TAG issues protocols for management of Covid-19 dead bodies

Relatives and families of the deceased can view the dead body but not touch it

Lhakpa Tshering

With the fastest spread of coronavirus and deaths beginning to rise in the region, it is certain to be prepared for the worst-case scenario of Covid-19 in the country should anything go wrong.

In the event of deaths involving Covid-19, the Technical Advisory Group (TAG) for Covid-19 at the Ministry of Health has issued protocols for management and safe handling of the dead bodies of Covid-19 suspects or confirmed cases.

The detailed standard operating procedures (SOP) have been formed to prevent transmission and infection of Covid-19 while handling and providing dignified cremation of dead bodies.

It SoP states that Covid-19 is an infectious disease mainly transmitted from person to person through infectious materials like respiratory droplets, fecal excretion, and oral secretion.

But there is less likelihood for an increased risk of the virus from a dead body to healthcare workers or volunteers who follow standard precautions while handling a diseased body.

In keeping with the norms, before any procedure, the family of a person who dies from the Covid-19 infection will be informed and fully explained about the nature of the disease, risk of infection, and cremation processes.

Taking into consideration their religious and cultural values, a public relations officer who would manage the family members will get formal consent from the family’s representative before proceeding with the cremation.

The family members will have to be on guard but protocol discourages not handling the body for preventing further transmission of the infection and associated problems.

Should they wish for it, however, it will permit them to handle the dead body with training to safe handling of the dead body following safety protocols – wearing personal protective equipment (PPE) – under the supervision of the team.

The health ministry’s protocol states that it will train a minimum of four physically able people in the infection prevention and control practices to handle Covid-19 dead bodies.

This includes the first team of two people for packing the dead body and decontamination of rooms or site and the second team of two people for helping to manage at the crematorium ground.

While moving a body from the isolation room, the standards require using PPE – disposable gloves, heavy-duty gloves, disposable coverall suit, face protection, N95 facemask, footwear, and shoe cover.

When the body is brought to the crematorium, the family members who will take part in the cremation or burial rituals would be identified.

Further, the standard allows family members to light the funeral pyre and take pictures of the preparation and cremation if they wish to do so. But they should follow standard infection prevention and control practices at all times.

The religious group identified by the family members will perform the religious rites outside the room in strict compliance with the Covid-19 norms.

The identified team will ensure that they carry the cremation out in a safe and dignified way, and will identify the rooms used by the deceased patient to be cleaned and disinfected.

Dead bodies repatriated from high-risk countries

In the second scenario, if a patient dies because of coronavirus infection being repatriated from any country during the pandemic is treated as a high risk for transmission and infection of the Covid-19.

On arrival in Bhutan – at the airport and ground crossing, the dead body of a diseased person after having been fully sealed as per the protocols will be handed over to the trained team.

At the same time, the families and relatives of the deceased are not allowed to handle and touch the dead body.

The standard also requires 21 days mandatory facility quarantine period for the family or persons accompanying the dead body.

After confirming the identity of the deceased and completing the required documentation, the dead body can be directly taken to the nearest cremation ground from the airport or ground crossing.

The guideline also recommends a minimum movement of the body or coffin and safe handling during the transfer ensuring the standard precautions, infection prevention and control measures including environmental disinfection are in place.

On the arrival at the cremation ground, the dead body would be handed over to the Bhutan Red Cross Society (BRSC) with information to the relatives.