The nation’s first case of a teenager dying from COVID-19 complications — a 15-year-old boy — was reported by the Central Epidemic Command Center (CECC) on Monday last week. The boy was diagnosed with COVID-19 on May 22, isolated at home for seven days until May 29, returned to school the next day, and fell unconscious on campus. He did not have vital signs when rushed to hospital, and it was determined that he died from myocarditis, acute pulmonary edema and cardiogenic shock associated with COVID-19.
The boy’s family said they had no time to pay their final respects or bury him as they wished, as they were told by the hospital and funeral service provider that the body of a person with COVID-19 must be cremated within 24 hours of death.
Minister of Health and Welfare Chen Shih-chung (陳時中), head of the CECC, said COVID-19 was listed as a Category 5 communicable disease on Jan. 15, 2020. The category does not stipulate that the bodies of those who die with such a disease must be cremated within 24 hours.
Chen said the protocol for handling the bodies of deceased persons with COVID-19 is to cremate or obtain approval for a deep burial as soon as possible. This came as a shock to many people, especially family members of deceased COVID-19 cases, and triggered an outcry from opposition parties, including the Chinese Nationalist Party (KMT). They accused the CECC of not explaining the rules clearly to hospitals and mortuaries, and called for Chen to apologize and resign.
Several local government heads said their understanding was that the bodies of deceased COVID-19 cases were to be cremated within 24 hours, and this has been the norm for more than two years. The center should have provided clear guidelines much earlier, they said.
While the CECC has not set a time limit for cremation, a problem lies in the rule requiring the bodies of deceased COVID-19 cases to be hermetically sealed in two body bags that cannot be reopened, which makes it nearly impossible for family members to see their loved ones and pay their final respects.
COVID-19 restrictions have limited the religious or cultural end-of-life rituals carried out in many parts of the world, leading to thousands of people dying or grieving alone. Several countries have significantly rolled back restrictions now that the less-virulent Omicron variant of SARS-CoV-2 has become the most prevalent strain of COVID-19. Taiwan also moved toward a strategy of tolerating controlled spread of the virus.
The controversy regarding cremations of COVID-19 cases should prompt Taipei to further rethink its disease prevention policies with a focus on being more humane. Economic recovery should not be its sole concern. If a certain degree of infection risk is deemed tolerable for business activities to resume, and policies are continually revised as understanding of the disease evolves, the government should also discuss with experts whether protocols for handling bodies should be revised. Families need better support and care in this regard.
The CECC should clarify its rules on basic hygiene and infection risk management protocols that funerary services must follow when handling the bodies of people who died with COVID-19.
Local governments should also share the responsibility of developing guidelines, including whether visitation services can be allowed. Local mortuary service offices should be included in such decisions given their expertise in mortuary refrigeration and other issues related to safe handling of bodies.
The CECC needs to ensure that the terrible misfortune that occurred to the family of the 15-year-old is never repeated.
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