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WHO guidelines on treating COVID-19 dead

Last week, my brother-in-law based in Canada, Rev. Fr. Benedicto “Dick” Tugano IV, shared an interesting story.

He said he was surprised when a family contacted him to preside over the funeral rites of a family member who died from COVID-19.

He was then aware that the COVID dead are supposed to be cremated immediately or buried within 12 hours from death.

He immediately called higher Roman Catholic Church authorities, who assured him that it was alright and in accordance with protocols of local health authorities.

At the funeral home in Alberta where he is assigned, he presided over the rites. The coronavirus victim was in the coffin and was not sealed and shrouded in black plastic. It was as normal as in pre-pandemic times but the bereaved family members and mourners were observing physical distancing of at least 2 meters especially for those who are not from the same households.

Pursuant to protocols of the Alberta Health Services, there was no kissing or hugging between those present and touching the body or clothing of the deceased or even the coffin is not recommended.

Likewise the passing of shared items like gifts, tissue, cards, money or religious items is prohibited, with the items to be placed in a designated area.

Singing or playing wind instruments in close proximity to other people in the venue should be carefully managed, the AHS guidelines state.

The gatherings are subject to capacity limits, the same rules say, with multiple, smaller events preferable instead of a single, large event.

But still, at least the bereaved families have a few days to mourn their loss in the presence of their deceased.

As they frequently say on social media, sana all.

In 2020, according to the Philippine Statistics Authority (PSA) Catanduanes Provincial Statistical Office, two deaths were reported to be due to COVID-19 and both were residents of Virac.

Six deaths were of individuals classified as probable COVID-19 cases, and 12 deaths were of individuals classified as suspect COVID-19 cases, the PSA report said.

Presumably, all 18 of probable and suspect cases were buried hastily within 12 hours pursuant to IATF guidelines.

Unseen by their loved ones, the deceased’s bodies were not even cleaned before burial, just wrapped in plastic, tightly taped and put into whatever grave or niche the family could afford in so short a time.

It did not matter to the authorities that these 18 dead later tested negative of the virus.

Imagine what the pain of not being accorded the time to properly grieve for a deceased loved one did to the emotional state of family members.

*****

A search on the Internet turned up an interim guidance on “Infection prevention and control for the safe management of a dead body in the context of COVID-19,” issued by the World Health Organization (WHO) on September 4, 2020.

“Based on current knowledge of COVID-19 and its main mode of transmission (droplet/contact), the likelihood of transmission when handling human remains is low,” it said in its introduction.

There is a common assumption that people who died of a communicable disease should be cremated to prevent spread of that disease, however, there is a lack of evidence to support this,” the organization states.

“The dignity of the dead, their cultural and religious traditions, and their families should be respected and protected throughout,” it stressed. “All measures should respect the dignity of the dead including avoiding the hasty disposal of the body of a person who has died of COVID-19.”

Thus, the WHO urges, authorities should manage each dead body 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.

The same WHO guidelines provide procedures for preparing, packing and handling the COVID dead from the patient room to an autopsy unit, mortuary, crematorium or burial site, along with health protocols for personnel who will interact with the body.

Funeral home workers preparing the body, it says, should wear appropriate PPE. While embalming is not recommended in order to avoid excessive manipulation of the body, it could be done only by trained, experienced staff.

“If the family wishes to view the body, allow them to do so, but instruct them not to touch or kiss the body, to maintain at least 1 meter distance from one another and any staff during the viewing and to perform hand hygiene after the viewing,” the guidelines state.

On the other hand, the belongings of the deceased person do not need to be burned or otherwise disposed of,” it adds, as it should be handled with gloves and cleaned with a detergent, followed by disinfection with a solution of at least 70% ethanol, hypochlorite or a bleach solution with a concentration of 0.1% (1000 ppm).

*****

Perhaps, the reason why IATF opted for the outright cremation or 12-hour burial window was due to the lack of properly equipped funeral homes with personnel trained to handle the embalming of a dead person who died of a communicable disease like COVID-19.

There is also that tradition among ordinary Filipinos to hold the wake until a family member has arrived from abroad or enough money has been collected from the gambling tables.

Another is the long wait for the test result if the suspect case had been swabbed.

If the Philippines were a first-world country and located in Europe, perhaps longer mourning can be allowed.

*****

 

THE NEW BRIDE. Three weeks after the wedding, a new bride called her priest in a state of great anxiety.

“Father,” she said, “John and I had the most dreadful fight. It was really awful. I just don’t know what to do next.”

“Calm down, my child,” said the priest. “It’s not as bad as you think. Every marriage has to have its first fight.”

“I know, I know,” she said. “But what am I going to do with the body?”

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