Not testing brought-dead, kin can be disastrous, say experts

Coimbatore: The state government’s decision not to test people, who are declared brought dead to hospitals, for Covid-19 has evoked mixed reactions from epidemiologists and doctors.
In the district, 15 people were found positive for the virus after death. They were all patients who were brought dead to hospitals.
District collector K Rajamani said, “Though we don’t have exact numbers, at least 30%-40% of these cases were earlier treated in private hospitals and referred to government hospitals after their survival chances dropped to nil. There are also instances of bringing patients to hospitals too late.”
TOI has data showing that another 40 Covid-19 patients had died within 24 hours of hospitalization.
Earlier, samples were collected from the body of a brought-dead patient for Covid-19 testing and the body was either cremated by city corporation officials or given for deep burial, and not handed over to the family members, if according to kin the deceased had flu-like symptoms and acute respiratory illness. But with changed regulations, while the body would be packed as in the case of a positive fatality, that would be handed over to the family.
Dr G Ramesh Kumar, deputy director of public health, said, “We will closely monitor the family and ensure more than 20 people are not attending the funeral. If they develop symptoms, they will be tested. We are only following the central government’s policy not to test people who are brought dead.”
Many epidemiologists with the health department fear that the state has taken this decision to reduce the number of Covid-19 deaths on paper. In the district alone, this would bring down the death numbers by 10%.
An official, who requested anonymity, said, “There has been a lot of pressure on the health department to bring down death numbers or provide reasons for the spike. However, the move to stop testing people who are brought dead, especially if they had flu-like symptoms or SARI symptoms, could lead to spread of virus.”
The official says a brought-dead Covid-19 patient must have infected at least two close family members, who might remain asymptomatic. “Once the body is returned to them, the family will conduct a funeral that is likely to be attended by at least 30 people. Another 100 people might visit them in batches of five or 10 daily. Those leading funeral rites might also get infected. It could have disastrous consequences.”
Less than two months ago, a 77-year-old communist party member from Velandipalayam was brought to the Coimbatore Medical College and Hospital (CMCH) with severe breathlessness. He died a few hours later. Doctors collected two samples of sputum from his chest, one before death and after death. As both the samples tested positive for the virus, authorities screened his family and contacts, and found his wife and three of his associates were infected.
In Jothipuram too, a woman was tested positive for the virus after her father, who was declared brought dead to CMCH, found to be infected.
There are many cases of funerals becoming Covid-19 transmission points, including in the Nilgiris.
Experts too say when the district is in the surge phase, it would be advisable to test at least the family members of the brought-dead patient. Dr K Kolandaswamy, former director of public health, said, “In the case of brought-dead patients who had SARI symptoms, the family members, especially who attended to the patients, must be tested.”