March 18, 2020 3:45:32 am
Only three people have died in India so far, but experts still stress care while handling the dead. The Health Ministry has issued guidelines for the disposal of bodies, while noting that an increased risk of infection from a dead body is unlikely. However, the lungs of a dead COVID-19 patient, if not handled correctly during an autopsy, can be infectious.
For infectious diseases, the World Health Organisation (WHO) prescribes various biosafety levels (BSL) with bodies, medical gear and disposables. For bodies of dead COVID-19 patients, the WHO is mandating BSL-3.
“By BSL-3, ideally bodies must be packed intact in leakproof plastic, and cremated. Relatives cannot be allowed to touch them during cremation,” said infectious diseases specialist Dr Om Srivastava. Embalming and unzipping the packed body must be avoided.
The Ministry guidelines recommend some standard precautions for health workers, such as hand hygiene, use of personal protective equipment (water resistant apron, gloves, masks, eyewear), and disinfection of the bag housing the body and linen. The Ministry advises families not to hug, wash, or kiss the body.
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To prevent contact of doctors and mortuary workers with the deceased’s body fluids, or aerosol generating procedures (those that induce coughing), an autopsy must be avoided unless serious doubt is raised about the cause of death. “In Europe, bodies are being incinerated. If autopsy is a must, we have to wear protective gear, and then disinfect the entire autopsy room including instruments with sodium hypochlorite,” Dr Harish Pathak, head of the forensics department in Mumbai’s KEM Hospital, said. In a mortuary, the body should be preserved at 4-6°C if not cremated immediately.
WHO and AIIMS advise cremation — unless a family insists on burial for religious reasons. Burials were allowed during the H1N1 outbreak, Dr Satish Pawar, assistant director in the Maharashtra Directorate of Health Services, said. “During burial we advise the family not to touch the body,” he said.
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