COVID-19 casualties: Embalming of dead bodies

Massive publicity of Coronavirus Disease (COVID-19) has inflamed human psyche and emotions. Our existence on this planet is ever since our conception though we celebrate our physical birth days. Human form of life is said to be the best of 2.1 million (2.1x10⁶) living species born through placenta. We have been better than other living creatures due to possession of superior mind, memory, intellect and emotions. We have social bonding with our family and friends. Coronavirus Disease (COVID-19) has taken the shape of a pandemic due to human to human spread of its causative agent. The Chinese authorities isolated this new type of coronavirus from patients of outbreak of pneumonia in December-2019, in Wuhan City of Hubei Province of China during laboratory investigations on 7^th January 2020 and named it 2019-nCoV.

Symptoms of COVID-19 are like influenza and include fever, headache, shivering (rigors), myalgia, malaise, cough and sometimes diarrhea also. In elderly and immunocompromised patients, it is causing severe respiratory distress due to pneumonia and causing death due to comorbidities in-spite of best treatment. Lack of immuno-prophylaxis is the cause of casualties as vaccines for this disease are not available. However, precautionary measures are in force to avoid catching nCoV infection. Personal hygiene, washing of hands frequently with soap and water, wearing of face mask and maintaining physical distance (social distance) from other individuals are the ways to save ourselves from COVID-19. Human to human spread of the disease is through micro-droplets of nasal secretions of infected person.

Need of the hour is to take necessary precautions to avoid catching nCoV infection. COVID-19 could be fatal in 2-3% patients only. Just being positive for 2019-nCoV by RT-PCR does not warrant any panic. Viral infections are self-curing in 95-97 cases with symptomatic treatment. Only 3 to 5% cases would need hospitalization. Imposition of stricter control measures by administration to avoid community transmission of COVID-19 has spread great scare of death in the minds of entire population. People have been avoiding receiving the bodies of their near and dear ones, who unfortunately died of COVID-19 complications.

Let me instill confidence in you that the dead would never spread any infection if bodies are embalmed. We need to maintain social distancing from the living persons and not from the dead. Dead are not exhaling any infectious droplets. Dead need our love and care for proper send off from this world. We could take necessary precautions to sanitize and temporarily preserve the bodies of our near and dear ones who unfortunately bid goodbye to us due to COVID-19 complications. Medical colleges and Medical Research Institutes have been embalming and preserving dead bodies for very long periods for dissection and demonstration to medical students. The history of embalming dates-back to 4000 BC. Egyptians were the first to master the methods of embalming. Why can’t we do embalming of dead bodies before handing over to the relatives?

Provincial governments all over the world should issue advisories to all the hospitals to essentially do hypodermic and surface embalming of dead bodies before handing over to relatives and friends of the diseased. Embalming would ensure safe transportation of the dead body for cremation without any risk of infection. Pathologists and Anatomists should be assigned the task of onsite embalming even if the death occurs at home. Dead bodied of army warriors are always preserved by Arterial embalming along with coloring and masking agents before transportation to native places of martyrs.
 
We have experienced that face mask and alcoholic sanitizers have potential to keep away any infection. Sodium hypochlorite at a concentration of 0.04% in tap water can kill bacteria, fungi and all the viruses including coronavirus. The bleach we use for fabric bleaching at home, contains 4% Sodium hypochlorite (see Figure-1). Sodium hypochlorite at a concentration of 0.04% in tap water is sprayed to sanitize roads and buildings in Containment Zones. One cap full (10 ml) of fabric bleach in 1000 ml (1 L) of tap water gives 0.04% Sodium hypochlorite solution. This solution could be used to sanitize dead body before short distance transportation. Dead body could be wrapped in a bed sheet soaked in 0.04% solution of Sodium hypochlorite. Body could be given bath of this solution.

Figure-1

We trust that eye/ear drops containing just 0.01% (w/v) Benzalkonium Chloride are free of any infectious agents and could be instilled in eyes or ears (see Figure-2).  People can use solution of Benzalkonium Chloride at the universally accepted concentration (0.01% w/v) to surface sanitize dead bodies of their dear ones without any risk of infection. We mop our floors with germicide Lyzol which contains very high percentage of Benzalkonium Chloride (2.4580% w/w: see Figure-3). Just one cap full (15 ml) of Lyzol (500 ml Pack) in 4000 ml (4L) of tap water would give 0.01% solution of Benzalkonium Chloride which could be used for surface sanitization of the dead body. Dead body could be wrapped in a bed sheet soaked in the solution of Lyzol at optimum concentration as cited above.

Figure-2

Figure-3

All relatives and friends of a diseased person should be provided counselling for handling the dead body. People should be educated and encouraged to accept the dead bodies of their loved ones without any fear of infection. Any disrespect to the corpse (dead body) invites applicability of section 297 IPC in India and similar laws must be available in other countries too. Section 297 IPC or similar sections should be invoked both for hospitals and people to show respect to the dead. I would like to appeal to World Health Organization (WHO) for issuing necessary advisory to all the countries to take necessary steps for embalming of the dead bodies during the pandemic for safe transportation for funeral.