CCPSL says no solid evidence indicating burial of COVID-19 victims increases spread of virus

• College of Community Physicians of Sri Lanka said in a position paper on cremation vs. burial debate all available scientific evidence says no threat of virus spread from burials
• Says it accepted mandatory cremation at onset as COVID-19 was a rapidly evolving situation in which precautionary decisions had to be made
• Says subsequent accumulation of evidence forced CCPSL to rethink and revise recommendations

The College of Community Physicians of Sri Lanka (CCPSL) said yesterday that there was no solid evidence indicating that burial of dead bodies of COVID-19 victims would increase the spread of virus.

“With the available scientific evidence and the impact of the decision on cremation on pandemic control activities at large, CCPSL concludes that adhering to global guidelines, each citizen of Sri Lanka should be allowed to be cremated or buried as per his/her and the family’s desire within the strict guidelines recommended by the Ministry of Health,” CCPSL said in a position paper on the debate about compulsory cremation of victims of COVID-19.

CCPSL said that it had accepted the Government mandatory rule at the onset of the pandemic as COVID-19 was a rapidly evolving situation in which the decision making had to be based on precautionary principles at the early stage of the pandemic.

“When there was an uncertainty at the onset of the pandemic, we as the College of Community Physicians of Sri Lanka accepted it at that point of time. However, the subsequent accumulation of evidence forces us to rethink and revise the recommendations,” the College said.

The College said that with more than 85,000 published scientific literature on COVID-19, not a single case has been reported due to virus transmitted through a dead body. 

“A report published in May 2020 suggested that two forensic medicine professionals contracted COVID-19 from a corpse, but later an erratum was published by the authors that the article was not on a case of confirmed transmission of COVID-19 from corpse.”

It added that claims on the SARS-CoV-2 spread directly through groundwater had not been scientifically substantiated and there was no indication that the virus could be transmitted through drinking water.

“The risk of COVID-19 from human remains/dead bodies has been discussed in almost all public health programs around the world. Two systematic reviews on dead body management during global pandemic of COVID-19 clearly show that there is no evidence on COVID-19 transmission so far from dead bodies. However, the duration of viral survival in dead body is still debatable and WHO, CDC and the European Centre for Disease Prevention and Control had issued clear and extensive guidelines on handling dead bodies confirmed or suspected as having COVID-19 with detailed attention to the procedures in relation to handling the body in the ward, mortuary, funeral home, during transfer, and crematorium/burial site. At the same time, these guidelines strongly discourage any ritual practice which may involve in risk of disease transmission. Nevertheless, all these global pandemic control programs clearly stipulate that the victims can be ‘buried or cremated’ with all precautions mentioned earlier,” CCPSL said.

It said the position paper was intended to voice a scientific opinion in this debate after examining the currently available evidence but noted that this position could change depending on the nature of evidence and the observations which would surface in the future.