COVID-19 survival reduces with time in dead body, but no time limit to declare it non-infective: ICMR

The survival of coronavirus gradually decreases with time in a dead body, as per scientific literature till now, though there is no specific duration to declare a body as non-infective, the ICMR said. So, it is advisable to adopt the necessary precautions and non-invasive autopsy technique while handling the body, the apex health research body said on Tuesday in response to a question over how many days is the infectivity period of COVID-19 in a dead body.

COVID-19 is a respiratory disease and mainly spreads through aerosols, the ICMR said while listing a series of frequently asked questions in its 'Standard guidelines for Medico-legal autopsy in COVID-19 deaths in India 2020' released on Tuesday. Responding to a question over the protocol to be followed for performing an autopsy in a COVID-19 suspected dead body with negative RT-PCR result, the ICMR said considering the relatively high rate of false-negative results of COVID-19 RT-PCR, every case still has to be considered as a possible coronavirus infection case.  "Thus, it is advisable to follow non-invasive autopsy in these cases throughout the duration of the pandemic," it said.

Asked if an invasive autopsy can be performed after disinfecting the body surface using one percent of hypochlorite or 70 percent of alcohol solution, the source of the infection from a COVID-19 confirmed case is mainly from the aerosol-generating procedure from internal body fluids and visceral organs. Even mucosal surfaces, such as those in nasal and oral cavities, gases, or fluids expelled through natural orifices as a result of compression of cavities, which can occur during transport, can be sources of disease transmission.

"Hence, surface disinfection does not provide protection against COVID-19 during the autopsy," the Indian Council of Medical Research (ICMR) said. Asked if there is any risk of infection to body handlers if COVID-19 and non-COVID bodies are kept in separate racks of the same cold chamber having the same compressor, it said the chances of contracting the infection is negligible if proper precautions are taken like double bagging of body and handling it with proper PPE.  The ICMR further said that there should be a dedicated hospital staff for the transfer of such bodies to the mortuary.

In case there is a shortage of staff in the mortuary, additional staff should be deputed for transportation of the body by hospital authorities. The help of NGO's and social welfare department may also be taken to address any kind of manpower issue. Asked what procedure should be adopted and whether internal dissection is required if a COVID 19 confirmed or suspected patient dies due to unnatural cause, it said in such cases the certification of death should be done in coordination with police and the body should be handed over to relatives without internal dissection.  In cases that are treated, hospital case records like lab investigation reports, reports of other diagnostic tests, including treatment given, will give an additional documentary background for correlating with the investigation and to reach a reasonable conclusion about the cause of death and other related queries.  "Non-invasive autopsy technique as described in guidelines should be used, if at all required to prevent the risk of spreading the infection to mortuary staff, police personnel, and contamination of mortuary surfaces," the ICMR said.

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