In this article, we want to tell ourreaders about the most unfortunate, but possible end result of any victim ofthis deadly virus – DEATH. What if our loved ones die of this Covid-19. Wouldthat be a normal death, like any other happening in hospitals. We have alreadylost many to this disease, but we don’t want them to be a source of infectionfor the rest of the world.
The doctors in this situation will alsohave to follow some guidelines which include:-proper hand hygiene, use ofpersonal protective equipment (PPE), disinfecting the body bag and all thepersonal belongings of the patient. The isolation ward or the area in which thepatients were kept also needs to be cleaned & disinfected, later to be usedby other patients. Health workers who will handle the body, or carry it, should be equipped with all the PPE andshould practice hand hygiene. All tubes, drains and catheters should be removedand caution applied while discarding the sharps. All puncture holes or woundscaused due to catheters or cannulas should be disinfected with 1% hypochloriteand dressed with impermeable material. All the opening (oral and nasal) must beplugged to prevent the leakage of any body fluids.
Family members or relatives, who want tosee their loved ones, may be allowed to do so but with proper precautions. Ourloved ones, now just a body, should be placed in a leak proof plastic body bagand the exterior of the body can be disinfected with 1% hypochlorite and thenwrapped in a waterproof sealed sheet. The body can be either handed over to thefamily or sent to the mortuary.
All used/soiled linen should be handledwith standard precautions, put in biohazard bag and the outer surface of thebag disinfected with hypochlorite solution. Used equipment should be autoclavedor decontaminated with disinfectant solutions in accordance with establishedinfection prevention control practices. All medical waste must be handled anddisposed of in accordance with bio-medical waste management rules. All surfacesof the isolation area (floors, bed, railings, side tables, IV stand, etc.)should be wiped with 1% Sodium Hypochlorite solution; allow a contact time of30 minutes, and then allowed to air dry.
Transportation
The body, secured in a bodybag, exterior ofwhich is decontaminated poses no additional risk to the staff transporting thedead body. The personnel handling the body may follow standard precautions(surgical mask, gloves). The vehicle, after the transfer of the body to burialstaff, will be decontaminated with 1% Sodium Hypochlorite.
At the burial ground
The burial ground staff should besensitized that COVID-19 does not pose any additional risk. The staff shouldpractice standard precautions of hand hygiene, use of masks and gloves. Viewingof the dead body by unzipping the face end of the body bag (by the staff usingstandard precautions) may be allowed, for the relatives to see the body for onelast time. Religious rituals such as reading from religious scripts, sprinklingwater and any other last rites that do not require touching of the body can beallowed. Bathing, kissing, hugging, etc. of the body should not be allowed. Thefuneral/ burial staff and family members should perform hand hygiene afterburial. Large gathering at the burial ground should be avoided as a socialdistancing measure as it is possible that close family contacts may besymptomatic and/ or shedding the virus.
Islamic Perspective
The European Fatwa Council and The FiqhCouncil of America have separately issued some rulings on how to bury a COVID-19 infected patient as per Islamic rulings which are summarised as under:
The default is that the washing of thecorpse is Fard-Kifayah and if we are allowed to do so without any harm to thelives of those who perform the ghusl, it should be done (CDC in America hasadvised that extra precaution be done while washing the body-by wearingappropriate PPE). If transmission of disease is feared, then it is better towash it by pouring water from a distance while taking necessary precautions. Ifthis is not possible, tayammum for the deceased will be sufficient. Otherwiseit can be buried without washing and/or without tayammum, in case thetransmission of infection would happen in either way. This is because thesafety of the living individual is more priority than the dead.
The deceased is to be shrouded in theIslamic shroud (Kaffan) if possible, otherwise a garment will be wrapped overhis garments in which he died, if available, or buried in the clothes in whichhe died.
Praying janazah for the dead isFard-Kifayah (collective obligation) – as is well known – the performance ofwhich is sought from the mukallafin collectively, but not from the everyindividual specifically. It is sufficient that janazah prayer, in thesecircumstances, will be attended by only 2 or 3 persons.
As for the burial, the basic principle isthat a Muslim can be buried in the graves of Muslims, if not available, he /shecan be buried wherever possible.
Authors:
Dr. Mariya Amin Qurieshi, Dr. RuqiyaQuansar, and Dr. Sheikh Mohammad Saleem work as Public Health Experts at theDepartment of Community Medicine, Government Medical College, Srinagar and canbe reached at saleem.900@gmail.com.