Doctors call for more efficient transfer of cadavers to funeral homes

Chiara Zambrano, ABS-CBN News

Posted at Apr 13 2020 07:59 PM | Updated as of Apr 13 2020 09:27 PM

MANILA - There are more cadavers in the morgue of the Quirino Memorial Medical Center (QMMC) than its freezers can store, a ranking physician in the hospital said Sunday.

The doctor, who spoke to ABS-CBN News on condition of anonymity, said that as of Sunday, April 12, the QMMC morgue has eleven cadavers, while its freezers can only accommodate six.

“We have 6 bodies inside the body freezers and currently 5 cadavers on stretchers. All of them are inside the morgue,” the doctor said.

While there is definitely a surge of deaths related to the coronavirus disease 2019 (COVID-19), the doctor said the biggest contributor to the congestion in morgues is the failure of funeral homes to collect cadavers than they regularly should.

“Funeral homes are not picking up,” said the doctor. “We have existing memoranda of agreement with funeral homes that regularly go to QMMC. But at the start of the pandemic, they haven't shown up.”

The doctor also said that since the pandemic has reached the country, some funeral homes have begun charging exorbitant fees before agreeing to collect a cadaver, while others demand that the cadaver comes with a conclusive test result before they collect it.

“Funeral parlors are wary of all cadavers, whether it is related to COVID-19 or completely unrelated to it,” the doctor said. “They want a certificate or letter saying that the cadaver is COVID-positive or not. This causes delay because test results take around a week to get. So the body stays in the morgue for a week.”

One particular cadaver has been inside the QMMC morgue for 12 days, far longer than the 12-hour period between death and cremation that the Inter-Agency Task Force on Emerging Infectious Diseases is mandating.

“The delay came from waiting for the test result and changing of the death certificate,” the doctor said of the cadaver, illuminating how the hospital has had to follow the funeral homes’ policy. The results came in post-mortem: positive for COVID-19.

This problem, the doctor says, has put the poor at a great disadvantage and makes it very difficult for them to claim the remains of their loved ones.

“This problem (piling up of bodies) is mostly seen in government hospitals because of patient demographics,” said the doctor. “Relatives of deceased patients in private hospitals can afford to pay funeral homes the price they demand for suspected or COVID+ patients. I know this for a fact because I have seen this first-hand in a private Quezon City hospital. The family was able to locate a funeral home in 2 days that was willing to accept the patient for a certain fee.”

The doctor said they understand why funeral homes are wary of coming into contact with cadavers at a time like this, but says all those who come to collect a body are given suitable personal protective equipment (PPEs). The congestion places the hospital workers at risk if the unclaimed bodies outside of the freezers start to decompose.

“The morgue cannot safekeep the bodies because our body freezer only has a six-body capacity,” the doctor said. “Our medical center chief has already given a go signal to purchase additional body freezers.”

Meanwhile, officials at the Lung Center of the Philippines spent the entire Good Friday making calls to funeral homes, also in an attempt to decongest its morgue.

“We had 12. Imagine, and capacity namin, four. 'Pag ganun, kailangan may gawin ka ng solusyon doon, kasi it’s a health issue eh,” said Dr. Tony Ramos, the Administrative Services Department Manager of the Lung Center.

(We had 12. Imagine, our capacity is only for four. If that's the case, you have to come up with a solution because it's a health issue.)

Like in the QMMC, Ramos said they had to place the eight other cadavers in stretchers inside the morgue.

“Isang (One) freezer can take in two. We have two freezers, so we can take in four.” Ramos said. “’Pag lumagpas na, we have many stretchers. So these bodies are in cadaver bags which are impermeable, kaya safe naman yan. And naka-kanya-kanya sila, may dignity yan, hindi naka-pile up.”

But while the morgue is air-conditioned and is spacious enough to fit up to 12 stretchers outside of the freezers, Ramos said this is not the ideal storage for human remains. At some point, he said security guards began to report a smell wafting into the hospital’s administration building.

“We cannot prevent the odor from going out. Lalo na ‘pag dumadami na. ‘Pag dumadami, tumataas yung temperature ng room eh. So may decomposition. So may amoy,” Ramos said.

Ramos said the hospital’s aggressive calling of funeral homes allowed them to clear the entire morgue by Black Saturday. The Quezon City Social Services Department picked up the cadavers of city residents by the evening. There were no new cadavers brought in for several hours after that, and they used the time to disinfect the entire room.

While successful, Ramos said there should be a more efficient way for all hospitals to gain access to funeral homes when they need it, without having to exhaust too much time cold-calling them individually.

He suggests that the government establish a system similar to the blood bank – a single clearing house for all hospitals to contact, which will then assign them to funeral homes that have availability. Their experience, he says, and the experience of other hospitals, should be a lesson for the more difficult times ahead.

“It was an indication of what will happen if there is an increase in number. Mao-overwhelm yung system,” said Ramos. “And so learning from that, we should set up a system where we can utilize other parties. Kung may freezer sila, baka pwedeng makilagay muna. Dapat may clearing house dito para we know who to call. Puno na yan, tumawag na kayo dito. Hindi yung tumatawag kami sa lahat," he added.

Ramos also requests for a relaxation of requirements for other funeral homes to be accredited by the cities, since many LGU-accredited funeral homes have also been overwhelmed.

“Basta maganda yung freezer nila, mayron silang sasakyan, baka pwede na yon. Para malagyan lang. Kasi otherwise, pag naiwanan sa ospital, naipon sa ospital, it really becomes a health issue. Naku, maniwala kayo, it’s not a nice thing to have," he said.

As of Monday, the Philippines has a total of 4,932 confirmed COVID-19 cases, with 315 deaths and 242 recoveries.