wishes only to view the body and not touch it, they may do so, using standard precautions at all times including hand hygiene. Adults below 60 years and immunosuppressed persons should not directly interact with the body.
Autopsy, including engineering and environmental controls
Safety procedures for deceased persons infected with COVID-19 should be consistent with those used for any autopsies of people who have died from an acute respiratory illness. If a person died during the infectious period of COVID-19, the lungs and other organs may still contain live virus, and additional respiratory protection is needed during aerosol-generating procedures (e.g. procedures that generate small-particle aerosols, such as the use of power saws or washing of intestines). If a body with suspected or confirmed COVID-19 is selected for autopsy, health care facilities must ensure that safety measures are in place to protect those performing the autopsy. However, the IEDCR in Bangladesh has decided not to perform any autopsy on the dead bodies.
People who have died from COVID-19 can be buried or cremated. However, it is to confirm that national and local requirements that may dictate the handling and disposition of the remains, are maintained. Family and friends may view the body after it has been prepared for burial, in accordance with customs. They should not touch or kiss the body and should wash hands thoroughly with soap and water after the viewing. Those tasked with placing the body in the grave, on the funeral pyre, etc., should wear gloves and wash hands with soap and water after removal of the gloves once the burial is complete.
Compiled by Law Desk (SOURCE: WHO.INT).