Giving final bath to the body of a loved one before cremation or burial is a ritual practised across cultures, but the kin of COVID-19 deceased should refrain from it.
According to the standard operating procedure specified in the document ‘COVID-19: Guidelines on Dead Body Management’ released by the Director General of Health Services, Union Ministry of Health & Family Welfare, relatives of the person who dies of COVID-19 infection may not be allowed to bathe, kiss or hug the dead body.
They can however, see the body one last time after unzipping the face end of the body-bag by the staff, using standard precautions. Further, religious rituals which do not require touching of the body may be allowed. The standard infection prevention control practices include, among others, maintaining hand hygiene, use of personal protective equipment such as water-resistant apron, gloves, masks and eye-wear, safe handling of sharp tools, and disinfecting the bag housing dead body, and instruments and devices used on the patient.
All staff handling dead bodies in the isolation area, mortuary, ambulance and the workers in the crematorium or burial ground should be trained in infection prevention control practices. While moving the body from the isolation area, all tubes, drains and catheters should be removed carefully, and any puncture holes or wounds should be disinfected and dressed with impermeable material. Oral and nasal orifices of the body should be plugged. Family of the patient may be allowed to view the body at the time of removal from the isolation ward with application of standard precautions.
The dead body should be placed in leak-proof plastic body-bag, exterior of which should be decontaminated. The bag may be wrapped with a mortuary sheet or sheet provided by the family. Thereafter, the body may be handed over to the relatives or taken to mortuary.
The body should be stored in cold chambers maintained at 4 degrees centigrade in mortuary, and the mortuary should be disinfected after removal of the body. Embalming should not be allowed.
Autopsies should be avoided on the body as lungs could be source of infection. If autopsy is needed, the team should be small, and wear full complement of PPE. Care is advised with regard to the tools and procedures of autopsy.
The vehicle used for transportation should be disinfected thereafter. After funeral, the staff of crematorium or burial ground along with family members should thoroughly wash hands and disinfect them.
Ash after cremation does not pose any risk and can be collected for last rites. Large gathering should be avoided at the funeral, as it is possible that close family contacts may be symptomatic and shedding the virus.
Used and soiled linen should be put in bio-hazard bag, outer surface of which should be disinfected. Used equipment should be autoclaved or decontaminated. Medical waste should be disposed of in accordance with biomedical waste management rules.
