COVID-19: Health ministry framing guidelines to handle casualties
New Delhi, Mar 15: Amid a controversy over the cremation of the 68-year-old woman who died in Delhi after being infected with 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 of a body, the guidelines are being drafted to dispel any misconception and raise awareness regarding spread of the disease from a deceased, a health ministry official said.
India reported its second casualty due to coronavirus on Friday with the Union Health Ministry confirming the death of the woman who had tested positive for the contagious respiratory disease after coming in contact with her son who acquired the virus after travelling abroad recently.
The first casualty was a 76-year-old man in Karnataka who died on March 10.
"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 in 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.
The World Health Organisation (WHO) guidelines on 'Infection prevention and control of epidemic and pandemic-prone acute respiratory infections in health care' recommends proper use of personal protection equipment in accordance with standard precautions to avoid direct contact with body fluids while moving a body from isolation room or area.
About mortuary care and post-mortem examination, WHO recommends packing and transporting a body with acute respiratory infection to a morgue, crematorium or burial by ensuring it is fully sealed in an impermeable body bag before being removed from the isolation area to avoid leakage of body fluid.
"When properly packed in a body bag, the body can be safely removed for storage in the mortuary, sent to the crematorium, or placed in a coffin for burial," it said.
The global health body advises using personal protective equipment such as disposable, long-sleeved, cuffed gowns for handling bodies; if the outside of the body is visibly contaminated with body fluids, excretions, or secretions, it has to be ensured that the gown is waterproof.
It further recommends that mortuary staff and burial team apply standard precautions like proper hand hygiene and use appropriate personal protective equipment, including facial protection, if there is a risk of splashes from the patient's body fluids or secretions onto the body or face of the staff member.
"Transmission of lethal infectious diseases associated with mortuary care has been reported... manage each situation on a case-by-case basis, balancing the rights of the family with the risks of exposure to infection," WHO said.
Respiratory pathogens which are transmitted through large droplets, include adenovirus, avian influenza A (H5N1), human influenza and SARS-CoV.
"During an influenza pandemic, the circulating human virus is expected to be transmitted in the same manner as seasonal influenza viruses. Hence, droplet precautions should be applied in addition to standard precautions," it said.
The cremation of the 68-year-old west Delhi resident was performed on Saturday under the supervision of medical authorities.
Doctors from the Ram Manohar Lohia (RML) hospital and from civic bodies oversaw the cremation after the crematorium staff reached out to the authorities seeking directives on ensuring that the infection didn't spread from the body, delaying the last rites by a few hours.
"The situation across the world is sensitive. We had to seek instructions first from MCD and medical authorities. They said the cremation will be done using CNG and the officials had come to supervise the process," Suman Gupta of the samiti said.
The number of coronavirus positive cases in the country has risen to 84 which includes the two deaths in Delhi and Karnataka, according to the Union Health Ministry.
Seven persons who had tested positive, including five from Uttar Pradesh, and one each from Rajasthan and Delhi have been discharged after treatment, a health ministry official said.
So far, Delhi has reported seven positive cases and Uttar Pradesh 11. Karnataka has six coronavirus patients, Maharashtra 14 and Ladakh three while Jammu and Kashmir reported two cases. Rajasthan, Telangana, Tamil Nadu, Andhra Pradesh and Punjab have reported one case each.
Kerala has reported 19 cases, including three who were discharged last month after they recovered from the contagious infection. Of the country's 84 confirmed cases 17 are foreigners -- 16 Italian tourists and a Canadian.