Mortuary services uneasy over funerals, cremations for Covid-19 victims

As of March 25, the official number of deaths in Japan due to the coronavirus stood at 43, with another 10 counted separately as passengers who were quarantined on the Diamond Princess cruise ship. 
Weekly Playboy (April 6) led off its article on "postmortem problems" by writing that should the pandemic in China and Italy also become a reality in Japan, it is possible those figures could soar. 
If a person dies in hospital, the general procedure in Japan is to use a service to provide cosmetic treatment and burial clothing for the deceased, after which the body is returned to the family and placed in a coffin. Then following the wake and funeral, the remains are cremated. 
But the coronavirus has impacted on this. 
"In principle, the body of a patient who has died from the coronavirus is dealt with according to requirements issued by the Ministry of Health, Labor and Welfare," said Taiyo Sunago, president of the Satoyama Sosai, a funeral service based in Kanagawa Prefecture. 
"Normally, the law prohibits cremation within 24 hours of death to ensure there is no possibility of resuscitation, but the exception is made in the case of certain specified contagious diseases such as Covid-19. 
"Avian influenza and SARS were the same," Sunago added. "Since transmission is a concern, cremation within 24 hours of death is permitted. One more thing: Since most of them will have expired in hospitals specially designated to deal with the coronavirus, the morgues where the bodies repose undergo disinfection after being placed in the coffin. In many cases, cosmetic treatment of a body that has died of a contagious disease is waived, so packing of cotton to prevent leakage of bodily fluids and so on is not performed. I suppose this will be the case for people who die of Covid-19 as well." 
Weekly Playboy's reporter then went to Nagoya, where 12 people have died from Covid-19, and asked an official at the Municipal Health Department concerning the holding of wakes and funerals. 
"If a wake or funeral is held in a crowded venue, there's a risk of cluster infection," he replied. "Likewise there is a strong possibility that members of the deceased's family also had close contact with that person. So we understand that in some cases families have dispensed with the ceremonies altogether and arranged for the body to be transported directly from the hospital to a crematory within 24 hours of the person's passing." 
Ryoji Igarashi, who operates a similar service in Tokyo, tells the magazine that the family members of a person who expired from the virus cannot ride together in the vehicle (usually a microbus) provided as a service to transport mourners to the crematory. 
"The driver would wear protective gear to prevent getting infected and the vehicle would have to be disinfected," he said. "But because the protective wear and disinfectants are in short supply right now, we're concerned that we can't provide such service. 
"Procedures have also changed at the crematory," he continued. "In the case of death from infectious disease, crematories in the Tokyo metropolis have limited attendants to a maximum of five people outside of regular operating hours; they have also prohibited any close contact when bidding farewell to the deceased, such as placing flowers inside the coffin prior to cremation." 
Some mortuary services are simply refusing to deal with Covid-19 patients outright. 
Another concern is that while hospitals are required to notify the mortician when a death occurred due to the coronavirus. But some patients are expiring of pneumonia without a PCR (polymerase chain reaction) test to determine the actual cause. "It's almost impossible for us to pose such a blunt question -- of the actual cause of death -- to a family in mourning," despaired one operator. 
In such a case, the funeral might proceed as a normal one, without protective wear for the driver or efforts to prevent the close family members from saying farewell to the deceased. 
"We're terrified of having to deal with requests from families who's deceased member who died of pneumonia but didn't undergo a PCR test," he admitted.

© Japan Today
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