What WHO says of handling and burying Covid-19 victims

 

Questions have cropped up over the required safety standards to be observed in the burial of Covid-19 victims. This is after Siaya County government was criticised for sanctioning hurried burial of James Onyango, who was reported to have died of Covid-19 at Matibabu Health Centre at Ukwala town.

The government had earlier issued precautionary measures where it directed that burials be conducted within 48 hours in the presence of at most 15 people.

However, the State did not go into the specifics of the time for the burial and the persons to lower the body into the grave. And, after the burial of Mr Onyango on Saturday at 2 am; members of the public have questioned whether WHO guidelines are in coherence with exercise as was conducted by Siaya County.

This begs question: What does the World Health Organization (WHO) say about handling and disposing bodies of Covid-19 victims?

Here are the WHO guidelines that strike the balance between safety in body disposal and achieving humane burial ceremony for Covid-19 victims.

Transmission

Except in cases of hemorrhagic fevers like Ebola, Marburg and cholera; dead bodies are generally not infectious. Only the lungs of patients with the virus, if handled improperly during an autopsy, can be infectious. Otherwise, cadavers (bodies) do not transmit disease.

Mode of disposal

That persons who have died of a communicable disease should be cremated is a myth hence untrue. Cremation is a matter of cultural choice and available resources. There is no evidence of persons having become infected from exposure to the bodies of persons who died from COVID-19.

Safety of health personnel

Before attending to a body, people should ensure that the necessary hand hygiene and personal protective equipment (PPE) supplies are available.

 

Burial rites and dignity of the dead

The dignity of the dead, their cultural and religious traditions, and their families should be respected and protected throughout. Hasty disposal of a dead from COVID-19 should be avoided. Authorities should manage each situation on a case-by-case basis, balancing the rights of the family, the need to investigate the cause of death, and the risks of exposure to infection.

Safety of family members

Any person, for example a family member or a religious leader preparing the deceased in the sense of washing, cleaning or dressing body, tidying hair, trimming nails or shaving) in a community setting should wear gloves for any contact with the body. For any activity that may involve splashing of bodily fluids, eye and mouth protection (face shield or goggles and medical mask) should be worn. Clothing worn to prepare the body should be immediately removed and washed after the procedure, or an apron or gown should be worn. The person preparing the body should not kiss the deceased. Anyone who has assisted in preparing the body should thoroughly wash their hands with soap and water when finished. NB: However, WHO discourages contacts with the body hence it should be avoided if possible. If there has to be a contact, then PPE must be in place.

Viewing the body

Family and friends may view the body after it has been prepared for burial, in accordance with customs but they should not touch or kiss the body. They should wash their hands thoroughly with soap and water following the viewing; physical distancing measures should be strictly applied. People with respiratory symptoms should not participate in the viewing or at least wear a medical mask to prevent contamination of the place and further transmission of the disease to others. Children, adults older than 60 years, and immunosuppressed persons should not directly interact with the body. Those tasked with placing the body in the grave, on the funeral pyre, etc. should wear gloves and wash hands with soap and water once the burial is complete. Cleaning of reusable PPE should be conducted in accordance with manufacturer’s instructions for all cleaning and disinfection products. Although burials should take place in a timely manner, in accordance with local practices, funeral ceremonies not involving the burial should be postponed, as much as possible, until the end of the epidemic. If a ceremony is held, the number of participants should be limited. Participants should observe physical distancing at all times, plus respiratory etiquette and hand hygiene; The belongings of the deceased person do not need to be burned or otherwise disposed of. However, they should be handled with gloves and cleaned with a detergent followed by disinfection with a solution of at least 70% ethanol or 0.1% (1000 ppm) bleach. Clothing and other fabric belonging to the deceased should be machine washed with warm water at 60−90°C (140−194°F) and laundry detergent.