The Indian Council of Medical Research, on Tuesday recommended that all suspected Covid19 cases should be tested for infection even after the death of the patients.
The document ‘Standard Guidelines For Medico Legal Autopsy In Covid 19 Deaths In India released by the ICMR said that “ it is advisable to collect nasopharyngeal swab at the emergency department/casualty/ward/ICU and should be sent for COVID-19 RT-PCR test in all suspected cases before moving the body to mortuary for preservation if the same was not sent in due hospital course.”
The guidelines assume significance in the wake of a decision by the Delhi government not to conduct tests on dead patients who were suspected for the infection, a move that has been labelled as a bid to cover up infection deaths by many public health experts.
“I hope at least now after the latest ICMR guideline, the Delhi government revises it earlier order and conducts the required tests on those who may have succumbed to the disease before even proper diagnosis,” said Malini Aisola, co-convener of All India Drug Action Network, a patients rights group.
“These guidelines will help the country see a clearer picture of the extent of infection spread.”
In the latest guidelines, ICMR said that during this pandemic, many of the dead bodies will be of COVID-19 suspected people, which can be alleged suicides, accidents, homicides or brought dead cases to hospitals.
“These cases will be labeled by emergency doctors as medico-legal case and subsequently police will be informed, which may necessitate a forensic autopsy.”
The research body also said the cases having at least one of the epidemiological history features or two clinical features of Covid 19 should be treated as “suspects”.
Epidemiological history will include travel history or residence in areas declared COVID-19 hotspots 14 days prior to onset of symptoms, contact with COVID-19 cases, exposure to patients with fever or respiratory symptoms in COVID-19 hotspots, evidence of clustering and fever with or without respiratory symptoms.
The guidelines also said asymptomatic infected people and patients in incubation period may not meet the diagnostic criteria for suspected cases but if they have possible epidemiological history, all dead bodies without reliable clinical or epidemiological history and all unidentified dead bodies should be treated as suspected COVID 19 deaths.
“Cases with negative swab results also should be treated as suspected COVID-19 deaths as false negative result is not uncommon,” said the national recommendation that has been prepared by the department of forensic medicine and toxicology, AIIMS, Delhi under the ICMR supervision.