Union Health Ministry framing guidelines on handling of COVID-19 casualties

Amid a controversy over the cremation of the 68-year-old woman who died in Delhi after being infected with the novel coronavirus, the Union Health Ministry has begun working on framing guidelines for handling the bodies of those who die of the disease.

Though it is unlikely that coronavirus infection could spread from handling a body, the guidelines are being drafted to dispel any misconception and raise awareness regarding the spread of the disease from a deceased, a health ministry official said.

"Coronavirus infection is a respiratory disease which spreads through droplets and the probability of mortuary or disposal staff contracting the virus from the dead is unlikely as against the case of high-risk pathogens like Ebola and Nipah which have very high chances of spreading through direct contact with body fluids of the deceased," the health ministry official said.

Cremation of a person who died due to coronavirus has no side effect by any methods -- using fire or electrical, gas or by burial, said Sudhir Gupta, head of the forensic medicine department of the AIIMS, New Delhi.

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In case of burial, the surface of the grave should be cemented, he said.

Meanwhile, the AIIMS forensic department has drafted guidelines for workers in the mortuary.

Mortuary and death care workers who have contact with human remains known or suspected to be contaminated must be protected from exposure to infected blood and body fluids, contaminated objects, or other contaminated environmental surfaces, the guidelines said.

They also said the number of people allowed in the autopsy room should be limited.

"Use of an oscillating bone saw should be avoided for confirmed or suspected cases of COVID-19. Consider using hand shears as an alternative cutting tool. If an oscillating saw is used, attach a vacuum shroud to contain aerosols," the guidelines said.

"This virus is most often spread from a living person, occurs with close contact via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. This route of transmission is not a concern when handling human remains or performing post-mortem procedures," Gupta said.

Post-mortem activities should be ideally waived to avoid aerosol-generating procedures and ensuring that if aerosol generation is likely that appropriate engineering controls and personal protective equipment (PPE) are used, he said.