I WAS PUT IN A BAG WHOSE LABEL CLEARLY READ "COVID-19-- HANDLE WITH CARE."
The author of this article, Silvy Sheetal is a student of University Law College, Bhubaneswar, Odisha.
''One
may live as a conqueror, a king or a magistrate, but he must die as a man. The
bed of death brings every human being to his pure individuality, to the intense
contemplation of that deepest and most solemn of all relations. The relation between
the creature and his creator''.
- Daniel Webster
I
was infected I DON’T KNOW HOW, it all started with a sore throat and now, I have
seen my wife wail her heart out but it was of no use. I died as a result
of COVID-19, a new strain of coronavirus. My family and my dead body were
treated with sensitivity, dignity, and respect upon my death. In the book
''Burial of the Dead'' written by William Henry Francis Bsevi clearly specified
that ''Across history, cultures with almost no other rituals in common treat
their dead with reverence''. The notion of respect is so rooted that we even
agree to deal gently with the bodies of our enemies. People
who work in these Medical services and the mourners were protected from the
infection. My body does not continue to be a risk now. Viewing of my body took
place under the supervision of the funeral director’s mortuary facility and
family members were ordered to avoid any contact with me. But there are slight
changes. I was likely to be a continuing risk of infection from the body fluids
and tissues, which were later thoroughly examined, by the clinical
diagnosis or laboratory confirmation conducted within the 24 hours of my death.
The Public Health India’s Rare and Imported
Pathogens Laboratory assessed the post-mortem risk from people who died of
coronavirus (SARS-CoV2) infection and identified little residual hazard apart
from:
- potential droplet generation from
artificial air movement during the initial care of the deceased
- post-mortem examination where the use
of power tools take place, which is a risk for an aerosol generation[1]
For
according to estimation, the viable virus could be present for up to 48 to 72
hours on environmental surfaces in “room air” conditions. In deceased bodies,
particularly those retained at refrigeration conditions, and depending on the
above factors, an infectious virus may persist for longer.[2]
The
right to decent burial is upheld in the Indian context, but who is authorized
for burial is not explained in any Indian Law. Generally, unless otherwise
provided before death, by the deceased, the right will be got to the surviving
spouse, if there is none it will go to the next of kin. In the case of
burial, the body needs to be buried at a depth of 4-6 feet and should be cemented
immediately as an additional precautionary measure. The guidelines have been
framed in conjunction with the World Health Organization (WHO) guidelines on
“Infection prevention and control of epidemic- and pandemic-prone acute
respiratory infections in health care".[3]
Three
months after the outbreak, China’s Infection Control Branch of the Department
of Health issued 24-page guidelines for handling and disposal of dead bodies. The
Department of Forensic Medicine and Toxicology at the All India Institute of
Medical Sciences in Delhi has released its specific protocol, which mentions
points missed in the guidelines issued by the Health Ministry. “For last rites,
cremation should be preferred for the complete elimination of chances of
infection in either electric or gas crematorium in a zipped body bag. However,
keeping in mind the religious views of the family, if the burial of the body is
requested, then it should be assured that the body is buried in a thick,
airtight coffin, “said the new protocol.[4]
The
medical Professionals had taken actions to reduce the risk of spreading the
infection among mourners who had gathered to pay their respects, with a
particular focus on protecting vulnerable people.[5] The mourners were not allowed
to take part in rituals or practices that brought them into close contact with my
body. For the contact with the body should be restricted to those who are wearing PPE which include,
- a clean protective outer garment, such as a gown, overalls or jumpsuit
- a clean pair of disposable glove
- a disposable surgical mask
and
had been trained in the appropriate use of PPE, while maintaining social
distancing, so that the novel Corona Virus does not pose any additional risk to
mortuary operators, pathologists and other medical practitioners, funeral
directors and their staff) who are required to manage bodies of deceased
persons infected with coronavirus (SARS-CoV2). [6]
Royal
College of Pathologists (RCPath) guidance Transmission-based precautions:
Guidance for the care of the deceased during COVID-19 pandemic, which details the
Personal Protective Equipment (PPE) required for Transmission Based Precautions
that can be used by any professional involved in the care of the deceased
appropriate eye protection such as goggles or a face shield. After use, PPE is
to be carefully removed and decontaminated or disposed of as clinical waste as
soon as practicable
My
body was taken care of in accordance with the Health and Safety Executive (HSE)
guidance:
•Managing
infection risks when handling the deceased, which details the standard
infection control precautions and transmission-based precautions that should be
followed in all occupational settings.
The
usual principles of Standard Infection Control Precautions (SICPs) and transmission-based
Precautions (TBPs) were applied to my body on the day I was confirmed to be infected with coronavirus (SARS-CoV2). My Personal waste (for
example, used tissues, continence pads, and other items soiled with bodily
fluids) and disposable cleaning cloths were stored securely within disposable
rubbish bags. The body bag was clearly and permanently labeled as containing
COVID 19, such as: “COVID-19 – Handle with care”. These bags further were
placed into another bag, tied securely and kept separate from other waste, put
aside for at least 72 hours before being put in the usual household waste bin
for disposal as normal.[7]
"Only
the lungs of dead COVID-19 patients, if handled during an autopsy, can be
infectious," as said by the post mortem surgeons. Prior to which I was
stored in cold chambers at about 4 degrees Celsius. The WHO guidelines recommend
the proper use of personal protection equipment in accordance with standard
precautions to avoid direct contact with body fluids while moving a body from the isolation room or area.[8]
From
being 5th one in my State to being the 41st in my country. Just a 55 yr old
male who complained of fever and other symptoms went to the local practitioner,
on March 23 with no travel history; he succumbed to death in one of the private hospitals in the city.
This is not the story of One but the thousands
throughout the world. We hear cases of people struggling in hospitals, to some pershing
to deaths, what happens to such infected bodies? Out of infection they were
once isolated from the outside world and had themselves turned out to be
pathogens. For the sake of humanity and seeing to the medical guidelines, the
World Health Organisation and the Government of every country have laid down various
guidelines for a safe and dignified burial to each COVID-19 death. Through
Guidelines taken from reliable government sources as provided in citations, this
article brings an insight into such COVID-19 deaths.
[2]
https://www.gov.uk/government/publications/covid-19-guidance-for-care-of-the-deceased/guidance-for-care-of-the-deceased-with-suspected-or-confirmed-coronavirus-covid-19
[3]
https://docplayer.net/132394899-Rights-of-the-dead-a-nasim-1-p-beena-1.html
[4]
https://theworldnews.net/pk-news/covid-19-mishandling-of-infected-dead-bodies-spell-anxiety-in-india
[5]
https://www.health.nsw.gov.au/Infectious/factsheets/Pages/covid-19-funeral-directors.aspx
[6]
https://www.health.nsw.gov.au/Infectious/factsheets/Pages/covid-19-funeral-directors.aspx
[7]
https://www.health.nsw.gov.au/Infectious/factsheets/Pages/covid-19-funeral-directors.aspx
[8]
https://www.staffordshire.gov.uk/Care-for-all-ages/Information-for-providers/Coronavirus-information/Care-Homes-COVID-19-Staffordshire-Guidance-26.3.20.pdf
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