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City of Banjul
Tuesday, November 24, 2020

Guidelines for infection control following death from Covid-19

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In general, all indications are that we are not yet near the worst of the Coronavirus disease 2019 (Covid-19) and deaths caused by the virus may continue to increase in some parts of the world.In many parts of the world, the bodies of Covid-19 victims are building up to be cremated / buried. It is important that we start thinking about how the bodies of patients that died of Covid-19 or are suspected to have died of Covid-19 should be handledto reduce the risk of transmission of this very deadly disease in the community.

For now, there seems to be one report which suggests that the bodies of Covid-19 victims are not contagious – that the virus stops spreading once the host dies. However, that report seems to be irreconcilable with the known resilience of the virus. The virus is known to stick around the dead body and on a variety of surfaces (e.g., hands, clothes, metal / plastic surfaces, phone, computer, etc. – we are learning more about this lethal virus) for a long period of time.

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Thus many public health bodies are ofthe view that there is a risk of contracting the virus from a Covid-19 victim. Unfortunately there seems to be no or limited restrictions on handling or washing the bodies (Ghusl) of patients who died from Covid-19. Since Covid-19 is highly contagious and lethal, the washing of the body of Covid-19 victims must be given careful consideration. Under the circumstances, serious consideration must be given to whether the act of dry ritual purification using dust (tayammum) or better still, no ritual purification of any form will do. The focus has to be onthe protection of the living and the less we tamper with the bodies of Covid-19 victims, the greater our chances of controlling the spread this menace in the community and the country.

Depending on beliefs and so on, a variety of rituals are done to the dead body before burial. Therefore, appropriate infection control measures must be adopted for Covid-19 victims to reduce the spread of the virus in the community / country.Funeral workers and those involved in washing/preparing the dead body must wear personal protective equipment (PPE) as per the guidelines issued by recognised public health bodiesin the country.

The National Burial Council (UK) has issued detailed guidance based on the latest information from public health bodies and the Department of Health (UK) on what to do following death from Covid-19. These precautions (reproduced below) should be adapted by communities and other faiths to thelocal conditions in the Gambia with a view to controlling the infection of Covid-19in the community /country. It is particularly important that we listen to and follow the advice of recognised public health bodies on how to handle the bodies of Covid-19 victims.

Precautions on the care of the dead body at the time of death
· [Where possible,the dead body should be classified by the attending physician as category risk.]
· Anyone coming in contact with the dead body must wear protective clothing/PPE such as gloves, water resistant gown / plastic apron over water repellent gown, and surgical mask. It is advisable to use goggles or face shield to protect the eyes, if there is a risk of splashes.

· All tubes, drains, and catheters attached to the dead body should be removed.
· All contacts with members of the family should be kept to a minimum and the bereaved family should wear PPE.

· Overall, there must be minimal contact with the deceased; where possible it should be restricted to individuals under the age of 60 years and in good health.

Precautions on handling the deceased
· The dead body should be first placed in a robust and leak-proof transparent plastic bag of not less than 150µm thick, which should be zippered closed- For those closer to the city of Banjul, this may be sourced from the Ports Authority.

· There will be the need for a second layer of cover. Whenever possible, the bagged body should be either wrapped with a mortuary sheet or placed in an opaque body bag.
· The outside of the body bag should be wiped with 1 in 4 diluted household bleach (– this is done by mixing 1 part of household bleach with 3 parts of water) and allowed to air dry.

To be continued

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