India / Antigen tests to be conducted on dead bodies in Maharashtra: Report

Mumbai: Now, any dead body brought to a government hospital will be subjected to a rapid antigen test to rule out or confirm Covid-19. A new government circular issued recently has said tests (used for detecting tuberculosis) like TrueNat/CBNAAT — also being used for Covid testing — can be used to facilitate quick handover of the bodies.

Maharashtra has reported over 10 lakh cases and more than 29,114 deaths till Monday. Mumbai, Pune and Thane have reported the highest number of deaths at 8,109, 4,754 and 4,134 respectively. Districts now reporting over 1,000 deaths include Jalgaon, Nashik and Nagpur.

Mortuaries are running full. For instance, at Sassoon general hospital, on an average of the daily 40-50 deaths reported, at least 15 are brought dead. At the government medical college and hospital at Nagpur, of the 30-35 daily deaths reported, at least five to 10 are brought dead.

Due to the increasing spread of Covid-19 infection it has now been decided to conduct an antigen test to rule out or confirm Covid-19. Since the results are given within an hour or so, it can help in quicker disposal of bodies, highly placed state health officials said.

The new circular issued on August 21 has raised concerns about false negatives that can be reported in these antigen tests that are likely to put forensic healthcare workers at risk for performing invasive autopsies to give cause of death. So far ICMR guidelines and state advisories based on that indicated waiving off of the forensic autopsy. According to these guidelines, invasive techniques should not be adopted for forensic autopsy in Covid-19 death cases as mortuary staff are exposed to potential health risks due to organ fluids and secretions.

Deaths in a hospital and under medical care for coronavirus infection does not require postmortem and the required certification for cause of death is done by the treating doctors.

The guidelines had also noted that bodies of suspected Covid-19 patients brought to the hospital may be labelled as medico legal cases by the doctor in emergency and sent to the mortuary and the police informed who may necessitate a medico legal autopsy for clarity in cause and manner of death (whether natural/unnatural). Here guidelines had indicated waiving off the forensic autopsy of these cases.

With the new circular now the government medical colleges and hospitals will have to reconsider every case that may test negative for Covid-19 via the antigen test and subsequently follow other tests to ensure cause of death. Health officials said there was a need to ensure dignity in death and specially when bodies are brought dead, there was a need to expedite the process by undertaking antigen tests. However, several officials at government medical colleges across the state have also called for specific guidelines as to the uniform medico legal postmortem protocols for government hospitals.