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Crematoriums and morgues feel the burden of COVID deaths
A number of crematoriums close to hospitals in heavily populated areas have started operating round-the-clock to clear a backlog of bodies, health authorities said.
Meanwhile, morgues are struggling to find space to store remains as their limited freezer facilities rapidly fill up.
The deceased are not exclusively COVID-infected. But the pandemic has significantly increased the number of remains received by morgues with rising COVID deaths adding on to those dying of other causes.
The results of PCRs on bodies take hours to be received. Other formalities–such as signing off on paperwork by hospital officials, registrar, public health inspectors, judicial medical officers, etc–take still more time. When the cause of death is not given, the process drags on even longer. A percentage of bodies remain unclaimed for various reasons. And as deaths rise, severe backlogs have arisen.
Hospitals with smaller morgues, in particular, are struggling. Teaching Hospital Ragama is one of the institutions that notified the Director General of Health Services this week of the challenges they have in storing bodies, the sources said. When freezer facilities fill up, bodies are stored in other spaces and are susceptible to decay. These can lead to other health issues.
The Panadura Base Hospital (PBH) is also over-burdened and has been looking for a freezer truck. One had been promised to the institution by a private donor but hasn’t yet been delivered. Wathupitiwala Base Hospital was recently gifted one.
On Friday night, the Panadura Urban Council’s crematorium at Minuwampitiya started operating at night. “Before the pandemic, we cremated around three bodies a day,” said Panadura Mayor Nandana Gunetilleke. “After the pandemic, we raised it to four. But because bodies have started piling up, from Friday was started cremating two more bodies at night. And it is still not enough to clear the backlog.”
As at Friday, the PBH had 37 bodies of which a percentage were COVID-positive. It has freezer space only for 12. The rest were not in coolers.
“The Kalutara General Hospital is also severely congested,” Mr Gunetilleke said. “The District Secretary asked us if we could accept six bodies but we don’t have the capacity for it so we had to refuse.”
Crematoriums are usually open for a certain number of hours and incinerate bodies at high temperature. The process cannot be carried out continuously and without interval as the cremators will break down. Necessarily, therefore, there are limitations on how many remains each furnace can handle per day.
Separately, health protocols require COVID-positive bodies–of which there are now more and more–to be cremated within 24 hours at the facility closest to the hospital where the remains are held. But with the spike in numbers, there aren’t enough crematoriums to handle these cases.
The problem is not severe yet at the National Hospital as they have two morgues. The Judicial Medical Officer (JMO) Colombo, anticipating problems, had also procured an extra freezer for bodies that are directed to his office for post mortems.
“There is a queue for cremation,” a senior medical officer said. Nobody wanted to be quoted owing to Government restrictions but said the public must be made aware of the actual situation.
“Ragama Teaching Hospital is seeing around seven or eight additional deaths per day,” he continued. “A certain percentage of these are inevitably positive. On Friday, seven PCRs were done on deceased and all returned positive. Some bodies are also claimed late because their next-of-kin is quarantined. This adds to the delay. The circular that says to use the nearest crematorium is another challenge.”
The nearest crematorium to Ragama Teaching Hospital is Enderemulla. When it is unable to grant appointments, the bodies pile up. Also, the same set of officers–such as PHIs and Medical Officers of Health–has to certify the deaths.
“There is, therefore, a capacity issue in addition to increased rate of death and slowing down of removals,” the doctor said. “We need a solution now to expedite cremations.”