In this article, we want to tell our readers about the most unfortunate, but possible end result of any victim of this deadly virus – DEATH. What if our loved ones die of this Covid-19. Would that be a normal death, like any other happening in hospitals. We have already lost many to this disease, but we don’t want them to be a source of infection for the rest of the world.
The doctors in this situation will also have to follow some guidelines which include:-proper hand hygiene, use of personal protective equipment (PPE), disinfecting the body bag and all the personal belongings of the patient. The isolation ward or the area in which the patients were kept also needs to be cleaned & disinfected, later to be used by other patients. Health workers who will handle the body, or carry it, should be equipped with all the PPE and should practice hand hygiene. All tubes, drains and catheters should be removed and caution applied while discarding the sharps. All puncture holes or wounds caused due to catheters or cannulas should be disinfected with 1% hypochlorite and dressed with impermeable material. All the opening (oral and nasal) must be plugged to prevent the leakage of any body fluids.
Family members or relatives, who want to see their loved ones, may be allowed to do so but with proper precautions. Our loved ones, now just a body, should be placed in a leak proof plastic body bag and the exterior of the body can be disinfected with 1% hypochlorite and then wrapped in a waterproof sealed sheet. The body can be either handed over to the family or sent to the mortuary.
All used/soiled linen should be handled with standard precautions, put in biohazard bag and the outer surface of the bag disinfected with hypochlorite solution. Used equipment should be autoclaved or decontaminated with disinfectant solutions in accordance with established infection prevention control practices. All medical waste must be handled and disposed of in accordance with bio-medical waste management rules. All surfaces of the isolation area (floors, bed, railings, side tables, IV stand, etc.) should be wiped with 1% Sodium Hypochlorite solution; allow a contact time of 30 minutes, and then allowed to air dry.
The body, secured in a bodybag, exterior of which is decontaminated poses no additional risk to the staff transporting the dead body. The personnel handling the body may follow standard precautions (surgical mask, gloves). The vehicle, after the transfer of the body to burial staff, will be decontaminated with 1% Sodium Hypochlorite.
At the burial ground
The burial ground staff should be sensitized that COVID-19 does not pose any additional risk. The staff should practice standard precautions of hand hygiene, use of masks and gloves. Viewing of the dead body by unzipping the face end of the body bag (by the staff using standard precautions) may be allowed, for the relatives to see the body for one last time. Religious rituals such as reading from religious scripts, sprinkling water and any other last rites that do not require touching of the body can be allowed. Bathing, kissing, hugging, etc. of the body should not be allowed. The funeral/ burial staff and family members should perform hand hygiene after burial. Large gathering at the burial ground should be avoided as a social distancing measure as it is possible that close family contacts may be symptomatic and/ or shedding the virus.
The European Fatwa Council and The Fiqh Council 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 the corpse is Fard-Kifayah and if we are allowed to do so without any harm to the lives of those who perform the ghusl, it should be done (CDC in America has advised that extra precaution be done while washing the body-by wearing appropriate PPE). If transmission of disease is feared, then it is better to wash it by pouring water from a distance while taking necessary precautions. If this is not possible, tayammum for the deceased will be sufficient. Otherwise it can be buried without washing and/or without tayammum, in case the transmission of infection would happen in either way. This is because the safety of the living individual is more priority than the dead.
The deceased is to be shrouded in the Islamic shroud (Kaffan) if possible, otherwise a garment will be wrapped over his garments in which he died, if available, or buried in the clothes in which he died.
Praying janazah for the dead is Fard-Kifayah (collective obligation) – as is well known – the performance of which is sought from the mukallafin collectively, but not from the every individual specifically. It is sufficient that janazah prayer, in these circumstances, will be attended by only 2 or 3 persons.
As for the burial, the basic principle is that a Muslim can be buried in the graves of Muslims, if not available, he /she can be buried wherever possible.
Dr. Mariya Amin Qurieshi, Dr. Ruqiya Quansar, and Dr. Sheikh Mohammad Saleem work as Public Health Experts at the Department of Community Medicine, Government Medical College, Srinagar and can be reached at email@example.com.