07 steps need to be followed when handling remains of individuals infected with SARS-CoV-2 in Vietnam

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Specifically, Decision 2233/QD-BCDQG of Vietnam stipulates the criteria for determining whether a person remains suspected of being infected with SARS-CoV-2 in the community as follows:

• The deceased individual had at least one of the following symptoms prior to death: fever, cough, sore throat, difficulty breathing, or pneumonia.

• The deceased individual had contact with a person infected with SARS-CoV-2 within 14 days prior to the determined time of death.

• The residential area of the deceased individual had at least one confirmed case of COVID-19.

• The deceased individual died in public places without a determined cause of death.

To prevent the spread of COVID-19 in the community, the remains of individuals infected with SARS-CoV-2 must be cremated; burial is only allowed in cases where cremation cannot be carried out. In this regard, when a person dies from a SARS-CoV-2 infection, the handling of the remains should follow the following steps:

Step 1: Notify the local authorities, healthcare agencies, or the Ministry of Health (phone numbers: 1900 3228 or 1900 9095) to receive advice and assistance in handling the remains. Limit the entry of individuals without assigned tasks into the area where the deceased person infected with SARS-CoV-2 is located, except for healthcare staff and those involved in handling the remains.

Step 2: Handling the remains infected with SARS-CoV-2:

- Wrap the remains in a body bag: Use waterproof material as the inner lining of the body bag and seal the bag tightly. In case there is no body bag available, tightly wrap the remains with a thick cotton cloth, then cover it with a layer of nylon and seal it with adhesive or tight knots. Use a label or sticker with the warning “THI HÀI NHIỄM SARS-COV-2” ("REMAINS INFECTED WITH SARS-CoV-2") on the outside of the bag.

- Disinfect the exterior of the body bag with a surface disinfectant solution. Preferably, use a solution containing 0.5% active chlorine.

Step 3: Viewing the remains infected with SARS-CoV-2:

- Place a large nylon sheet underneath the coffin to wrap the remains. Place the remains on the nylon sheet placed at the bottom of the coffin and wrap it tightly.

- Seal the coffin. Check and seal any openings in the coffin to ensure no leakage of fluids.

- Clean the entire surface of the coffin with a surface disinfectant solution.

Note: The viewing of the remains must be completed within 6 hours from the time of death or the discovery of the remains.

Step 4: Disinfection and handling of the entire environment in the area, chamber, or room where the deceased person is located:

- Collect all waste, including fabrics, personal belongings to be discarded, personal protective equipment, and waste generated during the handling of the remains. Collect the waste in the first yellow bag and tie the bag tightly. Then place the first bag into a second yellow bag, tie the bag tightly. The second yellow bag must be labeled “CHẤT THẢI CÓ NGUY CƠ CHỨA SARS-CoV-2” ("WASTE WITH SARS-CoV-2 RISK") and disposed of according to regulations.

- Disinfect all surfaces in the area where the deceased person is located with a surface disinfectant solution: Clean the surfaces requiring disinfection with the disinfectant solution, following the principle from clean to dirty, from inside to outside, from top to bottom. The areas to be cleaned include:

• Room where the remains are placed: floor, walls, deceased person's bed, chairs, wardrobe, doorknobs...

• Other areas in the house: floor, walls, toilet, faucets, kitchen area, windows, entrance/exit doors, etc.

• In the case of a deceased person infected with SARS-CoV-2 being discovered in a public place, disinfect the entire area where the deceased person was found, the surrounding area, and related areas.

- After completing the handling of the remains, all participants must wash their hands thoroughly with soap and water, then disinfect their hands with a hand sanitizer.

Step 5: Transportation of remains infected with SARS-CoV-2

- Transport the coffin to the cremation or burial site.

- Individuals accompanying the vehicle transporting the deceased person's coffin must wear full personal protective equipment.

- Immediately after transporting the coffin to the cremation or burial site, disinfect the entire surface of the vehicle carrying the coffin with a surface disinfectant solution.

- After disinfecting the transportation vehicle and coffin, the participants should remove and dispose of the personal protective equipment according to regulations. Wash hands thoroughly with soap and water, then disinfect hands with a hand sanitizer.

Step 6: Cremation, Burial

Cremation:

- The deceased individual infected with SARS-CoV-2 must be cremated within 24 hours from the time of death.

- After cremation, the surroundings, walls, reception room doors, and related tools and equipment must be cleaned and disinfected with a surface disinfectant solution.

- After cremation and disinfection, participants involved in the cremation process should remove and dispose of personal protective equipment according to regulations. They should wash their hands thoroughly with soap and water, then disinfect their hands with a hand sanitizer.

Burial:

- Choose a high and wind-facing location that is not prone to flooding for the burial. The burial of the deceased individual should be carried out within 24 hours from the time of death.

- After completing the burial, participants involved in the process should remove and dispose of personal protective equipment according to regulations. They should wash their hands thoroughly with soap and water, then disinfect their hands with a hand sanitizer.

Step 7: Personal Protective Equipment:

- Individuals involved in the handling, embalming, transportation, cremation, and burial of the deceased individual; disinfection; and environmental handling should always wear personal protective equipment and follow the proper procedures for wearing and removing personal protective equipment.

- After removing personal protective equipment, it should be collected in the first yellow bag and tightly tied. Then, place the first bag into a second yellow bag and tie the bag tightly. The second yellow bag must be labeled “CHẤT THẢI CÓ NGUY CƠ CHỨA SARS-CoV-2” ("WASTE WITH SARS-CoV-2 RISK") and disposed of according to regulations.

Furthermore, the Decision also stipulates that individuals who have been in contact with a deceased individual infected with SARS-CoV-2 must undergo quarantine measures as prescribed in Section IV of the Temporary Guidelines for Monitoring and Prevention of COVID-19 issued under Decision 963/QD-BYT dated March 18, 2020, by the Minister of Health.

Le Hai

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