Let families seek post mortem

Mbabane: Minister of Health Lizzie Nkosi has an advice for relatives who suspect Covid-19 as the cause of death.

“They must go to the hosting hospital and seek a post mortem!” advised the minister during an interview.

A report by one of the country’s weekly publications had issued that relatives of a certain man who died last week at the RFM Hospital in Manzini held back collecting the corpse for fear of contracting the deadly coronavirus. Before his death the man is said to have exhibited the COVID-19 symptoms but was not tested for confirmation. This led to uncertainty whether relatives were safe regarding the collection of the body.

Despite the country not having recorded any deaths due to the coronavirus the health ministry has issued a warning towards the handling of bodies due to viral deaths.

The minister told this publication that workers and family members who routinely handle corpses may risk contracting viruses only if they will not be protected. She said it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly their eyes.

Viral diseases include but not limited to the new coronavirus also called COVID-19, tuberculosis, blood-borne viruses like hepatitis B and C and HIV. Others are gastrointestinal infections like cholera, E. coli, hepatitis A, rotavirus diarrhoea, salmonellosis, shigellosis and typhoid or paratyphoid fevers.

The minister reiterated WHO reports that viral infections are spread through contact with contaminated droplets released by an infected person. “Dead bodies are prone to release droplets which may be contaminated and in the advent of COVID-19 extra caution should be taken,” said the minister. She said mortuary personnel are less likely to contract COVID-19 from deceased persons infected with the virus if they adopt appropriate infection control procedures and wear appropriate Personal Protective Equipment (PPE).

However, the greatest risk is likely to come from contact with family members. She said information on risks should be provided to both emergency workers and relatives to ensure adequate disposal of bodies, appropriate precautions when handling bodies and to avoid panic and misunderstanding.

The following precautionary strategies should be used to minimise public health risks and to prevent spread of disease:

Maintain droplet and contact infection control procedures when handling or transporting bodies confirmed or suspected to have COVID-19
Wear appropriate Personal Protective Equipment (PPE) at all times
Two leak-proof body bags (double bagged) labelled “COVID-19 – Handle with care” should be used to store and transport the body
Avoid unnecessary manipulation of the body that may expel air or fluid from the lungs
Embalming of a body confirmed or suspected to have COVID-19 is not recommended
Family viewing of the deceased may occur; however family members should avoid any contact with the body
Maintain the recommended social distance from families and friends of the deceased

CDC guidelines for relatives handling corpses

Graveyards should be at least 30 m from groundwater sources used for drinking-water.
Grave floors must be at least 1.5 m above the water table, with a 0.7 m unsaturated zone.
Surface water from graveyards must not enter inhabited areas.
Exercise universal precautions taken when handling blood and body fluids.
Use gloves once only and dispose of correctly.
Use body bags.
Wash hands with soap after handling bodies and before eating.
Disinfect vehicles and equipment.
Be vaccinated against hepatitis B.
There is no need to disinfect bodies before disposal (except in case of cholera)

The government of Eswatini strongly recommends that, until further notice, funerals be limited to no more than 20 of the decedent’s next-of-kin. This does not include funeral home staff, the clergy or celebrant or cemetery staff.