There is unlikely to be increased risk of infection from body of COVID-19 patient: Govt

There is "unlikely to be an increased risk of infection from a dead body" of a coronavirus patient to health workers or family members who follow standard precautions, the government said on Tuesday while issuing guidelines for handling corpses.

Guidelines for dead body management towards precautions, infection prevention and control measures, handling of body and environmental disinfection have been issued, a senior Health Ministry official said.

"The main driver of transmission of COVID-19 is through droplets. There is unlikely to be an increased risk of coronavirus infection from a dead body to health workers or family members who follow standard precautions while handling body.

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"Only the lungs of dead COVID-19 patients, if handled during an autopsy, can be infectious," the guidelines stated while listing out standard precautions to be followed by health care workers while handling bodies of those who die of the disease.

Listing out the guidelines to be followed at the crematorium or burial ground, the ministry said the crematorium and burial ground staff should be sensitised that novel coronavirus does not pose additional risk and that they should practice standard precautions of hand hygiene, use of masks and gloves.

Viewing of the dead body by unzipping the face end of the body bag (by the staff using standard precautions) may be allowed, for the relatives to see the body for one last time.

Religious rituals such as reading from religious scripts, sprinkling holy water and any other last rites that does not require touching of the body can be allowed, the guidelines stated, adding that bathing, kissing, hugging of the body should not be allowed and the burial staff and family members should perform hand hygiene after cremation or burial.

The guidelines outlined that the ash does not pose any risk and can be collected to perform the last rites.

"Large gathering at the crematorium or burial ground should be avoided as a social distancing measure as it is possible that close family contacts may be symptomatic and/or shedding the virus," it stated.

The guidelines stated that being a new disease there is knowledge gap on how to dispose of dead body of a suspect or a confirmed case of COVID-19.

This guideline is based on the current epidemiological knowledge about the disease.

India is currently having travel-related cases and a few cases of local transmission. At this stage, all suspect or confirmed cases will be isolated in a health care facility. Hence, the document is limited in scope to hospital deaths, it said.

The ministry listed certain standard infection prevention control practices, which include hand hygiene, use of personal protective equipment (e.g., water resistant apron, gloves, masks, eyewear, safe handling of sharps, disinfecting bag housing dead body and clean and disinfecting environmental surfaces, among others to be followed by health care workers while handling dead bodies of coronavirus patients.

Regarding removal of the body from the isolation room, the guidelines stated that health worker attending to the dead body should perform hand hygiene, ensure proper use of PPE, apply caution while handling sharps such as intravenous catheters, oral, nasal orifices of the dead body to prevent leakage of body fluids.

It said all medical waste must be handled and disposed of in accordance with biomedical waste management rules.

If the family of the patient wishes to view the body at the time of removal from the isolation room or area, they may be allowed to do so with the application of standard precautions.

Place the dead body in a leak-proof plastic body bag. The exterior of the body bag can be decontaminated with 1 per cent hypochlorite.The body bag can be wrapped with a mortuary sheet or sheet provided by the family members.

It advised mortuary staff handling dead body of COVID-19 patients to observe standard precautions like storing them in cold chambers maintained at approximately 4 degrees Celsius, disinfecting environmental surfaces, instruments and transport trolleys with 1 per cent hypochlorite solution and cleaning the chamber door, handles and floor with sodium hypochlorite 1 per cent solution after removing the body.

The guidelines suggest embalming of dead body should not be allowed and that autopsies should be avoided.

If autopsy is to be performed for special reasons, the infection prevention control practices should be adopted, it said.

The government issued guidelines after there was some delay in the cremation of a 68-year-old woman in Delhi, who died after testing positive for coronavirus, as the crematorium reached out to authorities seeking clarity on handling of the body.

The COVID-19 cases in India have risen to 137, including 25 foreign nationals, and the number of deaths stand at three.