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Avoid spraying water, don’t touch shroud without gloves: British Kashmiri docs issue guidelines for safe burial of COVID 19 bodies

Srinagar: British Kashmiri Medical Association (BKMA) has issued guidelines for the safe management and burial of COVID-19 bodies.

BKMA is a United Kingdom-based association of Kashmiri healthcare professional with no religious and political affiliation.

 

The guidelines are aimed at ensuring that bereaved people are treated with sensitivity, dignity and respect, and mourners and workers involved in the management of funerals are protected from the avoidable risk of infection.

BKMA said till date there is no scientific evidence of transmission of the virus through the dead body of COVID-19 deceased. Yet it is vital to ensure precautionary measures while handling the bodies of suspected or confirmed cases.

BKMA noted that when the body is prepared for shifting to mortuary or handing over to the family, people coming in contact during pre and post-interaction including health care or mortuary worker must ensure proper handwashing and use of disinfectants.

Anyone who is attending the body must use appropriate personal protection equipment (PPE) including gown, gloves, and mask. Use of face shield and goggles, if there is a potential risk of body fluid splashes, is highly recommended, the guidelines said.

“Remove all lines, catheters, and tubes thus preparing the body for transfer. Keep minimum movement of the body and safe handling during the transfer. Cover the body in a cloth and transfer it to the mortuary area as soon as possible. In case of any leakage of body fluids from orifices, body bags are highly recommended. Make sure the leakage is contained before the transfer,” the guidelines said.

BKMA said transfer can be through an ambulance or any other vehicle, no special arrangements required.

“In case any volunteer or family members are taking the responsibility of pickup of the dead body for ghusl and shrouding, everyone must ensure to wear appropriate protective clothing (PPE). They must ensure to limit the number of locations to which the body is transported,” the guidelines said.

The BKMA noted that the decreased should be transported in a sealed waterproof body bag as needed and avoid direct contact with blood or any bodily fluid from the decreased.

“Anything that came in contact with the decreased including stretcher, the interior of the vehicle, room, trolley, tables, the exterior of coffin or casket, trolley, or any other the surface used should be properly sanitized and disinfected.  Use disinfectants, sanitizers or diluted household bleach (mixing 1 part of 5.25% bleach with 4 parts of water) and allow to air dry,” the guidelines said.

Who Can Participate in Ghusl?

According to guidelines, very few should be deputed to perform ghusl of the body. Close family members of the deceased should be kept away from the ghusl of COVID-19 body.

People aged above 60 and with underlying health conditions or expecting mother or those who have been contacting with COVID-19 patient should not participate in ghusl.

Guidelines for preparing the body for Ghusl

Make sure the mouth and any wounds or leaks are covered with a waterproof bandage or mask.

Observe strict personal hygiene and put on appropriate PPE (Fluid-resistant surgical mask, full-sleeved gown, gloves, goggles or face visor, beard cover, head cover, shoe cover and, if possible, long gloves.)

The volunteer must ensure the washing area is fit for purpose, well-ventilated, and adequate drainage.

Ghusl performers should be fully trained in donning (putting on) and doffing (taking off) PPE.

Wash the body as normal (Sunnah ghusl) where possible. However, keep the movement of the body to a minimum. If a hose is being used, apply water with moderate force under the towel to wash away any impurities from the private areas without touching.

If the above is not possible, pour water over the entire body thrice (once is also sufficient) and this will discharge the obligation of ghusl.

Avoid spraying water – use bucket and jug to minimize any splashes.

 Ghusl performers should remove the PPE, discard and disinfect. All surfaces that may be contaminated should be wiped with 1 in 49 diluted household bleach (mixing 1 part of 5.25% bleach with 49 parts of water), leave it for 15-30 minutes, and then rinse with water.

Where adequate facilities are unavailable, there are no appropriately trained ghusl performers thereby increasing the risk of infection, the required PPE is unavailable or the body bag cannot be opened, refer to a reliable scholar for advice on the validity of resorting to tayammum or even burial without ghusl or tayammum.

Measures while shrouding the body

Under no circumstances touch the body or shroud without gloves.

Shroud the body as normal. If the body bag cannot be opened, the shroud may be applied over the body bag. The body bag itself can also suffice if need be.

Where the coffin is used, place the shrouded body in the coffin and close the lid. Wipe and disinfect the outside of the coffin and allow to air dry.

Proper measures should be considered for the final funeral prayer

Viewing may be arranged for close family and they must use appropriate PPE.

Janazah Prayer can take place as normal in a large open space; however, it should be open to immediate family members only. It is advisable to perform the Janazah at the cemetery or at the burial site.

Those handling the coffin should wear appropriate PPE and person who places the body in the grave must wear gloves.

Guidelines followed at mourning house

Space out seating for attendees who do not live in the same household to at least six feet (2 meters) apart. Attendees must ensure to wear masks when interacting with people.

Attendees should nod, bow, or wave instead of holding or shaking hands, hugging, or kissing anyone who does not live in their household. All attendees should follow everyday preventive actions to protect themselves and others from COVID-19, such as washing your hands and covering coughs and sneezes.

People who have been living in the same household can comfort each other in typical ways such as hugging, holding hands, and sitting next to each other